Developing a Nursing Problem

This document discusses the process of developing a nursing problem, focusing on a case scenario of a patient experiencing breathlessness and nausea. It explores the cues collected, information processing, problem identification, and nursing problem identification. The document also delves into the care plan development for heart attack and cardiomyopathy, as well as the analysis of oxygen therapy skills. It concludes with a reflection on the importance of observation skills in nursing.

DEVELOPING A NURSING PROBLEM 1
DEVELOPING A NURSING PROBLEM
By Student’s Name
Course
Instructor
Institution
City, State
Date

DEVELOPING A NURSING PROBLEM 2
Introduction
With reference to case scenario 1, we learn that Carol Jones has an age of 45 years and many
times she is away from home on business trips. Carol Jones has come to a clinic in the outskirts
of Flinders Ranges in South Australia (Levett-Jones, 2013, p.34). The reason behind her
appearance in the clinic is because of breathless feelings and nausea. We also learn that Carol
Jones is mildly tachycardic and her BP is 170/93 mmHg. The assurances by the GP at Flinders
Rangers are that Carol should make effort and follow up with her regular GP when she returns
home. However, before Carol leaves the health center she experiences some breathlessness.
When she is further tested, her blood pressure is found to be 160 bpm which is irregular.
Looking at her history, we learn that she is a consultant engineer who is specialized in
structures that are concrete and that are used for the construction of bridges. It is because of this
reason that she is normally required to travel between different countries to supervise
construction activities. Carol Jones has a busy lifestyle and many times her dietary intake is
always on the run. She also takes alcohol during lunchtime and evening which she claims helps
her relax after a hectic day. She further denies the usage of recreational drugs (Levett-Jones,
2013, p.34).
Cues collection
Carol Jones experiences episodes of breathlessness and nausea which forms her main
concerns; it is also evident that Carol has an appearance of pale color in her skin, her pulse rate is
160 bpm which is irregular, and she is also mildly tachycardic (Levett-Jones, 2013, p.34). She is
alert and responds accordingly by speech and hands as well. Her BP is 170/93 mmHg.
Information processing

DEVELOPING A NURSING PROBLEM 3
Normal (not concerning) Abnormal (concerning)
Responds accordingly and she is alert – she can
explain herself.
HR - 160 bpm
Mildly tachycardic
Pale skin color
breathlessness
Nausea
Stress
Problem identification
From the cues identified in the above scenario, which includes experiencing breathlessness
and nausea by Carol Jones, her skin turning pale in color, experiencing mildly tachycardic, and
an abnormal pulse rate of 160 beats per minute which is high (Levett-Jones, 2013, p.34). The
problem identified from the above cues is;
1. Heart attack
This is a sickness that happens when the heart doesn’t get enough blood (Banharak, Zahrli, and
Matsuo, 2018, p.18). The heart muscle receives oxygen and nutrients from the blood. When it
occurs that there is not enough blood flowing to the heart muscle, what results is damage or
death to the heart muscle. This becomes dangerous and deadly as well. The heart disease is
related to breathlessness due to over-pumping of the blood by the heart. This as well increases
the number of heart beat per minute. Due to over-pumping of blood, the blood is not fully

DEVELOPING A NURSING PROBLEM 4
oxygenated and thus causes the skin to change color into pale. In addition to this, heart attack
disease is characterized by mildly tachycardic (Kalman, Wells and Stewart Fahs, 2018, p.18).
2. Cardiomyopathy
This is a heart disease that affects the heart muscle that makes it difficult for your heart to
pump blood to every part of the body (Konersmanet, al. 2015, p.418). This disease might lead to
heart failure. The kind of heart disease that Carol Jones suffers is related to Cardiomyopathy
because Carol is experiencing breathlessness, due to the inability of the heart to pump blood to
all parts of the body, the skin may change color to pale (Maron, and Maron, 2016, p.983). Carol
Jones also has an increased heartbeat of up to 160 bpm.
Nursing problem identification
The breathlessness experienced by Carol Jones is due to an increased rate of heartbeat, this
causes blood to flow at a high speed causing one unable to breathe well. The reason behind skin
changing color to pale is as a result of poor oxygen circulation in the body. When one becomes
breathless, blood flows past the lungs without being oxygenated thus resulting into low oxygen
supply in the body and finally cause the skin to turn pale in color (Motoki et, al. 2016, p.16).
Care plan development
Problem Goal Related Actions Rationale Evaluate outcome
Heart attack The goal is to
treat the
condition
underlying cause,
for instance in
Use of
nitroglycerin
which is used to
treat pain in the
chest and can
Some of the
causes of heart
attack that have
been said are the
like of stress,
The heart attack is a
mental illness and
thus can affect all
aspects of your life.
More your

DEVELOPING A NURSING PROBLEM 5
our case heart
attack disease or
blood pressure.
also help
improve the flow
of blood in the
heart. It can also
slow down your
heartbeat and
reduce your
blood pressure
hence easing the
job done by the
heart.
high blood
pressure etc.
psychological
emotional health.
Although because
of computerized
guidelines there is
improved patient
outcome.
Cardiomyopathy The goal is to
treat the causes
of heart failure
whenever
possible. Upon
diagnosis, the
goal is to
improve the
function of
cardiac muscle
and symptoms
reduction.
Two or more of
these drugs are
required
depending on
your symptoms.
These drugs
include
Angiotensin-
converting
enzyme (ACE)
inhibitors. ACE
inhibitors may
Causes include
heart tissues
damage from
heart attack,
chronic rapid
heart rate, heart
valve problems
among others.
Death might occur
to patients that
undergo transplant
and is estimated to
be 26%. 1% of
patients that
undergo transplant
with one year of
transplant.

DEVELOPING A NURSING PROBLEM 6
improve heart
function.
Skill analysis
The administration of oxygen as a supplement is necessary more so as an element of the
treatment plan in Alpha-1COPD. As the progress of lung destruction continues the lungs' ability
to exchange oxygen becomes impaired (Patel et, al. 2016, p.14). This causes a condition known
as hypoxemia where the oxygen level in the blood is lowered.It is at this stage where more
oxygen supply to the patient is needed to support him and thus oxygen therapy skills required.
Strength and weakness of oxygen therapy skills
By far, the most important benefit of oxygen therapy for people with COPD is that prolongs the
patient’s life. For instance, in the oxygen therapy video, we learn that the oxygen level of the
patient is found to be low which means that the patient won’t survive for long. Due to this, the
patient is supplied with oxygen to prolong his life as he is still under medication (Simning,
Seplaki, and Conwell, 2018, p.96).
Although oxygen therapy has been in use for a long period of time for the patient with
suspected acute myocardial infarction (AMI), studies recently have focused on the safety and the
efficacy of supplemental oxygen in normoxaemic patients. Despite the evidence, studies show
that the average number of hours that the patient uses daily supplemental oxygen less compared
to oxygen prescribed by the doctor. When you fail to use oxygen as per the prescriptions of the
doctor, it limits its effectiveness. There is also no evidence that the patient will live for long due
to the fact that he/she is under oxygen therapy.

DEVELOPING A NURSING PROBLEM 7
Reflecting on the video performance, we see that the nurse is making a connection on the gas
cylinder is written medical air, not oxygen. Medical air is used to reduce the high concentration
of oxygen exposure. Therefore, the nurse making a connection on this gas cylinder makes a
mistake because it is not oxygen. Thus to promote positive health outcomes it is good for the
nurses to be observant and keen on the kind of air they supply to patients because such mistakes
might result in loss of life. We also learn that the nurse in new in the facility and he is not
conversant with the hospital facilities, therefore for positive health outcomes new nurse should
be educated on the hospital facilities before commencing work.
Reflecting on clinical reasoning cycle which involves cues collection, information processing
in order to understand the patient's problem and his/her situation, planning as well as intervention
implementation, outcome evaluation and finally learning from the process. I have learned that
the success of a nurse depends s on his/her observation skills in identifying symptoms because
failure to identify such correct threatens the life of the patient. Therefore to for me to be
successful in my future learning and work as well, observation is the key aspect of a nurse that I
need to embrace (Tummala, and Farshid, 2015, p.4).
References
Banharak, S., Zahrli, T. and Matsuo, H., 2018. Public Knowledge about Risk Factors,Symptoms,
and First Decision-making in Response to Symptoms of Heart Attack among Lay People. Pacific
Rim International Journal of Nursing Research, 22(1), pp.18-29.

DEVELOPING A NURSING PROBLEM 8
Kalman, M.B., Wells, M. and Stewart Fahs, P., 2018. Educating Rural Women about Gender
Specific Heart Attack and Prodromal Symptoms. Online Journal of Rural Nursing & Health
Care, 18(2).
Konersman, C.G., Bordini, B.J., Scharer, G., Lawlor, M.W., Zangwill, S., Southern, J.F., Amos,
L., Geddes, G.C., Kliegman, R. and Collins, M.P., 2015.BAG3 myofibrillar myopathy presenting
with cardiomyopathy. Neuromuscular Disorders, 25(5), pp.418-422.
Levett-Jones, T. ed., 2013. Clinical reasoning: Learning to think like a nurse. Pearson Australia,
pp.34.
Maron, M.S.,Maron, B.J., 2016. Reply: Nonobstructive Hypertrophic Cardiomyopathy: Low
Mortality but Not Always Benign. Journal of the American College of Cardiology, 68(9), p.983.
Motoki, N., Inaba, Y., Matsuzaki, S., Akazawa, Y., Nishimura, T., Fukuyama, T. and Koike, K.,
2016. Successful treatment of arrhythmia-induced cardiomyopathy in an infant with tuberous
sclerosis complex. BMC Pediatrics, 16(1), p.16.
Patel, H., Berg, M., Barasa, A., Begley, C.,andSchaufelberger, M., 2016. Symptoms in women
with Peripartum Cardiomyopathy: A mixed method study. Midwifery, 32, pp.14-20.
Simning, A., Seplaki, C.L. and Conwell, Y., 2018. The association of a heart attack or stroke
with depressive symptoms stratified by the presence of a close social contact: findings from the
National Health and Aging Trends Study Cohort. International journal of geriatric
psychiatry, 33(1), pp.96-103.
Tummala, S.R.,and Rashid, A., 2015. Patients’ understanding of their heart attack and the impact
of exposure to a media campaign on pre-hospital time. Heart, Lung,and circulation, 24(1), pp.4-
10.