Case Study Analysis: Mr. Curtis's Critical Health Conditions and Treatment Options
Added on 2023-01-04
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Running head: HIGH DEPENDENCY UNIT
NURSING ASSIGNMENT (CASE STUDY ANALYSIS)
Name of the student
Name of the university
Author note
NURSING ASSIGNMENT (CASE STUDY ANALYSIS)
Name of the student
Name of the university
Author note
HIGH DEPENDENCY UNIT1
Introduction
This paper discusses about the case study of Mr. Curtis, who is 74 year old
and has been admitted in the healthcare facility for a routine cholecystectomy. Upon
admission, he was observed with irregular heart rate, shortness of breath, reduced
oxygen saturation levels. Upon admission, his medical history was recorded as per
which he suffered from 2 acute myocardial infarctions in past one year and has a
prolonged history hypertension. This paper will discuss three of his critical conditions
observed and would conduct an analysis to understand the reason and would
discuss the treatment options available for his health improvement and positive
outcome.
Cardiac Arrhythmia Pathology and Treatment
While conducting patient assessment, it was seen that Mr. Curtis is
undergoing irregular heart rate and hence, an Electrocardiogram or ECG was
conducted to understand the reason of his irregular heart rate. The ECG strip
obtained after the test was then divided depending upon the 6 second method so
that the level of irregularity with proper analysis could be identified (Cohn & Adams,
2017). The strip identifies irregular cardiac rhythm and due to the higher frequency of
multiple smaller and irregular peaks of P and Q waves are observed. Further, it was
also seen that only the R waves, or the first outward deflections that is created after
the P wave are observed, that indicates towards the presence of ventricular
depolarization. Another critical condition, which indicates towards the irregularity of
his heart rate is the smaller and irregular distance between the S and T waves due to
which, multiple R peaks were observed in the 6 second strip of the obtained ECG
report. As per Hammers et al. (2016), the T wave is considered as the most labile
Introduction
This paper discusses about the case study of Mr. Curtis, who is 74 year old
and has been admitted in the healthcare facility for a routine cholecystectomy. Upon
admission, he was observed with irregular heart rate, shortness of breath, reduced
oxygen saturation levels. Upon admission, his medical history was recorded as per
which he suffered from 2 acute myocardial infarctions in past one year and has a
prolonged history hypertension. This paper will discuss three of his critical conditions
observed and would conduct an analysis to understand the reason and would
discuss the treatment options available for his health improvement and positive
outcome.
Cardiac Arrhythmia Pathology and Treatment
While conducting patient assessment, it was seen that Mr. Curtis is
undergoing irregular heart rate and hence, an Electrocardiogram or ECG was
conducted to understand the reason of his irregular heart rate. The ECG strip
obtained after the test was then divided depending upon the 6 second method so
that the level of irregularity with proper analysis could be identified (Cohn & Adams,
2017). The strip identifies irregular cardiac rhythm and due to the higher frequency of
multiple smaller and irregular peaks of P and Q waves are observed. Further, it was
also seen that only the R waves, or the first outward deflections that is created after
the P wave are observed, that indicates towards the presence of ventricular
depolarization. Another critical condition, which indicates towards the irregularity of
his heart rate is the smaller and irregular distance between the S and T waves due to
which, multiple R peaks were observed in the 6 second strip of the obtained ECG
report. As per Hammers et al. (2016), the T wave is considered as the most labile
HIGH DEPENDENCY UNIT2
wave in the ECG strip as there are multiple reasons due to which an ECG report
could be seen as irregular as the T waves are inverted inside in irregular manner. As
per T waves are usually in the similar direction, however, in irregular conditions such
as higher risk of cardiac arrest or myocardial infarction, the T waves shows low
amplitude. Hence, this is one of the critical conditions that could be inferred from the
critical health condition. Further, it was also observed that the distance between the
S and T waves were irregular throughout the strip and hence, it could be inferred that
this irregular distance was caused by the presence of critical risk of myocardial
infarction. The peak of the R waves was smaller in few of the sections and as per
Verrier, Nearing, Olin, Boon and Schachter (2016), it could occur due to the lack or
weakening of the electrical activities of the associated cardiac muscles involved.
Further, Amino et al. (2017) also mentions that due to the risk of ST elevated
myocardial infarction, irregular ECG strips are obtained. Due to the risk of myocardial
infarction, the cardiac muscles suffers from injury and in this condition, depression in
the PR and ST segments are observed. Therefore, from this interpretation, it could
be observed that the patient is suffering from higher risk of ST elevated myocardial
infarction. Finally, calculating the heart rate using 6 second method also identified
the elevated blood pressure as there are total 17 peaks of R wave that indicates
towards a high blood pressure condition that may arise due to the risk of myocardial
infarction.
The treatment options that are available in this condition are associated with
Mr. Curtis’s irregular heart rate and risk of myocardial infarction should be inclusive
of the Antiarrhythmic medications. As he is suffering from Arterial fibrillation, he will
be provided with blood thinner or anticoagulants so that blood could flow properly
through his veins and reduces the risk of stroke. Further, in Antiarrhythmic drugs, he
wave in the ECG strip as there are multiple reasons due to which an ECG report
could be seen as irregular as the T waves are inverted inside in irregular manner. As
per T waves are usually in the similar direction, however, in irregular conditions such
as higher risk of cardiac arrest or myocardial infarction, the T waves shows low
amplitude. Hence, this is one of the critical conditions that could be inferred from the
critical health condition. Further, it was also observed that the distance between the
S and T waves were irregular throughout the strip and hence, it could be inferred that
this irregular distance was caused by the presence of critical risk of myocardial
infarction. The peak of the R waves was smaller in few of the sections and as per
Verrier, Nearing, Olin, Boon and Schachter (2016), it could occur due to the lack or
weakening of the electrical activities of the associated cardiac muscles involved.
Further, Amino et al. (2017) also mentions that due to the risk of ST elevated
myocardial infarction, irregular ECG strips are obtained. Due to the risk of myocardial
infarction, the cardiac muscles suffers from injury and in this condition, depression in
the PR and ST segments are observed. Therefore, from this interpretation, it could
be observed that the patient is suffering from higher risk of ST elevated myocardial
infarction. Finally, calculating the heart rate using 6 second method also identified
the elevated blood pressure as there are total 17 peaks of R wave that indicates
towards a high blood pressure condition that may arise due to the risk of myocardial
infarction.
The treatment options that are available in this condition are associated with
Mr. Curtis’s irregular heart rate and risk of myocardial infarction should be inclusive
of the Antiarrhythmic medications. As he is suffering from Arterial fibrillation, he will
be provided with blood thinner or anticoagulants so that blood could flow properly
through his veins and reduces the risk of stroke. Further, in Antiarrhythmic drugs, he
HIGH DEPENDENCY UNIT3
would be provided with ibutilide through his intravenous route so that rapid and faster
action could be obtained. Further, to reduce the risk of high blood pressure he would
be provided with diuretics so that the health conditions that could arise due to high
blood pressure could be reduced. Therefore, these are the three primary treatment
options that would be provided to Mr. Curtis so that his risk of acute myocardial
infarction could be reduced. Further, he would also be provided with low sodium diet
so that with rapid reduction in his blood pressure the risk of myocardial infarction
could be reduced.
Pathophysiology and treatment
Upon analysing the provided information, it can be stated that the patient Mr,
Curtis had been coughing and had been experiencing increased shortness of breath.
The vital assessment suggested that the RR was 26 and SaO2 WAS 91%, which
suggested that the respiratory rate is elevated and the SaO2 level is below the
normal range of 97% TO 100%. In addition to this, the blood pressure level of the
patient is also elevated as revealed by the observation (170/80). The ABG
observation data reports that pH level to be 7.33. As reported by Bass et al. (2015),
the normal pH range is recommended to be in between 7.35 to 7.45. This stated that
the patient’s pH level is within the normal range. Further, the PaO2 level gas been
reported to be 68 mm Hg which is significantly lower than the recommended range of
80mm Hg to 100 mm Hg (Bass et al. 2015). The PaCO2 range has been reported to
be in between 58 mm Hg which is increased significantly than the normal
recommended range of 32 to 45 mm Hg (Bass et al. 2015). Further the HCO3 level
has been reported to be 25 mmol/L which is within the recommended normal range
of 22-28 mmol/L (Bass et al. 2015).
would be provided with ibutilide through his intravenous route so that rapid and faster
action could be obtained. Further, to reduce the risk of high blood pressure he would
be provided with diuretics so that the health conditions that could arise due to high
blood pressure could be reduced. Therefore, these are the three primary treatment
options that would be provided to Mr. Curtis so that his risk of acute myocardial
infarction could be reduced. Further, he would also be provided with low sodium diet
so that with rapid reduction in his blood pressure the risk of myocardial infarction
could be reduced.
Pathophysiology and treatment
Upon analysing the provided information, it can be stated that the patient Mr,
Curtis had been coughing and had been experiencing increased shortness of breath.
The vital assessment suggested that the RR was 26 and SaO2 WAS 91%, which
suggested that the respiratory rate is elevated and the SaO2 level is below the
normal range of 97% TO 100%. In addition to this, the blood pressure level of the
patient is also elevated as revealed by the observation (170/80). The ABG
observation data reports that pH level to be 7.33. As reported by Bass et al. (2015),
the normal pH range is recommended to be in between 7.35 to 7.45. This stated that
the patient’s pH level is within the normal range. Further, the PaO2 level gas been
reported to be 68 mm Hg which is significantly lower than the recommended range of
80mm Hg to 100 mm Hg (Bass et al. 2015). The PaCO2 range has been reported to
be in between 58 mm Hg which is increased significantly than the normal
recommended range of 32 to 45 mm Hg (Bass et al. 2015). Further the HCO3 level
has been reported to be 25 mmol/L which is within the recommended normal range
of 22-28 mmol/L (Bass et al. 2015).
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