Question: I Was Wondering If Anyone Can Help With Giving An Evaluation For This Patient. In The Evaluation, We Have To “Identify Outcomes” & “explain How Outcomes Were Measured”. Also For Interventions, We Have To “explain Details Regarding Patient Teaching Content And Methods”. Two Nursing Diagnosis That I Came Up With Are: Decreased Cardiac Output: Relating …

Mrs. Darsana SOCIOECONOMIC SPIRITUAL/RELIGIOUS GENDER Female AGE 67 SETTING Hospital ETHNICITY . Black American CULTURAL CONSIDERATIONS Risk of hypertension and heart disease PREEXISTING CONDITION Hypertension (HTN) COEXISTING CONDITION PHARMACOLOGIC Acetylsalicylic acid (aspirin); enoxaparin (Lovenox); GPllbllla agents; heparin sodium; morphine sulfate; nitroglycerin; tissue plasminogen activator (PA) LEGAL ETHICAL ALTERNATIVE THERAPY PRIORITIZATION Minimizing cardiac damage DELEGATION COMMUNICATION DISABILITY THE CARDIOVASCULAR SYSTEM & THE BLOOD Level of difficulty: Moderate Overview: This case requires the nurse to recognize the signs and symptoms of an acute myocardial infarction (MI). The nurse must anticipate appropriate interventions to minimize cardiac damage and preserve myocardial function. Serum laboratory tests and electrocardiogram findings used to diagnose a myocardial infarction are discussed. Criteria to assess when considering reperfusion using a thrombolytic agent are reviewed. The nurse is asked to prioritize the client’s nursing diagnoses. Client Profile Case Study Mrs. Darsana was sitting at a family cookout at approximately 2:00 P.M. when she experienced what she later describes to the nurse as “nausea with some heartburn.” Assuming the discomfort was because of something she ate, she dismissed the discomfort and took Tums. After about two hours, she explains, “My heartburn was not much better and it was now more of a dull pain that seemed to spread to my shoulders. I also noticed that I was a little short of breath.” Mrs. Darsana told her son what she was feeling. Concerned, her son called emergency medical services. En route to the hospital, emergency medical personnel established an intravenous access. Mrs. Darsana was given four children’s chewable aspirins and three sublin- gual nitroglycerin tablets without relief of her chest pain. She was placed on oxygen 2 liters via nasal cannula. Upon arrival in the emergency department, Mrs. Darsana is very restless. She states, “It feels like an elephant is sitting on my chest.” Her vital signs are blood pressure 160/84, pulse 118, respiratory rate 28, and temperature 99.9°F (37.4°C). Her oxygen saturation is 98% on 2 liters of oxygen. A 12-lead elec- trocardiogram (ECG, EKG) shows sinus tachycardia with a heart rate of 120 beats per minute. An occasional premature ventricular contraction (PVC), T wave inversion, and ST segment elevation are noted. A chest X-ray is within normal limits with no signs of pulmonary edema. Mrs. Darsana’s laboratory results include potassium (K) 4.0 mEq/L, magnesium (Mg) 1.9 mg/dL, total creatine kinase (CK) 157 /L., CK-MB 7.6 ng/mL., relative index 4.8%, and troponin 1 2.8 ng/mL. Her stool tests negative for occult blood,