Using and Information of Spray Anginine - Case Study Example

Case Study Customer’s Name: Customer’s Course: Tutor’s Name: 8th December, 2011. Anginine Spray is used to treat Angina, a symptom of Coronary Heart Disease (CHD) and refers to the pain experienced in the chest (Jones & Kline, 2009). The pain in some instances can spread to the arms, the neck and sometimes spread to the back and shoulders. Angina is said to be caused in most cases by exercises and stress and patients may use Anginine Spray to relieve the pain. Angina may also be caused by excessive cold or emotions. In using Anginine Spray, patients are advised to remain seated after taking the medication for the spray can cause dizziness and sometimes fainting which is probably what happened to Mary who got up too quickly after taking her Anginine Spray. As discussed that Angina effects can be felt in the chest and spread to the arms, neck and shoulder, Mary is most likely suffering from CHD. By the fact that Mary had used Anginine Spray because she felt tight in the throat confirms that Mary could be experiencing a heart attack. Therefore the first line in helping Mary will include First Aid given to patients who are suffering from heart attack. Ensuring that the patient has relaxed is important and among the list of what is to be done as a first line. This is done by having the patient calm down and having her sit down and rest. This ensures that the blood flow to her narrowed blood artery to the heart gets enough supply of blood and thus oxygen (Labarthe, et al, 2009). Then, the next step requires that any tight clothing that the patient may be wearing to be loosened. This is because, when a person is experiencing a heart attack, the flow of blood carrying oxygen to the heart is the one that is usually blocked and therefore heart muscles are starved of blood and thus starved of oxygen. The next step is to give the patient the medication that reduces chest pain which in this case Mary has her Anginine Spray. This is because when a patient is at risk of a heart attack, among the blood vessel that carries blood to the heart becomes blocked and cuts blood supply to the heart (Richard, & Fogoros, 2006). Anginine Spray is used to aerate the blood vessels to allow the free flow of blood to the vessels. Further assessments include checking the patient’s heartbeats to find out if there are any irregularities (palpitations) with the way the patient’s heart is functioning. We cannot rule out the probability that Mary may be having mild signs of a heart attack since the symptoms of a heart attack vary from patient to patient and they can be mild or sometimes severe. Another reason as to why the possibility that Mary is experiencing a heart attack cannot be overlooked is the fact that the symptoms which is the pain which manifests in the chest and spreading to the arms, shoulders and neck may keep on recurring after every few minutes (Khavjou et al, 2009). Therefore, she may have felt the pain in the throat and decided to take her Anginine Spray after which the pain subsides, only to recur again (Homer, 2008). Further assessments are needed to determine why Mary’s skin is moist, clammy and pale starting with assessment to determine whether Mary had taken an overdose of Anginine Spray. This is because a drug overdose can cause a patient’s skin to be clammy, moist and pale. If the patient’s use of Anginine Spray is not an overdose (Ganz & Curtiss, 2007), and not the one that is causing the patient’s skin to be moist and clammy, then the next probable symptom would that the patient’s heart attacks have recurred and therefore this needs caution when dealing with a patient with a heart attack condition. In addition, her heart attack could be salient, that is a heart attack that is not likely to be detected or a heart attack exhibiting little or no symptoms. In most cases, moist, clammy and pale skin indicates symptoms that are considered life threatening and heart attack is one of the conditions that cause patients to have moist, clammy and pale skin. Heart attack is a serious condition that requires the patient to be treated immediately. As the nurse, checking the patient’s chest to observe the rising and the falling of the patient’s chest is necessary to see if the patient has any breathing difficulty. This will entail physically examining the patient’s chest by use of a stethoscope (Marx, Hockberger, & Walls, 2009). Next is checking the patient’s pulse. If there is no pulse or the pulse is faint, the nurse is supposed to give the patient Artificial Respiration (AR) to restore the heart beat of the patient to the normal heart beat. AR will be aimed at increasing the flow of blood so that the heart does not experience a failure due to lack of blood leading to low levels of oxygen in the body. The AR will be done by first tilting the head of the patient and then lifting the chin of the patient. Then the nostrils of the patients are shut with two fingers so that there is no leakage of air from the nostrils. As the nurse in charge, the next step will involve taking a deep breath and then sealing my mouth with the mouth of the patient, in a way that my mouth covers the mouth of the patient (Ganz & Curtiss, 2007). In order to ensure that the patient’s chest is inflated, I will release the breath that I took to the patient’s mouth and this should take approximately 2 seconds to have the patient’s chest inflated with air. This practice will be repeated again while checking whether the patient’s chest is rising as I breathe the air into the patient’s mouth. However, AR should be done at the same time with CPR (Cardiopulmonary Resuscitation). More advanced tests include checking the patient’s blood pressure to see if the patient has a normal, high or low blood pressure. In addition, the nurse should run a Troponin test that is carried out on the blood of the patient to determine if the patient has heart tissues which are damaged (Cannon & Braunwald, 2011). If the Troponin test is positive and the patient has heart tissues which are indeed damaged, then the patient is diagnosed with a heart attack. It is also advisable that the nurse performs Coronary Angiography to check the flow of blood through the patient’s heart. The test is however most advisable when the patient is in a more stable condition and it is important especially if the patient is experiencing what is called unstable Angina (Angina that is happening when someone is resting) (Cannon & Braunwald, 2011). An ECG (Electrocardiogram), test will also be necessary for it will help in measuring the effects of any drugs or even devices that the patient may have used to try and control the heart (Brady, Harrigan, & Chan, 2009). For instance, Mary had used Anginine Spray which is used to aerate blood flowing to the heart. An ECG test is paramount when the patient has irregular pains that can lead to heart attack (Ganz & Curtiss, 2007). Possible causes of Mary’s collapse When taking Anginine spray and as previously discussed in the introduction section, Anginine may cause a patient to feel dizzy and the patient is required to remain seated and calm for some few minutes after the dosage of Anginine Spray (Davidson, & Bonow, 2007). Therefore, when Mary got up too quickly, the side effects of Anginine Spray, dizziness may have caused her collapse. Another possible reason as to why Mary would have collapsed is due to the heart attack which causes a severe pain in the chest at the center. But of importance to note is that elderly patients may little pain and in some cases no pain at all in cases of heart attack (Farris et al, 2009). It is possible that Mary had little pain and the pain that may have contributed to Mary’s collapse may be on and off and this would explain why Mary is conscious and able to talk but her skin conditions indicates the signs of a heart attack. All other factors remaining constant, for instance Mary taking Anginine Spray, by Mary standing up too quickly or abruptly can also be a contributory factor to her collapse. When seated and someone stands up too quickly, one is likely to feel dizzy and thus collapse (Simon, 2007). Other factors that are most likely to contribute to Mary’s collapse include lack of enough flow of blood to the head which can also cause dizziness and leads to a person collapsing, having heart circulation problems which has been linked to Mary’s condition of a heart attack, high blood pressure and low blood pressure can also bring dizziness and thus make a person collapse. Taking into consideration the age of the patient, the patient, Mary’s collapse is definitely attributed to heart attack (Calkins, & Zipes, 2011). References Brady, W. J., Harrigan, R. A., & Chan, T. C. (2009). Acute coronary syndrome. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier. Calkins, H. & Zipes, D. P. (2011). Hypotension and syncope. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier. Cannon, C. P. & Braunwald, E. (2011). Unstable angina and non-ST elevation myocardial infarction. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011. Davidson, C. J. & Bonow, R. O. (2007). Cardiac catheterization. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier. Farris, R.P., Pearson, T., Fogg, T., Bryant, L., Peters, K., Keyserling, T., Fitzpatrick, A. & Neal, W. (2008). Building capacity for heart disease and stroke prevention research: the cardiovascular health intervention research and translation network. Health Promotion Practice. Jul; 9(3):220-7. Ganz, L. & Curtiss, E. (2007). Electrocardiography. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. Homer, J., Milstein, B., Wile, K., Pratibhu, P., Farris, R. & Orenstein, D. (2008). Modeling the local dynamics of cardiovascular health: risk factors, context, and capability. Preventing Chronic Disease. 5(2):A63 Jones, A.E. & Kline, J. A. (2009). Shock. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier. Khavjou, O.A., Finkelstein, E.A., Farris, R. & Will, J.C. (2009). Recall of three heart disease risk factor diagnoses among low-income women. Journal of Women’s Health. Jul 15; 18(5):667-675. Labarthe, D.R., Dai S, Day, R.S., Fulton, J.E., Grunbaum, J.A., Shah, S.M. & Wen, E. (2009). Project Heartbeat! Concept, development, and design. American Journal of Preventive Medicine. Jul; 37(1 Suppl):S9-16. Marx, J. A., Hockberger, R. S., & Walls, R.M. (2009). Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier. Richard, N. & Fogoros, M. D. (2006). What is it, and what are its Causes. Retrieved from http://heartdisease.about.com/cs/coronarydisease/a/CP1.htm, retrieved on 8th Dec. 2011. Simon, RP. (2007). Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. Read More