Reference no: EM133612728

A 40-year-old man presents in the emergency department complaining of substernal chest pain that is also felt in his left shoulder. He is short of breath and nauseated. His blood pressure is 148/90 mmHg and his heart rate is 100 bpm. His ECG shows an ST-segment elevation with T-wave inversion. He is given aspirin, morphine, and oxygen. Blood tests reveal elevated CK- MB and troponin I. What is the probable cause of the man's symptoms? Explain the origin of the left arm pain, nausea, and increased heart rate. What is the significance of the ST-segment elevation and increase in CK-MB and troponin I? Relate the actions of aspirin, morphine, and oxygen to the treatment of this man's condition. A nurse is caring for an 85-year-old woman admitted to the hospital with a diagnosis of mitral stenosis. The patient has been experiencing dizziness and lightheadedness and fell before admission. During the physical examination, the nurse notes a diastolic murmur heard best at the left sternal border and crackles in the lungs. BP 130/80, P. 88, R. 16. Considering the diagnosis of mitral stenosis explain why the patient has both a diastolic murmur and crackles in the lungs. The patient is most concerned about her fall and the sensation of dizziness that has been progressing. Why would these symptoms be especially worrisome in a patient with mitral stenosis? Whenever a patient has an abnormal valve, there is an increased incidence of bacterial endocarditis. What are the important preventive measures that should be included in this patient's education plan? A 78-year-old man is admitted to the hospital with the chief complaint of shortness of breath. He states the shortness of breath has been increasing over the past 2 months and is aggravated by exertion. He has found that he often awakens at night with a sensation of smothering that is partially relieved when he gets up and opens the window. He has had not ankle swelling or edema noted. Past medical history is only positive for myocardial infarction 8 years ago. He currently does not have complaints of chest pain. BP is 140/98. When the nurse listens to his heart, she hears a normal S1 and S2 with a rate of 88. When listening to the lungs, the nurse notes bibasilar crackles. There is no peripheral edema. The admission diagnosis for the patient was left-sided heart failure. Describe the pathophysiology of left-sided heart failure. Which of the clinical manifestations given in the case would be found in a patient with left-sided heart failure? How does left-sided heart failure impact preload, afterload, and contractility? Describe other clinical manifestations the nurse would monitor for in this patient. Which clinical manifestations would be seen in only left-sided failure? Which symptoms would occur if right-sided failure was present also? Describe what drugs might be administered by the nurse and why?