Assessment details Assessment 2: Case study essay Weighting: 40% Word count: There is a word limit of 1250 words. Due date: Monday 9 th May at 2359 hrs Submission details: via Blackboard>...

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Assessment details Assessment 2: Case study essay Weighting: 40% Word count: There is a word limit of 1250 words. Due date: Monday 9 th May at 2359 hrs Submission details: via Blackboard> Assessments>Turnitin link. Aim of assessment The purpose for this case study is to enable students to produce a nurse-led case management plan, using evidence-based information relevant to nurses and up-to-date Australian statistics, for improving the health and quality of life for an older adult who have suffered a myocardial infarction. Content should include discussion on pathophysiological treatment options, based on national guidelines and implications for nursing practice. Patient profile Kath Harris is a 65-year old lady who lives alone. Kath was doing light cleaning around the house, prior to the onset of her pain. Mrs. Harris has a history of unstable angina, hypertension and diabetes mellitus type 2. She is a cigarette smoker, smoking two packets of cigarettes a day, for approximately 40 years. A recent history of indigestion suggests an active peptic ulcer. She is also obese (her body mass index is 32). She has had a history of head trauma due to an incident a few months ago, where she fell down a set of stairs. Mrs Harris’ current medication includes; GTN spray, carvedilol, and metformin. Subjective data • She had taken three glyceryl trinitrate tablets, which had little effect on reducing her chest pain. • Has an 6/10 chest pain • Pt is nauseated • Appears distressed Objective data Physical examination • GCS 15 • BP 92/58mmHg, HR 92 bpm, Temp 37 0Celsius, Resp 28 bpm, SaO2 91% RA, • Skin was pale • Peripheries were cool Diagnostic studies Lipid Studies • Total lipid 9.2 • Triglycerides 6.5 • Total cholesterol 7.95 • HDL cholesterol 2.1 • LDL cholesterol XXXXXXXXXXElectrolytes • Sodium 138 • Potassium 4.9 • Chloride 97 • Bicarbonate 21 • Glucose 11.2 • Iron 5.4 • HbA1c 7.9 Your assignment is to produce a written piece of work addressing the following areas; PATHOPHYSIOLOGY • Briefly explain the pathophysiology of myocardial infarction in this patient. In your answer identify the clinical manifestations of an MI demonstrated by Kath Harris and why these are occurring. Identify the risk factors evident within this case study. How would you manage Mrs Harris’ care? MANAGEMENT • Outline the immediate nursing and medical management Mrs Harris requires in the treatment of an acute MI. In your answer include the pharmacological management required by a patient with an acute coronary syndrome. MEDICATIONS • Identify three medications that would be used in the treatment of an MI and outline the indication for use, mechanism of action, administration method, side effects, and nursing care required for these medications (No tables). Important details about your assessment • This essay requires a standard essay introduction and conclusion. • There is a word limit of 1250 words (+/- 10% as per SNM Presentation and Assignment Guidelines). • Marks will be allocated as per SNM Assessment Rubric & the essay specific criteria below. • Submission instructions and the link is accessible under the ‘assessments’ tab. • Students should refer to the SNM Presentation and Assignment Guide, ECU APA Referencing Guide, and the SNM Marking Assessment Rubric. • Graphs, tables and flow charts to support the statistical data will not be accepted.
Answered Same DayApr 02, 2022

Solution

Dr. Saloni answered on Apr 03 2022
18 Votes
A Case Study of Kath Ha
is

Contents
Introduction    3
Pathophysiology    3
Risk Factor    4
Management    4
Medication for Ml    6
Aspirin    6
Atorvastatin    6
Heparin    7
Conclusion    7
References    9
Introduction
The Keith Ha
is, a 65-year-old woman, is hospitalised with acute myocardial infarction. She has a history of high blood pressure, type 2 diabetes, and unstable angina. She has a BMI of 32 and is presently obese. She has been a cigarette smoker who has been smoking for a long time (2 packets per day for the last 40 years). Her cu
ent medications are GTN, Metformin, and Carvedilol. Moreover, myocardial ischemia develops whenever the coronary artery is blocked partially or completely due to plaque development, preventing blood supply to the myocardium (Scalone et al., 2019). The aetiology of her myocardial infarction, as well as its management and pharmacology, will be discussed in this paper.
Pathophysiology
Reduced or full suspension of blood supply to a region of the heart causes myocardial infarction (MI), sometimes refe
ed to as a heart attack. The majority of myocardial infarctions are caused by coronary artery disease. Acute myocardial infarction could occur when one or more big endocardial coronary arteries are occluded for more than twenty to thirty minutes. The blockage is frequently thrombotic and occurs when a wedge in the coronary arteries ruptures (Saleh & Am
ose, 2018). Because there is a paucity of oxygenation in the heart, sarcolemma
eakdown and myofi
il relaxing occur. The active necrosis of cardiac tissue happens as a consequence of persistent ischemia. Heart function is weakened based on which part of the heart is damaged by the infarction.
Myocardial ischemia is caused by a mismatch in oxygen delivery and can progress to myocardial infarction. Hypo-perfusion complaints are identified using the patient's condition, electrocardiographic results, and increased serum indicators (Scalone et al., 2019). Keith's oxygen saturation is low at 91%. Chest pain, upper-limb distress, and epigastric discomfort might develop throughout exercise or at rest due to myocardial infarction, as in Keith's case. The epigastric discomfort might cause the patient to become nauseous, which is the case with Keith. Her chest pain ranges from 6/10 on the pain scale. Dyspnea and tiredness, which are ischemic counterparts, can also be symptoms of myocardial injury, as observed in Keith's case. She is distressed and fatigued as well. A lower BP, increased heart rate, and respiratory rate are the body's mechanisms of compensating for the low perfusion at the body tissue levels (Smit et al., 2020).
Risk Facto
In the case of Kath, risk factors for developing coronary artery disease and myocardial infarction include chronic smoking, abnormal lipid profile, history of diabetes and hypertension, obesity, lack of physical activity, and alcohol consumption as well. In Keith's case, she has all the relevant risk factors contributing to her coronary artery syndrome, such as obesity (BMI of 32), lipid abnormalities- cholesterol of 7.95 (high), HDL of 2.1 (low), and triglycerides of 6.5 (high) as well. Diabetes and hypertension also contribute to increasing the stress on the heart muscle. The clot formation is supported by an unhealthy diet, obesity, lack of physical activity, and smoking. This blockage leads to ischemic injury and infarction (Rathore et al., 2018).
Management
Acute coronary syndrome can be defined as a range of illnesses that are associated with the onset of reduced blood flow. The most common factor leading to this condition is the
eakdown of clots within arteries, restricting blood flow (Bonin et al., 2018). Common signs include chest...
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