NURS 696 Discussion Post

Instructions:  Pick one case scenario to discuss in your initial post (initial post must be 300-500 words and at least 1 reference-peer review journal within the last 5 year). For your peer responses, please reply to the case scenario you did not choose for the initial post. You are expected to respond to two different peers ( I will need 2 peer responses with 100 words each and 1 reference).

Case Scenario 1: A 67-year-old female with PMH of CVA, DM, HTN, Obstructive Sleep Apnea (OSA), and Venous Stasis who presents with a complaint of chest pain x 1 day. She described the pain as constant chest tightness and poking to the midsternum, radiating to the back, associated with SOB, cough, and nausea. The chest pain is worse when breathing in and out. Her initial vital signs are HR 89, BP 170/100, RR 18, and O2 sats 98% on room air.

Answer the following questions:

Subjective:

What pertinent questions will you ask to describe the patient’s chief complaints?

What are the risk factors of this patient?

Objective:

How do you differentiate the clinical signs and symptoms of Stable Angina, Unstable Angina, NSTEMI, and STEMI? Stable AnginaUnstable AnginaNSTEMISTEMI

1. What are the gold diagnostics tests to rule in or out?

Assessment and Plan:

• Give at least 3 differential diagnoses and provide a rationale.
• Complete the table below to differentiate the classifications of hypertension according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) Clinical Guidelines.  ClassificationSystolic BPDiastolic BPNormalPrehypertensionHypertensionStage 1Stage 2

1. A HEART Score assesses the patient’s 6-week risk of a major adverse cardiac event (MACE). What would be your disposition if the patient’s HEART Score is 7?

Plan:

• What is the gold standard treatment for the patient’s final diagnosis?