Case Study: Cardiovascular Disease Management and Patient Care

This case study focuses on a 63-year-old male admitted to the hospital with breathing difficulties and chest pain, diagnosed with cardiovascular disease (CVD). The case study explores his medical history, including diabetes, ischemic stroke, osteoarthritis, and asthma, along with previous treatments. A detailed nursing physical assessment reveals a body temperature of 99.7°F, BMI of 28.9, SpO2 of 87%, and a respiratory rate of 24 breaths/minute, leading to a diagnosis of coronary artery disease (CAD) primarily linked to his body weight. The pathophysiology of CAD, related treatments like lifestyle changes and medications, and nursing interventions such as dietary reviews and emotional support are discussed. The nursing diagnosis centers on the patient's high BMI, with the goal of weight reduction and self-management. The study recommends regular BMI measurements and structured behavioral interventions for weight management. The case study highlights the importance of a holistic approach to managing CVD and improving patient outcomes.

Running head: CASE STUDY
Case Study
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1CASE STUDY
Introduction
Michael is a 63-year-old man who is suffering from a number of health problems. Since last
night he has been having trouble breathing, chest pain and was not feeling comfortable for which
he has been admitted to the hospital. An ED healthcare professional comes to assess the issue
and help in treating him. After the assessment it was determined that he is having Cardiovascular
disease (CVD). Thus, the healthcare team focus was now on to help in treating the
cardiovascular disease and then help Michael in managing and guiding his body weight.
Medical history
Disease Treatment
Diabetes Healthy eating, regular exercising and few
medications such as Metformin, Sulfonylureas.
Ischemic stroke Healthy eating, clot-dissolving medicine like
the tissue plasminogen activator (TPA)
Osteoarthritis Acetaminophen, Duloxetine and physical
therapy
Asthma Inhaled corticosteroids and Albuterol
Nursing Physical Assessment
Normal tests were conducted on Michael, such as checking the body temperature, weight,
SpO2, respiratory rate and other type of blood tests to evaluate the type of Cardiovascular
disease (CVD). The body temperature observed was around 99.7OF, body weight measured
demonstrated a BMI of 28.9, SpO2 was 87% and he had a respiratory rate of 24 breaths/minute.
The healthcare professionals after the full assessment of Michael came into realization that he

2CASE STUDY
was having Coronary artery disease (CAD). The major behind this condition was his body
weight for which he was never treated for and that led to occurrence of different harmful
diseases.
Pathophysiology
When there is a formation of spread of plaque inside the walls of the coronary arteries,
which is responsible for the supply of blood to the heart, it leads to Coronary artery disease
(CAD). Plaque is made up of cholesterol deposits. As the time passes, the formation of the
plaque inside the walls of the coronary arteries makes the artery a narrow passage for the blood.
This process is called atherosclerosis (Ambrose & Singh, 2015).
Related Treatments
The healthcare team decided to help Michael in improving and changing his lifestyle by
guiding him to eat healthy foods especially fruits, involve in daily physical activities that will
eventually help in reducing the excess body weight and help in reduce stress (Mostafavi, Solhi,
Mohammadi & Akhondzadeh, 2017).
Though there are certain other medicines such as Cholesterol-modifying medications
which help in decreasing the level of cholesterol in the blood specifically low-density lipoprotein
cholesterol (Karimi et al., 2016). Aspirin is also being provided on a daily basis which is helping
in preventing the blood to clot that will reduce obstruction in the coronary arteries. To reduce the
chest pain in Michael Ranolazine can be suggested (Karimi et al., 2016).

3CASE STUDY
Nursing Diagnosis & Patient Goal
The main issue in Michael is body weight, where the BMI was measured to be 28.9. As
per the research, a Body Mass Index above the 24.9 is considered as obese. Here in the case of
Michael, he is having more body fat than is optimally healthy. Such kind of body weight has to
lead to several health issues in Michael.
As per the medication history, the report does not suggest that previously his body weight
was considered as a significant factor for his health issues, thus, it is necessary to reduce his
body weight and change his mindset so that he can self-manage his body weight.
Nursing Interventions
There are certain nursing interventions that can be suggested for Michael –
1. Reviewing daily food intake (calorie intake, eating habits, amount of food being eaten at
a time) – This will help in recognizing the changes that are required to be implemented in
the dietary program.
2. Discussing the emotional and psychological concerns with Michael will help in
recognizing whether he is eating to satisfy his emotional need or for the physiological
hunger.
3. On the basis of this records, an eating plan should be developed using the knowledge of
height, weight, age and many more. This kind of diet plan should focus on two important
things – reducing the body weight and providing all the necessary nutrients.
4. Physical activity should be highly suggested.

4CASE STUDY
Evaluation
After the nursing intervention is followed by Michael, it will become a daily habit for
Michael to follow the routine and will also help in reducing the body weight and cardiovascular
disease. The whole diet plan and weight reduction will show its effective results since after one
month of the implementation of the plan.
Recommendations
• It is recommended that height, weight and BMI should be measured at all primary
care visits (Brauer et al., 2015).
• Structured behavioral intervention is suggested for Michael which aims at decreasing
the weight (Brauer et al., 2015).

5CASE STUDY
References
Ambrose, J. A., & Singh, M. (2015). Pathophysiology of coronary artery disease leading to acute
coronary syndromes. F1000prime reports, 7.
American Diabetes Association. (2016). 8. Cardiovascular disease and risk
management. Diabetes care, 39(Supplement 1), S60-S71.
Brauer, P., Gorber, S. C., Shaw, E., Singh, H., Bell, N., Shane, A. R., ... & Canadian Task Force
on Preventive Health Care. (2015). Recommendations for prevention of weight gain and
use of behavioural and pharmacologic interventions to manage overweight and obesity in
adults in primary care. Canadian Medical Association Journal, 187(3), 184-195.
Karimi, M., Zare, H., Bakhshian Nik, A., Yazdani, N., Hamrang, M., Mohamed, E., ... &
Hamblin, M. R. (2016). Nanotechnology in diagnosis and treatment of coronary artery
disease. Nanomedicine, 11(5), 513-530.
Mostafavi, S. A., Solhi, M., Mohammadi, M. R., & Akhondzadeh, S. (2017). Melatonin for
reducing weight gain following administration of atypical antipsychotic olanzapine for
adolescents with bipolar disorder: A randomized, double-blind, placebo-controlled
trial. Journal of child and adolescent psychopharmacology, 27(5), 440-444.
Wilkins, E., Wilson, L., Wickramasinghe, K., Bhatnagar, P., Leal, J., Luengo-Fernandez, R., ...
& Townsend, N. (2017). European cardiovascular disease statistics 2017.