Nursing Care Plan for Adult Patient Experiencing Cardiovascular Event

This case study analyzes the nursing care provided to a 68-year-old patient, Mr. George Orwell, admitted with chest pain, indicative of a cardiovascular event. The paper explores the patient's medical history, including type 2 diabetes, hypertension, and a previous coronary artery bypass, linking these risk factors to the pathophysiology of chest pain and identifying dyspnea and peripheral edema as key nursing problems. The study details a comprehensive nursing management plan, including assessment methods, interventions such as position changes, breathing exercises, oxygen therapy, and therapeutic communication, as well as pharmacological interventions like bronchodilators and diuretics. It also covers medical management strategies and emphasizes the importance of discharge planning, highlighting the need for a multidisciplinary approach to ensure continuity of care and patient support post-discharge. The conclusion stresses the significance of combined treatment efforts for elderly patients experiencing cardiovascular events.

Nursing Care For An Adult Person Experiencing A Cardiovascular 1
NURSING CARE FOR AN ADULT PERSON EXPERIENCING A
CARDIOVASCULAR
By Student’s (Name)
Professor’s Name
College
Course
Date

Nursing Care For An Adult Person Experiencing A Cardiovascular 2
NURSING CARE FOR AN ADULT PERSON EXPERIENCING A
CARDIOVASCULAR
1.0. Introduction
The content of this paper is an evaluation of a clinical case scenario of Mr.
George Orwell, a 68-year-old patient who has been admitted to the hospital following a chest
pain diagnosis. Even though the patient had been diagnosed with chest pain, his condition
requires more assessments, thus the need for medical history and previous nursing health
records. The content of this paper, therefore, links pathophysiology and pharmacology concepts
to evaluate his case and identifies two major nursing problems related to the scenario. The paper
further provides an assessment, intervention as well as medical management and discharge plan
for the identified nursing problems.
2.0. Primary Admission Diagnosis
The case study patient Mr. George Orwell a 68-year-old, was admitted due to the chest
pains. Chest pain (Angina) is caused by the discomfort in the lungs as a result of the heart not
being able to pump enough oxygenated blood or blood rich in oxygen to the lungs (Paturzo et al.
2016). Further, chest pains ensue due to the inability of the heart muscles to pump enough blood
to the body. The pain may also extend to other parts of the body, and the patient may feel
discomfort in different parts of the body such as arms, legs, shoulders jar and back pain which
was evident at the admission time of Mr. George Orwell (Devlin et al. 2018).
However, chest pain is not a disease but asymptomatic sign of an underlying heart
problem (Urden, Stacy and Lough 2017). In most occasions, angina or chest is a symptom of

Nursing Care For An Adult Person Experiencing A Cardiovascular 3
cardiovascular disease (CVD) or coronary heart disease (CDH) which the patient in question Mr.
George had suffered according to his medical history (Pimple et al. 2018). However, much chest
pain is a symptom of various heart diseases; research shows that it is much linked to
cardiovascular disease. In most of the occasions, symptoms of angina are not typically
identifiable (Dewey et al. 2016). Nonetheless, with a close assessment of the patient and with the
knowledge of pathophysiology and pharmacology, one may be able to identify the symptoms as
the patient concurs and changes in physiology over time. This was quite evident with Mr. George
Orwell, whose physiological change coincided with chest pain symptoms over time (Sekhri et al.
2016).
At his admission, the patient Mr. George looked slightly anxious with unremarkable vital
signs. Conversely, after a while, he noted that he has pitting edema in both legs that are
associated with diminished pedal pulses (Sabatine and Cannon 2015). The problem of swelling
legs is a sign that there is an excess accumulation of fluids in his body since he has not been
taking his medication. Mr. Orwell feels breathless extortions, lightheadedness, which is an
indication of fluid collections in his lungs. Also, sweatiness, increased body temperature, and
anxiousness experienced by the patient are further signs of angina. Furthermore, the patient’s
past medical history indicated he suffered from type two diabetes mellitus, hypertension, and
coronary artery bypass five years ago, as well as overweight and smokes an average 15 cigarettes
per day which are the significant risk factors for chest pain.
3.0. Nursing Problems

Nursing Care For An Adult Person Experiencing A Cardiovascular 4
The patient Mr. George Orwell based on physiological assessment showed trajectories of
chest pain or angina. However, the patient has developed two nursing problems noted as
Dyspnea and or edema.
Nursing problems:
o Problem 1; Dyspnea (Shortness of breath)
o Problem 2; Peripheral edema (excess body fluid)
3.1. Nursing Management
A registered nurse is expected to follow the set process, which is the most appropriate
and core practice enabling nurses to deliver holistic and patient care. The nursing process is,
therefore, a patient management process that is useful and objected towards the patient's
recovery. A registered must, thus, to help the patient begin with an assessment, whereby the
patient data is obtained and assessed against the previous medical history (Odell 2015). The next
step that should be taken by the nurse to run a diagnosis and give a response to a potential health
problem. After diagnosis, according to nursing management, the nurse should make a plan and
outcome. The nurse should then implement the possible interventions and evaluate them against
the result.
3. 2. Nursing Problem One: Dyspnea (Shortness of breath)
3. 2.1.Nursing Assessment
Nursing assessment involves investigating the patient using various methods to come up
with a potential problem. It consists of the collection of patient data, organizing the obtained
data, validating the collected data as well as the documentation of the data (Sanchez, Everett,

Nursing Care For An Adult Person Experiencing A Cardiovascular 5
Salamonson, Ajwani. and George 2017). The most appropriate assessment method in the case of
Mr. George based on his condition is an evaluation of his medical history and physical
assessment.
Assessment of Mr. George’s nursing health history:
Obtaining patients health history is the most appropriate way in this case since the
patient is already indicating various symptoms. By going through the patient history, the nurse
will be able to collect data regarding the medications and risk factors that the patient may face
(Poulgrain, Rutherford and Mann 2016). Assessing patient nursing history will also provide
information on the patient's status and evaluate whether the patient has other current problems.
Since Mr. George Orwell was transferred from another health facility going through his previous
files would reveal the best way forward for his treatment. Therefore, patient assessment, in this
case, would be done by collecting information from his transfer files and previous nursing notes
will help the nurse identify what is causing Dyspnea such as the patient’s cardiac functions and
smoking history (Silva-Costa, Griep and Rotenberg 2015).
3. 2. 2. Nursing Intervention
Nursing intervention occurs at the implementation face where the nurse determines
various areas that may need nursing assistance and support. Therefore, since the symptoms
indicate that the patient Mr. George Orwell, suffers from the Dyspnea problem. To this manner,
the nurse dealing with the situation must come up with the most appropriate interventions to
relieve the patient form his current condition (Kupper et al. 2016). The first intervention is to be
taken in the situation of Mr. George is to change him from the current position. Changing
position for a patient with dyspnea maximizes respiratory exercise and also minimize breathing

Nursing Care For An Adult Person Experiencing A Cardiovascular 6
efforts. The nurse should also monitor the patient's vulnerable body point such as ankles,
elbows, sacrum, as well as the heels to relieve pressure from these points (Russell et al. 2015).
The nurse should also help the patient with breathing exercises to help clear the sputum from the
lungs. Another intervention for the patient is oxygen therapy, which can be done during meal
times using nasal cannula. Finally, the nurse can also engage the patient in therapeutic
communication to help with relaxation.
3. 2.3.Medical management
Apart from the discussed interventions, the condition can also be assuaged through
pharmacological interventions, particularly inhalation of bronchodilators and oxygen therapy.
The nurse dealing with dyspnea should, therefore, use a nasal cannula to alleviate the patient
from lower levels of oxygen in the arterial veins (Bolzani et al. 2017). While conducting this
procedure, the nurse should be aware of dosage and set the oxygen flow at an appropriate rate.
Another medical intervention that can be employed by the nurse is the subjection of the patient to
inhaled bronchodilators. The nurse should ensure that the patient has been put to the correct
dosage of the bronchodilators to open obstructed airways. The most appropriate drugs that the
nurse could use include nebulized medicines, diuretics, antibiotics, and corticosteroids to
minimize inflammation.
3.3. Nursing Problems Two: Peripheral Edema (excess body fluid)
3.3.1. Nursing Assessment
Physical examination
Concerning the state of the patient, the nurse can apply an interview through a
therapeutic mode of communication. The physical exam is one of the most efficient ways of

Nursing Care For An Adult Person Experiencing A Cardiovascular 7
revealing the patient's medical condition and establishing data. To collect data as fast as possible,
the most efficient way for the nurse to assess Mr. George’s situation is through physical
examination (Urden, Stacy and Lough 2017). The rationale for using physical examination is to
determine the patient's condition and come up with data from his treatment since the patient has
shown other symptoms of the problems such as leg swellings. Moreover, a physical examination
will enable the nurse to confirm the issues, and after that, come up with nursing interventions for
the patient.
3.3. 2. Nursing Interventions
There are various pharmacological interventions for peripheral edema. Thus, a
registered nurse dealing with Mr. George should come up with these interventions. The
immediate response should be to monitor the patient’s cardiac organs and impulse, offer Mr.
George therapeutic oxygenation, and another intervention is to help the patient calm himself to
reduce the level of pressure and depression. Also since Mr. George had been fasting on saline for
a long time, another intervention is to relieve him from the medication and offer an alternative
drug that will help reduce further complications of edema and relive him from excess body fluid
such as thiazide diuretics as prescribed (Hardin and Kaplow 2019).
3.3.3. Medical Management
As a nurse, various medical management practices can be employed in both medical and
non-medical interventions. The most immediate medical management is to provide Mr. George
with Lasix (furosemide) to expel the excess body fluids from his body (Lewis et al. 2016).
However, the long medical is to manage problem one that is CVD, so to help the patient, the
nurse must help the patient take prescriptions for the underlying cause of the disease. Further

Nursing Care For An Adult Person Experiencing A Cardiovascular 8
medical management that a nurse dealing with the case should undertake is to elevate that
patient’s legs and heart stroking to help move the fluids and reduce the swelling.
4. Discharging Planning
Discharge planning is essential for patient care more so in the case of older adults such
as case study patient Mr. George Orwell. The primary importance of the multidisciplinary
approach in the case is that it will include all medical interventions from all the medical
personnel involved in the treatment of the patient (Walker and Deacon 2016). It will also be
valuable in the case since it will include Mr. Orwell’s medical needs that will help continue with
his treatment while at home (Riley and Masters 2016). The nurse performs an essential role in
the multidisciplinary patient discharge planning is to prepare the patient, find out whom will take
care of the patient while at home, provide medical education to both patients and also conduct
follow-ups to ensure that patient maintains high chances of recovery.
The multidisciplinary team is composed of psychiatrists who offer psychological support
to the patient, community health nurses who offer support after the patient has been discharged,
social works whose main function is to offer services to patients at home, care worker whose
work is to provide support with homework such as cooking and a physician specialized in CVD
and CHD whose main work is to provide medical advice to the overall team (Davidson et.al
2017). The main social challenge to the discharge plan is lack of closer relationship between the
patient and his only son which means that there would be no close person to take care of the
patient and support him while at home (Okoniewska et al. 2015).
5. Conclusion

Nursing Care For An Adult Person Experiencing A Cardiovascular 9
In conclusion, elderly patients require combined treatment effort to ensure a quick
recovery. The case study patient Mr. George Orwell based, as revealed in the case, was
primarily diagnosed with chest pain, which is also indicated by various symptoms as evident in
the case. However, angina or chest pain is usually not a disease but asymptomatic sign for
underlying heart-related diseases, particularly the cardiovascular disease. To this manner, based
on the symptom shown by the patient such as chest pain, he likely suffers from cardiovascular
diseases, which has also led to the peripheral edema and. Based on the condition of the patient, a
multidisciplinary approach was required to ensure treatment continuity and full recovery for the
patient.
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