Nursing Case Study Essay Sample The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed Sample Undergraduate Nursing Case Study. See for yourself why we're the world's leading academic writing company. One of our expert writers has created this bespoke sample Nursing case study that shows the incredible quality that's guaranteed with every piece of work ordered. Secure your academic success and place an order today or view our services Jan 27, · Nursing Assignment Introduction. The objective of this paper is to analyse the case of health scenario of Mr. Carlos Sanchez as described below: Mr. Sanchez is a year old gentleman who lives at home with his wife Sandra
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The objective of this paper is to analyse the case of health scenario of Mr. Carlos Sanchez as described below:. Sanchez is a year old gentleman who lives at home with his wife Sandra. He is a retired public servant and has smoked heavily for the last 50 years. Since his retirement four years ago, Carlos had mildly elevated blood pressure for which he took diltiazem daily.
Two years ago, he was diagnosed with type II diabetes mellitus for which he was prescribed metformin. However, case study essay example nursing, Carlos often forgets to take his daily sugar tablet.
He is overweight and likes nothing better than to have a couple of glasses of wine and cheese every night with his wife. Over the last few weeks, he started to get breathless when gardening or walking up the gentle hill near his house. On Friday afternoon, while gardening while with Sandra, Carolos collapsed. Sandra rang ambulance and within twenty minutes he arrives to the emergency department on a stretcher. Prior to the admission, case study essay example nursing, the patient was reported to be having mild blood pressure, suffering from Type II diabetes, panting for breadth.
By disposition, he was obese, case study essay example nursing, a regular drinker and heavy smoker. Besides, he was forgetful to take his medication of Metformin prescribed for diabetes. The intern on duty who did a physical examination recorded that he had left and right crackles to mid-lung field and oedema to ankles and knees. According to him the preliminary findings point towards case study essay example nursing occurrence of congestive heart failure but in order to confirm he opines for the need to take additional tests towards which he orders for electro cardiogram and chest x-ray, case study essay example nursing.
The results show the existence of atrial fibrillation, pulmonary oedema, and cardiac hypertrophy. Episodes of Atrial fibrillation AF can either be sudden or chronical in nature. It is considered to be chronic case study essay example nursing it reappears after seven days. It is termed to be persistent if the attack does not cease within a period of 48 hours. Some of the important causes for the occurrence of AF could be traced to reversible factors as alcohol ingestion, hypothyroidism, or pulmonary embolism.
It often causes irregular and rapid heart rate resulting in palpitations, dyspnoea, and asthenia. It also causes impairment of hemodynamic function while at rest or physical activity. Its presence increases the risk of cerebrovascual insults Wolf, In a number of surveys, Kannel,it has been established that the cardiac and total mortality in patients with AF is doubled when compared with sex and age-adjusted groups in sinus-rhythm. A dominant part of such risk is attributed to the underlying structural heart diseases.
It needs however to be noted the risk level of those diagnosed with lone A. is at much lesser risk, at least in those who age is below 60 years Kopecky, This could be due to the fact that a decreasing tendency of the occurrence of primary AF is seen due to the availability of sophisticated diagnostic procedure which facilitates the exposure of the underlying diseases faster.
Its occurrence in elderly patients is also relatively lesser. The pathophysiological mechanisms of case study essay example nursing attack and of chronic AF even though have not been fully understood, yet the factors that are known to contribute to it are i shortened refractory period, ii regional variations of refractoriness and conduction velocity and iii increased ectopic activity.
The substrate of AF is described as a continuous activation of the atrial myocardium characterised by reentry of several circles which are not anatomically fixed but found to be spread and mingled in a seemingly chaotic pattern Moe, The probable reason for the forming of several reentry cycles could be attributed to the short refractoriness and slow conduct velocity respectively which results in short wavelength, case study essay example nursing.
This is confirmed by the existence of electrophysiologic remodeling with the gradual shortening of the refractory period during the first hours to days of an attack of atrial fibrillation. Cardiac hypertrophy is characterised by an increase in the mass of the contractile and ancillary proteins of the heart. Hypertension is seen as the commonest cause for the occurrence of cardiac hypertrophy.
A close relationship exists between total peripheral resistance TPR and hypertension. The starting phase of hypertension is marked by an increase in the TPR associated with the tropic factors in the blood vessel wall Marrero et al, They cause cardiac hypertrophy.
Besides, cardiac hypertrophy is more correlated to systolic dysfunction than diastolic dysfunction Middlemost, Alcohol consumption constitutes one of the important pathophysiological bases for cardiac hypertrophy. Furthermore where there is the presence of cardiac hypertrophy, there is a greater potential for arrhythmia.
Pulmonary Oedema is a condition where there is an abnormal accumulation of fluid in the lungs. It is characterised by the accumulation of fluid accompanied by low-protein content in the lung interstitium and alveoli due to cardiac dysfunction.
The pathophysiological mechanisms that account for Pulmonary Oedema are a increased pulmonary capillary pressure, b possible damages to the alveolar-capillary barrier, iii lymphatic obstruction. Pulmonary Oedema could be caused by excessive intravascular volume administration, pulmonary venous outflow obstruction, and or failure of the left atrial myxoma. Such patients develop acute breathlessness, anxiety and marked confusion. CHF refers to a syndrome wherein there is an inability seen in the heart to pump sufficient quantity of oxygenated blood to meet the needs of the body, case study essay example nursing.
Patients likely to be subjected to it suffer from shortness of breath, pulmonary oedema and it can result among other things in liver congestion. From a pathophysiology point of view, when CHF occurs and drop in cardiac output, the sympathetic nervous system SNS gets stimulated.
This results in increased heart rate and force of contraction, in addition to increased preload of left end case study essay example nursing pressure and vascular resistance.
Vasoconstriction also occurs. The kidneys try to compensate for the initial decrease in cardiac output by decreasing the renal perfusion and activating the rennin-angiotensin-aldosterone-system RAAS. However, in either acute or chronic heart failure such initial compensatory mechanisms ultimately prove counterproductive.
Once either the left or right ventricle loses its ability to handle the increase preload, there is a back up of fluid. In the case of left ventricle, the accumulation of the fluid reaches the pulmonary bed which is responsible for the causing of shortness of breath, dyspnea on exertion and result in pulmonary oedema. On the other hand, when the involved part is right ventricle, the fluid has a tendency to get into the systemic circulation and produces such symptoms as elevated central venous pressure, CVPhepatomegaly, anorexia, edema etc Hunt et al, Electrocardiogram ECG is one of non-invasive tests conducted to identify underlying heart problems.
Wherever the physician suspects irregular case study essay example nursing of heartbeats deviating from the normal rate ranging between 60 and beats a minute, they can order for the conduct of electrocardiogram test.
In such cases, it can act as a principal tool for the diagnosis of cardiac arrhythmias. In addition, it also provides valuable information to the physician on the state of the heart muscle arising out certain alterations in the electrocardiographic complexes, in particular the QRS-T part. Nonetheless, the interpretation of results assume a critical significance for the reason a normal ECG can show up in patients with serious heart problems while at the same time showing up of abnormal electrocardiogram in itself need automatically indicate the existence of serious heart disease.
However, this does not dispense away the utility of this tool for preliminary investigation in the assessment of the patient with suspected heart failure for the reason if the ECG is totally normal, it is reasonable for the physician to arrive at a conclusion that a patient is unlikely to have a heart failure Hurst JW, Chest radiology can provide additionally useful information particularly in regard to the presence or absence of cardiomegaly Fonseca et al, It can also throw light on the existence of pulmonary congestion.
Besides, it can provide clues to the causes of breathlessness as for instance as to whether it is due to the presence of chronic case study essay example nursing pulmonary disease or consolidation.
Its limitation consists in the fact that its quality cannot be assured in older patients, especially those in whom chest wall abnormalities are found. It is a life saving drug, shorter diuretics, when administered intravenous acts in minutes and is effective for six hours. It is given to eliminate Pulmonary Oedema. It is anticoagulant and when given subcutaneous aims at handling deficiency case study essay example nursing coronary blood circulation, case study essay example nursing.
When the dynamic circulation of blood gets altered, it results in stasis of fluid. This can result in the springing of blood clots. When administered subcutaneous, it helps in the prevention of fibrous clot formation and or alters the traveling of such clots.
It is an Angiotensin inhibitor and is given for the control of hypertension. It works on the kidney and prevents the conversion of Angiotensin 1 to Angiotensin 2. Conclusions When considered from the situation and experience of this nursing professional, the patient has been given the right kind of treatment and the tests asked for appear to be relevant.
This can also be said about the medication, but for the following observations, case study essay example nursing. Large doses of Frusemide can result in the depletion of potassium and hence there is a need for giving potassium supplement. There is no information whether this was done. Enalpril is now-a-days is replaced by Telemasarta. There is no reason given as to diltiazem was stopped.
There is also no information on the dosages and no explicit information on the seriousness of the condition of the patient. This can only be inferred and points towards the fact that at the time of admission the patient condition was serious. Cotter, G. January 01, : The pathophysiology of acute heart failure—is it all about fluid accumulation?
American Heart Journal,1, Fonseca CMota T, Morais H et al. EPICA investigator September, 01, : The value of the electrocardiogram and chest x-ray for confirming or refuting a suspected diagnosis of heart failure in the community.
Guyton, A. Philadelphia: Saunders. Hess OM and Carroll JDClinical assessment of heart failure : In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Hurst, J. January 01, : Observational data suggesting there are electrocardiographic abnormalities that strongly suggest the presence of chronic heart failure. Clinical Cardiology, 28, 3, Hunt SA, Abraham WT, Chin MH, et al.
Circulation ; e Kannel, W. January 01, : Epidemiologic features of chronic atrial fibrillation: the Framingham study. Case study essay example nursing New England Journal of Medicine,17,
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May 26, · A typical medical school essay, for example will involve research of existing literature and the setting up of a study based upon that literature. Writing a Nursing Essay Nursing students will find that a basic essay assignment will have the same structure as essays they have written for non-medical courses – introduction, body, and conclusion Jan 27, · Nursing Assignment Introduction. The objective of this paper is to analyse the case of health scenario of Mr. Carlos Sanchez as described below: Mr. Sanchez is a year old gentleman who lives at home with his wife Sandra 10+ Nursing Case Study Examples in PDF | DOC. ScienceDirect posted a nursing ethics case study where an end-stage prostate cancer patient, Mr. Green, confided to nursing staff about his plan to commit suicide. The patient asked the nurse to keep it a secret. The ethical problem is whether the nurse should tell the health care team members about the patient’s thought without his permission
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