Reply to each post 150 words each minimum by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source per each post
1. POST 1: For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors.
Non-Modifiable Predisposing Risk Factors
-Genetics – comprehensive genetics analysis has revealed an individual has a unique myocardial infarction locus that overlaps with chromosomal loci-depended risk factors, therefore having significant genetic influence. Significant cardiovascular risk factors hypertension and diabetes mellitus have firm genetic characteristics.
-Age – An increase in age also raises the susceptibility to heart disease, with approximately 80% of heart disease deaths occurring in patients 65 years or older.
-Hereditary aspects – People have a higher threat of heart disease or stroke if they have a male relative at the age of 55 years or a sick female relative at 65 years old. -Gender – Men have reportedly been revealed to be more vulnerable to heart diseases and heart attacks after menopause. Heart diseases have however become significantly dreadful for men and women.
-Cardiovascular risk factors also involve contributive genes that determine the pathogenesis of myocardial infarction.
-Modifiable Predisposing Risk Factors
The predisposing risk factors include hypertension, obesity, smoking, physical activity, LDL, triglyceride levels, and diabetes mellitus.
The risk increases when combined with other related health complications like hypertension and hypertriglyceridemia. Hypertension is a critical risk factor for myocardial infarction, as it can significantly cause atherosclerosis in coronary blood vessels, therefore risking the occurrence of myocardial infarction or even heart attack.
Obesity causes an increase in body mass index (BMI), therefore increasing the possibility of MI. The risk increases to dreadful levels for patients with extreme obesity.
Smoking significantly harms individual cardiac health by causing myocardial infarction, sudden cardiac death, and premature atherosclerosis, or even leading to early STEMI in healthy individuals.
Poor physical activity or inactivity risks individual development of myocardial infarction, especially if they are susceptible to multiple cardiac risk factors. It is vital for people with higher cardiac risk impacts to undergo physical therapy to maintain healthy lifestyles.
Myocardial infarction is at a higher risk for patients with elevated triglyceride levels and dense LDL particles. When the total cholesterol level rises and the individual also has nonfasting triglyceride levels, they are at significant risk of having Myocardial infarction (MI) in the future.
2. POST 2: Mr. W.G.’s chest discomfort during his myocardial infarction can be attributed to myocardial ischemia and subsequent myocardial injury. During a myocardial infarction, there is an abrupt reduction or complete cessation of blood flow to a portion of the heart muscle, typically due to the rupture or occlusion of a coronary artery plaque leading to thrombosis.
This interruption of blood flow deprives the affected area of the heart muscle of oxygen and nutrients, leading to ischemia. Ischemia triggers a cascade of events, including cellular energy depletion, accumulation of metabolic byproducts, and activation of pain-sensing nerve fibers known as nociceptors (Vukovic & Kiyan, 2020).
The sensation of chest pain, often described as pressure, tightness, or a crushing sensation, arises from activating these nociceptors in response to the ischemic insult. The pain may radiate to other areas, such as the neck, jaw, shoulders, or arms, reflecting the referral patterns of the nerves involved.
Mr. W.G. needs to understand that the chest discomfort he experienced was a warning sign of potential heart damage and required prompt medical attention. By seeking immediate care, he initiated interventions aimed at restoring blood flow to the affected area of the heart and minimizing further myocardial injury, ultimately improving his prognosis and reducing the risk of complications associated with myocardial infarction (Vukovic & Kiyan, 2020).
3. POST 3: Both Primary Care NPs and PMHNPs are the professionals who obtain the advanced clinical skills and knowledge through their training. They go through a rigorous course of education and clinical training in order to have the capability to offer complete care in their specialist fields. Instead of only paying attention to the physical health of patients, they also address their mental, emotional and social well-being (Htay, 2021). They evaluate and consider patients through the biopsychosocial lens, treating different factors that determine health status. Furthermore, both can directly contribute to patient education and advocacy by raising awareness about prevention of diseases or information on treatment options, management of medication and lifestyle modifications.
4. POST 4: Even though there are similarities in the focus of the APRN roles in advanced practice nursing, the roles are quite different. APN roles differ in their scope of practice, the type of patients they care for, and the settings they work in (Sevilla Guerra et al., 2022). Primary care NPs care for “delivering comprehensive care to the wide range of patients one would traditionally see in the primary care setting, including a broad-based set of health problems.” That means a primary care NP sees patients literally from birth to death and addresses many health issues. On the other hand, other APN roles, such as a Pediatric NP or Psychiatric-Mental Health NP, may be confined to a specific patient population and healthcare setting.
Moreover, the health needs roles addressed by each APN are different; for example, Women’s Health NPs provide exceptional care to women throughout their lifespan from puberty through menopause, focusing on reproductive health and wellness, while Adult-Gerontology NPs concentrate on the issues of older adults.
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