can you answer all the questions please because it is a case study and I can not post it separately . Question
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can you answer all the questions please because it is a case study and I can not post it separately
Cardiovascular Case Study: A client with angina
You are a nurse working the day shift in the Emergency Department (ED) at a local community hospital. The
paramedics bring a 54-year-old male into the Emergency Room due to reports of chest pain. His wife is with him.
Recent history:
Chief Complaint (CC): Client reported chest discomfort late last evening after a very stressful day. He felt better
after sitting down and reading the newspaper and attributed his discomfort to “indigestion.” The client was dressing
for work this morning, however, chest discomfort returned, and was more intense.
Allergies: None known drug allergy (NKDA)
Past Medical History (PMH): Hyperlipidemia. Quit smoking 2 years ago (2 pack per day smoker x 34 years)
Past Surgical History (PSH): transurethral resection of the prostate for obstructing benign prostatic hyperplasia 2
weeks ago.
Assessment Data
Subjective: Reports feeling anxious. Reports “pressure in my chest”
Objective: BP 146/90 HR 120 and regular RR 32 breaths per minute SpO2: 92% on 2 liters NC. Appears anxious,
skin color pale but warm and dry.
1. What differential diagnoses do you think we should consider as the cause of his chest pressure?
_________________________________________________________________________________________
2. Orders from health care provider. In what order will the nurse complete the orders?
1. Keep client NPO.
2. Serum troponin level
3. Cardiac enzymes every 8 hours x 3 sets (CPK, CK-MB)
4. Basic metabolic profile (BMP), Complete blood count (CBC), Prothrombin Time, Partial Thromboplastin
Time (PT/PTT)
5. Chest x-ray
6. EKG
7. Oxygen protocol to keep SpO2 greater than or equal to 93%
8. IV lock
9. Aspirin EC 325 mg by mouth now.
10. Nitroglycerine protocol with 0.4 mg nitroglycerine (NTG)
11. Morphine Sulfate 2 mg IV every 15 minutes for reports of chest pain. Total of 8 mg/hr.
12. Cardiac monitor
3. The nurse is paging the physician to clarify an order. Which one do you think may need clarified?
4. What other items would you like for the health care provider to order?
5. The physician orders nitroglycerin sublingually (SL) stat for the client. In administering the nitroglycerin, you
realize that sublingual administration is indicated because the drug:
A. Could cause nausea in the client if swallowed
B. Will dissolve and be absorbed quickly if given SL
C. Is less likely to cause hypotension if given SL
6. To evaluate the client’s response to nitroglycerin, which of the following assessments are indicated? Select
all that apply.
A. Breath sounds
B. Apical heart rate
C. Blood pressure
D. Oral temperature
E. Chest discomfort
F. Respiratory rate
7. The client reports that his “chest pressure” is getting worse. The health care provider asks the nurse to begin the
nitroglycerine protocol. What are the steps to administer nitroglycerine?
1. __________________
2. __________________
3. __________________
4. __________________
5. __________________
6. __________________
7. __________________
8. __________________
9. __________________
10. _________________
SCIENCE
HEALTH SCIENCE
NURSING
can you answer all the questions please because it is a case study and I can not post it separately
