Case Study Analysis of Mrs. Sharon McKenzie

This document provides a case study analysis of Mrs. Sharon McKenzie, a patient suffering from congestive heart failure. It discusses the disease outline, causes, symptoms, and a care plan developed for the patient. The document also mentions the drug used for treatment and its pharmacokinetics and pharmacodynamics. Find relevant study material and assignments on Desklib.

Running head: NURSING ASSIGNMENT
CASE STUDY ANALYSIS OF MRS. SHARON MCKENZIE
Name of the student
Name of the university
Author note

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Answer 1
Disease outline
Congestive heart failure (CHF) is known as the disorder in which the human heart
becomes weaker in pumping blood throughout the body (Maru et al., 2016). In this progressive
and critical as well as chronic heart condition, the muscles of the heart ventricles gradually
becomes weaker and hence, the contraction and relaxation process associated to systole and
diastole of heart movement do not occur properly (Voigt et al., 2014). Due to this, the human
heart becomes unable to meet the requirement of blood of entire body and the blood circulation
associated complication of the heart increases (Maru et al., 2016). This is because, while
suffering from congestive heart failure, the heart ventricle do not becomes unable to pump
adequate blood to the bodily organs due to which, all the organs starts accumulating fluid around
their anatomy and hence, the person starts feeling congestive in their heart and distress condition
increases (Voigt et al., 2014). In this case study, all these symptoms were witnessed by Mrs.
Sharon McKenzie (77) and the symptoms were cold feet, swollen feet, breathlessness and others.
Cause, incidence and risk factors
The primary cause of CHF is past experience of Myocardial infarction, as due to this
condition, the heart muscles of the patient becomes weaker and in unfavorable condition, it could
lead to weaker cardiac symptoms and creates CHF condition (Kumar, Ashwlayan & Verma,
2018). It was clearly mentioned that patient Sharon McKenzie (77) had myocardial infarction 12
years ago and hence, she had higher risk of developing chronic CHF. Further, it was seen that
due to bacterial and viral infection, performing excessive work out in spite of weak heart muscles
and hence the chances of CHF increased. Besides this, due to plaque formation in the heart blood

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vessels, due to excess consumption of fats. The blood vessel becomes unable to provide adequate
blood to the organs and hence, CHF heart failure associated condition arises (Marzo et al., 2016).
The incidence related to CHF around the world is high as due to increased physical and
environmental stressor, people are prone to suffer from myocardial infarction, However, in
Australia, the data related to congestive heart failure mentions that more than 300,000 people are
affected with this disorder and every year more than 30,000 cases are registered. Further, in this
majority of affected individuals were male over the age of 45. Hence the prevalence for CHF
was higher in older adults than younger individuals (Australian Institute of Health and Welfare,
2019).
Risk factors associated with CHF was related to previous occurrence of myocardial
infarction, due to which the heart muscles becomes weak. Further, increased blood pressure,
weaker heart muscles, diet and nutritional factors, fat or plaque accumulation in the blood vessels
were other reasons for the CHF condition (Liu & Gao, 2017).
Further, this health condition affected Mr. Sharon McKenzie’s (77) family by breaking
their morale. It was seen that the patient’s husband used to take her for walks so that they could
spend some quality time together. Further, it was seen that her husband used to take care of her
health condition. Hence, this condition affected the overall health of her condition (Marzo et al.,
2016).
Answer 2
Sign & symptoms Underlying pathophysiology
Shortness of breath Due to weaker heart muscles. Heart could not
meet the requirement of the body, due to
which, the organs of the body starts
accumulating fluids around it, Due to this

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condition, the lungs, kidney, heart and other
organs accumulate fluid around them. Due to
this, the patient affected with it starts feeling
heaviness or congestion around their heart and
lead to this symptom (Bartunek et al., 2016).
Due to this, the patient Mrs. McKenzie was
seen suffering from acute shortness of breath,
which used to arise while working or walking
around her house.
Increased BP and higher heart rate When the heart muscles becomes weaker, the
patients suffer from shortness of breath
because the heart in the course of fulfilling the
requirement of blood in the body, the heart
muscles starts beating faster so that blood
requirement of the body could be met. Hence,
the heart rate increases, further, while pushing
blood through the blood vessels, excess
pressure should be created because the
amount of blood pumped through the vein is
low. Hence, this condition arises (Mahmood
et al., 2014).
This is because the patient was seen suffering
from increased BP and elevated heart rate and
these conditions affected the CHF condition
of the patient
Swollen ankle and cold feet Due to accumulation of fluid around the
bodily organs and smooth muscles throughout
the body, patient also seen suffering from
swollen ankle (Ferreira et al., 2014).
This was also observed in the patient. Mrs.
McKenzie’s symptoms as she was seen
suffering from this health condition in her
CHF condition.
The drug and its pharmacokinetics and pharmacodynamics
The drug which has been provided to the patient while treating her CHF condition,
belonged to the glycosides drug class. The primary role of this drug inside the human body is to

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provide the heart muscles enough strength so that while suffering from CHF, the heart muscles
could pump enough blood to the human body (Noh et al., 2016). The underlying
pharmacodynamics and pharmacokinetics if the drug has been mentioned below:
While mentioning the pharmacokinetics, the absorption, metabolism, distribution and
the excretion of the drug inside the human body should be provided (Hao, Zheng & Wang,
2014). It was seen that the drug showed majority absorption through the oral route and in capsule
form, it showed 90% absorption, whereas, in tablet form, it showed 70% absorption. Further,
through intravenous route the absorption of the medication was more than 65%. The metabolism
of the drug generally does not occur in the human body, however, in human gut, due to bacterial
interference, minimal metabolism was seen (Noh et al., 2016). Further, the distribution of the
drug was seen majorly in the heart, liver and kidney of human body. The primary route of
excretion of this drug is through urination and hence, the half-life of the drug is more than 48
Hours within human body (Haiser et al., 2014).
Further, the pharmacodynamics of this class of drug is associated to the inotropic
action, creating balance between the unsynchronized heartbeats of the patient (Noh et al., 2016).
The primary purpose of this drug within patient’s body is to creating balance between the SA
nodes by affecting the sympatholytic action of the body and then exerting cholinergic effects on
the human body (Haiser et al., 2014). Hence, this drug was provided to the patient in the case
study so that the heart muscles of the patient could be strengthened and through this the patient
and associated increased heartbeat and heart rate could be decreased (Hao, Zheng & Wang,
2014).

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Answer 4
Care plan developed for the patient is as follows:
The goal of the nursing care
plan
Intervention applied The rationale of the
intervention
The first aim of this nursing
care plan for the patient in
case study would be
decreasing her increased
heart rate and blood
pressure so that excess
heart pressure could be
removed (Mahmood et al.,
2014)
The intervention which would
be applied for this goal would
be providing the patient with
enalapril drugs which helps to
decrease the excess blood
pressure from the heart and
relieves the tension from the
heart so that muscles of the
heart could work freely.
Further, the patient would be
asked to limit her movements
within her house or would be
asked to stop her walk so that
her risk factor of chronic
heart condition could be
eliminated (McMurray et al.,
2014).
As per McMurray et al.
(2014), enalapril drug helps
to decrease the increased
blood pressure from the blood
vessels and hence, while
administering the intervention
for CHF, the patient should
be provided with this
medicine so that her
increased heart rate could be
decreased.
Further, McMurray et al.
(2014) mentioned that
patients with past history of
myocardial infarction should
not move or work so much, as
it could affect her heart
condition. Hence, this was
included in the intervention
of the patient.
The second care plan goal
for this patient would be
treating her shortness of
breath so that the patient
could breathe freely
(Ferreira et al., 2014)
The second intervention
applied to treat the shortness
of breath of patient would be
providing her with inhalers so
that through this medication,
the smooth muscles around
the airway could be relieved
and she could breathe freely
and without any strain (van
Riet et al., 2014).
Researchers has mentioned
that people with higher risk
factor for CHF, should be
provided with inhalers as
shortness of breath is a
condition in which patients
suffer from breathing issues
and providing care for her
breathing issue could increase
her distress. Hence, this
intervention is rationally
correct (van Riet et al., 2014).
Further, researchers has also
mentioned that relieving
smooth muscles of airway
could affect the patient
positively and hence compete

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attention of treatment could
be reoriented in the treatment
of CHF (van Riet et al.,
2014).
The third goal of the care
plan would be reducing the
amount of accumulated
fluid from the heart muscles
of the patient so that the
congestive feeling of the
disorder could be overcome
(Bartunek et al., 2016)
The third intervention applied
in this situation would be
application of diuretic class
of drug in her medication list
so that the accumulated fluid
could be removed from the
smooth muscles of several
bodily organs and she should
sleep or walk freely without
any strain in her heart
(Ponikowski et al., 2016).
Researchers Ponikowski et al.
(2016) has mentioned that
while treating the CHF
condition of the patient,
physicians should include
diuretic drug as it helps to
reflux all the excess fluid
from the body and decreases
the rate of fluid accumulation
around the human body.
However, in this condition, it
was seen that patients usually
become affected with
dehydration. Hence, with
application of diuretic drugs,
the patients and her
dehydration condition should
also be assessed (Ponikowski
et al., 2016).

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