Rainey is a 64-year-old woman of Maori descent who has been marriedfor 42 years and has two grown-up children. Both of Rainey’s parents died when they were in their mid-60s of ‘heart attacks’. Two of her four brothers have had heart attacks and have high blood pressure, and her remaining uncle has had ‘two heart attacks and a stroke’. Rainey leads a sedentary life and her diet is moderately high in fat and sugar. Rainey is 162cm Tall and 105KGs. Her body mass index (BMI) is 40 and her waist measurement is 101 cm.Rainey began experiencing central chest pain radiating to her back and neck after walking up stairs at the shopping centre. She was short of breath and sweaty and sat down clutching her chest. Her daughter was with her who called an ambulance and that arrived after 5 minus and took her to ED.On arrival to the hospital, Rainey is given 50 microgs of fentanyl. Her observations are as follows:Blood pressure is 220/160Pulse 92, radial pulse is present but weak and thready.Respiratory rate 24Temperature 36.7Skin is cool and clammyECG is below. Raniey’s ECG Question 1 – When admitted to ED, Rainey was administered 50 microgs IV fentanyl.identify the indications for the medicationwhy was this medication used instead of morphine – justify your answer with relevant literatureidentify the medication schedule (e.g. S1, S2, S3, S4, S4R, S8) and explain what this means for administrationsummarise the pharmacodynamics and pharmacokineticsdiscuss alternatives if applicableexplain 3 common adverse effects (side effects).use your core text books and research from the last 5 years to reinforce your work.Rainey has been prescribed the following medication:Clopidogrel 300 mgHeparin 5000 iuQuestion 2identify the indications for Clopidogrelidentify the contraindications for Clopidogrelsummarise the pharmacokinetics and pharmacodynamics of Clopidogrel analyse the dose that has been give – is this dose correct? Why/why not? what alternatives are there to Clopidogrel? Analyse why these would be more or less suitable for the patient. identify how you would describe to Rainey (in layman’s terms) how these work on her bodyUse relevant literature from the last 5 years and your core text books to support your argumentsQuestion 3identify the indication for Heparinidentify the contraindications for Heparinsummarise the pharmacokinetics and pharmacodynamics of Heparin analyse the dose that has been give – is this dose correct? Why/why not? what alternatives are there to Heparin? Analyse why these would be more or less suitable for the patient. identify how you would describe to Rainey (in layman’s terms) how these work on her bodyUse relevant literature from the last 5 years and your core text books to support your argumentsReferencesPlease list in APA format all references used. Please note the indents used in APA are not transferable to PebblePad and it is therefore acceptable to not have an indent. Health Science Science NursingNUR 356
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