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    Case Study Nursing 202 Cardiac Case Study

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    Carla Miller
    The home health care nurse is visiting Mr. Simpson, a 62-year-old male with a history of angina pectoris. During the visit, the nurse assesses Mr. Simpson's vital signs, activity level, and dietary intake. Mr. Simpson is taking several medications including nitroglycerin, metoprolol, cardiazem, and clopidogrel. The nurse reviews the purpose and dosages of each medication and determines the dosages are appropriate for Mr. Simpson's condition with the exception of cardiazem, where the frequency of doses is not specified. The nurse also explains to Mr. Simpson the difference between angina and a heart attack and the proper procedure for taking nitroglycer

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    Case Study Nursing 202 Cardiac Case Study

    Uploaded by

    Carla Miller
    755 views2 pages
    The home health care nurse is visiting Mr. Simpson, a 62-year-old male with a history of angina pectoris. During the visit, the nurse assesses Mr. Simpson's vital signs, activity level, and dietary intake. Mr. Simpson is taking several medications including nitroglycerin, metoprolol, cardiazem, and clopidogrel. The nurse reviews the purpose and dosages of each medication and determines the dosages are appropriate for Mr. Simpson's condition with the exception of cardiazem, where the frequency of doses is not specified. The nurse also explains to Mr. Simpson the difference between angina and a heart attack and the proper procedure for taking nitroglycer

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    CASE STUDY NURSING 202 CARDIAC CASE STUDY

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    The home health care nurse is visiting Mr. Simpson, a 62-year-old male with a history of angina pectoris. During the visit, the nurse assesses Mr. Simpson's vital signs, activity level, and dietary intake. Mr. Simpson is taking several medications including nitroglycerin, metoprolol, cardiazem, and clopidogrel. The nurse reviews the purpose and dosages of each medication and determines the dosages are appropriate for Mr. Simpson's condition with the exception of cardiazem, where the frequency of doses is not specified. The nurse also explains to Mr. Simpson the difference between angina and a heart attack and the proper procedure for taking nitroglycer

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    755 views2 pages

    Case Study Nursing 202 Cardiac Case Study

    Uploaded by

    Carla Miller
    The home health care nurse is visiting Mr. Simpson, a 62-year-old male with a history of angina pectoris. During the visit, the nurse assesses Mr. Simpson's vital signs, activity level, and dietary intake. Mr. Simpson is taking several medications including nitroglycerin, metoprolol, cardiazem, and clopidogrel. The nurse reviews the purpose and dosages of each medication and determines the dosages are appropriate for Mr. Simpson's condition with the exception of cardiazem, where the frequency of doses is not specified. The nurse also explains to Mr. Simpson the difference between angina and a heart attack and the proper procedure for taking nitroglycer

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    CASE STUDY NURSING 202 CARDIAC CASE STUDY

    BY CARLA MILLER

    OCTOBER 12, 2010

    The home health care nurse is visiting Mr. Simpson, a 62-year old male with a significant history of
    angina pectoris. During the visit, the nurse assesses Mr. Simpson’s status, including his vital signs,
    activity level and dietary intake. Mr. Simpson’s medications include: Nitroglycerin sublingual as needed
    for chest pain (CP), Metoprolol 25 mg po, Cardiazem 30 mg po, and Clopidogrel 75 mg po (po = by
    mouth)

    1. What are the rationales for each of the ordered medications? Are the doses appropriate

    for this patient? Why or why not?

    A. Nitroglycerin-Sublingual/PRN. The rationale for this medication is to increase the infrequency

    and severity of an angina attach. The dosage was not stated in the situation. It is prn or as needed. I

    cannot say if does are appropriate or not appropriate for this patient. The book said sublingual for adult

    patient is 0.3-0.6 mg. May repeat q 5 minutes for two additional doses for acute attack.

    B. Metoprolol 25 mg po-The rationale for this medication is to decrease blood pressure and to

    decrease the frequency of angina pectoris. The book stated for dose by mouth is 25-100 mg/day as single

    dose initially or two divided doses and may be increased every 7 days as need up to 450 mg/day. The

    dose is correct for this patient.

    C. Cardiazem 30 mg po- The rationale is to decrease the frequency and severity of angina attacks.

    It increases coronary vasodilatation. The book stated the dosage is 30-120 mg po (3-4 times daily). The

    order did not say how many times a day the medicine was to be given for this medicine.

    D. Clopidogrel 75 mg po- The rationale for this medicine is the reduction of atherosclerotic events

    in patients at risk for unstable angina, MI or stroke. The dosage is correct for this patient. It did not say

    how many times a day dosage is given.


    2. How does smoking increase patient’s chances of angina episodes?

    Smoking affects the blood vessels in the by vasoconstriction. Blood flow is restricted to the heart

    and other parts of the body. When less oxygen goes to the heart, angina pectoris will get worse.

    3. Patient asks nurse if angina pectoris is same thing as a heart attach. How does she respond?

    A heart attack is different from angina pectoris, but they both can involve pain. Angina is a

    clinical syndrome characterized by episodes of pain and pressure in anterior chest. The cause of angina is

    not enough coronary blood flow, which results in decreased oxygen supply to the heart. Unlike a heart

    attack, angina subsides with either rest or by taking nitroglycerin or both. A MI (heart attack) gets worse

    and does not stop or get better unless patient get immediate medical help. Angina lasting longer than

    thirty minutes may develop into a MI or heart attack.

    4. Nurse reviews the correct procedure for taking nitroglycerin for chest pain, and includes what

    information?

    Take the medication as directed, even if you start feeling better. If you would happen to miss a

    dose, take it as soon as you remember unless the next dose is scheduled within 2 hours. Do not double

    dose or stop it suddenly. Tablet should be held under tongue until it dissolves. Avoid eating, drinking or

    smoking until tablet is dissolved. Some of the side effects are dizziness, headache, restlessness,

    weakness, blurred vision and hypotension, tachycardia and syncope. Caution patient when he or she is

    changing positions to minimize dizziness or lightheadedness. Do not keep tablets in containers made of

    plastic or cardboard. Do not let tablets be exposed to air, heat or moisture. They will lose potency.

    References

    1. Davis Drug Book for Nurses -2010

    2. Brunner and Suddarth’s Textbook of Medical-Surgical Nursing 2010

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