Case study NURS7105 Semester 2 2017
This assessment is designed to enable students to demonstrate their capacity to critically analyze the clinical case study presented below. Further details are provided at the end of the case study.
Mrs Eleanor Hale is a 56-year-old female who has been in your ward for 2 days for treatment of pneumonia. You are a Graduate Nurse on the second rotation of your Graduate Program and Mrs Hale is one of your patients today.
You learn from her notes that Mrs Hale lives alone in rented accommodation and has recently retired on a superannuation pension as her only source of income. Mrs Hale’s son lives in Melbourne and rarely sees him. When you are talking to Mrs Hale, she is teary and tells you she has been feeling down lately. She is worried about going home as her chest pain has occurred several times recently when she’s doing the housework. Mrs Hale states that she hates asking anyone for help.
As documented in the progress notes Mrs Hale has a history of Ischemic Heart Disease (IHD), Hypertension and beginning Peripheral Vascular Disease (PVD). She had Coronary Artery Bypass Graft Surgery (CABG) six years ago with Saphenous Vein grafts to her Left Anterior Descending (LAD) coronary artery and Diagonal branch. Two years ago Mrs Hale underwent a Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting to her Right Coronary (RCA) and Posterior Descending (PDA) arteries.
Mrs Hale smoked for 30 pack years, starting at the age of 19 and ceasing at 49 when she was first diagnosed with Coronary Artery Disease (CAD).
Her weight is charted as 88kg and her height 158cm
Her observations at 0800 hours were as follows:
Temperature: 37.3ᵒC
Pulse: 74bpm, regular, volume strong
Respiratory rate: 14/min, regular, normal depth
BP: 165/90mmHg (normal for her)
SpO2: 98% on room air
30 minutes later when you are administering Mrs Hale’s medications you notice that she is a little diaphoretic. On questioning she says that she does not feel well, has a mild pressure sensation in her chest (rated 4/10) that started about 10 minutes ago while she was lying in bed. She states that it is much the same sort of pain she has had previously. When further questioned she states that she also has a slight ache in the underside of her upper left arm, and is feeling a little nauseated.
You assess her vital signs again and they are as follows:
Temperature: 37.2ᵒC
Pulse: 116bpm regular and volume is not as strong as previously
Respiratory Rate: 26/min, regular, a little shallower than previously
BP: 105/70mmHg
SpO2: 92% on room air
She has developed slight shortness of breath. Peripheries are a little cool to touch.
Students must address the points below:
1. Provide an introduction (approx. 150words)
2. Briefly discuss Mrs Hale’s heart disease and the likely stage of her disease process including: (approx. 500 words)
a) anatomy
b) physiology
c) pathophysiology
3. Analyse the changes in Mrs Hale’s clinical presentation and link these to the pathophysiological processes which are occurring. You will need to explain what could be causing the changes in her signs and symptoms. (approx. 500 words)
4. Discuss and critically analyse the priorities of care that you have included as part of your nursing care. You will need to consider the changes in her condition, giving rationales for the priorities of care and specifically the management of her chest discomfort. (approx. 800 words)
5. Briefly discuss the psychosocial issues relating to Mrs Hale’s current stage of disease and her life situation. (approx. 200 words)
6. Discuss one legal or ethical issue which the nurse may need to consider. (approx. 200 words)
7. Provide a conclusion (approx. 150 words)
Additional Information
Word limit: 2500 words maximun
UQ APA 6th referencing is to be used throughout
Academic style writing is required
Line spacing should be 1.5sp for ease of marking
Criteria & Marking: Marking Guide Essay.pdf
Submission:
All courses require students to submit an electronic version of their assignment via Blackboard. Please check the companion website assessment area for specific instructions on this process. A link will be made available in the assessment area of your Blackboard course to allow you to submit your assignment electronically.
The anti plagiarism software TURNITIN is being used at UQ. The electronic version of your assignment will be submitted via Blackboard, using the TURNITIN software. Work submitted may be subjected to a plagiarism detection process. If this process is used then copies of this work would be retained and used as source material for conducting future plagiarism checks. Please refer to ITS help if you experience difficulties in submitting your assignments in Blackboard or using TURNITIN as instructed on the companion website.
