Question

      Scenerio
A 66-year-old, 70-kg woman with a history of MI, HTN, hyperlipidemia, and diabetes mellitus presents with sudden-onset diaphoresis, nausea, vomiting, and dyspnea, followed by a bandlike upper chest pain (8/10) radiating to her left arm.
She had felt well until 1 month ago, when she noticed her typical angina was occurring with less exertion.
Electrocardiography showed ST-segment depression in leads II, III, and aVF and hyperdynamic T waves and positive cardiac enzymes. BP = 150/90 mm Hg, and all labs are normal; SCr =1.2 mg/dL. Home medications are aspirin 81 mg/day, simvastatin 40 mg every night, metoprolol 50 mg twice daily, and metformin 1 g twice daily.  

                                                                                                                 Question

Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

Answer 1

In the case presented above the patient is having MI along with she also has hypertension , hyperlipidemia , diabetes mellitus . Her health needs includes regular health check-up , diet management , compliance to medications , recognition of warning signs and management . In this case the type of treatment regimen include :-

Morphine- treat pain

* Oxygen: treat tissue hypoxia

* NTG- SL, IV 24-48 hrs. titrated

* Aspirin- orally

* Continuous EKG monitoring: Watch for changes

- Patient might not feel pain d/t morphine. May still have lack of O2 to myocardium. Watch for ST elevation

* Beta Blockers: Given initially and continued after discharge. Long term therapy with beta blockers decrease incidence of future cardiac events:

* Thrombolytic

* Heparin

* Lidocaine

* ACE inhibitors

* Percutaneous Coronary Intervention (PCI)

#. Patient education strategy that i would recommend is therapeutic relationship based health education .