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Home » NRSG353: Sharon McKenzie Case Study- Congestive Cardiac Failure- Nursing Case Study Assignment

NRSG353: Sharon McKenzie Case Study- Congestive Cardiac Failure- Nursing Case Study Assignment

    Added on: 0000-00-00 00:00:00Order Code: Question Task Id: 0

    MAHOZ52
    Nursing Case Study Assignment:

    Task:

    Instructions:
    • Students are to choose one (1) of the case studies below and answer the associated questions. The assignment is to be presented in a question/answer format not as an essay (i.e. no introduction or conclusion).

    • Each answer has a word limit ; each answer must be supported with citations.

    • A Reference List must be provided at the end of the assignment.

    • Please refer to the marking guide available in the unit outline for further information.

    The following questions relates to the patient within the first 24 hours:

    1. Outline the causes, incidence and risk factors of the identified condition and how it can impact on the patient and family
    2. List five (5) common signs and symptoms of the identified condition; for each provide a link to the underlying pathophysiology
    a. This can be done in the form of a table – each point needs to be appropriately referenced

    3. Describe two (2) common classes of drugs used for patients with the identified condition including physiological effect of each class on the body
    a. This does not mean specific drugs but rather the class that these drugs belong to.

    4. Identify and explain, in order of priority the nursing care strategies you, as the registered nurse, should use within the first 24 hours post admission for this patient.

    Case Study 1

    Mrs Sharon McKenzie is a 77 year old female who has presented to the emergency department with increasing shortness of breath, swollen ankles, mild nausea and dizziness. She has a past history of MI at age 65. During your assessment Mrs McKenzie reports the shortness of breath has been ongoing for the last 7 days, and worsens when she does her gardening and goes for a walk with her husband.

    On examination her blood pressure was 170/110 mmHg, HR 54 bpm, respiratory rate of 30 bpm with inspiratory crackles at both lung bases, and Sp02 at 92% on RA. Her fingers are cool to touch with a capillary refill of 1-2 seconds. Mrs McKenzie states that this is normal and she always has to wear bed socks as Mr McKenzie complains about her cold feet.

    Her current medications include: digoxin 250mcg daily, frusemide 40mg BD, enalapril 5mg daily, warfarin 4mg daily but she sometimes forgets to take all of her medications. The following blood tests were ordered: a full blood count (FBC), urea electrolytes and creatinine (UEC), liver function tests (LFT), digoxin test, CK and Troponin. Her potassium level is 2.5mmol/L.

    Mrs McKenzie also has an ECG which showed sinus bradycardia, and a chest x-ray showing cardiac enlargement and lower-lobe infiltrates.

    Impression: Congestive cardiac failure

    Case Study 2

    Ms Maureen Smith is a 24 year old female who presented to her GP for ongoing gastrointestinal bleeding, abdominal pain and fatigue which has been worsening, and was referred to the local hospital for further investigation.

    Maureen was diagnosed with rheumatoid arthritis (RA) when she was 15 years old, and has experienced multiple exacerbations of RA which have required the use of high dose corticosteroids. She is currently taking 50mg of prednisolone daily, and has been taking this dose since her last exacerbation 2 months ago.

    Maureen also has type 2 diabetes which is managed with metformin. She is currently studying nursing at university and works part-time at the local pizza restaurant.

    On assessment, Maureen’s vital signs are: PR 88 bpm; RR 18 bpm; BP 154/106 mmHg; Temp 36.9oC: SpO2 99% on room air. She has a body mass index (BMI) of 28kg/m2 and the fat is mainly distributed around her abdominal area, as well as a hump between her shoulders.

    Maureen’s husband notes that her face has become more round over the past few weeks. Her fasting BGL is 14.0mmol/L. Blood test results show low cortisol and ACTH levels, and high levels of low density lipoprotein cholesterol. She is awaiting a bone mineral density test this afternoon, and is currently collecting urine for a 24-hour cortisol level measurement.

    Impression: Cushing’s syndrome

    Uploaded By : jack
    Posted on : April 07th, 2018
    Downloads : 0

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