ACS Acute MI Case Study -Macomb Community College
History of Present Problem:
JoAnn Smith is a 68-year-old woman who presents to the emergency department (ED) after having three days of progressive
weakness. She denies chest pain, but admits to shortness of breath (SOB) that increases with act...
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
1. Fluid and Electrolyte Balance
2. Clinical Judgment
3. Communication
4. Collaboration
, Christina Hammack and Cash Thomas
UNFOLDING Reasoning Case Study-STUDENT
Acute Coronary Syndrome/Acute MI
History of Present Problem:
JoAnn Smith is a 68-year-old woman who presents to the emergency department (ED) after having three days of progressive
weakness. She denies chest pain, but admits to shortness of breath (SOB) that increases with activity. She also has
epigastric pain with nausea that has been intermittent for 20-30 minutes over the last three days. She reports that her
epigastric pain has gotten worse and is now radiating into her neck. Her husband called 9-1-1 and she was transported to
the hospital by emergency medical services (EMS).
Personal/Social History:
JoAnn is a recently retired math teacher who continues to substitute teach part-time. She is physically active and lives
independently with her spouse in her own home. She has smoked 1 pack per day the past 40 years. JoAnn appears anxious
and immediately asks repeatedly for her husband upon arrival.
What data from the histories are RELEVANT and have clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
d3 days of progressive weakness dWomen can present with alternative symptoms than men when
Denies chest pain, reports epigastric pain with experiencing a myocardial infarction so it is important to consider them in
nausea radiating to her neck and shortness of this context as opposed to ruling out MI since it is not the “typical”
breath presentation
RELEVANT Data from Social History: Clinical Significance:
Lives with a spouse Patient has a support person who lives with her and can help provider care
Heavy smoker, 40 year history which is important to keep them involved in the care as appropriate (and
Anxious appearing legally - patient gives consent to share information). Significant smoking
history means patient has had prolonged vasoconstriction and diminished
lung capacity; smoking also leads to heart disease. Anxiety can alter vital
signs like increased heart rate and blood pressure.
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds?
(Which medications treat which conditions? Draw lines to connect)
PMH: Home Meds: Pharm. Classification: Expected Outcome:
● Diabetes mellitus type II 1. Iron Sulfate 325 1. Iron supplement 1. Replace iron
● Hypertension mg PO daily 2. ACE inhibitor 2. Reduce BP
● Hyperlipidemia 2. Lisinopril 5 mg PO daily 3. Antihyperlipidemic 3. Reduce cholesterol
● Cerebral vascular 3. Simvastatin 20 mg PO daily (-statin) 4. Reduce platelets/prevent
accident (CVA) with no 4. Aspirin 81 mg PO daily 4. Salicylate clotting
residual deficits 5. Clopidogrel 75 mg PO daily 5. Platelet aggregation 5. Reduce platelets/prevent
● Gastro-esophageal reflux 6. Omeprazole 20 mg PO daily inhibitor clotting
disease (GERD) 7. Metformin 500 mg PO bid 6. Proton pump inhibitor 6. Reduces stomach acidity
● Anemia-Iron deficiency 7. Biguanide antidiabetic 7. Reduces blood glucose
levels
One disease process often influences the development of other illnesses. Based on your knowledge of
pathophysiology (if applicable), which disease likely developed FIRST that created a “domino effect” in her life?
Voordelen van het kopen van samenvattingen bij Stuvia op een rij:
Verzekerd van kwaliteit door reviews
Stuvia-klanten hebben meer dan 700.000 samenvattingen beoordeeld. Zo weet je zeker dat je de beste documenten koopt!
Snel en makkelijk kopen
Je betaalt supersnel en eenmalig met iDeal, creditcard of Stuvia-tegoed voor de samenvatting. Zonder lidmaatschap.
Focus op de essentie
Samenvattingen worden geschreven voor en door anderen. Daarom zijn de samenvattingen altijd betrouwbaar en actueel. Zo kom je snel tot de kern!
Veelgestelde vragen
Wat krijg ik als ik dit document koop?
Je krijgt een PDF, die direct beschikbaar is na je aankoop. Het gekochte document is altijd, overal en oneindig toegankelijk via je profiel.
Tevredenheidsgarantie: hoe werkt dat?
Onze tevredenheidsgarantie zorgt ervoor dat je altijd een studiedocument vindt dat goed bij je past. Je vult een formulier in en onze klantenservice regelt de rest.
Van wie koop ik deze samenvatting?
Stuvia is een marktplaats, je koop dit document dus niet van ons, maar van verkoper HIGHSCORE. Stuvia faciliteert de betaling aan de verkoper.
Zit ik meteen vast aan een abonnement?
Nee, je koopt alleen deze samenvatting voor €11,52. Je zit daarna nergens aan vast.
