Nursing Question

Learning Goal: I’m working on a nursing question and need an explanation and answer to help me learn.

Please read the following and create a 150 word peer response.

 

The client must also provide subjective data on how she feels pain in her chest while walking up steps. The center of the sternum feels achy or burning. She is an obese female with a history of hypertension. An immediate ECG is an appropriate diagnostic test for this patient, which shows typical characteristics when the patient is at rest or pain-free. It is highly indicative of ischemia when no pain is associated with ST depression. Ischemia indicates a depression of the ST segment or an inversion of the T wave. Heart block and dysrhythmias may also occur. There is evidence of a previous MI based on significant Q waves. 24-hour ECG monitoring and stress electrocardiography are crucial tests because they can provide more diagnostic information. This test identifies diagnostic information such as the duration and level of activity achieved before the onset of angina (Schiffrin et al., 2020).

A markedly positive test indicates severe CAD. A cardiac enzyme test is essential to check for any enzyme elevations. Chest x-rays detect infiltration, which may indicate cardiac decompensation or pulmonary complications in patients. The purpose of this is to reveal more information about the patient. Radiologists use X-rays and fluoroscopy machines to observe the contrast material travel down the esophageal and into the stomach after the patient swallow’s barium or Gastrografin. Furthermore, this test can determine if the esophagus muscles work rhythmically enough to push the contrast material into the stomach and will look for irregularities or inflammation within the esophagus and esophageal walls. The potassium level, serum lipids, lipoprotein electrophoresis, and enzyme cholesterol levels were all assessed. The cause of chest pain is abnormal valvular action, as an echocardiogram reveals. In nuclear imaging studies, areas of decreased thallium uptake in the body detect ischemia (Rhoads & Dlugasch, 2021).

The MUGA test evaluates specific and general ventricle performance, regional wall motion, and ejection fraction. If a patient has angina or incapacitating chest pain and has known ischemic disease, cardiac catheterization with angiography is the definitive test for CAD. Patients with resting angina experience chest pain, ST elevation, depression, a severe rise in LVEDP, a decrease in SBP, or a high-grade narrowing of the coronary arteries. It would be a diagnostic test that I would order to include an endoscopy. I would also request a manometry and pH test. A pressure monitors and acid measurements from within the esophagus may help diagnose atypical symptoms when conventional therapy fails to confirm the diagnosis (Schiffrin et al., 2020).

Angina is an appropriate nursing diagnosis for the following patient. Angina pectoris by paroxysmal episodes of chest pain or pressure, as a result of physical exertion or emotional stress, poor coronary blood flow results from inputs to a decrease in oxygen supply to the heart. Esophageal pain by stomach acid refluxing into the esophagus. Pain behind the sternum or breastbone is a sharp pain or burning sensation. Mitral valve prolapse syndrome would be my final nursing diagnosis and the one I would address in the care plan. An insufficiently closed mitral valve results in mitral valve prolapse. In mild cases of mitral valve prolapse, there may be no symptoms, such as chest pain, palpitations, or dizziness. irritation (Rhoads & Dlugasch, 2021).

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