Schizophrenia Case Study Nursing

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

- The goals of treatment include a decrease in ventricular response (to less than 100 beats/minute), prevention of stroke, and conversion to normal sinus rhythm, if possible. To accomplish this, I would expect the health care provider to initially order drugs to control the ventricular rate, such as calcium channel blockers, beta-adrenergic blockers, digoxin, and dronedarone. For some patients, pharmacologic or electrical conversion of the atrial fibrillation to normal sinus rhythm may then also be considered, such as by using amiodarone or electrical cardioversion. If the atrial fibrillation lasts for longer than 48 hours, anticoagulation therapy will be needed for 3-4 weeks before the cardioversion and for weeks after as well. If drugs or cardioversion do not work, radiofrequency catheter ablation and the Maze procedure would be expected as further options.

In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.

At this point, we do not know exactly what are the settings, we have previous requested pacemaker operative report from Regions. Unfortunately, from what he is telling today, his date of the birth was not correct as such dose report were not same. He noted that he thinks he came back from the hospital, he has not had similar complaint or concern or report of chest pain. It should be noted that hospital records, with a troponin that was negative, 12-lead EKG was similar to the one that was obtained here, essentially identifying sinus bradycardia with first-degree AV block, left ventricular hypertrophy with repolarization abnormality. QT was prolonged, similar EKG obtained at facility also identified pretty much the same abnormality pattern. Troponin was negative. Other workup included chest x-ray in the hospital were all unremarkable. Today he is not reporting any chest pain, no shortness of breath, no nausea or emesis. He has got healed ____ scar to the left chest from pacemaker implantation which is completely healed but slightly

Mr. Howard, a 57-year-old man, had a 3-month history of progressive typical anginal chest pain. He reported that the symptoms first occurred with heavy exertion and involved what he described as“heaviness” in his chest. The symptoms were promptly relieved with rest. Over the past weeks, he had been experiencing increasingly frequent episodes of chest pain and diaphoresis. The episodes had become more prolonged, and he had experienced one episode of pain occurring at rest after a heavy meal. Mr. Howard was moderately obese and had a 20-year history of hypertension, which was being treated. Other risk factors in Mr. Howard’s history include hypercholesterolemia (350 mg/dL), which he was attempting to treat with dietary modifications, and a 30-year two-pack-a-day smoking history which continued up to the present time. Mr. Howard previously had surgery for a bilateral inguinal hernia repair, cholecystectomy, and arthroscopic surgery on his left knew. He also gave a history of problems with gastric reflux and was currently taking cimetidine (Tagamet).

Situation: the patient is a 78 year old male, with chronic obstructive pulmonary disease, demonstrating restlessness, agitation with a rapid heart rate, tachycardia.

RESPONSE: Yes. There are no alternative treatments to the use of the LIFE Vest during this period of time. The only other option is pure observation, which will clearly not treat any life threatening arrhythmias. There is no trial with drug data to say that any pharmacologic agent is sufficient during this period.

The patient had a medical history of hypertension, hyperlipidemia, coronary artery disease, myocardial infarction in 2010, COPD, pulmonary embolism, prostate cancer, gastro esophageal reflux disease, and small bowel adhesions. The patient had an echocardiogram six months ago with an ejection fraction of 45%. Individuals with “an EF of 25% to 50% have an intermediate risk for the development of postoperative low cardiac output

When one begins to discuss issues that arise with an intrinsic organ, things get serious. Unfortunately, vital organs like the heart and liver that are causing problems can’t be removed like the appendix or the kidney and “cure” people of issues such as Appendicitis or constant dealings with gallstones. This is true when things begin to go awry within the heart and conditions begin to arise. Atrial Fibrillation (A-fib) is the most common type of arrhythmia, or issue with the heart rate or rhythm. Though A-fib is not a condition that is life-threatening, depending on the severity and lack of treatment, this condition leads to more serious issues like heart disease, and even heart attacks and strokes, which are usually what end up being the cause of death in individuals diagnosed with the condition. Because of A-fib leading to other more detrimental problems, such as the ones listed above, it is difficult to identify and pinpoint if someone has it or had it, which is why it is known as one of the contributors to the “silent killer,” also known as the heart attack. In this paper, gaining a deeper understanding of Atrial Fibrillation will be accomplished through the exploration of: causes, diagnosis, symptoms and treatment, the variation of types, what all is affected within the body as a result, what happens physically, and what occurs at the cellular level when diagnosed with this disorder. All in all, Atrial Fibrillation should be taken seriously and further research is

The patient has been diagnosed with atrial defibrillation and congestive heart failure. There is no visible jugular vein distention or pulsations on either side of the neck. The patient was not comfortable with removing her sweater, therefore, pulsations, lifts, or heaves were not seen if present. Palpated and auscultated the carotid arteries for vascular sounds, no bruits heard. Heart sounds were auscultated with the bell and diaphragm of the stethoscope. S1 82/min, even and regular. S2 85/min, even and regular. S3 82/min, even and regular. S4 83/even and regular. No murmurs were heard. The apical pulse rate was 92 bmp, regular and was accessed with patient in sitting position and between the 4th and 5th intercostal space. Patient stated

He underwent multiple cardiac related procedures, including a cardiac catheterization and stent placement. After discharge, he developed a fast heart rhythm (180-190 beats per minute -ventricular tachycardia) and other serious heart problems (cardiomegaly, valve regurgitation, and others) that required a cardiac defibrillator implant. He fatigued easily; his condition deteriorated and was hospitalized once more. The diagnoses listed included myocardial infarction (heart attack), acute on chronic respiratory failure, congestive heart failure (CHF), kidney failure, liver failure, hypertension, and anemia. His blood tests were abnormal.

The main concerns regarding treating a patient with AF are rhythm control, rate control, and anticoagulation (Zak, 2010). For patient X, he was started on Metoprolol (beta blocker), Amiodarone (anti-dysrhythmic) and Warfarin (anticoagulation). Due to Warfarin’s ability to alter the INR of the blood, it is imperative to monitor the INR frequently to ensure that the level is therapeutic (Shea and Sears, 2008). Patient X had a full time job though making minimum wage. He was unable to take time off of work to get his blood drawn monthly for INR levels at his doctor’s office. This would result in sub therapeutic levels of anticoagulation and therefore noncompliance. He suffered a pulmonary embolus from the sub therapeutic anticoagulation and was hospitalized. After speaking with his cardiologist regarding other means of anticoagulation, the decision was made to change his medication from Warfarin to Pradaxa, an anticoagulant of a different

Doctors will prescribe medication to treat MVP related chest pain, arrhythmias, and other complications. Those types of medications include beta blockers which help prevent irregular heartbeats by making the heart beat slowly with less force. Diuretics to drain any fluid from the lungs. Heart rhythm medications which help control the heart rhythm by normalizing the electrical signals in heart tissue. Aspirin helps prevent blood clots and prescription anticoagulants which also work to prevent blood

Atrial fibrillation is the most commonly encountered arrhythmia (abnormal heart rhythm) in the United States, diagnosed in approximately 1% of the population or 2.5 million people (Nottingham, 2010). Atrial fibrillation has always been of interest during this author’s healthcare career. It is always out there, insidiously hiding, causes a multitude of symptoms and problems. This author remembers puzzling over the presentation of atrial fibrillation and it’s management. Identification is always the first challenge. Banner and Lauck (2013) cite Falk (2001) acknowledging the wide presentation of symptoms from asymptomatic to life threatening. Patient specific options can be confusing and challenging to navigate. Treatment algorithms include pharmacology, electrophysiological interventions, and surgery (Berry, Padgett, & Holton, 2015). This author believes, given the prevalence and consequences of mismanagement, the study of relevant evidence based practice in the treatment of atrial fibrillation is a worthy concentration. For many patients, nurses are the first point of contact in the healthcare system. This demands nursing leadership in the areas of identification, treatment and education for atrial fibrillation.

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.