Posted: August 23rd, 2022

Mrs Helen Georgopoulos is a 64-year-old lady

The ISBAR Handover:
Introduction: Mrs Helen Georgopoulos is a 64-year-old lady.
Situation: Mrs Georgopoulos arrived at the Emergency Department at 1130 hrs with central crushing chest pain radiating to her jaw since 1100 hrs. Findings from the 12 lead ECG recorded by paramedics showed ST elevation in leads V2, V3, V4. Aspirin 300mg administered on route to hospital.
Background: Hypertension (Captopril 12.5mg bd); Hyperlipidaemia (Simvastatin 40mg nocte); Type 2 Diabetes Mellitus (DM) (diet controlled) and Allergy – Penicillin.
-Airway patent
– Breathing: Respiratory rate 24, bilateral air entry, breath sounds clear. SpO2 on room air 91%
– Circulation: Sinus Tachycardia 120 bpm. BP 110/60. Diaphoretic and peripherally cool. Central crushing chest pain radiating to the jaw.
Character: crushing chest pain
Onset: 11am
Location: Central, radiating to jaw
Duration: ongoing
Severity: 8/10
Pattern: at rest, not relieved by SL Anginine Spray x 2
Associated symptoms: diaphoresis
Disability: Alert & oriented. Pupils equal and reacting to light (PEARL); Equal strength in all four limbs.
– Exposure: IVC Left cubital fossa.
– Fluid: NBM. NO IVF
– Glucose: 14.0 mmol/l
– Weight 88kg

Nursing Interventions:
1. Perform venepuncture to collect pathology – Troponin, UEC, FBC, TFTs, LFTs, BSL
2. Initiate supplemental oxygen if SpO2 < 93%
3. Attach Continuous Cardiac Monitoring
4. Record a 12-lead ECG
5. Monitor blood pressure and report systolic BP
Pathology Results:
– Elevated Troponin 35ng/L troponin
– 12 lead ECG: ST elevation (>2mm) V2, V3, V4
The diagnosis of Acute Anterior STEMI is made
Morphine 2.5mg IVI 2/24 (PRN maximum 4 x 2.5mg doses = 10mg total)
Nitro-glycerine 600mcg SL (PRN maximum 3 doses); monitor systolic BP >100 mmHg
Clopidogrel 300mg PO STAT
Heparin 5000IU IV STAT
As per STEMI reperfusion flowchart:
Transfer to Cardiac Cath Lab for urgent primary PCI when ready (<90min)
If PCI delayed, give Tenecteplase 45mg IV as per PACSA @ 1230pm

Short Answer Questions:

1. You are the registered nurse caring for this patient. List and prioritise the order that you will complete each of the five Nursing Interventions (indicated above):
2. (200 words)Critically analyse, and then concisely explain using your own words, each of the clinical manifestations and related pathogenesis for the following: i) Central crushing chest pain with radiation to the jaw (ii) ST elevation (iii) elevated Troponin (35ng/L)
3. Question 3: (500 words)
(i) Select one Category only, from the three (3) categories given below.
(ii) Provide a rationale for each of the interventions listed for the category that you have selected.
(iii) You must critically analyse the available evidence-based literature and/or pathophysiology texts to support your rationale. You must then concisely explain the rationales using your own words.
Category 1 Non-pharmacological interventions
• Supplemental oxygen if SpO2<93%
• 12 lead ECG within 10 minutes of arrival and then every 30 minutes.
• Troponin at 0 and 2 hours
Category 2 Pharmacological interventions
Morphine 2.5mg IV
• Nitro-glycerine 600mcg SL
• Aspirin 300mg
• Heparin 5000iu IV
• Clopidogrel 300mg

Category 3
Reperfusion interventions
• Tenecteplase 45mg IV
• Primary Percutaneous Coronary Intervention


Order for this Paper or Similar Assignment Writing Help

Fill a form in 3 easy steps - less than 5 mins.

Why choose us

You Want Best Quality and That’s our Focus

Top Essay Writers

We carefully choose the most exceptional writers to become part of our team, each with specialized knowledge in particular subject areas and a background in academic writing.

Affordable Prices

Our priority is to provide you with the most talented writers at an affordable cost. We are proud to offer the lowest possible pricing without compromising the quality of our services. Our costs are fair and competitive in comparison to other writing services in the industry.

100% Plagiarism-Free

The service guarantees that all our products are 100% original and plagiarism-free. To ensure this, we thoroughly scan every final draft using advanced plagiarism detection software before releasing it to be delivered to our valued customers. You can trust us to provide you with authentic and high-quality content.

How it works

When you decide to place an order with Dissertation App, here is what happens:

Complete the Order Form

You will complete our order form, filling in all of the fields and giving us as much detail as possible.

Assignment of Writer

We analyze your order and match it with a writer who has the unique qualifications to complete it, and he begins from scratch.

Order in Production and Delivered

You and your writer communicate directly during the process, and, once you receive the final draft, you either approve it or ask for revisions.

Giving us Feedback (and other options)

We want to know how your experience went. You can read other clients’ testimonials too. And among many options, you can choose a favorite writer.