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Case Study
After completing this week’s readings, please choose either prompt #1 or #2 to answer followed by, everyone will answer prompt #3.
Prompt 1
You are caring for a patient who suffered an acute myocardial infarction 2 days ago. He is now beginning to show early signs of acute heart failure, with fine crackles at his lung bases, tachypnea, shortness of breath, and easy fatigue with minimal exertion.
• What are your three overall treatment goals for this patient?
• What are the challenges associated with trying to develop a treatment that achieves all three of these goals?
Prompt 2
The student you are precepting asks about the difference between mitral regurgitation and mitral stenosis. She does not really understand the difference between the two disorders. How would you explain the following?
• Primary pathophysiologic differences between mitral stenosis and mitral regurgitation.
• Distinguishing clinical manifestations of each of the two disorders and their underlying mechanisms
Prompt 3
Give an example of how you might approach teaching your patients about proper drug disposal at home. What would you cover as each medication class may have a different disposal requirement? What resources would you use to ensure that the information you provide is correct? What is available in your local community to assist with disposal issues?
The three overall treatment goals for this patient suffered an myocardial infarction 2 days and is early signs of acute heart failure would be
Relieve symptoms of heart failure reducing shortness of breath, fatigue, and crackles in the lungs (McMurray et al., 2012).
2 Improve cardiac function and output through medications and like diuretics, vasodators, and potentially inotropes if the patient does not (McMurray et al.,
Prevent further damage to the reduce mortality risk prevention measures like cholesterol-lowering drugs, beta-blockers, ACE inhibitors, and lifestyle changes (McMurray et al., 2012).
The challenges a treatment that achieves all three goals simultaneously include the diuretic and vasodilator therapies needed to symptoms against potential hypotension from overaggressive treatment that could further impair cardiac function. Close monitoring is needed to titrate medications for optimal relief of maintaining cardiac output and blood pressure (McMurray et al., 2012).
Prompt 2:
The primary pathophysiological difference between mitral stenosis andurgitation is that mitral stenosis involves a narrow stenosis of the mitral valve, impeding blood flow from therium ventric diastole. Mitral regurgitation on the other hand, involves an incompetent oraky mitral valve that allows blood to flow back into the left atrium from the left ventricle systole (Nishimura et al., 2014).
The distinguishing clinical manifestations of disorder stem from these underlying mechanisms. Mitral stenosis presents with symptoms left at including dyspnea,,op potentially pulmonary hypertension or atrial fibrill.urg presents with symptoms of overload like exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea and potentially signs of heart failure (Nishimura et al., 2014).
Prompt 3:
When teaching patients about proper medication disposal, I would the different requirements based on the medication class. For example, I would explain that most medications can be thrown in the household trash but need to be with an undesirable substance like coffee grounds first (FDA, 2022). However, certain medications like controlled substances secure disposal often by flushing or use of a drug take-backFDA, 2022). I would provide take-back in the community and their safe and legal disposal methods. Resources I would use include FDA guidelines (FDA,22) from our local authority on safe flushing practices. The goal is to accidental poisoning, misuse, or drugs entering the water.
Mc,. V., Adamopoulos, S., Anker, S.., Auricchio, A., Böhm, M., Dickstein, K., … &arsma, T. (2012). ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force the Diagnosis and Treatment of Acute and Chronic Heart Failure of the Society of Cardiology.ed in collaboration with the Heart Failure Association (HFA) of the ESC. European heart journal, 33(14), 1787-1847.
Nishimura, R. A., Otto, C. M., Bonow, R. O.,lo, A., Erwin,.., Guyton, R. A., … & Thomas, J. D. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. – homework help writing assignment service. Journal of the American College ofiology, 63(22), 2438-2488.DA. ( February 23). Disposal of unused medicines: What you know. U.S. Food and Drug Administration. https://www.fda.gov/drugs/safe-posal-medicines/disposal-unused-medicwhat-you-should-know
