C.L. is a 76-year-old man who presented
C.L. is a 76-year-old man who presented to the emergency department after a fall at home. C.L. is complaining of feeling dizzy, he is diaphoretic and pale. Pulse is weak and regular. His wife said he was not feeling well at home and was unable to go on their typical morning walk due to complaints of fatigue. Vitals are taken and his bp is 89/42, HR is 38 bpm, RR is 24 and he is saturating 92% on 4L NC. His blood glucose is 145. He denies chest pain, but states he is feeling heaviness to his chest. C.L. has a history of Myocardial infarction three years ago, he underwent cardiac catheterization and received a stent to the left anterior descending artery. He also has a history of HTN, hyperlipidemia, diabetes and was a 1PPD smoker for 35 years, he quit three years ago after his MI His current medications include metoprolol, lisinopril, metformin and simvastatin. An ECG is done and shows third degree heart block. What are some clinical associations of third-degree heart block? Explain the characteristics you would expect to see on an ECG with third degree heart block. What are the actions, uses and side effects of C.L.’s current home medications? What other diagnostics would you expect to be performed during this admission? CASE STUDY PROGRESSES C.L. is admitted to the step-down unit. When asked about his medications, C.L. states that he forgot to take his beta blocker yesterday, so he took double the dose today to make up for the dose he missed. What is a priory nursing diagnosis for C.L.? Please state a goal in SMART format for C.L. and two interventions to help meet that goal (One independent and one dependent). What treatment do you expect for C.L. to manage his third-degree heart block? Explain the forms of pacemaker. What education would you want to provide C.L and his wife about his disease process and current condition
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