Ateneo de Zamboanga University

College of Nursing
RLE

Name: ______________________________________ Date:

__________________

Scenario: Acute Coronary Syndrome with Impending Myocardial Infarction.

A 60 year old , male ,Mr. Robin Cruz with a history of hypertension and angina, presents
to the ER with severe chest pain. In the last hour, he has become lightheaded, and,
remembering the signs of heart attack, he is seeking diagnosis and treatment.
V/S: BP-150/90, HR-102/min, RR-22/min T- 37⁰C, SaO2-95%

Oxygen inhalation administered via nasal cannula at 3L/min, IV line initiated with 0.9%
NaCl 1L at KVO. 12 lead ECG performed, for blood test; Troponin I, CK-MB, LDH, CBC, Na,
K, Calcium, Magnesium. Isordil 5 mg Subligual, Aspirin 300mg tablet given. Portable
Chest X-ray done and for 2Decho. Admitted in the telemetry unit.
After an ECG, laboratory work up and other tests result, it is determined that Mr. Cruz
has acute coronary syndrome. The cardiologist explains the condition, and the risks and
benefits of cardiac revascularization.

Mr. Cruz consented for the procedure underwent Coronary Angioplasty and placement
of a stent. The procedure is successful and blood flow is increased to the heart muscle.
The patient is for discharge on the 5th day post angioplasty procedure.

Pre-work:

1. Review the following:

 What is Acute Coronary Syndrome?
 What are the 3 types of ACS ?
 What are the risks factors of ACS ?
2. What could be the immediate goals of treatment for ACS?
3. What are the cardiac markers used to diagnose ACS?
Study Guide:

1. During initial assessment, identify abnormal findings.

2. Provide at least 3 nursing diagnosis appropriate to the case scenario.
3. What priority nursing interventions should be implemented for the patient with
ACS?

Tasks/activities: (Base on the above scenario)

1. Formulate a discharge teaching plan/ discharge instructions for patient with post
coronary angioplasty.