Case Study Question 1 Congestive Cardiac Failure
Mr Ward is a 71 year old male who reports feeling a non-radiating, "heavy" discomfort in the lower retrosternal and epigastric region particularly when he bends over or walks short distances. He also reports a further 7 days of dyspnoea during moderate exertion. On examination his blood pressure was 165/95 mm HG, pulse 90 -100 bpm, respiratory rate of 24 with inspiratory crackles at both lung bases.
The following blood tests where ordered: a full blood count (FBC), Urea Electrolytes and Creatinine (UEC), Liver Function Tests (LFT), CK and Troponin. All results were within normal limits.
An Arterial Blood Gas was also collected resulting in: pH 7.410, pCO2 38.7mmHg, PO2 69.8mmHg, HCO3 24.0mmol/L, BE -0.7mmol/L and O2 SAT 89.3%
Mr Ward also has an ECG that showed normal sinus rhythm, and a chest x-ray showing cardiac enlargement and lower-lobe infiltrates, suggesting the presence of acute exacerbation of congestive cardiac failure.
The following questions relates to the patient within the first 24 hours:
1. Outline the causes, incidence and risk factors of chronic congestive cardiac failure (250 words), (10 mark)
? Linked to case study
? Provides a comprehensive explanation of impacts on client and/or family
2. List five (5) common signs and symptoms of congestive cardiac failure; for each provide a link to the underlying pathophysiology (300 words), (10 mark)
? Provides a comprehensive look at the identified five (5) common signs and symptoms
? Provides a comprehensive link to pathophysiology
3. List three (3) common tests (including normal values) used to diagnose congestive cardiac failure and the likely abnormalities that will be detected within these tests and why these occur pathophysiologically. (create a table for your answer; 200 words), (10 mark).
? Identifies three (3) common test and values
? Identifies all appropriate abnormalities
? Provides comprehensive reasons why these occur pathophysiologically
4. Describe two (2) common classes of drugs used for patients with congestive cardiac failure including physiological effect of each class on the body (250 words), (10 mark).
? Two (2) classes of drugs appropriately identified.
? A comprehensive understanding and explanation of the physiological effects on the body
5. Identify and explain, in order of priority the nursing care strategies you, as the registered nurse, should use within the first 24 hours for this patient. (500words), (35 mark).
? The care plan was articulate, logical, balanced and convincing. A diverse range of perspectives offered.
? All important aspects are covered demonstrating comprehensive knowledge of the key areas.
Within 10% of word limit :
• Flawless presentation
• An extensive range of relevant literature utilized with sophisticated interpretation and analysis.
• Accurate referencing using APA format. ( 5 mark)
• _Adheres to word limit
• _Clear progression of ideas
• _Correct grammar, syntax, spelling and punctuation
• _Structure and overall presentation appropriate to format chosen
• _Presentation and