Another blood pressure and pulse is obtained a few hours later as it was still both high at 148/91 blood pressure and a heart rate of 100. When assessing her routine labs, there is no significant abnormalities noted. After presenting the data to the physician and the physician assesses the patient, it is concluded that M.S. has the medical diagnosis of stage 1 hypertension. According to ATI, stage 1 hypertension is a blood pressure reading of “systolic 140 to 159 mm Hg; diastolic 90 to 99 mm Hg” (ATI, RN Medical Surgical Nursing, pg.411). In the patient care plan, the priority nursing diagnosis is risk for decrease cardiac output related to increased vascular resistance. Another nursing diagnosis in the patients care plan is, knowledge deficit related to lack of knowledge of new diagnosis. In order to get her blood pressure and heart rate to go down, the physician ordered metoprolol…
The jugular veins empty into the superior vena cava and then into the right atrium, so JVD…
Greg Wilson, a 65-year-old man, is diagnosed with pneumonia. He has a history of congestive heart failure. His physician has ordered an antibiotic for the pneumonia and he takes digoxin every day.…
Thoroughly read all patient information. Using critical thinking, answer the questions in full and thoughtful sentences. All work must be typed and submitted via My Classes as a Word document.…
11/3/16 1800 Instill 1 drop in both eyes at routine for dry eyes. Gave PRN Tylenol 325mg 2 tablets for complaints pain on right thumbnail rated 6/10. Patient states that she is having shortness of breathing when she was walked back from the dining room to her room. O89% by NC. Reported to nurse. Gave routine albuterol and ipratropium 0.5 mg nebulizer. Offered 1 cup of protein shake mixing with nectar powder. Encourage pt to drink it because she didn’t eat much at supper, will get hungry later. Drank 60%. HDoan WATC PN 2.…
Mrs. Julia Steel is a patient I have had the pleasure of meeting with recently. As discussed during the appointment, Mrs. Steel is a 72 year old retired, married woman. Collectively, Mrs. Steel's family history includes the following information: one son at the age of 40 who is being treated for high blood pressure, father's record showed background of heart disease and deceased at the age of 90 due to a brain aneurysm, mother's record provided extensive history with heart disease and deceased due to congestive heart failure at the age of 92, brother who passed at the age of 81 due to heart disease, sister at the age of 76 who has suffered multiple minor heart attacks. According to the biographical data collected, her family history exhibits a…
You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.…
Mrs Webster has been referred to me due to the pain in her chests and her recent diagnoses of high blood pressure that puts her at a higher risk of getting CHD. My role as her cardiologist is to ensure that I carry out further investigation to diagnose and to provide treatment for Mrs Webster.…
Hi Tamela, great post. You made great points on the different questions we need to ask the patient. I agree with you that she might be experiencing the side effects of the medication. There are times that the patient just take the medication as ordered by the physician but don’t know about the side effects. It is indeed important to educate our patients regarding the possible side effects, drug-drug interactions, herbal-drug interactions, or food-drug interactions. Due to S.P.’s history of MI, it is important that her hypertension and hyperlipidemia be manage properly to prevent recurrent…
The patient’s chief complaint, present illness history, past history, family history, social history, current medications, and review of systems…
In my role as a specialist nurse I am involved with caring for patients within a community setting and providing a holistic assessment of their needs. This can involve assessing patients as a result of a supported discharge from secondary care or referral from General Practitioners (GP’s) for issues related primarily to their cardiac condition, their general overall health and any other health related issues. These assessments can take place within the patient’s home or within a clinic setting. These assessments are quite commonly carried out with very little prior knowledge regarding the patient and this is currently an area under review. For the purpose of this case study I will look at a lady who attended a clinic session within a GP’s practice.…
Mr. Debourg is 62 year old male. In 2013, during routine physical with his physician, he was referred to a cardiologist for further evaluation. Patient was diagnosed with high blood pressure and started on Lisinopril 10mg daily. Due to stress from work, he started having palpitation and shortness of breath. On 4/13/2014, patient started feeling hot and dizzy. When his wife noticed patient’s face was turning pale, she took his blood pressure. Patient states he’s blood pressure at that time was around 200/100, heart rate above 150. Mr. DeBourg drove himself to the hospital where he was admitted for further evaluation and tests. Angiogram showed 2 blocked arteries and he received Cardiac stent placement. Patient is now on 4 blood pressure medications and sees cardiologist…
Living with a chronic debilitating disease is very challenging and the effects eventually will make an impact on an individual personally, emotionally, socially, and financially. Congestive heart failure (CHF) is one chronic disease that is progressive and difficult to manage. Patients diagnosed with congestive heart failure have a critical learning curve to maintain health and to manage and live with this disease. Physicians and nurses are in the frontline to providing patient education, which will interpret the degree of compliance by the patient. Heart failure begins when the heart is not able to pump blood efficiently out to the body. In left-sided heart failure, the heart muscle becomes weak and the ventricles do not eject adequate blood volume, leading to pulmonary edema. Cardiac output reduces and the metabolic demands of the body are not met. Right-sided heart failure results when the right ventricle does not provide sufficient cardiac output causing systemic congestion. Contractility diminishes because of causes such as cardiomyopathy, myocardial infarction, myocarditis, coronary artery disease, hypocalcemia, drug effects, or from receiving radiation therapy. Research results suggest that heart failure may be linked to genetic disposition, and occurs at any age or race (Sommers, 2011).…
PC does know his medication and their doses. He also can tell you what interacts with his medications and what they are used for. Patient currently takes lisinopril 10mg once a day and Lipitor 10mg, which was recently reduced from 20mg. PC states he also uses a OTC Prilosec to help with heart burn.…
This document contains a brief over view of teaching methods that will be used to educate my patient about the medications she is taking, diagnosis and enhancing mechanisms as well. Only the medications that are prescribed to my client daily and on a regular basis will be included. Materials may accompany this document for teaching purposes.…