Case Study of Violet Paterson

Running head: CASE STUDY OF VIOLET PATERSON
CASE STUDY OF VIOLET PATERSON
Name of the student:
Name of the university:
Author note:

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CASE STUDY OF VIOLET PATERSON
Considering the patient condition:
Clinical reasoning cycle can be explained as the systematic framework that guides nursing
professionals to develop evidence based care plans that meet up of the healthcare needs of the patient
and accordingly help the patient in living better quality lives. This cyclical framework advises nurses to
first identify the cues and symptoms of the patients and the, relate them with their health concerns and
the disorders they have. Following these, the nursing professionals need to set nursing priorities which
mainly help in attending the main health concerns that needs care on an urgent basis. Following this,
nurses need to set nursing goals and develop evidence based care plans that help patients overcome
their suborders and achieve holistic health. In the case study it is seen, that the patient named Violet is a
77 year old woman who has been admitted to the ward with Acute Myocardial Infarction (AMI). With
thorough treatments by the experts of the emergency ward, she is now stable. The patient history
reveals that she is also suffering from hypertension as well as osteoarthritis. Both the disorders are not
been able to be managed by the patient successfully and hence they have impacted her life making it
difficult for her to continue her activities of daily living. She is residing currently in her own apartment on
the third floor that has no lift. This is yet another concern for the patient as her restricted mobility due
to osteoarthritis might make it difficult for her to climb up or down. This would ultimately make her
socially excluded which would in turn affect her mental stability.

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CASE STUDY OF VIOLET PATERSON
Nursing assessments:
One of the most important tests that the nurses need to conduct is an ECG or
electrocardiogram. This test helps nurses to diagnose the current condition of the heart. This is mainly
done by recording the electrical activity of the heart. This system mainly utilizes a system of electrodes
which are attached to the skin and this helps in recording the impulses (Fors et al., 2015). It has been
found that the system of ECG mainly helps in revealing the information about whether the heart is
facing the acute myocardial infarction or whether it is in progress. Injured muscles of the heart cannot
conduct electrical impulses and ECG works through identifying such impulses and helping professionals
to understand the condition of the heart. Another important test that can be also conducted for Violet
to know about her health condition is the blood test. It has been found that there are important
proteins in the heart which gets leaked into the blood when the heart gets damaged (Boyde et al.,
2015). Nurses can also follow the blood test report to find out whether those proteins are found in
abnormal conditions in the blood. This would also help nurses to identify whether the heart conditions
are still at the risk or is out of danger.
Another important assessment is to develop an idea about the present condition of
osteoarthritis in the patient named violet. Nurses would first need to identify the pain level of the
patient so as to relieve her from the pain and also develop proper care interventions to relieve her from
the pain (Finney et al., 2016). For this, the pain assessment tool can be used where patients are asked to
provide score to their pain level from 0 to 10 with zero being complete absence of pain to 10 being high
level of unbearable pain. Another important assessment that also needs to be conducted for Violet is
the fall risk assessment (Fors et al., 2016). She is suffering from excessive pain from osteoarthritis which
had restricted her activities of daily life and mobility. Hence, she might be at increased risk for fall both
in the hospital as well as in her apartment. Hence the FRAT tool or the Fall Risk Assessment Tool can be

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CASE STUDY OF VIOLET PATERSON
used which incorporates assessing three important segments. These are the Part 1 - falls risk status; Part
2 – risk factor checklist; and Part 3 – action plan. With the help of the score, the nurses can accordingly
set up precautionary measures and prevent the patient from any form of additional harm.
Nurses should constantly measure the vital signs from time to time. This assessment would
provide a detailed account of her body temperature, blood pressure, respiratory rate, saturated oxygen
level as well as heart rate. Measuring the blood pressure is extremely important in order to assess the
present blood pressure of the patient (Bray et al., 2016). It has been found that nurses need to consider
an average of three blood pressure readings that would be taken 2 minutes apart with the use of the
mercury manometer. In this way, the current blood pressure of Violet needs to be taken and accordingly
care plans would be to help her bring her blood pressure under control.
Care planning:
Nursing goals Nursing interventions and nursing rationale Evaluation
Violet has suffered from acute
myocardial infarction and
therefore, she might be at an
increased risk for decreased
cardiac output. This can result in
inadequate blood pumped up by
the heart which in turn might
affect the metabolic needs of the
body. Hence, the nurses need to
set goals for the management of
the risks for the decreased
 The nurse would need to monitor both
the heart rhythm as well as the heart rate.
She would also need to document any
dysrhythmias with the help of the
telemetry. The main reason behind this
intervention is that both heart rate as well
as heart rhythm responds to different
types of medication as well as activity and
other developing complications. Studies
have also found that dysrhythmias
compromise cardiac function as well as
The nurses
would need to
evaluate the
results of serial
ECGs as this
would help in
providing
information
regarding
status of
ventricular