Case Study Analysis

Running head: CASE STUDY ANALYSIS
CASE STUDY ANALYSIS
Name of the Student
Name of the University
Author’s Note:

CASE STUDY ANALYSIS1
Case Study 1
Answer to the question number 1(a):
From the case study three identified key issues are arterial fibrillation, sudden heart failure,
and pulmonary oedema.
The primary risk William is in for arterial fibrillation. The reason behind is that the patient’s
tachycardiac pulse. Tachycardiac pulse occurs due to the irregular and chaotic impulses in the
chambers of the heart. This phenomenon in turn leads to the irregular contraction of the atria.
This irregular contraction leads to the improper working of the heart and as a direct result
heart become unable pump enough blood to the brain (Andrade, Khairy, Dobrev, & Nattel,
2014). Hence the primary issue is arterial fibrillation.
The next key issue for the patient is the sudden heart failure. Heart failure occurs when there
is lack of adequate blood supply in the brain. From the above discussion, it can be seen that
the patient has tachycardiac pulse which might happen due to blocked or narrowed artery
which in turn will prevent adequate blood supply to brain (January et al., 2014). Therefore,
the patient is in a risk for sudden heart failure.
Another issue that has been identified for the patient is pulmonary oedema. From the case
study, it can be seen that the patient has laboured breathing. Laboured breathing happens
when the pulmonary veins are filled with extracellular body fluid which leads to lack of
oxygen in the body. Studies have also reported that the irregular heart beat might happen due
to the pulmonary oedema (Nicholson, 2014). Therefore, it can be stated that the patient’s
another issue might be pulmonary oedema.
Answer to the question number 1(b):

CASE STUDY ANALYSIS2
From the laboured breathing, it is evident that the patient has lack of adequate oxygen supply
in his body. Thus, the first nursing intervention will be to supply the patient with external
oxygen source which can be administered by the nasal route. The reason behind this is to
maintain the patient’s oxygen saturation level in his body.
The next step of action for the nurse will be to address the patient’s comfort level. Patient is
having laboured breathing which might be happening due to the pulmonary oedema. Hence,
Angiotensin II receptor blocker or ACE inhibitor drug can be administered to the patient
(Braunwald, 2015). In addition to that, plasminogen activator drugs for tissues can also be
administered for the patient as a precaution for sudden heart attack. This drug should be
administered to the patient through the intravenous route.
From the discussion in 1(a) section, it has been established that the patient is in a risk for
arterial fibrillation. Hence, the patient should administer with the medicine like Amiodarone,
Dofetilide, Sotalol, and Flecainide, for the betterment of the patient (Qin et al., 2016).
Additionally, the nurse should be monitoring the patient condition in a priority basis as the
patient is in a risk for three different kind of critical issue and the patient should be monitored
for the chance of further deterioration.
Answer to the question number 1(c):
In this scenario, the responsible nurse is very young, new to the job and is in under the
supervision of a Registered Nurse. As a result, the nurse has to report to the registered nurse
first instead of a doctor in case of any changes in the patient condition. In this scenario, the
nurse reported the condition about the patient to the registered nurse but was told not to worry
(Safetyandquality.gov.au, 2019). The nurse was in mind that a doctor should be consulted in
this scenario but was told not to worry about his/ her immediate supervisor. This is put the
nurse in an ethical dilemma whether the nurse should listen to his/ her immediate supervisor

CASE STUDY ANALYSIS3
or disobey him to consult a doctor as nursing practice and code of conduct suggest him/ her
to do so (Baykara, Demir &Yaman, 2015).
Case study 2
Answer to the question number 2(a):
In this scenario, three key issues that were identified are hypovolemic shock, septic shock and
pulmonary distress.
Based on the case study, the hypovolemic shock of Carol is seen to have caused the huge
amount of blood loss from the knee. Hence, it would lead lack of blood supply into all the
cells or tissues of the body resulting in seizures. Therefore, the patient can experience
multiplied organ failure and inadequate tissue infusion. These circumstances are going to lead
to a stroke and coma. In the end, the patient must therefore be examined primarily for
hypovolemic shock and low blood pressure (Siddall, Khatri & Radhakrishnan, 2017).
In this scenario, the nurse has found the patient, Carol, in very drowsy condition and she was
unable to speak properly. For drying up the site, Carol's knee replacement surgery also needs
blood suction (Zhou, Li, Xiong, Jiang, Li, & Wu, 2013). Thus her immune system for
microbial attacks can be said to be very much susceptible, as it is more vulnerable than ever
to a blood loss out of her body. There is therefore a high risk of a microbial attack and
septicaemia can be diagnosed in this particular instance. Septic sepsis causes septic shock as
microbial infections can affect the whole body (Gotts & Matthay, 2016).
In this case, Carol also demonstrates a 12 per minute breathing rate as well as low blood
pressure and her blood oxygen content in that condition must be higher (Baratloo et al.,
2014). Therefore, respiratory distress tends to occur and hypovolémic shock, low blood
pressure and septic shock are the causes of this respiratory distress (DiPiro, Talbert, Yee,
Matzke, Wells & Posey, 2014).