Question

Pathophysiology: Case Study - Mr. Reynolds, age 65, is slowly recovering from a recent heart attack. He has a history of emphysema but is having more difficulty breathing. He dislikes medications and any form of therapy.

Question 1: Using normal anatomy and physiology, discuss how impaired ventilation can interfere with cardiac recovery and function.

Question 2: Based on the patient’s medical history and his feelings about recovery programs, in conjunction with the patient’s need for medications and other therapies, discuss the need for medication and participation in recovery programs and possible strategies and the roles of other professionals in support of his recovery from the heart attack and to manage his respiratory condition.

Answer 1

heay TV Heart Attack Myocotelial Impraction + attack 7 coronary » Occusiork On acute infraction result in the death 1 of heart muscled. The affected inyocardial cut in the heart are petermanently destroyed. Myocardial infraction occur fronn la partial or cortmplete blockage of coronary artery which supply to the cells of ter the blood the heart supplied by Me blocked coronady arterys Definition dute MI also known as heart no to atteck or Coronary occasional It is a life threatening condition, of localized Chracterized by the formation necetie area with Vin the myocardial & sudden severe chest pain that is not reclived by rust or nitroglycerin e of _MI acclusion a usually to the sudden Coronary arfost arel odcupt storing los I blood le a flow to the myocardicum muscus, because of heart muscles function. The most common site of mi is the conderiar wall of the left ventricles. Eliology / Caused so Habis 1. W most common cause of mi are complete ca propeway complete occlusion of coronari Camscanr 1 wrferry due to - 1 0

Notes » Acute coronary thrombosis it is associated with 90% MIN » Severe coronary artery disease substra » » The atherosclerosis balogue ruptured into the _ Vedral lumen restylin arferry occlusion - Endothelial, ingury to coronary artery may causes platelet l'aggression le cause thrombur Formation, 2. Other etiological factor include » Coronary artery exerbolism wolorias - Infectious diskuse to coronary artery the ? catuse arterial instanation + Severe hypoxin ! → Severe anemia, la labi - 5 Risk factors > Rame ab CAD, but wonnen who Smoke is case of oral contraseptives have as higher risks ML. س ت بنتر متولد Clinical Manifestation > 1 Cordiovascular system. to Chest pain » It ie a roper clinical a " manifestation a Severe substermal pain , that radiate to the left arm, jaw, mme neck relibed by Just I nitroglycerin but requir & back, not nestratil such as Morphine Qulphatesek a Camsernes Teniss

> Continuous pain may rudiate to the left arma, Shoulders neck o back Ejaws. → Continuous for more than 15 minute may product ansiety fear, resulting les heart rate, blood pressure, respiratory rate B. Hypo & Hypertension e. Tacky & bradycardia E cool diogeniel Shock 2. Respiratory Sysve Respiratory System Shortness breath wara o Trachy porea is aim La Palsmonary edema muy be alive. I mods 2 Gastro-intestinal system > nenn » Nosen & konniting a → constipation se samne c edent din → S rba BAB 4 bunary System > Aile e des Purinary output - Cardiogenic shock * tes (wine output may imelicate careliogenic Shacka 2 Shion Systems Cool, diaphoratie appearance of the Skime me Neurological system and was the Headach Restlessness to store cs. V eith distforbance - Altereni speech 2 loss of consiousness, nature

Notes Poce No : | Dete; - T poychological symptoms fear & Clive shoughts. Pathophysiology Ranne ad CAD Diagnoosis ay History and physical examination Ale to s 18. Laski ECG - Ischemia myocardial infraction causes Changes in the P-wave, s 1 segment Tr wave » Myocardial infraction & ischemia altered disturbed, ventricular depolarization or repcelarizejien 03] Rii a n be pattern of GCG in ML 2 ST segment depression TE Ţn werke inversion indicate the pattern of ischemią Slet segment devation indicate an injurh pattern Abronnal P-wave indicate tissue necrosis a permanent changes > Through the cause of mil changed in the o FCG ocurre first in the S-IT-segment than in I wave i finally in pa tware, 2. Eco-cardia Gram - It is use to elevated the ventricular function. Teacher's Signature

2 Laboratore lest Elevation of Serum enzyme le Iso enzyme - Elevation of creatione kinase , normal value 21-25 IV lit I - Elevation och my oglovin less than gong sait no indicate MI. Elevation of DHL Lecto defydrogenase / SL Normal value to 198 2001/lif ] - Elevation of serum SGPT CSGOT , hanshis mes [20-30 T L 20-4019 sich um Elevation of trophion-I e trophim-T; it is a protein found in myocardium & mast important worker for Mi [ 2006 mg Idl, 21-5 mytell I indi lade MI ع عيها علمیت نے 8

T. L - Nursing Diagnose - La Acatch chat pain related to dies - Commary blood flow to the myo cardium layer of the heart and impaired Og and I blood supply to the heart mussule. Goals To Reduse the chest paine maintain he normal cardine output of the heart 3 Intervention > » Add my bitration of the Mitroglycerin Jabalet jo had patient by the sub- linguali ees ordered byl doctors » Modifors the location intensity and E duration of the chest paint o provide comfortable position to the - paffert buch a Jouler pajetion Provide diversion Messphy so the patient such as subsie Mesophy E reading the booke. 4. Rationale – chest pain is Reduse by nitroglycersin Jabaled & his drets aukion are les the contractility A meta myocardia hans the pain les seves Scanned

ihto Eschemia • (B) des or cardiac ouf puf infraction 2. Goals D D - To maintain the normal cardiste auf pes and as the or prevent il the schemia aver schraltion 3. Intervention > ► » Addministration of the Cardine - geycosided defeh asa Delete - No dogs that des the cardial offers due to ischernia a ve infraction. The > Modificasich of the deesory Fochoris, Sedef as d avoid the high coles pole. . dies are cese: ich l hibrous dish, lant » Reduse or + avoid the risk factors such as modified T riste sectors .eg. DM obosity, e. Embling ekly Educased the patient care his relation about the life style modification and avoid the st Sidansory I Rationale > Cardiac output s maintain by the doldsministration of the Cardene glycoside mumci Mese siste faltore pochers Seine

c) Fear related to treat death, changes in life style, chest pain one procedebies Goals het to ves the fear about the disease condision and wrotivation the patient disease i Intervention > provide the psychological support to the pasient pe Ofis predatives regarding ? Jo t disease condition Healsch i education and is arcurge the pasient about. Et modelissas, & sito avoid the fear's of death, o provide diversi tonove the reply to the patient w such es 'mhusie theraphy, - Provide the knowledge about the deisease and h at easissa 4:1 Rationale - Fear ich by hearth education krowedge of he disease ? condlsiast and is avalele TIF n nadalities. Nos A