NURSING 414 - 413 Atypical Chest Pain: Shelly Diana.

NURSING 414 - 413 Atypical Chest Pain: Shelly Diana. In this simulation, you will be getting an introduction on combining you knowledge, critical thinking and practical skills Background: This 71 years old patient has a history of Type 2 Diabetes, HTN, Smoker (1/2 PPD x 37 years) and GERD. She is 71 year old female who lives alone. Her children and grandchildren help care for her. Assessment: She is awake and oriented, she is a little anxious. A complete assessment has not been done. She is coming into the ER from Triage. The ER physician is seeing her now and writing orders. This scenario takes place in an ED environment. Based on the patient report (students have already listened to report and completed preparatory work prior to coming), she woke complaining of indigestion that has moved to the center of her back. She was triaged and placed in an ED bed which is where the scenario begins: Student Learning Outcomes: 1. Perform focused cardiac and pain assessments 2. Obtain health history data 3. Correlate the sign and symptoms to pathophysiology of MI 4. Initiate interventions for client experiencing acute chest pain 5. Evaluate the effectiveness of the interventions 6. Demonstrate professional communication with member of the multidisciplinary team using SBAR format 7. Discuss feelings and concerns related to caring for patients during lifethreatening situation 2 Ask student, what their objective(s) for this session might be? Please Complete these study guide questions. DM results in an elevation of blood glucose levels, enhancing the glycation of low-density lipoproteins (LDLs) and triggering the initial stages of the inflammatory response. In addition to this increased inflammatory response, increased hyperglycemia, insulin deficiency, metabolic conditions, and other cellular abnormalities cause platelets to be hyperreactive leading to increased activation and aggregation leading to ACS. 1. Why patients with diabetes frequently experience atypical or silent MI? Describe symptoms of MI that a patient with diabetes most likely to experience. They typically present with nonspecific chest pain syndromes. Unexplained new onset or increased dyspnea is the most common symptom. Other symptoms may include nausea, epigastric pain, indigestion, pleuritic pain, and syncope. Diabetic patients may not experience pain because of neuropathy associated with the disease. 2. What is the difference between stable and unstable angina? 3. What changes in glucose level are expected after MI? Why? 4. What does the acronym MONA stands for? 3