Case Study Rule Out MI Answers.docx - Case Study Rule Out...

This preview shows page 1 - 3 out of 5 pages.

Case Study: Rule Out Myocardial Infarction Scenario: The time is 1900 hours. You are working in a small, rural hospital. It has been snowing heavily all day, and the medical helicopters at the large regional medical center, 4 hours away by car (in good weather), have been grounded by the weather until morning. The roads are barely passable. W.R., a 48-year-old construction worker with a 36-pack-year smoking history, is admitted to your floor with a diagnosis of rule out myocardial infarction (R/O MI). He has significant male-pattern obesity (“beer belly,” large waist circumference) and a barrel chest, and he reports a dietary history of high-fat food. His wife brought him to the emergency department (ED) after he complained of (C/O) unrelieved “indigestion.” His admission vital signs (VS) were 202/124, 96, 18, and 98.2° F. W.R. was put on oxygen (O2) by nasal cannula (NC) titrated to maintain SaO2 (arterial oxygen saturation) over 90%, and an IV of nitroglycerin (NTG) was started in the ED. He was also given aspirin 325 mg and was admitted to Dr. A.’s service. There are plans to transfer him by helicopter to the regional medical center for a cardiac catheterization in the morning when the weather clears. Meanwhile you have to deal with limited laboratory and pharmacy resources. The minute W.R. comes through the door of your unit, he announces he’s just fi ne in a loud and angry voice and demands a cigarette. 1. From the perspective of basic human needs, what is the first priority in his care?
2. Are these VS reasonable for a man his age? If not, which one(s) concern(s) you? Explain why or why not.
3. Identify five priority problems associated with the care of a patient like W.R.
Teaching needs : Teach him to report changes. Pain control Cardiac arrhythmias secondary to MI : These increase the possibility of sudden death.

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture