Case scenario:

Mr David Thompson is a 53-year-old self-employed driver who presents to his local Emergency Department (ED) with a crushing central chest pain that radiates to his left arm. On arrival to ED, he is anxious, reports nausea and severe chest pain. He has rapid breathing and is cold and clammy to touch.

Mr Thompson very rarely drinks alcohol and he does not smoke. Apart from his hypertension, which is well controlled with an angiotensin-converting-enzyme (ACE) inhibitor, he considers himself healthy. He adds that he has put on weight as he tends to eat sugar-based snacks while driving during the day and has a large meal late in the evening once he has finished work.

Mr Thompson arrived alone but he has informed his spouse in the taxi about his condition. He expresses concern about his wife and their 16-year-old autistic son, Peter who became very anxious and slightly aggressive, hitting the furniture, when he heard the news about his father being unwell. Mr Thompson also states that he is worried about his work as he is the main income earner in the family. Mrs Thompson stays at home as the main carer of their son.

On admission, the following observations are recorded:
• Respiratory rate: 25 breaths per minute at rest
• Oxygen saturation: 91 % on room air
• Blood pressure: 167/88 mmHg
• Heart rate: 117 beats per minute, regular, ST segment elevation noted on electrocardiogram (ECG)
• Temperature 36.80C

A diagnosis of ST elevation myocardial infarction (STEMI) is made.

In relation to the above scenario:

1. Define and discuss the condition the patient is presenting with, including the relevant related pathophysiology. (500 words)
2. Using a systematic approach, discuss the assessment and the priorities of nursing care related to the scenario demonstrate an understanding of the biopsychosocial factors that may influence the patient’s care. (1500 words)
3. Critically discuss the impact of acute illness on the patient and family. (1000 words)

Sample Solution