Nursing Essay 2022

Running head: NURSING
NURSING
Name of the Student
Name of the University
Author Note

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Introduction- Nurses play an important role in the recovery of the patient. This essay
mainly focusses on a particular case study where a new graduate nurse have to provide care
for a patient named Mrs. Kennedy who was admitted in hospital due to pneumonia but later
the nurse came to know that Mrs. Kennedy actually had coronary heart disease. Later, her
condition worsens with rise in heart rate and respiration rate and decrease in oxygen
concentration and blood pressure. This essay thus deals with a reflection based on the case
study scenario and how the nurse will provide accurate care to her patient. It will also reflect
all the pathophysiological problems that will help in the proper diagnosis of Mrs. Kennedy.
Discussion- Mrs. Kennedy is a 56year old patient hospitalized due to pneumonia.
According to the previous notes, it is focused that she lives alone in a rented flat and her son
lives in abroad. She is depressed due to her loneliness. She is also a retired woman and hence
has no such work to do at home. According to the previous medical history, Mrs. Kennedy
had ischemic heart disease, hypertension and onset of coronary heart disease. Six years ago,
she also had coronary artery bypass graft surgery. She went through percutaneous
transluminal coronary angioplasty two years back along with stenting to her right coronary
artery as well as posterior descending artery. Mrs. Kennedy was found to be a chain smoker
till she was diagnosed with coronary artery disease. According to previous observations in the
hospital, Mrs. Kennedy had pulse rate of 74bpm and blood pressure 165/90 mm/Hg. She had
a respiratory rate of 14/minute and SpO2 98%. I went through all these reports before onset
of my care procedure. Half an hour later when I went to administer her medicine I observed
that she was diaphoretic. On questioning her she replied that she was not feeling well and her
chest pain started. I again checked all the necessaries and found that her pulse increased to
116bpm and respiratory rate to 26/min. her blood pressure came down to 105/70 mmHg and
SpO2 to 92%. She had a breathing difficulty and also a cool sensation. According to my
examination her heart rate and respiratory rate increased gradually whereas blood pressure
and SpO2 decreased significantly. Heart rate generally increases due to occurrence of atrial
fibrillation. Vascular pathophysiology results in the increase of heart rate. It has thus emerged
as an risk factor for patients like Mrs. Kennedy suffering from hypertension, coronary artery
disease as well as myocardial infarction (Zoni-Berisso, Lercari, Carazza & Domenicucci,
2014). Respiratory rate is a major symptom for numerous diseases but physicians do not pay
much attention to it. Respiratory rate may increase due to pain, anxiety or other situations. It
mainly occurs when the acid level is high and hence the breathing rate increases in order to
blow off carbon dioxide (Jensen, Suadicani, Hein & Gyntelberg, 2013). It can be well

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explained by the term tachypnea . High respiratory rate marks the risk of occurrence of
myocardial infarction in patients already suffering from coronary heart disease. Many
evidences show the relation of decreased blood pressure with coronary heart disease (Xie et
al., 2016). Low blood pressures generally results due to insufficient flow of blood to body
organs which mainly leads to strokes, heart attacks as well as kidney failures(). On the other
hand, decrease oxygen saturation level or SpO2 is an independent risk factor for arrhythmia.
According to Jiang (2013), healthy heart tolerates hypoxia better and hence should have
oxygen saturation from 93% to 98%. All the symptoms thus conclude that Mrs. Kennedy is at
major risk of coronary heart disease and should be treated immediately. Cold sensation and
difficulty in breathing may result in cardiogenic shock. Therefore, all the treatment will be
related to the diagnosis of cardiogenic shock which is the main risk factor or Mrs. Kennedy.
Nurses should first immediately call the supervised physician and accompany them in
their treatment procedure. After the physician completes their checkup and prescribed
medications, nurse’s role comes into account. Mrs. Kennedy was suffering from acute pain
hence the nurse should monitor and review the location as well as the nature if the pain. In
addition they should also monitor her vital signs like blood pressure, pulse, respiration after
every two hours (Pegram & Bloomfield, 2013). They should also instruct Mrs. Kennedy to
report them whenever she is having chest pain. It is the duty of the nurses to create a calming
atmosphere for the patient and make the patient comfortable (Slatyer, Williams & Michael,
2015). Administering medications in the correct route is another important criterion which
should be kept in mind. This is because there were various incidences that cause deterioration
in patient’s health due to administration of drug through wrong route (Bibby, 2019).
Intolerance activity must be followed and the nurses should record the blood pressure, rhythm
before and after the activity. They should convince Mrs. Kennedy to take more rests and not
to think about her ill health. Rest helps in the process of recover a lot. The nurses should also
educate Mrs. Kennedy about the various stages of treatment that the doctor prescribed to do.
They should also take care about the diet that should be followed by Mrs. Kennedy. Her diet
should be such that it is easily digestible and does not contain caffeine (Kennedy, Lavie &
Blair, 2018). They should help in carrying out the ECG examination, chest radiograph. As
Mrs. Kennedy is suffering from risk of impaired tissue perfusion due to her lowering of blood
pressure level, hence the nurses should assess her change in consciousness. They should
inspect occurrence cold skin, cyanosis (Cavalcante, Brunori, Lopes, Silva & Herdman, 2015).
As she is already suffering from cold skin and breathing difficulty, therefore nurses should