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NCMB 312 Lec Course Task CU2: Our Lady of Fatima University

The document provides scenarios and questions about a 65-year-old woman admitted for angina pectoris and a 46-year-old man brought to the emergency room suffering a myocardial infarction, asking how to respond to their questions, anticipate their conditions, understand how various medications work, and identify priorities for intervention or complications to monitor. Sample answers are provided that address relieving the angina pain, patterns associated with chronic stable angina, how nitroglycerin works, appropriate actions if nitroglycerin is ineffective, ECG findings that indicate myocardial injury, positive laboratory tests for a heart attack, and complications like dysrhythmias that the nurse

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256 views

NCMB 312 Lec Course Task CU2: Our Lady of Fatima University

The document provides scenarios and questions about a 65-year-old woman admitted for angina pectoris and a 46-year-old man brought to the emergency room suffering a myocardial infarction, asking how to respond to their questions, anticipate their conditions, understand how various medications work, and identify priorities for intervention or complications to monitor. Sample answers are provided that address relieving the angina pain, patterns associated with chronic stable angina, how nitroglycerin works, appropriate actions if nitroglycerin is ineffective, ECG findings that indicate myocardial injury, positive laboratory tests for a heart attack, and complications like dysrhythmias that the nurse

Uploaded by

Mushy_aya
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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OUR LADY OF FATIMA UNIVERSITY

CABANATUAN CAMPUS
COLLEGE OF NURSING

NCMB 312 Lec

Course Task CU2

Question:

Answer the following questions base on the cited situation. Answer will be submitted through CANVAS.
Consider the scenarios and answer the following questions:
Scenario 1: Angina Pectoris
Lita a 65 year-old retired secretary, is admitted to the medical surgical area for management of chest pain
caused by angina pectoris. (20 points)
1. The patient asked the nurse “What is causing this pain?” What is the best response by the nurse?
2. The patient is diagnosed with chronic stable angina. The nurse can anticipate that her pain may
follow what type of pattern?
3. Lita has nitroglycerin at her bed side to take PRN. The nurse knows that nitroglycerin acts in what
ways?
4. Lita took a nitroglycerin tablet at 10:00 AM, after her morning care. It did not relieve her pain, so 5
minutes later, she repeated the dose. 10 minutes later, and still in pain, she calls the nurse. What is
the priority intervention of the nurse?

Answer:

1. The nurse should inform Ms. Lita that her chest pain caused by angina pectoris happens
due to a painful tightening of her heart muscle. It may be caused by doing strenuous
activities resulting to the heart needing more oxygen-rich blood than the body can supply.
Angina isn’t a condition. It’s a warning sign of heart disease.
2. The nurse can anticipate when the pain will pain because chronic stable angina has a
predictable pattern, it usually has a trigger such as physical exercise or exertion, anxiety
or emotional stress, cold temperatures, or heavy meals, that after experiencing or doing
these things chest pain.
3. Nitroglycerin works in relieving chest pain by relaxing the muscles in the walls of the
blood vessels, causing them to dilate. Opening or widening blood vessels results in
improved blood flow to the heart in return the squeezing sensation you feel in your chest
improves.
4. Nitroglycerin is fast acting in relieving chest pain, if Ms. Lita took 2 doses and still in
pain t she may be experiencing a heart attack the nurse may immediately advise her to
take aspirin, it is a blood thinner this will prevent clotting and keeps blood flowing
through a narrowed artery after this immedietly call the patient’s physician.
OUR LADY OF FATIMA UNIVERSITY
CABANATUAN CAMPUS
COLLEGE OF NURSING

Scenario 2: Decreased Myocardial Tissue Perfusion 


Mr. Santos, a 46 year-old teacher, is brought to the ER by ambulance with a suspected diagnosis of MI. He
appears ashen, is diaphoretic, and tachycardic, and has a severe chest pain. The nursing diagnosis is
Decreased Cardiac Output  related to Decreased Myocardial Tissue Perfusion. (20 points)
1. The nurse is aware that there is critical time period for this patient. When should the nurse be most
vigilant in monitoring this patient?
2. The nurse is interpreting the result of the ECG. What findings does the nurse understand are
indicative of initial myocardial injury?
3. What laboratory test are positive indicators of MI?
4. The nurse should closely monitor the patient for a complication of an MI that leads to sudden death
during the first 48 hours. Which complication should the nurse monitor for?

1. The should be closely monitoring Mr. Santos’ heart rate and blood pressure. The nurse
should auscultate apical pulses and sssess heart rate and rhythm. As well as peripheral
pulses and perform capillary refill test, because decreased cardiac output may result in
insufficient blood supply.
2. The nurse will fiind an indication of an initial myocardial injury if Mr. Santos’ ECG
findings shows change such as large peaked T waves (or hyperacute T waves), then ST
elevation, then negative T waves and finally pathologic Q waves develop.
3. Troponin tests measure the level of cardiac-specific troponin in the blood to help detect
heart injury. When there is damage to heart muscle cells, troponin is released into the
blood. The more damage there is, the greater the concentration in the blood. Primarily,
troponin tests are used to help determine if an individual has suffered a heart attack. They
may also be helpful in evaluating someone for other forms of heart injury.
4. The nurse should monitor for dysrhythmias. The nurse’s attention should be focused
towards identifying and alleviating the cause of the dysrhythmia, such as pain, fear,
hypoxia, acidosis or electrolyte imbalance.

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