Introduction
The client is MK, a 50 year old female who is status post 3 hours of a percutaneous transluminal coronary angioplasty (PTCA). The PTCA was performed because MK failed a cardiac stress test and was found to have significant coronary disease with a 90% blocked mid-left anterior descending artery and a 90% blocked proximal circumflex artery, which required the placement of two stents. MK is currently employed as a daycare owner, and she is married, but the couple does not have children of their own. The client was a smoker, who smoked one pack a day for 30 years, but quit last month. MK also has a past medical history of hypertension, hyperlipidemia, diabetes type II, and coronary heart disease.
Situation
Initially, clients may accumulate …show more content…
Another thing the nurse should be concerned with is the client’s heart rate. Not only is the client tachycardic, with a heart rate of 124 beats per minute, but the electrocardiogram (EKG) was previously showing ST elevation in two anterior leads. Currently, the EKG is showing that MK is experiencing premature ventricular contractions. The nurse should also be concerned about the client’s lab reports. While the client’s creatinine phosphokinase (CPK), blood urea nitrogen (BUN), and creatinine levels are within normal limits, her CPK-MB and troponin 1 levels are both elevated. The elevation in labs signifies that MK had a myocardial infarction, which puts her at risk for cardiogenic shock due to tissue damage and necrosis. Lastly, the nurse should be concerned about the client’s history of smoking, as the client only quit smoking one month ago and smoking reduces the blood flow to the coronary arteries (Ignatavicius & Workman, …show more content…
These medications also help increase stroke volume and contractility, which helps to improve tissue perfusion (Warise, 2015). Positive inotropic agents are also used in cardiogenic shock to maintain organ perfusion, as well as help improve the heart’s contractility (Warise, 2015). Beta blockers, such as metoprolol, are used to decrease the response of the sympathetic nervous system, reduce the heart rate, and reduce oxygen needs of the heart (Warise, 2015). Lastly, the client may receive antiplatelet agents, such as aspirin and clopidogrel, in order to inhibit or reduce platelet activity and accumulation, reduce thrombus formation, and help to reduce the possibility of another myocardial infarction from occurring (Warise,
The client is MK, a 50 year old female who is status post 3 hours of a percutaneous transluminal coronary angioplasty (PTCA). The PTCA was performed because MK failed a cardiac stress test and was found to have significant coronary disease with a 90% blocked mid-left anterior descending artery and a 90% blocked proximal circumflex artery, which required the placement of two stents. MK is currently employed as a daycare owner, and she is married, but the couple does not have children of their own. The client was a smoker, who smoked one pack a day for 30 years, but quit last month. MK also has a past medical history of hypertension, hyperlipidemia, diabetes type II, and coronary heart disease.
Situation
Initially, clients may accumulate …show more content…
Another thing the nurse should be concerned with is the client’s heart rate. Not only is the client tachycardic, with a heart rate of 124 beats per minute, but the electrocardiogram (EKG) was previously showing ST elevation in two anterior leads. Currently, the EKG is showing that MK is experiencing premature ventricular contractions. The nurse should also be concerned about the client’s lab reports. While the client’s creatinine phosphokinase (CPK), blood urea nitrogen (BUN), and creatinine levels are within normal limits, her CPK-MB and troponin 1 levels are both elevated. The elevation in labs signifies that MK had a myocardial infarction, which puts her at risk for cardiogenic shock due to tissue damage and necrosis. Lastly, the nurse should be concerned about the client’s history of smoking, as the client only quit smoking one month ago and smoking reduces the blood flow to the coronary arteries (Ignatavicius & Workman, …show more content…
These medications also help increase stroke volume and contractility, which helps to improve tissue perfusion (Warise, 2015). Positive inotropic agents are also used in cardiogenic shock to maintain organ perfusion, as well as help improve the heart’s contractility (Warise, 2015). Beta blockers, such as metoprolol, are used to decrease the response of the sympathetic nervous system, reduce the heart rate, and reduce oxygen needs of the heart (Warise, 2015). Lastly, the client may receive antiplatelet agents, such as aspirin and clopidogrel, in order to inhibit or reduce platelet activity and accumulation, reduce thrombus formation, and help to reduce the possibility of another myocardial infarction from occurring (Warise,