Cardiovascular Disorders Case Study Ext

1608 WordsNov 16, 20147 Pages
Cardiovascular Disorders Case Study 11 Scenario: The time is 1900 hours. You are working in a small, rural hospital. It has been snowing heavily all day, and the medical helicopters at the large regional medical center, 4 hours away by car (in good weather), have been grounded by the weather until morning. The roads are barely passable. WR., a 48 year old construction worker with a 36 pack year smoking history, is admitted to your floor with a diagnosis of rule out myocardial infarction (R/O MI). He has significant male pattern obesity (beer belly, large waist circumference) and a barrel chest, and he reports a dietary history of high fat food. His wife brought him to the ED after he complained of unrelieved indigestion. His…show more content…
11. One of the housekeeping staff asks you, “If the poor guy can’t smoke, why can’t you give him one of those nicotine patches?” How will you respond? Housekeeping staff is not in a situation where this would be information that they would need to know to perform their job (HIPPA). I would politely say, “Unfortunately, I am unable to discuss the client’s care, but I would be glad to relay information to the client in case he is concerned. The next opportunity that I have, I would provide information to the client about the nicotine patches and why he is unable to use them at this time, just in case he and the housekeeper has had a conversation about it. At that time if he wants to relay the information to the housekeeper he can do so. Nicotine replacement therapy is not generally recommended for pregnant women and persons who have experienced an acute myocardial infarction within 2 weeks, have unstable angina, or have life threatening dysrhythmias. (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011, p. 170) 12. If the patch were to be used later to help him quit smoking, how would it be dosed for him? The nicotine replacement would be dosed high and would taper off over a longer period of time (patches 8 wks or more) to help with craving and withdrawal. The patch allows for a slower delivery of the drug and elimination of the carcinogens and gases associated with tobacco smoke. (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011, p. 170) 13. Before leaving
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