cardio2: | Nursing

Clinical Requirement:

Cardiovascular2.docx Cardiovascular Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and having had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. In route to the hospital, the patient was placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills. Case Study Questions 1. For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors. 2. What would you expect to see on Mr. W.G. EKG and which findings described on the case are compatible with the acute coronary event? 3. Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarct, which would be the most specific laboratory test you would choose and why? 4. How do you explain that Mr. W.G temperature has increased after his Myocardial Infarct, when that can be observed and for how long? Base your answer on the pathophysiology of the event. 5. Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarct. Elaborate and support your answer.   Submission Instructions: · Include both case studies in your post. · Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points. · You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)  · All replies must be constructive and use literature where possible. · Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday. · You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.  · Grading Rubric  · · Your assignment will be graded according to the grading rubric. Discussion Rubric Criteria Ratings Points Identification of Main Issues, Problems, and Concepts Distinguished - 5 points Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts. Excellent - 4 points Identifies and demonstrates an accomplished understanding of most issues, problems, and concepts. Fair - 1-3 points Identifies and demonstrates an acceptable understanding of most issues, problems, and concepts. Poor - 0 points Identifies and demonstrates an unacceptable understanding of most issues, problems, and concepts. Or nothing was posted. 5 points Use of Citations, Writing Mechanics, and APA Formatting Guidelines Distinguished - 3 points Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors. Excellent - 2 points Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors. Fair - 1 point Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail. Poor - 0 points Ineffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. Or nothing was posted. 3 points Response to Posts of Peers Distinguished - 2 points Student constructively responded to two other posts and either extended, expanded, or provided a rebuttal to each. Fair - 1 point Student constructively responded to one other post and either extended, expanded, or provided a rebuttal. Poor - 0 points Student provided no response to a peer's post.   2 points Total Points  10