I will upload the case study medical record that needs to be read to answer my ? listed below
QUESTION #3:
Following the initial management provided in Question 2, an interventional cardiologist was consulted and discussed with the patient the need for primary PCI to restore blood flow to the heart. Within 1 hour of his arrival to the ED, the patient was transported to the cardiac catheterization lab. The patient’s wife, Laura, who had brought the patient in is distraught.
• As the nurse, explain the procedure of the primary PCI to the patient’s family.
The catheterization revealed a 60–70% proximal stenosis in the RCA (right coronary artery) with thrombus. Additionally, there was a 40% mid-LAD (left anterior descending coronary artery) obstruction and 20–30% distal circumflex disease, neither of which was amenable to PCI. In the catheterization lab, the patient was loaded with oral ticagrelor (antiplatelet) 180 mg, anticoagulation was continued with Heparin, and an eptifibatide infusion was started. The following day, the echocardiogram reported a left ventricular ejection fraction (LVEF) of 35%.
• Analyze the findings of the PCI. Based on these findings, discuss best practices to optimize medication therapy for the post-discharge management of this patient’s CAD and other problems.
