A 48 year old male is admitted to the interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life.interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life.
-Acute Pain related to tissue trauma and prescribed post procedure immobilization as evidence by patient rating pain 8 on 1-10 scale. Demographics: White male, 48 years old. Weight is 285 pounds, Height is 5’9″. Pt is married and his wife and 2 children are at the bedside. Pt speaks fluent English. He is Catholic. He finished high school and 2 years of community college. He is employed in an office with about 30 other employees. Past medical history: HTN, Hyperlipidemia, Smokes
Current labs: Glucose – 165, Sodium 140, Potassium 3.2, Chloride 98, BUN 15, Creatinine 0.8.
Chest Xray – normal
Medications: Select 3 medications for your care plan. One should be for hypertenstion, 1 should be for pain while in the hospital, the 3rd one is of your choice (a medication that goes along with his diagnosis).
-The patient will rate his groin pain less than 5 on a 1-10 scale within in 2 hours from admission.
-The patient and his wife will relate to the nurse that they feel like they can integrate the new medication and stop smoking regimen into their lifestyle before discharge.
-The patient and his wife will verbalize 4 benefits of quitting smoking for the heart by discharge.
-The patient and his wife will demonstrate and verbalize how to administer and take his new medications before discharge.
-The nurse will assist the patient with re-positioning techniques as needed to help alleviate pain.
-The nurse will educate the patient and his wife on 4 benefits of quitting smoking by discharge.
-The nurse will verbalized and demonstrate to the patient and his wife how the patient needs to take his new medications by discharge. The patient and his wife will verbalize their understanding of the medications.
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