Mr. Curtis Case Study - Nursing Assignment Help

Assignment Task

CASE STUDY: Mr Curtis 
You are caring for Mr Curtis, a 69-year-old man who has been admitted for a routine laparoscopic cholecystectomy. He has a medical history of hypertension and angina over the last year that has previously responded to treatment with GTN spray.

QUESTION 1: Cardiac arrhythmia

When performing your observations after Mr Curtis returned from theatre 6 hours ago, you find that he has an irregular Heart Rate (HR). You perform an Electrocardiogram (ECG) and see the following cardiac rhythm:

a. Thoroughly interpret and explain the above cardiac rhythm.
b. Discuss three (3) potential reasons for this cardiac rhythm to occur.
c. Discuss three (3) treatment options for a patient in this cardiac rhythm.

QUESTION 2: Pathophysiology and treatment

You notice that Mr Curtis is coughing and short of breath. His respiratory rate (RR) is 26, his SaO2 is 91% on RA and Blood Pressure (BP) is 170/80. The met call team has requested a chest X-Ray and an Arterial Blood Gas that have been performed, suspecting Acute Pulmonary Oedema (APO). The results are as follows:

ABG Normal Range
pH 7.27 7.35 – 7.45
PaO2 64 80 – 100 mmHg
PaCO2 58 35 – 45 mmHg
HCO3- 25 22 – 28 mmol/L
SaO2 91% 95 – 100 %
a. Provide a basic interpretation of the above ABG results.
b. Discuss the pathophysiology of APO.
c. Discuss the medical and nursing interventions generally for a patient in APO and specifically for Mr Curtis, taking into account handover content, the ABG and vital signs stated above.

QUESTION 3: Patient assessment with respiratory focus. You are providing a handover to the RN on the PM shift.

a. Describe and outline each component of an ED or HDU patient assessment.
b. Discuss three (3) respiratory signs and symptoms of APO and explain why they occur.
c. Detail and rationalise the assessment/monitoring required for Mr Curtis throughout the PM shift

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