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select medical condition and briefly describe (pathophysiology)

select medical condition and briefly describe (pathophysiology)

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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select medical condition and briefly describe (pathophysiology)

As a nurse working the night shift on an inpatient medical-surgical unit, you receive hand off communication from the ED nurse on a patient being admitted to your floor: Anita Ruiz is a 77-year-old Hispanic woman being admitted with a diagnosis of Chest Pain. She came to the ER early this morning c/o crushing chest pain that started in epigastric area radiating to left shoulder and arm. Her medical history includes HTN, CAD, Hyperlipidemia, Diabetes Type 2, and CKD stage 2; surgical history includes CABG with three grafts x 2 months ago, Cholecystectomy in 2015, and TAH in 2013. The following workup was completed: CXR, ECG, Echocardiogram, and lab work of cardiac enzymes series, CBC, Chem 7, and a Lipid panel. She is scheduled for a stress test in AM. She was downgraded from Telemetry to M/S when her third enzymes and the latest ECG came back normal. She is on 02 2L/min via NC. The meds she received in the ER include, Morphine 2 mg IVP x 2, Metoprolol 5 mg IVP followed by 50 mg po x 1, and Aspirin 81 mg po x 1. The latest vitals are, BP 134/76, HR 72, RR 17, T 37.2 C, 02 Sat 98% and is pain free. A 21g IV with a saline lock was inserted to the left forearm. She is A+Ox3 and will be accompanied by her daughter. Physician orders include: NPO p MN for Stress Test, IV fluids Dextrose 5% + 0.45%NS 1L @ 60ml/hr p MN, POC Glucose AC + HS with Hypoglycemia protocol, AM Lab work: CBC, Chem 7, PT/PTT, Cardiac enzymes x 1 with Troponin, Repeat ECG in AM, BRP as tolerated, Nutrition consult, Social Work consult, Cardiology consult.
Transcribed Image Text:As a nurse working the night shift on an inpatient medical-surgical unit, you receive hand off communication from the ED nurse on a patient being admitted to your floor: Anita Ruiz is a 77-year-old Hispanic woman being admitted with a diagnosis of Chest Pain. She came to the ER early this morning c/o crushing chest pain that started in epigastric area radiating to left shoulder and arm. Her medical history includes HTN, CAD, Hyperlipidemia, Diabetes Type 2, and CKD stage 2; surgical history includes CABG with three grafts x 2 months ago, Cholecystectomy in 2015, and TAH in 2013. The following workup was completed: CXR, ECG, Echocardiogram, and lab work of cardiac enzymes series, CBC, Chem 7, and a Lipid panel. She is scheduled for a stress test in AM. She was downgraded from Telemetry to M/S when her third enzymes and the latest ECG came back normal. She is on 02 2L/min via NC. The meds she received in the ER include, Morphine 2 mg IVP x 2, Metoprolol 5 mg IVP followed by 50 mg po x 1, and Aspirin 81 mg po x 1. The latest vitals are, BP 134/76, HR 72, RR 17, T 37.2 C, 02 Sat 98% and is pain free. A 21g IV with a saline lock was inserted to the left forearm. She is A+Ox3 and will be accompanied by her daughter. Physician orders include: NPO p MN for Stress Test, IV fluids Dextrose 5% + 0.45%NS 1L @ 60ml/hr p MN, POC Glucose AC + HS with Hypoglycemia protocol, AM Lab work: CBC, Chem 7, PT/PTT, Cardiac enzymes x 1 with Troponin, Repeat ECG in AM, BRP as tolerated, Nutrition consult, Social Work consult, Cardiology consult.
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