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The patient is admitted to the hospital for a heart attack as evidenced by the hospital setting and what they say verbally.

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Caring support group that involves presumably his friend and wife.

The patient feels that he has experienced a "wake up call" , which indicates that he may be open to lifestyle changes, as evidenced by the patient acknowledging that changes need to be made, when he stated that "There’s so many changes they’ve already told me I have to make"

The patient appears to have a caring support group, consisting of his wife and friend, Lamont. The supportive relationship is evidenced by Lamont's statement " I was so worried man, you didn't look good."

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What is atrial fibrillation, and how does it increase the risk of an MI?

Rationale: understanding dysrhythmia is another point to understand the pathophysiology and causes of the patients MI.

What is an ANTERIOR STEMI?

Rationale: understanding the pathophysiology of the STEMI enables better dx. of patients condition and plan of care.

What is the significance of measuring aPTT and the administration of anti-coagulants?

Rationale: we want to understand why the pt. is being started on anti-coagulant.

What is the plan of care for heart attack patients?

Rationale: we can explain to the patient what their treatment plan is and offer support during their recovery.

Why is there fluid in his lungs?

Rationale: if we understand the pathophysiology, we can identify the exact cause of his heart attack.

How is left-sided heart failure related right-sided heart failure?

Rationale: because the patient has left-sided heart failure, we should be aware of the symptoms of right-sided heart failure. We also want to know the likelihood of right-sided heart failure from happening.

What tests are done to confirm a heart attack? What are the results of the tests?

Rationale: in order to help identify a heart attack and the normal values for these tests.

How do other co-morbidities affect his risk for another heart attack?

Rationale: so we can better educate the patient on lifestyle modifications to prevent and manage his symptoms

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Winton is not knowledgeable about heart attacks and its symptoms as evidenced by Winton stating "I guess all those years of good food and smoking caught up with me."

Winton is at risk for future acute heart complications as evidenced by the increased genetic risk since it was mentioned that his brother passed away from a heart attack at 59 years old.

Based on subjective data that Winston has fluid in his lungs and has experienced left-sided heart failure, the patient is at risk for right-sided heart failure due to poor oxygen perfusion to the peripheral.

Winton is willing to change his lifestyle as he stated that he had a wake-up call from the heart attack.

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We want to know what medication he is currently on and has previously been on so that we can understand his medical history and if he knows he is at risk for myocardial infarctions.

We want to know if he has a family history of heart disease as that would increase his risk for further complications because it is hereditary.

We want to know what his diet/alcohol is like because his food can directly impact his blood pressure and cholesterol levels. For example, a high salt and fat diet increases both, thus increasing the likelihood of atherosclerosis and, subsequently, coronary artery syndrome, leading to an MI.

We want to know if he engages in exercise because it is a preventative activity that can improve the patients outcome by lowering his weight. This is directly correlated to his LDL levels and understanding this can serve as a point of intervention in his overall well-being.

We want to know how many cigarettes he smokes so that we can determine the pack year. We want to know this because smoking leads to an increased risk of atherosclerosis. Understanding this can also be another intervention point to lower the chances of the patient having another acute cardiac problem.

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Mary did not know Winton was having a heart attack as evidenced by the lack of knowledge of signs and symptoms when she suggested he didn't eat properly in the morning.

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Winton's brother recently passed away from a heart attack at the age of 59 years

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Anxiety towards the future evidenced by his concern for his wife,

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Anxiety towards the future evidenced by his concern for his wife,

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as evidenced by Winton stating that "(Mary) is only gonna have half a man at home.”

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We want to know his lab results, specifically cardiac enzymes such as Troponin, his vitals (blood pressure) and cholesterol levels. Knowing these values will help us to understand his baseline and to identify any other co-morbidities that put him further at risk for heart related diseases, such as future MI.

We want to know his ECG results to visualize the QRST wave of the heart and determine what kind of heart attack occurred, if it was STEMI or NSTEMI. This will help create a treatment plan that prevents future MI's and angina that might accompany it.