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This essay should be written in APA format, to include a cover page and reference page. The essay will need to be between 3- 5 pages long not including the cover page and reference pages. It is required to utilize a minimum of 4 evidence-based sources (NO WEBSITES – MUST USE ARTICLES no more than 7 years old) to support responses.No need for an intro paragraph or a conclusion paragraph. Just go straight into answering each questionAnswer the following questions and use these objectives as the first level headings for each question:-ST-elevation myocardial infarction
-Peripheral vascular disease
-Post op respiratory complicationsQuestion 1: A 55-year-old woman is brought to the emergency department via ambulance complaining of severe, acute chest pain. The patient states, “It came on all of a sudden like someone is sitting on my chest crushing me.” An ECG shows ST-segment elevation, and the presumptive diagnosis is acute ST-elevation myocardial infarction (STEMI). While taking the history on the patient, what symptoms should the nurse prioritize? What are the emergency department goals of management for a patient with a STEMI? What are the current guidelines and nursing interventions to include in the plan of care?Question 2: Mr. Cook is a 76-year-old African American man admitted to the ED with pain in both legs. His history includes a left femoral popliteal bypass 5 years ago. Smoking history of 45 pack years. Diabetic for 30 years, insulin controlled. He has a diminished right femoral pulse, a popliteal pulse with Doppler only; posterior tibial and pedal pulses are absent. Describe the pathophysiology of Peripheral Vascular Disease? What are the top 3 nursing priorities for this patient? What teaching would you need to include in the plan of care for this patient?Question 3: Mr. April, 24 years of age, is a male patient who was admitted to the surgical unit after a successful repair of an inguinal hernia. Wt. 342lbs, height 5’10. His vital signs are as follows: blood pressure 122/70 mm Hg, respiratory rate 26 breaths/min, heart rate 88 bpm, and temperature 98.6°F. The patient complains of incision pain and rates it on the pain scale as 7 of 10. His family is visiting at the bedside. You administer a dose of morphine as ordered. Fifteen minutes after administering the pain medication, a family member enters the hallway and yells, “We need help in here! John is not breathing.” Upon arrival you find Mr. April having periods of apnea lasting a few seconds followed by a short snorting gasp and then he begins breathing at a rate of 12 breaths per minute. His lips are bluish in coloration and so are his nail beds. He is lying supine in the bed. He awakens as you enter but is very lethargic and somnolent. Describe the correlation between a patient who is obese and hypoventilation? How does atelectasis, and the retention of CO2 play a role? What are your priority interventions with this patient?
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