Past medical history: 58 year old man,

Past medical history: 58 year old man, married with 4 children. He works long hours, rarely gets home before 8pm and was diagnosed with CAD 2 years ago after complaining of chest pain. He suffered an anterior myocardial infarction 8 months ago, and since his heart attack, he has not successfully altered his lifestyle (he remains sedentary, continues poor/high-fat and cholesterol diet, and smokes 1 pack of cigarettes per day). Current admission sequence of events: during a visit to his physician because of fatigue and a 10-pound weight gain, he had labored respirations at 32 breaths per minute and crackles bilaterally in all lung fields. HR 115 with occasional irregular beats, BP 180/100 with an S3 noted, and he had 2+ pitting edema in his lower extremities bilaterally. He was sent to the hospital for workup and treatment. 1. What is relevant data regarding this client’s physical status and why? 2. What further data is necessary to better assess the client’s situation? What is missing that you would like to know and why? 3. What is the probable medical problem/diagnosis based on the current admission information listed above? What led you to this conclusion? 4. This client has a history of CAD and an MI. This can cause for what types of advanced medical complications? 5. What abnormal lab values would you expect to see and why? 6. The patient asks what is the difference between CK, CKMB, and troponin labs (time frame for testing). How would you describe these lab findings to the patient? 7. What medications would you anticipate being ordered for this patient? State the drug class, an example drug from the class and its mechanism of action. How will these medications help this patient? 8. What orders should the nurse expect at this time? What interventions should be done? 9. What interventions can be done to help prevent further complications for this patient? What are the modifiable risk factors and how will you address these?

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