Clinical Scenario Assignment
Directions For this assessment task, you are required to write a 2000-word report answering the questions from the scenario.
Question 1 (5 marks) Your buddy nurse asks for an ECG even though Betsy has no chest pain. Explain the rationale for the ECG request.
Question 2 (20 marks) Betsy has stable angina that is responsive to GTN. 2a. Describe the pathophysiology of angina, with reference to causes, progression and outcomes. Include stable angina, unstable angina, nonSTEMI and STEMI in your answer (18 marks) 2b. List two risk factors specific to Betsy (not including age or gender) that increase her risk of Acute Coronary Syndrome (2 marks)
Question 3 (10 marks) Appendix 1 is an ECG that was taken while Betsy was experiencing nausea and shortness of breath. Systematically analyse the ECG, commenting on the: - Rhythm - Rate - Presence and regularity of p waves - ST segment What is your interpretation of this ECG?
Question 4 (10 marks) Acute Coronary Syndrome is suspected when specific clinical criteria are met. Discuss three of the central findings that potentially lead to a diagnosis of Acute Coronary Syndrome.
Question 5 (24 marks) Use the table below (or something similar) to discuss the following drugs: GTN, diltiazem and pravastatin. Do not list gastrointestinal upsets (such as nausea and vomiting) as complications/side effects or nursing considerations. Only include information that can be directly applied to Betsy. Generic name GTN Diltiazem Pravastatin Drug group (1 mark) Mechanism of action (3 marks) Complications/side effects (2 major) (1 mark each) Nursing considerations (2 major) (1 mark each) Page 4 of 5
Question 6 (6 marks) Betsy has been commenced on ticagrelor in addition to her aspirin. Discuss the mechanism of action and use of aspirin and ticagrelor in cardiac patients. Include in your answer how these drugs combined will improve the outcome for Betsy.
Question 7 (5 marks) The use of morphine in Acute Coronary Syndrome (ACS) is currently undergoing review. Discuss how morphine is used in ACS, including the benefits and controversies. Make sure to include current research in your answer. Question 8 (10 marks) Betsy has an increased risk of depression due to her coronary heart disease (a chronic illness). Use current research to link the increased risk of depression with chronic illness.
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