Reference no: EM133608090
Case Study: George Jones is a 59-year-old male who has arrived at the emergency department with chest pain. He had experienced this chest pain for 30 minutes, and it was not relieved after taking four nitroglycerin tablets 5 minutes apart. He reports the pain feels "like an elephant is sitting on my chest." He is diaphoretic and appears anxious. His vital signs are as follows: temperature, 99°F; blood pressure, 100/68 mm Hg; heart rate, 110 beats/min; and respiratory rate, 24 breaths per minute. Mr. Jones is overweight and has type 2 diabetes mellitus, hyperlipidemia, and hypertension. He quit smoking last year after a 40-year history of smoking one pack of cigarettes a day. His troponin level is elevated, and the ECG shows ST segment elevation. The nurse administers oxygen and draws blood for arterial blood gas analysis. Mr. Jones is told he will have a cardiac catheterization to locate the blockage, determine its severity, and evaluate left ventricular function.
The cardiac catheterization revealed a 90% blockage in one coronary artery. The cardiologist performed a balloon angioplasty and placed a stent in Mr. Jones's blocked coronary artery to reestablish perfusion. Mr. Jones was admitted to the cardiovascular surgery unit and was ambulating within 24 h after stent placement. The nurse's goals for Mr. Jones's plan of care are to maintain effective cardiac output, control pain, relieve anxiety, and balance physical activity with energy-conserving activities. The nurse also played a significant role in Mr. Jones's therapy by teaching him and his family about lifestyle changes, including diet and exercise, and the purpose of his prescribed medications, including adverse effects and the importance of following the medication regimen. Mr. Jones is referred for cardiac rehabilitation after discharge.
Questions: answer theses' questions :
1. What risk factors does Mr. Jones have for impaired perfusion?
2. Does this case exemplify an impairment of local perfusion, central perfusion, or both?