NUR 606 Week 7 Assignment 1 Written Case Study

March 8, 2022
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NUR 606 Week 7 Assignment 1 Written Case Study

NUR 606 Week 7 Assignment 1 Written Case Study

After completing your readings, learning activities, and assignments for this week, please download and complete the case study worksheet. Make sure to address all components of each question and answer thoroughly and concisely. Support each answer with evidence. Please be sure to use evidence-based, peer-reviewed journals that have been published within the past three to five years, in addition to your textbook and course materials. APA format is required for references and citations, but not for the body of the case study. Please use the case study worksheet to help with organization.
Case Study
Download the Week 7 Cardiovascular Case Study Worksheet (Word).
Please refer to the Grading Rubric for details on how this activity will be graded.
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NU606 Week 7 Cardiovascular Case Study
Part 1
Ms. X, age 55 years, has been complaining of severe fatigue and “indigestion” on and off, but it seems to be getting worse over the past several hours. Her son is quite concerned and decides to take her to the emergency department. On arrival, she appears very anxious, and her facial skin is cool and clammy; her blood pressure is 90/60, and the pulse is around 90, weak and irregular. She is given oxygen, an intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. Her son provides information that indicates Ms. X is a long-time smoker, has a stressful job as a high school teacher, is recently separated after 20 years of marriage, and is fearful of losing the family home. She has also seemed to be more fatigued, and stopped going to the gym about 18 months ago. She has begun to rely on “fast foods” like pizza and fried chicken and cooks infrequently. Her father died of a heart attack at age 50. She has also noticed more fatigue and intermittent leg pain when walking or climbing stairs at work. Generalized atherosclerosis is suspected.
1. List the high-risk factors for atherosclerosis in this patient’s history. For each risk factor, identify whether that would be measured/reported subjectively, objectively, or both.

2. Assuming Ms. X does, indeed, have atherosclerosis, how would this lead to the condition she is experiencing today?

3. What do you suspect Ms. X was experiencing when she reported “indigestion”? Was this true indigestion or related to her cardiac condition? Explain the pathophysiology behind this pain.

4. Think about the normal or typical presenting signs of myocardial Infarction. What is atypical in Ms. X’s symptoms? How does this affect treatment and prognosis?

5. What serum enzyme and electrolyte levels do you anticipate being checked in the ED. How are these levels related to the changes happening in Ms. X’s cardiovascular system?

Part 2
Since Ms. X is now stable and you are waiting on labs, you review some of her medical records. At her last several office visits with her PCP, her blood pressure was noted to be 145/90, 138/96, 150/94, and 142/96. She is not taking any medications for blood pressure at this time.
6. Do you think Ms. X has essential hypertension? Evaluate her blood pressure readings and use them to support your position.

7. Describe the pathophysiology of essential hypertension.

8. Identify and describe two possible problems associated with prolonged high diastolic pressure.

Part 3
After some diagnostics, it is determined that Ms. X has a large infarct in the anterior left ventricle; she continues to be monitored on telemetry.
9. What ECG changes would you expect to support left ventricular involvement and infarction?

10. X is showing increasing PVCs on the ECG. What is causing these and what can happen if these continue to increase in frequency.

11. X is preparing to go home with her son. Write her discharge instructions.

12. What lifestyle measures should be included to prevent a recurrent cardiac event?

13. It is determined by the team that she should be started on an antihypertensive agent, as her blood pressures have remained elevated during her admission. Identify two medications helpful in treating hypertension and describe their actions.

Part 4
Unfortunately, Ms. X’s condition becomes less stable, and she is unable to go home. Several days later, she is found unconscious on the floor of her hospital room bathroom. Her pulse is weak and elevated, and her skin is moist with pallor evident. Her BP is 50 systolic. A diagnosis of cardiogenic shock is made, and resuscitation efforts are started.
14. What signs and symptoms is Ms. X exhibiting that support cardiogenic shock? Label each as subjective (symptom) or objective (sign).

15. Describe the pathophysiology of cardiogenic shock and the effects of cardiogenic shock on the organs of the body.

nt and Meaning Through critical analysis, the submitted case study provides an accurate, clear, concise, and complete summary of the scenario.
Information from scholarly resources is synthesized, providing new information or insight related to the context of the assignment by providing both supportive and alternative information or viewpoints.
All instruction requirements noted.
30 points Case study is complete, providing evidence of further synthesis of course content via scholarly resources.
Information is synthesized to help fulfill the case study requirements. The content supports at least one viewpoint.
Submission provides clarification of the assignment by correctly answering all posed questions within the instructions.
All instruction requirements noted.
26 points Lacks clarification or new information. Scholarly reference supports the content without adding any new information or insight. Case study content may be confusing or unclear, and the summary may be incomplete.
Most instruction requirements are noted.
23 points Submission is primarily a summation of the assignment without further synthesis of course content or analysis of the scenario.

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Demonstrates incomplete understanding of content and/or inadequate preparation.
Missing some instruction requirements.
Submits assignment late.
20 points 30
Application of Knowledge The summary of the case study provides information validated via scholarly resources that offer a multidisciplinary approach to the scenario provided.
The student’s application in practice is accurate and plausible, and additional scholarly resource(s) supporting the application are provided.
All questions posed within the assignment are answered correctly in a well-developed manner, applying knowledge with citations for validation.
All instruction requirements noted.
30 points A summary of the study, findings, and knowledge gained from the assignment is presented.
Student indicates how the information will be used within their professional practice.
All questions posed within the assignment are answered within the case study. The answer to one question may be vague and/or limited in development, but as a whole all answers are correct.
All instruction requirements noted.
26 points Objective criteria are not clearly used, allowing for a more superficial application of knowledge between the assignment and the broader course content.
One question is answered incorrectly and/or two case study answers are vague or limited in development but remain correct.
Student’s indication of how they will apply this new knowledge to their clinical practice is vague.
Most instruction requirements are noted.
23 points The application of knowledge is significantly lacking.
Demonstrates incomplete understanding of content and/or inadequate preparation.
Student’s indication of how they will apply this new knowledge to their clinical practice is not practical or feasible.
Application of knowledge is incorrect and/or student fails to explain how the information will be used within their personal practice.
Multiple questions are not answered or are answered incorrectly (e.g., two questions answered incorrectly, or three case study answers are vague or limited in development but remain correct).
Missing some instruction requirements.
Submits assignment late.
20 points 30
Organization Well-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.
5 points Organized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.
4 points Poor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work. Purpose statement is noted.
3 points Illogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.
Demonstrates incomplete understanding of content and/or inadequate preparation.
No purpose statement.
Submits assignment late.
2 points 5
APA, Grammar, and Spelling Correct APA formatting with no errors.
The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).
Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.
There are no spelling, punctuation, or word-usage errors.
5 points Correct and consistent APA formatting of references, and cites all references used. No more than two unique APA errors.
The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.
There are minimal to no grammar, punctuation, or word-usage errors.
4 points Three to four unique APA formatting errors.
The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.
Multiple grammar, punctuation, or word usage errors.
3 points Five or more unique formatting errors, or no attempt to format in APA.
The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).
The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.
Grammar and punctuation are consistently incorrect. Spelling errors are numerous.
Submits assignment late.
2 points 5
Total Points 100

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Posted in nursing by Clarissa