Master of Science in Nursing (MSN) Student Scholarship

Date Written

Fall 2014

Document Type

Project

Course Number

NURS 5330

Course Name

Advanced Pathophysiology

Professor’s Name

John D. Chovan, James R. Cacchillo

Keywords

Diabetes, Case Studies, Blood Sugar Management, Insulin, Coronary Artery Disease

Subject Categories

Endocrine System Diseases | Medical Pathology | Nursing

Abstract

A 72 year old male patient was admitted to the hospital presenting with sharp substernal pain and pressure to the left upper chest rated a “10” out of 10. Patient complained of chest pain even at rest which was relieved by a nitroglycerin infusion. Patient had established coronary artery disease as evidenced by five prior stent placements, with the last stent placement being in 2010. The patient also presented to the Emergency Room with a blood glucose level over 600 mg/dL and because of his complaints of chest pain, was transferred to a neighboring hospital facility to have a cardiac catheterization procedure. Past medical history included: uncontrolled type 2 diabetes with an A1c value of 10.0 %, coronary artery disease, hyperlipidemia, hypertension, gastroesophageal reflux disease (GERD), and osteoarthritis. Cardiac catheterization procedure was performed and recommendation for him to have open heart surgery due to three vessels being 90-100% occluded was given. Patient underwent three vessel coronary artery bypass graft procedure (CABG) the following week and was discharged to an extended care facility (ECF) for rehabilitation another week later after having difficulty managing blood sugars under 225 mg/dL. Other postoperative course in the hospital was unremarkable and uneventful.

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