Nursing Assignment: Case Study Analysis

This paper discusses a case study analysis of a 77-year-old woman with acute myocardial infarction and osteoarthritis, focusing on nursing assessment, care planning, patient education, and teamwork.

Running head: NURSING ASSIGNMENT
CASE STUDY ANALYSIS
Name of the student
Name of the university
Author NOTE

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Considering the patient condition
While working with terminally and critically ill patients, the primary concern of
healthcare professionals is to understand the needs and requirements of the patients and their
health condition by observing, and assessing the healthcare condition of the patients (Dalton,
Gee & Levett-Jones, 2015). In this aspect, prioritization of care interventions becomes most
important and to determine this healthcare professionals conduct clinical reasoning cycle so that
prioritization of care could be achieved (Hockenberry & Wilson, 2018). As pre this clinical
reasoning cycle, healthcare professionals consider patient condition to collect the cues and then
after processing the information identified the priorities and then develops goals for the
healthcare process. Therefore, through this process, holistic cares for the patients are achieved
(Green et al., 2016)
This paper discusses one such care process of a 77 year old woman Violet Paterson who
is admitted to the healthcare facility after the concern of Acute Myocardial Infarction or AMI
and after the effective treatment of the healthcare professionals, she is stable. Her past medical
conditions indicated that hypertension and osteoarthritis are the main healthcare conditions due
to which her health was affected. Further, due to these healthcare conditions she was unable to
manage these properly and severely impacted her quality of life. In the case study, it was noted
that the patient is residing at her home, which is a three storey building and does not have a lift,
due to which h=she is unable to move out of her home as osteoarthritis has decreased her
movement abilities. Therefore, due to her osteoarthritis and hypertension, her quality of life has
been hampered and she is not being able to communicate socially. Hence, this ultimately affects
her mental strength and abilities due to limited movements and abilities.

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Nursing assessment procedure
The first assessment method that would be conducted in the care process assessment of
the nurse would be the electrocardiogram or ECG that would provide a detailed and accurate
assessment of the heart. The ECG method helps to assess the ability of the heart and its pulses,
through the usage of electrical impulses which is provided to the heart thorugh an electrode
attached to the skin surface. As per Ishikawa, Ishikawa & Kari, (2015), ECG is the most
prominent and effective assessment tool for the patients suffering or having high risk factor for
chronic heart condition. It also reveals that for patients suffering from or has a history of
suffering related to myocardial infarction, then conducting ECG could easily reveal the risk or
the current status of their heart condition. This is because as per Belfort et al. (2015) weaker of
injured heart muscles are unable to react to electrical impulses and hence, the ECG is unable to
detect their activities and the report shows blank results. Because this conducting of a complete
blood test for the identification of her blood status as in myocardial infarction condition, patients
heart starts losing or releasing a specific protein due to which the protein content of the blood
increases. Hence, blood test for the identification of high protein content could provide them
with the indication that the blood has increased level of proteins. Hence, these tow healthcare
assessment test would help the healthcare professionals to assess the patients healthcare
complication related to myocardial infarction (Chauhan & Vig, 2015).
Another assessment that would be conducted for the healthcare process of Violet
Paterson would be identifying the current status of her osteoarthritis related health condition.
This is an important assessment so that the status of her past and history of healthcare
complications could be identified. Hence, the pain status of the patient would be assessed first as
per the healthcare assessment for osteoarthritis. The pain assessment process would be conducted

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thorugh a pain scale assessment in which 0 would be the lowest pain and 10 would be the highest
pain. Further, Violet Paterson is 77 year old and is suffering from osteoarthritis and due to which
her risk of fall increases. Hence, the second assessment process should be conducted for her fall
related risk factors so that through the assessment of fall conditions with the help of fall risk
assessment tool, her level of risk could be determined. As per Ishikawa, Ishikawa and Kario
(2015), conduction of fall risk assessment would help the nursing professionals to understand the
level of patient’s pain and determining and measuring the additional harm of the patients. Hence,
through these above- mentioned assessment plans the nursing professionals would be able to
identify the risk factors that currently affect the healthcare condition of Violet Paterson. Further
her temperature, blood pressure, heart rate, oxygen saturation rate, respiratory rate and other vital
signs would also be conducted. As the patient is suffering from risk factor of recurrence
myocardial infarction, assessment of her healthcare condition would be helpful in determining
the care plan and interventions that would be implemented for her health improvement (Chauhan
& Vig, 2015).
Care planning
Nursing goals Nursing interventions
and nursing rationale
Evaluation
In the case study it is
seen that Violet Paterson is
suffering from osteoarthritis and
hence, suffering from pain
related condition. Further it is
seen that her crucial health
condition, this might also
Physiotherapists would be
included in the care process so
that would help the patient to
overcome her pain and agony.
Further, thorugh exercises, she
would be able to maintain
A well developed pain
assessment scale would be
included in the care process of
the patient so that. Reduction of
pain could be achieved and
patient could be provided with

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increase his chances of fall.
Hence, the second nursing goal
would be helping the patient with
arthritis management and help
her to overcome pain.
healthcare condition.
To reduce the risk factor related
to fall of the patient, the layout of
the rooms of the patient would be
reduced. Nurses should also
provide non-skid shoes to reduce
the risk of fall. Clutters should be
removed from the floors as well
effective healthcare conditions .
the high pressure and
hypertension should be the
another healthcare priority for the
patient so that management of
her mental complication could be
achieved.
the set of medication that can be
also provided is the drug related
to the beta-blockers. The main
rationale behind using this drug
is that it helps in blocking the
effects of the sympathetic
nervous system on the heart and
thereby lowers the blood pressure
the blood pressure would be
assessed and the reported
insecurities would be addressed.
Violet Paterson has been
observed of suffering from AMI
due to which her cardiac output
could be reduced to severe rates.
Due to this, her heart would
become weak and it would not be
able to provide her body with
enough amount of blood and
The primary intervention the
nurse would implement in the
care process would be
assessment of the heart rhythm
with complete observation of the
heart rate. With the help of
telemetry, the nursing
professionals would assess the
after completion of entire
process, nurses would nursing
professionals would be asked to
conduct a detailed evaluation so
that all the healthcare
complications could be
identified. Further, application of
ECG, x- ray and other

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metabolic substances. Therefore,
the primary goal for the
healthcare professionals involved
in the care process would be
determining her balanced cardiac
output
cardiac output of the patient. The
primary rationale for
implementing this intervention is
that thorugh the help of one
assessment methods, she would
be provided with increases heart
rate and increased blood pressure
related intervention.
If the patient was observed with
severe fall in her cardiac output,
the nursing professionals would
provide the patients with external
oxygen so that with increase in
the amount of oxygen her risk
related to myocardial infarction
could be eliminated.
The dietician would be asked to
provide the patient with small
and light meals so that
application of it could increase
her strength and abilities to
overcome healthcare
complications. She would be
prevented to consume caffeine so
that application of proper diet
physiological evaluation process
this would help them to identify
the presence of pulmonary edema
so that AMI condition could be
reviewed.

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could easily increase her
healthcare improvement related
to osteoarthritis and
hypertension.
Patient education
Besides all the above- mentioned healthcare interventions, the patient would also be
provided with healthcare education and within this healthcare literacy, the majority of the section
would be about diet and nutritional changes and modification in her lifestyle so that the patient
could overcome her typical healthcare condition (Chauhan & Vig, 2015). In case of her diet
modification, she would be provided with controlled sodium foods to reduce the risk of high
blood pressure, would eliminate fat and cholesterol from her diet and she would be asked to
consume vegetables and fruits so that free radicals could be pushed in her blood stream. Further,
in this condition, it should be mentioned that she would be asked to avoid citric acid containing
food products as it could increase her osteoarthritis related healthcare complications. Te second
education that would be provided to the patient would be about activity and physical exercises
for her bone health, arthritis condition. The education related to physical activity would help the
patient to overcome her inactive lifestyle and thorugh proper activeness and health literacy, she
would be able to lower her chances related to acute myocardial infarction. Further, it was seen
that excessive weights exerts pressure on her joints and make them susceptible to increasing
osteoarthritis. Hence, the physiotherapist and dietician would help her to manage her diet and
through the application of physical exercises, she would be able to overcome her muscle and
joint concerns.

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Team work
As the patient is suffering from critical and crucial healthcare condition a
multidisciplinary team should be included in the care process for Violet Paterson. A
multidisciplinary team is a group of healthcare professionals, who belong to several healthcare
disciplines and as team they help the patient by providing them with holistic acre process. In this
care process, it was noted that the patient is suffering from cardiology related disorders and
hence, the care process should be leaded by a cardiologist and all the important healthcare
interventions, decisions, medication and important ideas for effective healthcare process would
provided by cardiologist only (Drevenhorn et al., 2015). Therefore, this would help the patient to
overcome her critical heart conditions. On the other hand, for her osteoarthritis associated health
condition, she would be provided with a physiotherapist who would provide the patient with
effective exercises and would help her to increase her mobility. Further as per Belfort et al.,
(2015) application of physiotherapist would help her to reduce her pain so that she could easily
perform her activities of daily life. Further, application of physiotherapists would her to develop
health condition. Besides these two, application of occupational therapists in the care process
would help to teach the patient with abilities so that with or without the presence of healthcare
professionals, she could overcome her health complications. Further, the patient would be asked
to stay active in her home so that with adequate activity her health conditions could be treated
properly. Further, she would also be provided with a nutritionist and a dietician so that with
proper vigilance on her diet, her healthcare condition could be treated. She would be asked to
communicate with people at her home and community so that her mental status could be
improved and she could overcome her hypertension and resulting depressive condition. Further,

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her osteoarthritis condition and blood pressure related condition would also be treated thorugh
the cumulative action of the multidisciplinary team.

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