Clinical Reasoning Cycle - PDF
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Added on 2019-12-18
Clinical Reasoning Cycle - PDF
Added on 2019-12-18
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CASEBASEDWRITTENASSIGNMENT1
TABLEOF CONTENTSIntroduction......................................................................................................................................31.......................................................................................................................................................3Describe the pathophysiology, health assessment and clinical findings specific to MG’scondition......................................................................................................................................32.......................................................................................................................................................5State the risk factors she have for cardiovascular disease...........................................................53.......................................................................................................................................................5What other complications does MG present with and why have these occurred........................54.......................................................................................................................................................6Using the Clinical Reasoning Cycle, identify three priorities nursing diagnoses.......................65.......................................................................................................................................................7State the goal of care, specific nursing intervention and their corresponding rationale..............7Conclusion.....................................................................................................................................10References......................................................................................................................................112
INTRODUCTIONThe present research study has been emphasizing on MG who is a 76 year old femalecurrently admitted to emergency department and she is also diagnosed with congestive heartfailure problem. From past medical history, it is identified that she is having hypertension andchronic renal failure. Thus, looking towards her medical situation, the study has analysingseveral risk factors that present in MG’s case due to cardiovascular disease. 1Describe the pathophysiology, health assessment and clinical findings specific to MG’s conditionHeart failure develops when the heart fails to pump blood at a rate commensurate withthe requirements of the metabolizing tissues. Congestive heart failure is a syndrome that can becaused by a number of abnormalities such as loss of muscle, pressure and volume overload andhigh output failure (Hockenberry, Wilson, & Rodgers, 2016). For the purpose of maintainingnormal cardiac output, several mechanisms are important to consider such as compensatoryenlargement cardiac hypertrophy and cardiac dilatation. Heart failure also results in depressionof the ventricular function curve and compensation arises in the form of stretching of myocardialfibres (Abrahams-Gessel and et.al., 2016). Heart failure is the pathophysiologic state that may be caused because of myocardialfailure and it may also occur in the presence of near-normal cardiac function under conditions ofhigh demand. It is an apparent aspect that heart failure always causes circulatory failure becauseof noncardiac conditions such as hypovolemic and septic shock. The major symptoms ofcongestive heart failure includes the following things:Exertional dyspneaAcute pulmonary edema Nocturia and oliguriaDistention of neck veins Increased intensity of P2 heart sound Fatigue and weaknessAnorexia, weight loss and thread pulse Central or peripheral cyanosis (Connolly and et.al., 2017)3
In acute heart failure, patient care consists of stabilizing the patient’s clinical condition,establishing the diagnosis, etiology and precipitating factors. However, in the usual form of heartattack, the heart muscle reduced contractility and this produces a reduction in cardiac outputwhich then becomes inadequate to meet the peripheral needs of the body. In this disease, heartrate is generally increased According to the health assessment, it is identified that that her pulse rate is 102 and herBP level is 160/100, RR is 24 and temperature is 37.3C. According to the diagnosis, she haswidespread creps on chest auscultation and she is sweaty as well. At the same time, afterconducting ECG, it is ascertained that MG has atrial fibrillation (Ding and et.al., 2017). Afterconducting radiology, it is being analysed that she has cardiomegaly and pulmonary congestion.Laboratory testing is also carried out and it is analysed that the level of potassium and sodium ishigh because she is not following the fluid and salt restriction which was ordered to her at thetime when she was admitted in the hospital. According to the case analysis, she was discharged from the hospital prior 11 days andafter that again she come up in the hospital as she is unable to catch the breath and because ofthat her legs are getting big and heavy (Faithfull and et.al., 2017). When question was askedfrom the health care practitioner, she said that she is not following the fluid and salt restriction;hence reportedly she gained 2kg weight after her discharge. Since, she had the issue of4
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