Task:Read the case studies below, chooseonecase study to discuss by answering the associated...

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Task:Read the case studies below, chooseonecase study to discuss by answering the associated questions. You do not need an introduction or conclusion and headings are advised. You must use academic writing and reference your work using APA referencing. Your ISBAR may be presented in table form. Please do not use bullet points, use well-structured paragraphs and ensure you have edited the text.Case Study 2: CardiacMr Jae-Kwang Lee, a 65-year-old male who presented to the Emergency Department stating his chest felt heavy. At the triage desk he was holding his chest, when asked if the heaviness went anywhere he said yes and then proceeded to rub his left arm. When questioned further during the triage process he had associated symptoms of shortness of breath and dizziness. He had not had pain as severe as this before, he said he "has been having pains in his chest for a few months but it stops when I sit down, but it didn't stop this time, I have been waiting for it to stop, it started yesterday". Mr. Lee was taken into the Emergency Department and connected to cardiac monitoring, a 12 lead ECG was taken which showed a Non-ST-elevated Myocardial Infarction (NSTEMI). His first set of observations are as follows:	Temp:36.5	HR:110	BP:108/73	RR:21	SpO2:95%Mr. Lee also had blood tests taken including UEC, FBC, CK-MB, Trop T, Coags. Mr. Lee was also given sublingual GTN for pain 300mcg x2 - 5 minutes apart without effect, he was then given morphine 5mg, in 2.5mg increments with effect.Due to the business of the Department, it was decided to transfer my Lee to the Coronary Care unit to wait for acardiology review. You accept the care of Mr. Lee.	2 hours into your shift,you are assessing Mr. Lee and notethatMr. Lee has become tachycardic, hypotensive and hypoxic his observations are as follows:	Temp:36.5	HR:133	BP:87/53	RR:25	SpO			2		:88%	BGL:4.6mmolAs his oxygen saturation's are at 88%, you start him on oxygen via a simple face mask at 6LO2. Mr. Lee is awake but lethargic. He responds appropriately to questions.Questions1. Identify the elements which signify a deterioration in this patient’s condition. Identify whether these elements of deterioration indicate a rapid response or a clinical review as per the NSW Health Between the Flags? Justify your decision with the data from the case and relevant support.2. Using a table construct your communication with the Doctor regarding this patients deterioration employing the ISBAR tool [this section does not need to be referenced].3. Discuss the pathophysiology of the patient’s signs of deterioration as they relate to a diagnosis of cardiogenic shock.Please, be careful about the ISBAR format. It does not need to be referenced but need to be succinct and in paragraph not in bullet points. Please, make a ISBAR table for this section. Stick to 10 12 references for this assignment.Be specific to the pathophysiology. How it is interrelated and how the symptoms are seen in the given condition. How and when these occur and also mention how ECG changes.Please, comply with the CERS and clinical review criteria and refer to the government sites. NSW Health sites for this.

Soumi · Accepted Answer

Running Head: CASE STUDY 2: CARDIAC		1
CASE STUDY 2: CARDIAC		9
CASE STUDY 2: CARDIAC
Table of Contents
1. Elements Showing Deterioration of Patient’s Condition	3
2. Use of ISBAR Tool to Communicate with Doctor about Patient’s Condition	4
3. Pathophysiology of Signs Leading to Diagnosis of Cardiogenic Shock	6
References	8
1. Elements Showing Deterioration of Patient’s Condition
	Mr. Jae-Kwang Lee, a 65 years old male was admitted to the emergency department. At time of admission he complaint about heaviness in chest, dizziness and shortness of breath. He complained that he had been suffering from the pain since past few months. He had high heart rate and 12-lead ECG shown Non-ST-elevated Myocardial Infarction (NSTEMI). Blood test was conducted and medicine administered to him. After initial review, he was shifted to the coronary care unit for a cardiology review. 
 	After two hours in coronary care unit, when his condition was again assessed, it was seen that there was deterioration in his condition. The elements, which established deterioration is very high heart, rate that is 133. The normal heart rate is between 60 and 100 beats per minutes (Kim, Son & Kang, 2016). As mentioned by Tzou et al. (2017), very high heart rate results in tachycardia.
It has been observed that the blood pressure of patient reduced from 108/73 to 87/53. The normal blood pressure is between 120/80 and 140/90 (Wu et al., 2015). As noted by Flythe et al. (2015) lowering of blood pressure lead person to hypotension. It has been seen that oxygen saturation of the body is 88%. The normal oxygen saturation is between 94 and 100%. (Collins, Rudenski, Gibson, Howard & O’Driscoll, 2015) As suggested by Nakada et al. (2017), low blood pressure results in hypoxia. 
	The body of the patient is showing tachycardia, hypoxia and hypotension. All these three conditions are the symptoms of cardiogenic shock (Obling et al., 2018). Between the flag initiative started the clinical review system that response to a deteriorating patient in their care. This system includes clinical review and rapid response. In clinical review, respond is done within 30 minutes of breach of criteria. In rapid response, immediate action is taken in response to breach of criteria (CEC Health, 2019). High heart rate, low blood pressure and low oxygen saturation rate come under the red zone category of between the flag. The red zone category when breached needs rapid response (CEC Health, 2019).
 Low oxygen content of the body makes Mr. Lee lethargic. As noted by Anil, Sayami, Nepal, Jaiswal and Bhattarai (2016), people who suffered from Non-ST-elevated Myocardial Infarction can slipped into cardiogenic shock. 
	Tachycardia, hypoxia and hypotension needs rapid response as all these conditions come under red zone of the observation chart developed by NSW health (Between the flags, 2014). As noted by Becker et al. (2018), person whose blood pressure is lowering can slip into coma or get cardiogenic shock. As suggested by McEwen (2018), hypoxia can lead to suffocation. All the three condition if not control on time, can result in death of the patient. 
2.

Task: Read the case studies below, choose one case study to discuss by answering the associated questions. You do not need an introduction or conclusion and headings are advised. You must use academic...

Case Study 2: Cardiac

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