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Author Question: Mr. Garcia's chest pain resolved after two sublingual NTG at 3-minute intervals and 2 mg of IV ... (Read 30 times)

haleyc112

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on: Aug 21, 2018
Mr. Garcia's chest pain resolved after two sublingual NTG at 3-minute intervals and 2 mg of IV morphine.
 
  In the cardiac catherization lab he was found to have a totally occluded distal right coronary artery and a 70 occlusion in the left circumflex coronary artery. The left anterior descending was patent. Angioplasty of the distal right coronary artery resulted in a patent infarct-related artery with near normal flow. A stent was left in place to stabilize the patient and limit infarct size. Left ventricular ejection fraction was normal at 42, and a posterobasilar scar was present with hypokinesis. Explain angioplasty and stent placement. What is the purpose of this medical procedure?

Question 2

Estimate Mrs. Washington's energy and protein requirements. Should weight loss or weight gain be included in this estimation? What is your rationale?
 
  What will be an ideal response?


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ms_sulzle

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Reply #1 on: Aug 21, 2018
Answer to Question 1

 Angioplasty is a non-invasive procedure used to open narrowed or blocked blood vessels of the heart.
 A tiny deflated balloon attached to special tubing is threaded up to the coronary arteries, where the balloon is inflated to widen blocked areas, allowing increased blood flow to the heart muscle.
 It is often combined with implantation of a stent to help prop the coronary artery open and decrease the chance of another blockage.
 A stent is a metal wire mesh tube placed over the balloon.
 When the balloon is inflated, the stent expands, locks in place, and holds the artery open.

Answer to Question 2

 Women: RMR = (9.99 x 84.1) + (6.25 x 157.48)  (4.92 x 77)  161
RMR = 1349.2 kcal (AF 1.2) = 1619 or about 1500-1700 kcal
 Protein requirements  0.8-1.0 g/kg = 67-84 grams
 Even though her BMI places her in the obese category, weight loss is not recommended at this time.
 She is at risk for decreased oral intake so weight maintenance should be the goal at this time.


haleyc112

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Reply #2 on: Aug 21, 2018
Thank you!


ms_sulzle

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Reply #3 on: Aug 21, 2018
Always glad to help...


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