Clinical Reasoning Assignment Case Study - Nursing Assignment Help

Assignment Task

Brief task description Critically analyse the case study of a patient presenting with chest pain, to plan nursing assessments and interventions.

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SITUATION Mrs Donna Hovey is a 60-year-old female who was admitted to the ward two (2) days ago for pneumonia. She is now complaining of mild pressure in her chest (rated 4/10) that started 10 minutes ago while she was lying on the bed. Mrs Hovey states she also has a slight ache in the underside of her upper left arm.
She is diaphoretic and feeling a little nauseated. Mrs Hovey has developed slight shortness of breath. Her peripheries are a little cool to touch

BACKGROUND Mrs Hovey has a history of Ischaemic Heart Disease (IHD), hypertension and beginning Peripheral Vascular Disease (PVD). She had Coronary Artery Bypass Graft (CABG) surgery six (6) years ago with Saphenous Vein grafts to her Left Anterior Descending (LAD) coronary artery and diagonal branch. Mrs Hovey also
had a Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting to her Right Coronary Artery (RCA) and Posterior Descending Artery (PDA).

ASSESSMENT Her observations at 0700 hours were as follows:
Temperature: 37.3?C
Pulse: 74bpm, regular, volume strong
Respiratory rate: 14/min, regular, normal depth
BP: 165/90mmHg (normal for her)
SpO2: 98% on room air
Her observations NOW:
Temperature: 37.2?C
Pulse: 116 bpm, regular, volume not as strong as previously
Respiratory rate: 26bpm, regular, a little shallower
BP: 105/70 mmHg
SpO2: 92% on room air
RECOMMENDATION You have informed the Team Leader of Mrs Hovey’s complaints and vital signs
and the Team Leader will be contacting the treating team. You continue to stay
with Mrs Hovey while waiting for the treating team to arrive.

Question 1:
Mrs Hovey’s BMI puts her at the ‘Obese’ category. Discuss the impact of obesity on the cardiovascular diseases in relation to Mrs Hovey’s presentation. Ensure ALL your
statements are supported with relevant literature

Question 2:
a. Glyceryl Trinitrate (GTN) is a commonly used medication to manage chest pain. Describe the mode of action of this medication and ensure ALL your statements are supported with relevant recent scholarly literature

b. List two (2) side effects of the medication. Ensure ALL your statements are supported with relevant recent scholarly literature

c. Explain two (2) nursing responsibilities in relation to the side effects (identified above) of the medication. Ensure ALL your statements are supported with relevant recent scholarly literature

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