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CONCEPT MAP WORKSHEETDESCRIBE DISEASE PROCESS AFFECTING PATIENTDIAGNOSTIC TESTSPATIENT INFORMATIONANTICIPATED PHYSICAL FINDINGSANTICIPATED NURSING INTERVENTIONSMyocardial Infarction:("heart attack") is the irreversible damage of myocardial tissue caused by prolonged ischemia and hypoxia. This most commonly occurs when a coronary artery becomes occluded following the rupture of an atherosclerotic plaque, which then leads to the formation of a blood clot (coronary thrombosis). This event can also trigger coronary vasospasm. If a vessel becomes completely occluded, the myocardium normally supplied by that vessel will become ischemic and hypoxic. Without sufficient oxygen, the tissue dies. The damaged tissue is initially comprised of a necrotic core surrounded by a marginal (or border) zone that can either recover normal function or become irreversibly damaged. The hypoxic tissue within the border zone may become a site for generating arrhythmias.Ventricular Fibrillation: Ventricular fibrillation is a heart rhythm problem that occurs when the heart beats with rapid, erratic electrical impulses. This causes pumping chambers in your heart (the ventricles) to quiver uselessly, instead of pumping blood.Mechanic OJ, Grossman SA. Acute Myocardial Infarction. StatPearls Publishing; 2020 Jan-. Available from: - Creatinine Kinase Test:Test is not specific to the heart and is more general. Overuse of muscles causes creatinine to spill out. - Creatinine Kinase Isoenzymes (CK-MB):0-5% of total. Total: Male: 38-174U/L; Female: 26-140 U/L- Troponin Level Test:Less than 0.04 ng/mL; Above 0.40 ng/mL may indicateMI- Lipid profile, c-reactive protein, BNP, PTT, PT, INR, CBC- Chest x-ray, electrocardiogram- No pain during beginning of assessment- During assessment patient experienced ventricular fibrillation. Symptoms anticipated are lightheadedness or dizziness, palpitations, fatigue, chest pressure,shortness of breath, fainting- Admitting complaint: chest pain, diaphoresis, and shortness of breath- Male- 54 years old- Frequent traveler- Complaints: chest pain, diaphoresis, and SOB- Peripheral IV running normalsaline- Receiving oxygen at 4L/min- SpO2 at 97%- Last rated chest pain as a 0 out of 10- Meds: nitroglycerine- Telemetry unit- Frequently assess vital signs- Auscultate lungs and heart frequently- Pain assessment- Cardiac monitor- Cardiac stress test: NPO x 4 hours, educate patient on the importance of avoiding stimulants such as caffeine and tobacco- Prepare patient for any cardiac evaluations ordered (myocardial perfusion imaging, CT scan, MRI, PET scan)- Hemodynamic monitoring- Intra-arterial blood pressure monitoring- Obtaining a venous blood sample
vSim ISBAR ACTIVITYSTUDENT WORKSHEETINTRODUCTION“Hello, my name is Carolina Sanchez I am the nurse taking care of the patient in room 6 in the Telemetry unit. Is this ____________? “Your name, position (RN), unit you are working onSITUATION“Patients name is Carl Shapiro. He is a 54-year-old male being seen for acute chest pain, diaphoresis, and shortness of breath.”Pati