Mandy Case Study Assignment Report

Running head: MANDY CASE STUDY
MANDY CASE STUDY
Name of the Student
Name of the University
Author note

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The paper discusses about a six months old baby Mandy suffering from heart
problem. The paper is structured to discuss about different nursing interpretation and analysis
done to interpret the disease Mandy is suffering and find a proper diagnostic measure for the
cure of the disease.
Answer 1
Various objective and subjective finding showing that Mandy was suffering from cardiac as
well as circulatory dysfunction are as follows-
Mandy have reduced her food intake along with the drinking of water. Mandy’s mom has
observed that Mandy is having breathing difficulty. Mandy appears in toxic in nurse’s eyes
and was hence recommended for further diagnosis. Mandy is having a heart rate of 160,
which is very high. This might be sign of sinus tachycardia (Matiasz & Rigolin, 2018).
Mandy is also diagnosed to have holosystolic murmur that might be a sign of septal defect.
The signs and symptoms of heart disease includes breathing shortness, faster breathing,
fatigue, and very less gain in the weight. Hence, in-toxic appearance suggests that Mandy is
having deoxygenated blood flow or she might be having low red blood cell count in her body
(Chen & Levy, 2016). Moreover, she was having dry oral mucosa that means she is having
dehydration. Therefore, all the diagnostic features obtained after physical exam suggests that
Mandy is having heart problem and there is flow of deoxygenated blood in her body which is
making her look pale and pink
Answer 2
The subjective and objective analysis that proves that Mandy is suffering from
respiratory dysfunction are her respiration rate which is high 65 minutes per minute.
Normally infants have respiration rate of 20-60 breaths per minute. Faster breathing might be
a sign of tachypnea (Sanchis-Gomar, Perez-Quilis, Leischik & Lucia, 2016). She is having

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cough and nose drainage. Mandy was also having breathing difficulty and she was suffering
from breathing shortness and is having dry lips. Mandy was having upper airway congestion
along with average subcostal retraction, crackles, bobbing and tachypnea. All this shows that
her lung is not working properly and she needs immediate treatment (Anderson et al., 2016).
Mandy was having crackles in lungs which means that there might be some inflammation in
her lungs or infection in alveoli, bronchi or bronchioles. Crackles after coughing indicate
edema (pulmonary). This crackling might also be a sign of heart disease indicating fluid in
the alveoli due to failure in the heart.
Answer 3
The patient Mandy is having fever for last 3 days, she is having difficulty in breathing
and is having fast breathing, food intake has decreased and she looks pale and pinkish, her
breathing rate is high as well as her heart rate (Michael, Scharf, Letzkus & Vergales, 2016).
Oxygen content in her blood is less.
The background history of Mandy displayed that Mandy was delivered in 40 weeks
and 2 days’ time without any complication during birth, her birth weight was 3.8 kg and she
was of 50 cm in length. However, Mandy had to stay in NICU, as she is having a hole in her
heart. However, her mother said that there is no family history of hypertension,
hyperlipidaemia, heart disease, bleeding disorder, and chromosomal abnormalities neither
from Mandy’s mom or dad’s side (Michael, Scharf, Letzkus & Vergales, 2016). However, it
was noted that her 18months old cousin is suffering from hole in heart and hence underwent
surgery six months ago.
After analysing all the signs and symptoms along with past data it was assessed that
Mandy is suffering from cardiac as well pulmonary distress. Low oxygen content states that
the level of oxygenated blood in her blood is less and her high respiration and heart rate
suggested that Mandy is suffering breathing difficulty and heart problems (Shrivastava,

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Singh, Raizada & Singh, 2015). As she is having crackling while breathing, Mandy is not
taking food and water that is causing no weight gain. The temperature of her body is high.
Hence all above sign indicates disorder Mandy is going through. However, nose drainage is
clear and her blood pressure is in stable state. She is having soft and round abdomen which is
a good sign.
It is recommended that Mandy must undergo immediate diagnosis and medication.
Moreover, it is better she must go surgery so that the hole in heart can be blocked and she can
have a normal life (Belialov, 2017). Blocking the hole in her heart would improve Mandy’s
difficulty, reduce her respiratory distress and hence she can have a normal life.
Answer 4
Priority list according to nurse
Priority Orders
1 Laboratory Orders: CBC, chem 8, BNP, Respiratory viral panel
2 Echocardiogram stat
3 Chest x-ray stat
4 Insert NG tube
5 Suction nose before each feed
6 Oxygen 100% 1 L via nasal cannula
7 IV insertion
8 Administer 10 ml/kg of normal saline IV over 30 minutes
9 Offer 150 ml of formula every 4 hours PO. Gavage the remainder over
30 minutes.
As all the symptoms suggests that Mandy is suffering from cardiac problem. First
CBC necessary to blood testing to see the overall health of the person. This blood count test
would help in predicting the blood composition for Mandy at present. Chem8 test is done to
understand the basic metabolic panel for Mandy as, it was reported that Mandy was not