Mr Clive Jenkins Case Study – Several Admissions to Hospital – Nursing Assignment Help

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Assignment Task :

Using a case study, this assessment task will assess your ability to apply clinical reasoning to explain the pathophysiological mechanisms underlying the patient presentation, progression, and rationale for therapy.

Mr Clive Jenkins is a 78 year old retired navy engineer. He has a past medical history of Congestive Cardiac Failure (CCF). This developed after he experienced a severe myocardial infarction 2 years ago. Both ventricles were affected.

The recent death of several close friends have made it difficult for Clive to be concordant with his CCF  management and sustain the necessary life-style adjustments required to prevent exacerbations. This has resulted in several admissions to hospital for management and review of his CCF.

For this current admission, Mr Jenkins was referred to hospital by his GP after recently rapidly gaining weight (currently 95kg), since his last visit the previous week.

The time now is 0800 and you have just come on for your morning shift. Mr Jenkins has been on the ward for only two hours after spending approximately 12 hours in emergency waiting for a bed to become available.

Mr Jenkins appears slightly disoriented. When repositioning himself in bed you observe that he becomes short of breath. You ask him if he will get out of bed for breakfast but he is reluctant to mobilise as he feels so tired. You also note that his water jug is empty.

 

Assessment task description

In this assessment task you will be provided with a case study which includes relevant patient information. Using the case study details provided, you will be required to respond to a variety of questions types. These questions will require you to:

• consider the patient situation and identify cues (signs and symptoms) from clinical information provided.

• process this information by analysing the cues, and explaining the relevant physiology and pathophysiology underpinning the patient presentation and progression.

• apply knowledge of physiology to explain the rationale of suggested therapeutic approaches for that patient.

It is expected that you will engage with scholarly literature to substantiate your clinical reasoning in the long answer question. 

 

Question 1 

Clive’s HR of 112bpm is contrary to what would be expected to a compensation for a blood pressure of 150/90 mmHg. Explain what the normal response should be, and the pathophysiological mechanisms for Clive’s tachycardia.

 

Question 2

Relating to Clive’s past and present medical history, explain the rationale why Mr Jenkins was prescribed Spironolactone.

 

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