Clinical Reasoning Case Study on Obesity and Chest Pain

Clinical Reasoning Case Study

Step 1
Consider the person
and context
According to hovey's case study, obesity is the main cause of
increasing cardiovascular disease in old age. It is because people above
50 who are in obese category needs extra blood to supply the oxygen,
nutrients to their bodies. Deficient which ultimately leads to an increase
in blood-pressure. As per the past medical history of Mrs. hovey,
obesity is also connected with hypertension. Overweight when
associated with elevated visceral adiposity involves main cause of
hypertension (Anzueto (2017)).
Step 2
Collect cues and
information
(a) In context with Hovey's case study, Glyceryl trinitrate is basically
used to treat chest pain (angina) related problems. It works by
broadening the arteries and veins. Increased surface area will ultimately
leads to elevate in blood supply to heart. This response leads to supply
more blood to muscles present in heart and decrease the chest pain.
(b) According to this case study, the most common side effects are
mentioned below:
 Feeling sick (nausea)
 Increased heart rate.
(c) According to Hovey's case study, the responsibilities of nurse with
respect to the side effects of medication which are mentioned above
should be taken as detailed below:
 It is their duty to check whether nitrates are taken or not, failing
can leads to drop in blood pressure that may results in fainting.
 It is also their responsibility to check whether the patient quit
smoking or not. This is because smoking is the main cause of
increased heart beat as it tightens the arteries which may cause
improper heart rhythm (Benson (2019)).
Step 3
Process information
In context with Hovey's case study, the symptoms which are included
in her case are mentioned below:
Decreased blood pressure: In Hovey's case, she is suffering from low
blood pressure i.e. 105/65mmHg. It is a case of hypotension, as it exists

when the systolic pressure is below 90mmHg and the diastolic pressure
is below 60mmHg. It decreases the blood flow which may leads to
reduce the supply of oxygen within organs as well as tissues that may
causes cellular harm and dysfunction (Geng (2021)).
 Increased heart rate: In Hovey's case, she is suffering from
increasing heart rate i.e. 116 bpm. It is considered that the
normal heart rate of a human body is 60 to 100 beats per
minute. Increasing heart rate generally called as tachycardia. In
this, it involves decrease in venous pressure that may results in
reduced stroke volume. Increased heart rate in patients causes
anxiety, stressful emotions. Smoking is one of the major leading
cause of increased heart beat as it contains nicotine in it which
is highly addictive in nature. It is because when someone breath
in cigarette smoke, the contaminated blood is supplied in the
whole body which contains smoke chemical (KNOW (2020)).
Step 4
Identify problems and
issues
According to Hovey's case study, there is no supplemental oxygen was
provided to Mrs. Hovey at this stage because the oxygen treatment is
normally not required to the patient unless the range of SpO2 is less
than 92%. In the case of Mrs. Hovey, her oxygen level is observed as
approximately 92% and therefore, administration of supplemental
oxygen is not required in her case. In other cases, if someone suffers
from heart failure it is quite necessary to provide such patients an
oxygen therapy so that their heart pumps well. It is because this therapy
increases the amount of oxygen which is required in body tissues and
hence helps in decrease the patients heart workload.
Step 5
Establish goal
There is need to provide different intervention which can help in
proving care to the Mrs. Hovey. Nursing intervention can help to
reduce the effectiveness of the diseases. There is discussion about two
different priority nursing intervention includes pain management and
proper medication (Quinn (2017)).