Question

I need some help filling out this Focus report.

Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. He was seen in the Emergency Department at 1:30 p.m. for complaints of chest pain, diaphoresis, and shortness of breath. He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. Chest pain improved with nitroglycerin administration. IV infusion of normal saline was started in the Emergency Department and is running at 25 ml/hour. Ordered lab values are pending. Provider wants to be called as soon as the labs are available. Patient is receiving oxygen at 4 L/min with Spo, values at 97%. Chest pain was last rated as a "0" following second nitroglycerin dose and nitroglycerine patch 0.4 mg. He has been admitted to the Telemetry Unit.

Answer 1

Priority assessment -patient havechestpain ,diaphoresis and shortness of breath so Ecg was the first priority assessment and also perform and document vitalsigns.

Priority diagnostic /labs-ecg,troponin test,CK or CK-MBtestand serum myoglobin test.

Priority nursing interventions -administer oxygen along withmedication therapy to assist with relief of symptoms .encourage bedrest with backrest elevated to relieve discomfort.

Priority medication -aspirin,thrombolytics,painrelievers, .

Priority collberative goals-the goals for treating MI are to relieve chest pain,stabilize heart rhythm, reduce cardiac workload and revascularize the coronary artery ,preserve myocardial tissue.

nytroglycerin,beta blockers ,ACE inhibitors

Priority potential Vs actual potential -patient with previous myocardial infarction and stroke are the highest risk group for coronaryand cerebral events .

QSEN

Patient centerd care-provide patient centerd care with sensitivity and respect .all cares should give and ease out tension of the patient. Give all medicines as per medical roule  As per doctors order. Provide emotional support and physical comfort.

Safety - safety should be mandatory in each cases.free from fall was the primary intervention in all cases. Explain each procedure before and after to the patient .