Artery Bypass Graft : Adv Nursing Questions ( 110 Points )

A 68 year old male presented to the emergency department at 0800 hours via ambulance after experiencing chest discomfort and intermittent palpitations since 0500 hours. Prior to presentation, the patient stated he

Mr. XXXX is a 44 years old Caucasian male, a general construction worker who works on a nearby highway for the bridge project, and checked in this urgent care center for complaining of chest pain and shortness of breath (SOB). The chest pain is constant dull and pressure like pain, and started 3 hours ago. The pain is located on the center of chest. He rates the pain 4 out of 10 on a pain scale 0 to 10 while resting. The pain gets worse and increases after eating. He experienced increased chest pain and SOB with simple walking from the parking lot to this office. The pain was not resolved with taking PO 365mg of Aspirin 2 hours ago and resting. He was diagnosed with hyperlipedemia 10 years ago. He is taking medication to manage his high cholesterol level. He denies past history of chest pain, hypertension, and coronary artery disease. He denies any history of heart surgery or cardio artery bypass surgery. He is anxious and fearful for his first chest and SOB. He smokes a half pack a day for past 20 years. He drinks one bottle of bear every evening with meals. He denies taking any herbal medication or illicit drugs. He has been a good appetite. He reported 20 lbs weight gain since his retirement from military. He has an irregular meal time and does not exercise as much as he used to do in the military.

and a 5-year history of angina pectoris. During the past week he has had more frequent episodes of

Jonathan is a 63-year-old man, born on August 23rd, 1956 and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was from southern Ontario, he moved here shortly following his second divorce. He is of Italian decent and is a practicing Catholic. The patient’s weight is 95 kilograms; he is 178 centimeters tall and has a body mass index (BMI) of 28.3. Jonathan says he smokes around one pack of cigarettes a day, does not exercise enough and eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his myocardial infarction (MI) or heart attack. He was transferred from another hospital in the beginning of November and was waiting for more tests to be completed before he could be discharged. Jonathan has some known comorbidities that can exacerbate his CHF, this includes smoking, obesity, and noncompliance with medications.

History of Present Illness: Mr. Olson is a very pleasant 57-year-old gentleman with multiple medical problems to include severe COPD, who is here today for an initial consultation for his shortness of breath. He is followed by a pulmonologist Dr. William Goodman, at the Veteran Affairs Administration. His last evaluation there was in February 2015. Mr. Olson states he has had ongoing dyspnea on exertion over the last two years. He complains of minimal cough. He does note some sinus problems for which he is on Flovent. In the past, he has had pulmonary function testing that did demonstrate reversible airflow obstruction, therefore he likely has some component of asthma overlay. He states that occasionally has chest tightness and chest heaviness. He has gained about 25 pounds over the last year. He is currently using Spiriva, albuterol as needed as well as Symbicort. He is also using supplemental oxygen at 2.5L per minute at night as well as on an as needed basis during the day. Mr. Olson admits to continued tobacco use with about a half pack to a pack a day. He states that when he is feeling depressed, he will smoke more.

Mr. S is a 29-year-old male with past medical history of (PMH) hypertension (HTN) and obesity who presented to local emergency room (ER) with headache and chest and back pain. Mr. s had been seen at urgent care three days prior for a headache and near syncope and was told to hold his metoprolol due to bradycardia. Due to health insurance related problem, he has been off amlodipine and lisinopril for a month.

Mr. Steward was pain free until this morning. He initially complained of right-sided chest pain and then complained about pain in his hip and ankle. We recognized this was a new onset of pain that persisted, despite giving him some pain medication. When Mr. Steward was discovered in his room clutching his chest, we recognized this as a non-verbal sign of pain and asked him whether he was having chest pain. Although Mr. Steward doesn 't provide a definitive answer, he displayed non-verbal signs of pain, such as restlessness, frequent shifting in bed, and act of clutching his chest. Recognizing Mr.

On Tuesday August 30, 2016 a Male 63 years of age came into Christus Spohn South Heath Center with a diagnostic order for chest and rib x-rays. He was being seen because of chest pain on his right side due to a fall. He had an extensive patient history of x-rays that went as far back as 2014. For the year of 2016 he received approximately 12 different x-ray series. For example, on January 12, 2016 he received a chest 1 view image and cardiac catheterization. On May 21, 2016 he received a chest 1 view and a complete 4 view foot. On May 30, 2016 he received a cardiac catheterization. On June 1, 2016 and again on June 2, 2016 he received a chest 1 view. On June 10, 2016 he received a catheterization. On August 25, 2016 he received a chest 2 view. On August 26, 2006 an upper extremity without contrast. The patient also has a history of open heart surgery and receives dialysis treatments and is on oxygen.

One of the most frightening medical diagnoses a patient can receive from a physician is a malfunctioning heart, a diagnosis that will eventually lead to death if correction of the issue is not attempted. The heart supplies the entire body with oxygenated blood in addition to requiring its own supply of oxygen rich blood. This is why coronary arteries are vital to the hearts ability to pump. A final option to correcting non-patent coronary arteries is a surgical procedure, coronary artery bypass grafting (CABG). Every year approximately 450,000 patients have CABG surgery in the United States (Mullen-Fortino & O 'Brien, 2008). Based on continuing healthcare trends, more and more people each year are having coronary artery issues causing the need for CABG surgery to rise. Also patient demographics are changing, they are older, sicker, coronary artery blockage / damage is more extensive, and likely have a decrease in functioning of the hearts ventricles (Sidebotham, McKee, Gillham & Levy, 2007). The nursing profession not only has a critical role in caring for these patients, but also in teaching and educating them before and after the procedure. Education and teaching has been implemented into evidence-based practice for years to facilitate better patient outcomes. The goal of this literature

Coronary Artery Bypass Graft surgery is predominately effective in reducing the symptoms of cardiac disease. Despite that fact, research has shown

This paper describes in detail considering one of the possible post- procedural complications of Mrs. Elizabeth Green, who has undergone the coronary angioplasty procedure to relieve chest pain caused due to blood vessel occlusion. Mrs. Green, a 78-year-old Caucasian woman, lives independently at home with her pet dog. She has a son and daughter, who occasionally visit her and provide some support (School of Nursing & Midwifery 2014). ). Mrs Green has a past medical history of gastro oesophageal reflux disease, hypertension, hypercholesterolemia, osteoarthritis and diet controlled type two diabetes mellitus (School of Nursing & Midwifery 2014). There are certain complication arises as a result of the procedure

It is likely that his current condition has been brought on by damage to the intestinal mucosa possibly due to alcohol consumption and poor diet. Lack of HCl due to PPI and H2 blocker use has either initiated the state of dysbiosis or has exacerbated it, possibly having caused his symptoms of chest pains (costochondritis) and duodenal ulcer. Although the sequence of etiology is unclear, multiple causal factors for SIBO exist. The etiology of his costochondritis could be related to symptoms of GERD, and perhaps correlated to Hiatal Hernia.1 Alternatively, PPI use has also been associated with myocardial infarction.4 In either case a differential diagnosis should be done in order find the root cause of the chest pain.5 Treatment of costochondritis is frequently focused on quelling pain symptoms with NSAIDs,5 additionally contributing to GERD if he were taking them. Dysbiosis is a condition correlated to GERD as well as to bacterial overgrowth-related intestinal

Mr. Johnson is a 28 y/o African American man, presents with an 8 month history of heart burn in the epigastric region. Pt. reports “I have heart burn after each meal and it’s painful to swallow at times” Pt. reports a productive cough. The pt. throat is reddened. Pt states the pain worsens while lying down and rate pain 8 out of 10. Pt takes 3 antacid a day. Pt. has a history of hypertension and Asthma. Pt. reports sour taste in back of throat and regurgitation.

Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.

Clinical presentation may resemble acute coronary syndrome with chest pain and exertional shortness of breath. The patients can present with