[SOLUTION] Managing Care in a Culturally Considerate Manner
Managing care in a Culturally Considerate mannerCASE STUDY 2Patient ProfileF.M. is a 68-year-old white man who comes to the emergency department (ED) in the early afternoon with a 2-day history of severe chest pain. The pain started on wakening the previous day. The pain increased during the night, but his wife could not convince him to go to the hospital. He comes to the ED today because the pain is severe and no longer relieved by rest.Subjective DataDescribes recurring chest pain for the past 6 months that was relieved by rest; the pain is a feeling of heaviness in chest with no radiating pain to arm or jaw or accompanying complaints of nausea or dizzinessRecently the chest pain has become severe and is no longer relieved by rest; is now complaining of being slightly nauseatedHis father died of a heart attack at age 62Denies alcohol or drug useSmokes one pack of cigarettes per dayDescribes his lifestyle as sedentaryObjective DataPhysical ExaminationBlood pressure 180/96, pulse 98, temperature 99.8° F, respirations 20Height 511, weight 210 lbs, BMI 29.3 kg/m2Alert and oriented to person, place, and timeSkin diaphoretic and clammyHeart rhythm regular, no murmurs or extra heart soundsLungs are clear to auscultationDiagnostic StudiesHemoglobin 14 g/dLChemistry panel is normalCardiac markers – pendingElectrocardiogram showing changes that correlate with non-ST-segment-elevation myocardial infarction (NSTEMI)Collaborative Care9% NaCl infusing into IV catheter at 75 mL/hrNitroglycerin and morphine given with relief of painWhat are F.M.s modifiable risk factors for coronary artery disease (CAD)? What are his non-modifiable risk factors?What is the difference between chronic stable angina pain and pain associated with myocardial infarction?What are diagnostic studies indicated for F.M.?F.M. is diagnosed as having a myocardial infarction (MI).What are the signs and symptoms of Myocardial Infarction?What is the priority nursing care for F.M.?What other interventions do you anticipate for F.M. at this time?
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