PMED1010CaseStudyIt’s1500hrs andyouaresent Code4...

1 answer below »


















PMED








1010








Case








Study












It’s








1500hrs and








you








are








sent Code








4 to








a 72


-


year


-


old








male complaining








of chest




pain.






















As you enter the residence you’re directed to the bedroom. During your scene survey you








notice








that








the








bed








is








made,








however








there








are








several








pillows








on








one








side








of








it.








You








also








note








that the head of the bed is sitting on two blocks of wood.






















You








see








your








patient








sitting








in








his








bedroom








on








a








chair.








You








note








obvious








work








of








breathing,








and








that he is




clutching his chest. He appears pale in colour and diaphoretic. He is restless as he is








sitting in the chair, appearing anxious and distressed.






















The patient’s wife informs you that he has not been sleeping well the past few days due to








“feeling short of br


eath at night”. He is usually an active man who works around the house








however she has noticed this past week that he is unable to complete most of his chores








because








he








starts








to








have








pain








in








his








chest


-


this








pain








is








usually








resolved








when








he








rests








and








takes












his Nitro Spray.






















Today








the patient began to feel chest pain again,








but this time it was








while








he was at rest. He








took








his








Nitro








x3








sprays,








however








the








pain








did








not








go








away.








His








wife








became








concerned








when








she saw how uncomfortable he looked, so she




called 911.






















He








is compliant








with his








medications and








takes them








as




prescribed.












Past








Medical




History












Angina








CHF












Hypertension








Diabetes












High








cholesterol






















Vitals








&








Pain








Assessment












Medications












Metformin








Metoprolol








Nitro Spray








ASA












Furosemide








Atorvastatin












Allergies












NKDA












BP














172/95














O














Today,








while








at




rest












Pulse














68,




regular














P














Pain/discomfort








is








constant,








does








not








change








with breathing, movement or palpation












Resp








Rate














20,




regular














Q














Heavy,








ache












SpO


2








97%














R














Into








Left








arm,








upper








back








between








shoulders








and into jaw












Temp














36.7














S














8/10












BGL














6.8














T














Today’s








episode








started








~1hr








ago












Skin














Pale/cool/diaphoretic



















































































Physical








Exam








Findings






















Head and




Neck














JVD








present.








Trachea








midline.








Patient








complaining








of








pain








in








his








lower








jaw








(originates in chest and radiates up)












Chest














Fine crackles noted bilaterally in the bases on auscultation. Accessory








muscle use noted, 3


-


4 word dyspnea is noted when he tries to speak.








Patient complaining of 8/10




retrosternal chest pain with radiation to his








Left








arm and








jaw. Pain described








as heaviness.








Onset of pain








was at




rest












today,








however








throughout








the








week








he








has








been








having








pain








while








doing








chores. No trauma noted.












Abdomen














Soft








on








palpation.








No








pulsating masses








noted.








No








nausea








or








vomiting.












Back














“achiness”








described








in








upper








back








between








his








shoulders












Pelvis














Unremarkable












Extremities














Bilateral








pitting








edema








noted








in








his








ankles.








Strong








radial








and








pedal








pulses








noted






















12


-


Lead




















































*Analysis= STEMI, with ST elevation noted in the inferior leads. Reciprocal changes








noted. Possible posterior involvement, where a 15


-


lead will be required for full








analysis.



































































Using the textbook, lectures, and your research, answer the following questio


ns








about the relevant pathophysiology and the patient described above. The marking








rubric is shown in Canvas.
























1.








Explain








the pathophysiology of








atherosclerosis development and how it could








cause a












myocardial




infarction.






















2.








Compare and contrast a


ngina and myocardial Infarction. Discuss the pathophysiology








of












each,








in


cluding the similarities and differences in typical patient presentation.








Does








your patient appear to fit in one of these categories? Explain your answer.
























3.








Define








right








sided








heart








failure








and








left








sided








heart








failure


.








What are








the




“forwards”








and “backwards” effects of each?




. Based on




your








pati


ent information, do you expect








this patient to be in right


-


sided or left


-


sided failure?








Why?






















4.








As the attending paramedic, what are your top 3 differential diagnoses for




your












patient? What are your priorities when treating and transporting this patient?








































Using the textbook, lectures, and your research, answer the following questio


ns








about the relevant pathophysiology and the patient described above. The marking








rubric is shown in Canvas.
























1.








Explain








the pathophysiology of








atherosclerosis development and how it could








cause a












myocardial




infarction.






















2.








Compare and contrast a


ngina and myocardial Infarction. Discuss the pathophysiology








of












each,








in


cluding the similarities and differences in typical patient presentation.








Does








your patient appear to fit in one of these categories? Explain your answer.
























3.








Define








right








sided








heart








failure








and








left








sided








heart








failure


.








What are








the




“forwards”








and “backwards” effects of each?




. Based on




your








pati


ent information, do you expect








this patient to be in right


-


sided or left


-


sided failure?








Why?






















4.








As the attending paramedic, what are your top 3 differential diagnoses for




your












patient? What are your priorities when treating and transporting this patient?


















































Answered 2 days AfterMar 04, 2023

Answer To: PMED1010CaseStudyIt’s...

Dr. Sulabh answered on Mar 06 2023
47 Votes
5
                    Case Study
1.     In atherosclerosis there is a blockage of the flow of blood in the arteries. This further leads to the development of pain in the chest with the occurrence of myocardial infarcti
on. Further, the patient is suffering from breathing problems and breathlessness. This patient has edema with deposition of fluid and swelling in the ankles. The ECG wave electrocardiogram analysis depicts an elevation in the ST wave in the graph with swelling in the limb regions. The ST-wave elevation is due to the occlusion and the blockage of the coronary vessels leading to alterations in the waves obtained in the electrocardiogram. According to the wave graph given in the question, there is a depression of the ST wave in graph I and graph II in the VL and VR region segment wave. Further there is an inversion and depression of the V1, V2, and V3 wave in the I, II and III ECG graphs obtained while monitoring the patient. Further is an inversion and shortening of the waves V5, V6, and V7 as observed in the ECG graph. The V6 wave is very short in comparison to the V4 and V5 waves and there is an observation of wave inversion also. There is observation of a crackling sound also leads to the observation that there is an infection in the lungs of the patient (Themes, 2020). Due to the observation of an ST wave elevation, this patient is showing the occurrence and prevalence of myocardial infarction. 
2.     There are differences between the occurrence of angina and myocardial infarction. In angina, there is a prevalence of stress and exertion in the body. Further, the condition of angina can be relieved by providing a dose of nitroglycerin. Further, in the condition of angina, there is an observation of a T-wave inversion and depression of the ST waves with cardiac arrhythmias. In comparison in the condition of myocardial infarction, there is a prolonged condition of chest pain with the prevalence of problems during breathing, breathlessness, and diaphoresis. In myocardial infarction, there may not be an elevation in the ST wave but there is an elevation in the levels of troponin. In addition in the condition of angina, there is spread and movement of the pain originating from the chest to the left arm region. In myocardial infarction, there is movement and spread of the pain to the distant regions of the arms leading to discomfort. Further, the pain is felt in the jaw region, shoulders, back, and abdomen region of the patient. As this patient has pain in the jaw originating from...
SOLUTION.PDF

Answer To This Question Is Available To Download

Related Questions & Answers

More Questions »

Submit New Assignment

Copy and Paste Your Assignment Here