ASSIGNMENT l INSTITUTIONAL AFFILIATION AND MANAGEMENT

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Nursing
Student’s Name
Institutional Affiliation

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Michelle Dunn came into the GP clinic and complained of cough and chest pains. As a registered
nurse, I was asked to asses her. Michele looks a bit pale. My interview with her revealed that she
was experiencing some chest while climbing hills. The pains were focused on the left side of her
chest. She said that the pain had started radiating to the jaw, but she currently not experiencing
chest pain. A week ago, Michelle narrated that she had a chest infection and that she was treated
with some antibiotics, but she was not taking them at the moment. With this information, I will
provide Michelle with a rationale for the assess.
Consequently, I conducted an objective structured clinical examination that is aimed at
assessing performance and measuring clinical competence. My assessment on Michelle revealed
that she had some chest pains at her left side, she was relieved with rest, coughing for chest
pains, and she suffered from SOBI pain. Taking some test on her revealed that Nausea and
yellow sputum were, pain radiating to jaw, she had high blood pressure, Michele was on
medication but did not take medicine, she smoked about 10 cigarettes per day though she does
not take alcohol, she didn't have any known allergies, Mitchelle suffers from cardiovascular
disease. Reports revealed that her sister has heart problems. Mitchelle eats and drinks well; she
didn't have any weight gain; vital signs revealed that her Temperature was at 37.2 degrees
Celcius, her pulse at 62, her Resp at 22, blood pressure at 150/86 and saturation at 92.
Subsequently, Mitchelle could be experiencing substernal pains that at times radiate to
the neck, arms, and jaws. These pains are associated with angina and myocardial. Angina is
usually related to coronary artery conditions and diseases. It involves low oxygen circulation and
that accumulates plaque. The substernal pains radiating to sides of the shoulders, parts of the
neck, the upper back, left arm, jaw and, may result in nausea. Considering stable angina is
majorly pain on the chest that occurs in a repeatable and typical pattern during an exertion. Also

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caused by running up or walking on an inclined plane. Stable angina is normally relieved by rest,
especially with sublingual nitroglycerine (Gimbrone Jr, 118).
Furthermore, stable angina often has something that blocks the arteries. It makes it
difficult for the freshly pumped blood to flow through the arteries. This explains why Mitchelle
has high blood pressure that stands at 150/86. This deficiency in blood flow to the heart is often
referred to as ischemia. This is what causes the pain. Mitchelle has episodes of pain that are
caused by exertion or even stress. These pains from angina are a warning sign and an indicator of
a possible heart attack (Yahagi, 13).
In addition, Mitchell's lifestyle of smoking ten cigarettes in a day highly contributed to
this condition. Smoking and its long exposure to tobacco smoke greatly contribute to the
damaging of the interior walls of the arteries. These damages include the heart by allowing the
deposits of cholesterol that collect and cause, blocking blood flow slowly. Smoking tightens and
damages blood vessels; it also raises high cholesterol levels and an increase in blood pressure.
Smoking also limits the amount of oxygen that reaches the body tissues (Holdt, 7).
Moreover, Mitchelles symptoms reveal that she has heart disease in her blood vessels,
referred to as atherosclerotic disease. This also explains why she had nausea and shortness in
breathing. It is clear Atherosclerosis is simply a disease through which a plaque builds up inside
a person's arteries. And since the plaque is made up of cholesterol, fat, and other substances
found in blood, then there is a possibility of hardening overtime (Bennett, 118).
Clearly, atherosclerosis starts when certain factors that damage inner layers of arteries
take place. Like Mitchell's case, these factors may include, heavy smoking, high intakes of