Management of Changing Patient Condition Questions

Management of Changing Patient Condition Questions ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Management of Changing Patient Condition Questions Please fill out case study attached – 3 nursing diagnosis needed – There are 7 questions that need to be answered throughout the case study. Management of Changing Patient Condition Questions – Please only accept if familiar to nursing and the nursing diagnosis. – If you have any questions throughout the case study don’t hesitate to ask attachment_1 Element: Patient Outcomes Management of Changing Patient Condition Concept: Impaired Circulation Overview This learning tool is designed to enhance physical assessment, critical thinking, and clinical decision-making skills. Use pathophysiology and the nursing process as the cognitive framework to guide your progress through the case study. Learning Outcomes By the end of the experience, the learner will be able to do the following: Link related pathophysiology to assessment findings in a patient with impaired circulation. Use clinical reasoning skills to anticipate nursing interventions in the patient experiencing a rapid change in condition. Communicate the patient’s condition to an interdisciplinary team. Develop a discharge plan for a patient with impaired circulation. Case Scenario A 40-year-old man presents with complaints of chest pain, rating the pain as a 9 on a 10-point scale. He states that the pain began suddenly about 30 minutes before arriving to the emergency department. He states that he cannot do anything to relieve the pain and describes it as “crushing.” The patient states he visited his doctor 4 days earlier with a complaint of pain in his left leg. He was given a prescription for Motrin, 800 mg orally every 3 to 4 hours as needed, and returned home to rest. He has been taking the Motrin as prescribed. 1. Based on the presenting information, what do you think is going on with this patient? 2. What are risk factors for coronary artery disease? 3. What other symptoms would you like to ask the patient about? 4. When completing your initial assessment, the patient states, “I feel a little light-headed.” He also states, “I feel short of breath and I have pain in my left shoulder.” He appears to be very anxious. What else do you want to know about his past medical history? Medical history reveals the following: He has a 40 pack/year history of smoking. His blood pressure has been “a little elevated,” somewhere in the range of 148/92 mm Hg on his last two visits to his medical practitioner. He admits to eating fast food three to five times per week but is proud that his total cholesterol “hovers” around 242 mg/dL. His father has angina that began at age 53 years but is alive and well. His mother has no known medical history. He exercises regularly and recently noticed a couple of episodes of shortness of breath while jogging but attributed it to “getting old.” He was hospitalized 3 years ago for influenza complicated by pneumonia. He perceives himself as being healthy, takes no routine medications, and has no known drug allergies. 5. What medications might someone take who presents with a similar picture? Physical Assessment Physical Assessment Rationale Use this column to describe the link between assessment findings and related pathophysiology. Indicate the pertinent positives and pertinent negatives of the condition using the information presented. Vital signs: T 37 °C P 100 with an occasional premature beat RR 24 BP 130/70 O2 saturation on room air 96% Height, weight, and waist circumference: 5?11?, 220 lb, 40? waist General appearance: Alert, moderately anxious, appears to be in moderate distress Skin Eyes: PERRLA Ears and hearing: Denies hearing loss or drainage Nose and sinuses: Clear without tenderness Mouth: Teeth in good condition Neck: Supple without thyromegaly, no bruits, < 2 cm jugular vein distention Lymph nodes Thorax and lungs: Tachypneic, with mild use of accessory muscles of respiration No tenderness upon palpation of the chest wall Slight inspiratory crackles (rales) heard at both bases No rubs Heart: Tachycardia with occasional premature beat Apical pulse at 5th intercostal space lateral to midclavicular line Soft S3, no S4, no murmurs No rubs Peripheral circulation: Extremities with full symmetric pulses, mild edema LLE Abdomen: Abdomen with bowel sounds throughout, no tenderness Musculoskeletal Neurologic: Alert and oriented, neurologic examination intact to cognition, strength, sensation, gait, and deep tendon reflexes 6. What is the main priority for this patient? Admission The patient is admitted with the following orders: ECG stat CT pulmonary angiogram (CTPA) to rule out pulmonary embolism Left lower extremity ultrasound Chest xray Echocardiogram to look for wall motion abnormalities and ejection fraction Oxygen 2 L via nasal cannula IVF with NS at rate of 10 mL/hr ASA 325 mg orally now Clopidogrel 75 mg oral daily Morphine sulfate 2 mg IV every 10 minutes as needed for pain Furosemide 40 mg IV Nitroglycerin 0.3 mg sublingual every 5 minutes × 3 Complete metabolic panel (CMP) Complete blood count (CBC) Prothrombin time/international normalized ratio (PT/INR) to determine clotting times Troponin Creatine kinase myoglobin (CK-MB) Brain natriuretic peptide (BNP) 7. Develop three nursing diagnoses related to the pathophysiology of this patient, as informed by the findings of your assessment and the preceding lab values. In other words, link the pathophysiology to what you anticipate will happen with the patient. Use the following table to guide the process. Alteration in Condition (Pathophysiology) Critical Thinking and Clinical Decision Making Apply your knowledge of pathophysiology to the clinical decisions you will make as you plan for client care. Using critical thinking to guide the process, link the pathophysiology to the clinical plan of care. Consider, “What do I anticipate will happen with this patient?” Management of Changing Patient Condition Questions Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10