The knowledge and skills related to nursing care of individuals experiencing acute medical health alterations.
This essay has to be designed to assess the knowledge and skills related to nursing care of individuals experiencing acute medical health alterations, and the best practice in managing this exacerbation. Specific focus will be on researching the pathophysiology of the
relevant disease, the pharmacology of medications used to manage the disease, and the evidence based nursing care required to look after
these patients, while supporting this information with appropriate references (APA 2009-2015).
This essay has to answer the associated questions and presented in a question/answer format
The following questions relates to the patient within the first 24 hours:
1. Outline the causes, incidence and risk factors of the identified condition and how it can impact on the patient and family
(approximately 400 words)
2. List five (5) common signs and symptoms of the identified condition; for each provide a link to the underlying pathophysiology
(approximately 350 words) a. This can be done in the form of a table – each point needs to be appropriately referenced
3. Describe two (2) common classes of drugs used for patients with the identified condition including physiological effect of each class
on the body (approximately 350 words) a. This does not mean specific drugs but rather the class that these drugs belong to.
4. Identify and explain, in order of priority the nursing care strategies you, as the registered nurse, should use within the first 24
hours post admission for this patient (500 words).
Case Study – Congestive cardiac failure with possible ? digoxin toxicity
Mrs Sharon McKenzie is a 77 year old female who has presented to the emergency department with increasing shortness of breath, swollen
ankles, mild nausea and dizziness. During your assessment Mrs McKenzie reports the shortness of breath has been ongoing for the last 7
days, and worsens when she does her gardening and goes for a walk with her husband.
On examination her blood pressure was 105/55 mmHg, HR 54 bpm, respiratory rate of 24 bpm with inspiratory crackles at both lung bases, and
Sp02 at 92% on RA. Her fingers are cool to touch with a capillary refill of 1-2 seconds. Mrs McKenzie states that this is normal and she
always has to wear bed socks as Mr McKenzie complains about her cold feet.
Her current medications include: digoxin 250mcg daily, frusemide 40mg BD, enalapril 5mg daily, warfarin 4mg daily.
The following blood tests were ordered: a full blood count (FBC), urea electrolytes and creatinine (UEC), liver function tests (LFT),
digoxin test, CK and Troponin. Her potassium level is 2.5mmol/L.
Mrs McKenzie also has an ECG which showed sinus bradycardia, and a chest x-ray showing cardiac enlargement and lower-lobe infiltrates,
suggesting the presence of acute exacerbation of congestive cardiac failure.
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