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    Nursing Informatics-1

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    Jovan Teopiz
    The patient presented with right arm weakness and numbness and a history of mitral valve replacement and atrial fibrillation. Examination found atrial fibrillation with controlled heart rate and EKG signs of ischemia. The doctor recommended stopping a medication, starting a new one, and referring the patient to cardiology for testing and possible cardioversion given concerns over embolic risk and signs of ischemia.

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    Nursing Informatics-1

    Uploaded by

    Jovan Teopiz
    6 views1 page
    The patient presented with right arm weakness and numbness and a history of mitral valve replacement and atrial fibrillation. Examination found atrial fibrillation with controlled heart rate and EKG signs of ischemia. The doctor recommended stopping a medication, starting a new one, and referring the patient to cardiology for testing and possible cardioversion given concerns over embolic risk and signs of ischemia.

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    nursing informatics-1

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    The patient presented with right arm weakness and numbness and a history of mitral valve replacement and atrial fibrillation. Examination found atrial fibrillation with controlled heart rate and EKG signs of ischemia. The doctor recommended stopping a medication, starting a new one, and referring the patient to cardiology for testing and possible cardioversion given concerns over embolic risk and signs of ischemia.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    6 views1 page

    Nursing Informatics-1

    Uploaded by

    Jovan Teopiz
    The patient presented with right arm weakness and numbness and a history of mitral valve replacement and atrial fibrillation. Examination found atrial fibrillation with controlled heart rate and EKG signs of ischemia. The doctor recommended stopping a medication, starting a new one, and referring the patient to cardiology for testing and possible cardioversion given concerns over embolic risk and signs of ischemia.

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    © All Rights Reserved
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    of 1

    Name: Teopiz, Mark Jovan Jr.

    Date: December 7, 2021


    Subject: NURSING INFORMATICS
    Activity #: 1

    CARDIOLOGY CONSULTATION

    Diagnosis:

    A diagnosis is one mitral valve disease, status post mitral valve replacement with
    a St. Jude’s prosthetic valve and coronary artery bypass times one hospital. A
    history of two previous repair vascular accident secondary to blood disorder from
    inadequate
    Anticoagulation, 3 atrial fibrillations, on coumadin with iron or 3.1 or what
    possible tia.

    Subjective:

    On, yesterday, with right arm weakness and numbness this patient returns to
    Cardiology clinic in this not feel well today. He thinks that he had a (transient
    Ischemic attack) tia yesterday in which he had sudden right on weakness.

    Objective:

    His EKG shows atrial fibrillation with a controlled ventricular response, and t-
    Wave inversions consistent with ischemia.

    Physical examination today bp is 149 / 69 left 167 / 72 right pulse 89 in the


    regular

    Way to 180 pounds, chest is clear. Cardio examination reveals good prosthetic
    clips

    Of the mitral valve prosthesis. There is a low-pitched rumble in diastole which is


    Appropriate. There is no mitral regurgitation clinically. There is no edema.

    Comments/recommendations:

    Comments and recommendations as patient know with mitral valve replacement and
    Atrial fibrillation INR should be 3.5 to 4.5 especially in the setting of previous
    Embolic episodes. EKG suggesting ischemia is a concern and patient should probably
    Have a thallium imaging study.

    Plan:

    My plan will be to stop sotalol since patient has been chronically in atrial
    Fibrillation, we placed him on the top-level xl 25mg today for hypertensive
    control
    Which may be increased. I am going to give the patient a copy of this ekg and
    Suggested that very strongly that he see his primary his local private
    cardiologist
    To continue it, for consideration of tallying imaging, possible transesophageal
    echo
    To assess mitral valve, possible dc cardioversion. I will plan a cardiology follow
    Up in our clinic in my next available slot probably six to nine months to review
    The patient. I am not going to order a repeat echo.

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