Intravenous access should be obtained and 12 lead ECG/continuous monitoring plus blood draw for enzymes. The patient with angina will respond to sublingual nitroglycerine given 0.3 mg to 0.4 mg repeated every 5 minutes for up to three doses. If pain persists after the third dose, suspicion for MI should be high (Harvey, 2004). An ECG is the next step in assessment of the patient with angina vs. MI, although it should be noted that only 45% of all the patients with MI will have obvious ischemic changes on their ECG. Patients should be monitored for minor changes. ST segment elevations with tall T. waves will usually be the first changes (Docherty, 2003). Evaluators should also be sensitive to ST segment depression in leads which are opposite the site of the injury. T-wave inversion and the development of Q. waves are considered to be pathologic evidence of evolving MI. Changes like these will appear within hours of the infarction and the changes may remain on the ECG indefinitely or eventually resolve. It should be noted that in patients with non-ST segment elevation MI the changes on the ECG will be much less specific.
No one serological test can identify MI from angina. Serological markers can be used to evaluate for myocardial infarction. Troponin T. And Troponin I may be...
Troponin levels usually begin to elevate 2-3 hours after the onset of myocardial damage.
Creatinine Kinase (CK) and the iso-enzyme CK-MB are frequently used, but are nonspecific. Myoglobin elevations may be noted up to two hours after the onset of ischemic muscle damage but is nonspecific as well.
Conclusions
Discerning angina from a myocardial infarction is a difficult task, requiring the rapid use of evaluation skills as well as the prompt administration of treatment. More than 6 million people in the United States have angina, but a history of angina does not rule out the diagnosis of MI. Rapid diagnosis and intervention can literally be the difference between life and death.
Reference:
Docherty, B. (2003). 12-lead ECG interpretation and chest pain management: 1. British Journal of Nursing, 12(21), 1248-1255.
Harvey, S. (2004). The nursing assessment and management of patients with angina. British Journal of Nursing, 13(10), 598-601.
Sommers, M & Johnson, S. (2002). Diseases and Disorders: A Nursing Therapeutics Manual (2nd Ed.). Philadelphia: F.A. Davis.
Tough, J. (2004). Assessment and treatment of chest pain.…
Osteoporosis Approximately 8 million people in the United States are affected by osteoporosis (Ray, Chan, Thamer, et al., 1997). Of these, 80% are older women (Ray, Chan, Thamer, et al., 1997). In addition to this problem, another 17 million people in this country have low bone mass, which puts them at an increased risk for developing osteoporosis as they get older (Ray, Chan, Thamer, et al., 1997). Every year, 1.5 million
The symptoms and signs of chronic schistosomiasis are mostly the body's reaction to the eggs retained in the tissues. S. mansoni or S. japonicum can cause mucosal ulcerations, bloody diarrhea, focal fibrosis, strictures, fistulas and papillomatuous growths. Ulcerations in the bladder by S. haematobium may bring on dysuria, hematuria, frequent urination, and chronic cystitis. Secondary bacterial infections in the genitor-urinary tract may also develop. S. mansoni can induce persistent
Religion Nowadays more than 700 million people, when asked the question: "What religion do you observe," answer the Arabian word: Muslim -- a man that observes Islam. The religious beliefs and religious origins of Islam go all the way back to the 7th century AD, the time when the religion was forming on the Arabian peninsula. Religion and experiencing of Islam for Muslim can be looked as on a special psychological condition
Country Evaluation Pakistan is the South Asian country and was established in 1947. It shares border with India, Tajikistan, Afghanistan, Iran and China. It has a coastline spanning of 1,046 km with Arabian Sea. The country has highest peaks in the world that are K2 and Nanga Parbat of Karakorum and Pamir in the northern and western highlands of Pakistan. Islamabad, Lahore and Karachi provide the major by air gateways to
1% and agriculture 6.0%. ("Jamaica," 2010) The U.S. is more heavily focused on services, with this accounting for 76.9% of the GDP. This is followed by: industry (coming in at 21.9%) and agriculture (accounting for 1.2%). ("United States," 2010) Labor Force The labor force of Jamaica is currently 1.311 million people. ("Jamaica," 2010) While the labor force of the United States is 154.2 million. ("United States," 2010) Labor Force by Occupation The labor force
They have been committed to the development of what they deem to be Consciousness Cosmetics for more than a decade. Entry into the Portuguese market offers certain benefits, such as the Portuguese people's commitment to high moral standards, which would be conducive to cruelty-free, environmentally responsible products such as Alba Organics. However, there are risks as well that need to be taken into consideration. The Portuguese market is small and