NURBN2012: Nursing Practice 3 - Betsy Case Study - Pathophysiology and Pharmacology - Report Writing Assessment Answer

Internal Code: D_BJ_DFJI_BBE Code: NURBN2012

Nursing Assessment Answer

Assignment Task: NURBN2012 NURBN2012: Nursing Practice 3 - Pathophysiology and Pharmacology Applied to Nursing Assessment Task 2 – Clinical Scenario Assignment Directions - NURBN2012 For this assessment task, you are required to write a 2000 word report answering the questions from the scenario. You will need to explore the pathophysiology, pharmacology and psychosocial aspects of the scenario and demonstrate your understanding in the answers you provide. Your answers should be informed by your reading of current research and literature. A report format includes an introduction and conclusion, but headings are used in the body of the text. Use the question you are answering as your heading. Do not use dot points for your answers. Do not write in the first person. Appropriately referenced and labelled tables, diagrams or images may be used in the body of the paper. You may reproduce the tables used in the questions in your answers. Use APA referencing throughout your assignment. References must be current, preferably from the past five years. You are required to cite no less than 10 references, and the majority of these should be current journal articles. We are looking at information informing current clinical practice, and your choice of references must reflect this. Consider the quality of the references you use. Wikipedia, Web MD, the Better Health Channel and blogging websites are not acceptable references. Any non-reliable sources in your reference list will not count toward the number of required references, and this will result in a loss of marks. At this point in your BN you are expected to engage with best practice literature. Criteria for grading - NURBN2012 Marking of this assessment task will be undertaken by academic and teaching staff. Pre and post moderation will be undertaken for this assessment task. The marking rubric for the assignment is provided on Moodle. Marks will be allocated for each section according to the rubric. Use the rubric as a guide when writing your assignment to identify the depth of the answer expected. Betsy Case Study - NURBN2012 Betsy Blogger is a 72 year old woman on your surgical ward complaining of nausea and shortness of breath. She had an uncomplicated fixation of a right tibula and fibula fracture 2 days ago. Past medical history - NURBN2012 Coronary Artery Bypass Graft (CAGs) x 3 (8 years ago) Chronic Obstructive Pulmonary Disease (COPD) Coronary Heart Disease Hypertension Type 2 Diabetes Mellitus Current Medications - NURBN2012 Aspirin 100mg oral daily Diltiazem SR 240mg oral daily Endone 5mg oral PRN QID Enoxaparin 40mg S/C BD (while immobile in hospital) GTN spray 1 – 2 sprays S/L PRN Metformin 500mg oral BD Paracetamol 1g oral QID Pravastatin 40mg oral nocte (bedtime) Salbutamol 2 puffs PRN Spiriva 2 puffs daily History of presenting complaint - NURBN2012 Betsy has just returned from the toilet and buzzed as she sat back down on the bed. She tells you she feels short of breath and nauseous. She denies any chest pain. Observations - NURBN2012 HR 90, regular BP 145/85 Skin – sweaty and pale RR 26, regular SpO2 94% RA Temp. 37oC Pain 3/10 to surgical wound BSL 5.5 Your buddy nurses ask you to perform an ECG while she calls the doctor to review Betsy. Question 1 - NURBN2012 Your buddy nurse asks for an ECG even though Betsy has no chest pain. Explain the rationale for the ECG request. Question 2 - NURBN2012 Betsy has stable angina that is responsive to GTN. 2a. Describe the pathophysiology of angina, with reference to causes, progression, and outcomes. Include stable angina, unstable angina, nonSTEMI, and STEMI in your answer 2b. List two risk factors specific to Betsy (not including age or gender) that increase her risk of Acute Coronary Syndrome (2 marks) Question 3 - NURBN2012 Appendix 1 is an ECG that was taken while Betsy was experiencing nausea and shortness of breath. Systematically analyse the ECG, commenting on the: - Rhythm - Rate - Presence and regularity of p waves - ST segment What is your interpretation of this ECG? Question 4 - NURBN2012 Acute Coronary Syndrome is suspected when specific clinical criteria are met. Discuss three of the central findings that potentially lead to a diagnosis of Acute Coronary Syndrome. Question 5 - NURBN2012 Use the table below (or something similar) to discuss the following drugs: GTN, diltiazem and pravastatin. Do not list gastrointestinal upsets (such as nausea and vomiting) as complications/side effects or nursing considerations. Only include information that can be directly applied to Betsy. Generic name GTN Diltiazem Pravastatin Drug group (1 mark) Mechanism of action  Complications/side effects (2 major) Nursing considerations (2 major) Question 6 - NURBN2012 Betsy has been commenced on ticagrelor in addition to her aspirin. Discuss the mechanism of action and use of aspirin and ticagrelor in cardiac patients. Include in your answer how these drugs combined will improve the outcome for Betsy. Question 7 - NURBN2012 The use of morphine in Acute Coronary Syndrome (ACS) is currently undergoing review. Discuss how morphine is used in ACS, including the benefits and controversies. Make sure to include current research in your answer. Question 8 - NURBN2012 Betsy has an increased risk of depression due to her coronary heart disease (a chronic illness). Use current research to link the increased risk of depression with chronic illness.

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