Nursing Case Study: Pathophysiology and Rationale

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

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NURSING CASE STUDY
Case Study 1
Pathophysiology and Rationale
Based on the nursing diagnosis of William, the three issues can be found which are sudden
cardiac arrest, pulmonary oedema and myocardial infarction.
William is a 64-year-old person and had a medical history of NYHA class IV heart failure or
severe heart failure. It has been seen that he has laboured breathing condition. Based on the
assessment, it can be said that he has a ventricular tachycardia or ventricular fibrillation. This
condition leads to the sudden contraction of the heart chambers, which leads to sudden cardiac
arrest (Katritsis, Gersh & Camm, 2016). The ventricular fibrillation or the atrial fibrillation
would be the cause of the sudden cardiac arrest. Another reason for these factors would be the
chaotic electrical impulse in the heart chambers and valves. Which lead to the imbalanced
contraction of muscles and the sudden cardiac arrest can lead to the ischemic stroke as well
(Arboix, 2015).
William also showed the symptoms of the tachycardic pulse along with laboured breathing,
which refers to the pulmonary oedemic condition. Pulmonary oedema can be caused by fluid
retention in the lungs,
The blockage of the oxygen flow in the blood, thus affects the breathing along with the
oxygen content of the blood. Other than these, the congestive heart failure could also be the
cause of pulmonary oedema as it leads to improper pumping of blood. Thus the blockage occurs
into the pulmonary artery and even blocking the air spaces of the lungs (Coccia, Palkowski,

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NURSING CASE STUDY
Schweitzer, Motsohi & Ntusi, 2016). In pulmonary oedema, the lungs filled up with
deoxygenated blood, and the oxygen blood ratio hampered; thus the ischemic stroke would be
the resulting consequence for the situation (Amarenco et al., 2016).
On the other hand, the myocardial infarction or common heart attack would be caused by
the decreased blood flow in the heart chambers and damage to the heart muscles. The
imbalanced electrical impulse can be the cause of these factors. Other than the imbalanced or
chaotic electric impulse in the heart, the cholesterol blocked veins and arteries also create the
situation of the lower rate of blood flow. This factor can be the cause of the cholesterol retention
in the blood vessels; thus, the blood flow rate reduces to the heart. Other than these, the coronary
artery disease also leads to the myocardial infarction (Heusch & Gersh, 2016). The lower rate of
blood flow to the lung causes the laboured breathing and affects heartbeat as well as the severe
chest, shoulder, arm, back and jaw pain (Talman & Ruskoaho, 2016).
Nursing action and Rationales
In case of William’s prevention of the sudden cardiac arrest, pulmonary oedema and
myocardial infarction the nurse should provide the patient with supplementary oxygen. The
nurse should administer the tissue plasminogen activator drug for the prevention of the
possibility of ischemic stroke (Komajda et al., 2016).
Even the diagnosis of the patient needed to be done with the help of the ultrasound, X-ray
and other blood tests as well. The nurse should provide support to the patient by means of
administering supplementary oxygen by nasal prongs and also diagnose the condition of the
heart beat and the pulse rate along with the blood pressure level detection of Williams.

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NURSING CASE STUDY
Professional issue
Here as a new nurse, the nurse should be able to consider the consent of the supervisor or the
doctor as the ethical condition of a nurse. However, nurses are needed to be able to recognize the
factor of the patient health condition over any other aspect. Based on the NMBA nursing
standards the nurse should use patient centred care, the nurse should focus on the situation and
the needs of the patient over other factors and show compassion to the patients along with
integrity, honesty and respect in order to maintain professional behaviour. Other than person
centred care the cultural practice and respectful relationship should also be considered by the
nurse for maintenance of NMBA standards (Nursingmidwiferyboard.gov.au, 2019).The
professional problem of the nurse here basically is the ethical dilemma based on decision making
and providing proper care for the patient (Dehghani, Mosalanejad & Dehghan-Nayeri, 2015).The
NSQHS standards also needed to be followed which includes the clinical communication,
medication safety, comprehensive care, management of pressure injuries and response to the
deterioration of the clinical condition of the patient (Safetyandquality.gov.au, 2019).
Case Study 2
Pathophysiology and Rationale
In the case of Carol the nursing assessment on her condition can refer to three
fundamental issues such as hypovolemic shock, septic shock and respiratory distress.
Carol, a 59-year-old lady after knee replacement has shown blood pressure of 90/46
mmHg, 12 breaths per minute and 90bpm pulse rate. Other than this closed suction drain system