TY  - CHAP
M1  - Book, Section
TI  - Drugs Used in the Treatment of Angina Pectoris
A1  - Jobst, Erin E.
A1  - Panus, Peter C.
A1  - Kruidering-Hall, Marieke
PY  - 2020
T2  - Pharmacology for the Physical Therapist, 2e
AB  - CASE  STUDYJ.M.  is  a  52-year-old  man  with  a  14-year  history  of  hypertension  and  coronary  artery  disease.  He  works  as  a  union  pipe  fitter  employed  at  a  shipyard.  A  major  component  of  his  work  includes  climbing  on  scaffolding  for  activities  performed  in  the  process  of  ship  construction.  Three  days  ago,  he  fell  8  ft  to  the  ground  off  a  platform,  resulting  in  a  compound  fracture  of  the  right  femur.  Relevant  history  includes  moderate  alcohol  intake,  25-year  history  of  smoking  one-half  pack  of  cigarettes  per  day  (12.5  pack-year),  and  a  body  mass  index  of  32.  Current  daily  drugs  include  metoprolol,  hydrochlorothiazide,  and  quinapril  for  chronic  treatment  of  hypertension,  and  additional  medications  for  pain  control.  The  patient  is  also  prescribed  sublingual  nitroglycerin,  as  needed.  Two  days  ago,  the  compound  femur  fracture  was  reduced  via  internal  fixation  with  a  medullary  rod;  surgeon-prescribed  weight-bearing  status  is  weight-bearing  as  tolerated.  On  postoperative  day  one  (POD  1),  the  physical  therapist  observed  that  the  patient  had  normal  upper  body  strength  and  trunk  control  and  that  he  was  independent  in  squat  pivot  transfers  from  bed  to  chair.  In  the  morning  of  POD  2,  the  therapist  brings  the  patient  to  the  inpatient  gym  in  a  wheelchair  for  initial  assessment  of  standing  and  ambulation  in  the  parallel  bars.  Seated,  resting  vitals  signs  are  135/88  mm  Hg,  60  bpm.  The  patient  expresses  considerable  apprehension  about  today’s  therapy  goals  due  to  fear  of  excessive  pain.  The  physical  therapist  convinces  the  patient  to  attempt  to  stand  in  the  parallel  bars  with  the  use  of  a  gait  belt  plus  another  assistant.  The  patient  comes  to  a  complete  standing  position  with  both  hands  on  the  parallel  bars  for  assistance.  Prior  to  taking  his  first  step,  the  patient  complains  of  left-sided  chest  pain  that  begins  to  radiate  down  the  left  arm.  The  patient  is  quickly  assisted  to  a  seated  position,  and  the  therapist  records  the  following  vitals:  145/92  mm  Hg,  78  bpm.  The  therapist  notes  that  the  patient  is  pale  and  diaphoretic  and  asks  the  assistant  to  notify  the  nurse  of  the  patient’s  current  status  and  position.  The  patient  declined  an  afternoon  physical  therapy  session.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accessphysiotherapy.mhmedical.com/content.aspx?aid=1192814123
ER  -