A 56-year-old man presented to themedical surgical floorwith complaints of chest
pain and shortness...

Question

A 56-year-old man presented to themedical surgical floorwith complaints of chest 
pain and shortness of breath. he was transferedfrom emergency room to medical surgical floor.The patient reported a sudden experience of 
tightness in his chest while doing yard work 4 hours prior to the ER visit. He 
has subsequently been experiencing episodes of nausea and periods of coughing. 
His past medical history is significant for hypertension, type 2 diabetes 
mellitus, and hypercholesterolemia. His current home medications are metoprolol, 
metformin, and simvastatin; his wife pointed out that he does not take his 
medications regularly. He has no known allergies. He smoked 30 packs of 
cigarettes per year for the past 30 years, and consumes 2 to 3 glasses of wine 
per day in addition to 2 cups of coffee. The patient denies any history of 
recreational drug use. The patient does not exercise regularly. currently he is on 4 liter oxgen via nasal canula; and recieved nitroglycerine for his chest pain. beside this, he is currently talking phenergan to control nausea and trodol to control pain.
	
Document Preview: Daily Hours:						Cumulative hours: 100Date: July 11, 2012 Daily learning ObjectiveRecognize major risk factors for developing gouty arthritis.To become familiar with signs, symptoms and nursing interventions of gouty arthritisTo familiarize myself with pharmacologic and non-pharmacologic treatment options of gouty arthritisTo educate client about lifestyle modification to help prevent acute gout attacks.Learning strategies:			preceptor instruction					Medication given					Clinical symptoms					Literature review obtained from:Gouty arthritis XXXXXXXXXXCurrent treatment and new developments. Retrieved July 11, 2012, from  HYPERLINK "http://www.stueckpharmacy.com/downloads/2008_gout.pdf" http://www.stueckpharmacy.com/downloads/2008_gout.pdfThe information I utilized from the this reference is was to enhance my knowledge of gouty arthritis. Gout is a medical condition that shows a strong correlation with hyperuricemia and is characterized by deposition of monosodium urate crystals in the synovial fluid and tissues (tophi) in and around joints. Hyperuricemia is defined as a serum uric acid level of >7.0 mg/dL in men or >6.0 mg/dL in women. The classical clinical symptoms of acute gouty arthritis result from inflammation of involved joints, usually the first metatarsophalangeal joint (but may involve lower extremities and arms), and include severe pain, erythema, warmth, and swelling. However, atypical gout can also occur, and it may present with less dramatic onset, especially in the elderly. Atypical gout can often be confused with rheumatoid arthritis or osteoarthritis. Even though an acute gout attack can occur at any time, some conditions precipitating an attack are stress, infection, alcohol consumption, and rapid changes in serum uric acid levels.Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first line of drug therapy for acute gouty arthritis; especially for patients without complications or contraindications. Although ketoprofen and...

Robert · Accepted Answer

Daily Hours:        Cumulative hours: 100 
Date: July 17, 2012  
Daily learning Objective 
1. Recognition of chief factors responsible for myocardial infarction. 
2. Being familiar with signs, symptoms and nursing interferences of myocardial 
infarction. 
3. To understand pharmacologic and non-pharmacologic treatment alternatives of 
myocardial infarction. 
4. To inform client regarding lifestyle adaptation to prevent myocardial infarction.
Learning approaches:     Preceptor training 
         Prescription specified 
         Medical symptoms 
Literature review gained from: 
Medline Plus [Internet]. Bethesda (MD): National Library of Medicine (US); Heart attack; 
Available from: http://www.nlm.nih.gov/medlineplus/heartattack.html 
The information utilized via me from this reference was to increase my 
knowledge of myocardial infarction. Myocardial infarction may occur owing to blockage 
of blood flow to a part of heart for such time period in which cardiac muscles may get   
http://www.nlm.nih.gov/medlineplus/heartattack.html
 
damaged or die. In simple language it is also known as; heart attack. It might be 
characterized by pressure, or pain in the core of chest which may last within few 
minutes. Such pain may extend beyond the chest and can reach up to other organs too 
such as; shoulder, arm, back etc. Increasing episodes of pain in chest, breathing 
shortness, excessive sweating, nausea and vomiting are its other main symptoms which 
may be accompanied by prolonged abdominal pain and fainting. Certain factors may 
contribute to the undesirable accumulation of fatty deposits (atherosclerosis) which can 
further narrow arteries all over the body, including arteries to heart such factors may 
include  Age(more than 45 years for men and 55 years for women), consumption of  
Tobacco, Diabetes. High blood pressure, High blood cholesterol, Family history, Lack of 
physical activity, Obesity, Stress etc. 
With each passing minute after a heart attack, more heart tissue loses oxygen 
and deteriorates or dies.

A 56-year-old man presented to themedical surgical floorwith complaints of chest pain and shortness of breath. he was transferedfrom emergency room to medical surgical floor.The patient reported a...

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