Alan Case Study - ECG - Glycerine Trinitrate (GTN) - Nursing Assignment Help

Assignment Task:

Case Study:

A 52-year-old man named Alan presents to a metropolitan emergency department with central. crushing chest pain radiating to his jaw and left arm. His wife noticed that he was looking pale and felt clammy. The pain came on over 5- 10 minutes after eating his dinner. Alan says the pain is 9/10 in severity and is associated with nausea and some shortness of breath. His medical history includes hypertension and types 2 diabetes mellitus. Alan has smoked 20 cigarettes daily for the past 27 years. His regular medications include Aspirin, Ramipril and Metformin. His brother had a heart attack at the age of 60 years.
 
On arrival at the emergency department, you observe that Alan is overweight and looks visibly uncomfortable. His observations are as follows:

• Temperature: 366 degrees Celsius
• Heart rate: 70 born, regular
• Blood pressure: 159/88mmHg
• Respiratory rate: 28rpm
• Oxygen saturation: 95% on RA
• GCS: 15 PEARL

You perform an ECG (see below).

Question 1:

Assess the ECG and, using a systematic approach. describe and interpret the ECG. Discuss the aetiology and pathogenesis of coronary atherosclerosis and myocardial ischaemia in your answer.

Question 2:

Alan was administered Aspirin, Glycerine Trinitrate (GTN) and morphine in the emergency department. Discuss the combined physiologic effects of these medications on the patient with chest pain and the anticipated therapeutic benefits.

Question 3:

Critically appraise and evaluate the care of patients with chest pain in your emergency department with reference to current Australian guidelines.

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