Diploma of Nursing: Clinical Scenarios and Nursing Care Plan

0Running head: DIPLOMA OF NURSING
Diploma of nursing
Name of the student:
Name of the University:
Author’s note

1DIPLOMA OF NURSING
Clinical Scenario 1
Answer 1:
Emphsyema, a progressive disease of lung is caused by the innate respiratory dense
mechanism of the lung’s epithelial cell and mucociliary transport system after the foreign
antigens infiltrate the lungs cells. The inflammatory immune cells transfer them to lymphatic
tissue layer and the release of proteolytic enzymes leads to the destruction of the lung’s epithelial
barrier and the condition of emphysema (Goldklang & Stockley, 2016).
Answer 2
Heart rate and blood pressure are two vital signs that are affected by
Mr. Brown’s emphysema. This occurs because the condition of emphysema results in inefficient
oxygen diffusion and low oxygen content in blood. Hence, heart also suffers from lack of oxygen
and compensates it by beating faster. Exacerbation of COPD results in hypertension because of
airflow limitation in COPD patients (Imaizumi, Eguchi & Kario, 2014).
Answer 3:
Angina pectoris, a clinical manifestation of myocardial infarction is caused by chemical
and mechanical stimulation of sensory nerve endings in the myocardium. During ischemia, the
degradation of ATP to adenosine leads to the stimulation of receptors in cardiac afferent nerve
ending and induces angina (Ford, Corcoran & Berry, 2018).

2DIPLOMA OF NURSING
Answer 4:
Myocardial infarction (MI) is the sudden death of myocardial tissue. The
pathophysiology of the condition is linked to the thrombotic occlusion of coronary vessel caused
due to rupture of plaque. It caused rapid depression of systolic function (Frangogiannis, 2015).
Non-ST segment elevation myocardial infarction is one type of MI and it affects the arteries of
the heart.
Answer 5
Mr. Brown’s past AMI (Acute myocardial infarction) might have caused his CCF
(congestive cardiac failure). This is said because heart failure complications increase in patients
having AMI. It leads to acute structural complications of the heart muscle and diagnosis of CCF
signifies acute alterations in left ventricular function of patient (Dharmarajan et al., 2015).
Answer 6:
Swelling of leg is a condition of accumulation of fluids in the tissue also called as edema.
Mr. Brown’s swollen ankles and legs are related to CCF because CCF limits the ability of heart
to pump blood efficiently. Hence, heart failure affect blood pumping ability of the heart and
causes fluids to accumulate in different parts of the body.
Answer 7:
Benign Prostrate Hypermegaly (BPH) is a condition of enlarged prostrate in males. The
prostate grows two times and the BPH results in the second growth phase. It weakens the bladder
and its ability to completely empty the urinary bladder (Hashemzadeh et al., 2017).

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Answer 8:
Pulmonary oedema (PO) is a clinical condition associated with accumulation of fluids in
the lungs. As the condition affects a person’s ability to gain oxygen, they start to struggle for
breath. Hence, symptoms of running out of breath show signs of PO in patient.
Answer 9:
Nursing care plan for Mr. Brown:
Care plan Patient problem One goal Course of action
1. To balance
fluid intake of
patient
Shortness of breath,
edema or swollen legs
To maintain fluid
balance in patient and
decrease symptoms of
edema
 Balance fluid
intake in
patient by
means of diet
changes and
fluid
restriction
 Evaluate and
monitor urine
output in
patient
2. To manage
ineffective
breathing
pattern in
Shortness of breath To improve breathing
rate and tissue
oxygenation in patient
 Conduction
work of
breathing
assessment in