Identify five priority problems associated with the

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3. Identify five priority problems associated with the care of a patient like W.R.
1. CBC → A 2. EEG in the morning I → An EEG is a test that tracts brain wave patterns. This type of test would not reveal any information about a possible MI. 3. Chem 7 (Electrolytes) → A 4. PT/PTT → A 5. Bilirubin every morning → I Bilirubin testing reflects the health of the liver. While studies do show that liver congestion due to an increase of central venous pressure may possibly cause elevations of serum bilirubin, recurrent testing every morning would not confirm an MI. 6. Urinalysis (UA) → I While there is a list of things you can tell from testing a person’s urine, especially the health of the kidneys and bladder, a myocardial infarction in not something on that list. 7. STAT 12-Lead ECG → A 8. Type & Crossmatch (T&C) for 4 units packed RBCS → A (Ignatavicius & Workman, 2013) (Alvarez & Mukherjee, 2011) 4. Which of the following laboratory tests might be ordered to investigate W.R.’s condition? If the order is appropriate, place an “A” in the space provided. If inappropriate, mark with an “I,” and
Cardiac biomarkers/enzymes Troponin levels Creatine kinase (CK) levels: CK-MB levels increase within 3-12 hours of the onset of chest pain, reach peak values within 24 hours, and return to baseline after 48-72 hours Myoglobin levels: Myoglobin is released more rapidly from infarcted myocardium than is troponin; urine myoglobin levels rise within 1-4 hours from the onset of chest pain Lipid profile C-reactive protein (CRP) and other inflammation markers 5. What significant lab tests are missing from the previous list?
6. How are you going to respond to W.R.’s angry demands for a cigarette? He also demands something for his “heartburn.” How will you respond? I
Case Study Progresses You phone Dr. A.’s partner, who is “on call.” She prescribes morphine sulfate 4 to 10 mg IV push (IVP) q1h prn for pain (burning, pressure, angina).

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