Case Study: NUR 114 - Angina/CAD (Marcy Jones) Clinical Analysis

This case study presents a scenario involving Marcy Jones, a 65-year-old female admitted to the emergency department with symptoms of fatigue and malaise, potentially related to Angina/CAD. The assignment requires the student to identify expected medical orders, probing questions for patient assessment, and appropriate nursing interventions. The solution outlines the expected diagnostic tests, such as CT angiography and cardiac MRI, and details the importance of obtaining a thorough patient history, including family history of similar conditions. It also emphasizes focused assessments like behavioral therapy and therapeutic communication. The student is expected to identify potential risk factors, such as learning difficulties or psychological disorders, and the use of diagnostic tools like an event recorder and exercise tests. The solution further addresses the role of the nurse in patient education, emotional support, and preparation for potential medical procedures, such as pacemaker implantation. The case study covers the interpretation of diagnostic results, nursing actions post-procedure, and the monitoring of potential complications, such as heart attacks or arterial damage following VCD placement. It also differentiates between collaborative and non-collaborative nursing actions and includes references to relevant medical literature.

1
Case study

2
1. The other orders to be expected from Mercy Jones are as follows.
 CT angiography
 Cardiac MRI
 Eco cardiograph
2. Mrs. Jones will be encountered by asking the longevity of persistence of the pain and whether
she has a family history of similar conditions.
3. Focused assessments to be conducted on Mercy Jones are behavioral therapy and therapeutic
communication.
4. It is important to look out that if she is having any other risk factors such as learning
difficulties or other psychological disorder.
5. In order to assess the condition event recorder will be conducted on her to record heart
activity. Also an exercise test will be monitored. If the reports deviate from the normal level she
will be treated by clinician that avoided e3livation of vagal tone (Vasovic et al. 2018).
6. I would calm him and ensure positivity for the treatment process
 I will ask him to consult a doctor to get detailed treatment plan
 I will also suggest him to support her emotions
7. I would assist the doctors to start the treatment process. I will make the person ready for any
intervention required for instance, if she is advice to implant a pace maker.
8. The sinus node generates impulse between 60-100/min that is considered as normal. If the rate
is below the range it is considered abnormal.
 Prevent eating and drinking 8hrs before test.
 Doctor should be aware of the medication patient has on regular basis.
 Patient should be emptied bladder
 Asking the patient to sign consent (Ben-Zvi et al. 2015)

3
9. It is a vascular closer devise used to close femoral access for catheterization.
10. I would order the RN to report any changes the patient is facing
I will order her to follow all the standards of patient care after cardiac catheterization
11. She was susceptible to risk factors after VCD placement for instance she could get a heart
attack or arterial damage so her heart rate should be monitored regularly.
12. collaborative-
 I will report that to doctor immediately and seek his opinion
Non collaborative-
 I will fix if there is any lag in the care plan

4
Reference list
Ben-Zvi, I., Lidar, M., Giat, E., Kukuy, O., Zafrir, Y., Grossman, C., ... & Livneh, A. (2015).
Clinical picture in adulthood and unusual and peculiar clinical features of FMF.
In Familial Mediterranean Fever (pp. 47-80). Springer, Cham.
Vasovic, L., Trandafilovic, M., Vlajkovic, S., & Radenkovic, G. (2018). Congenital absence of
the bilateral internal carotid artery: a review of the associated (ab) normalities from a
newborn status to the eighth decade of life. Child's Nervous System, 34(1), 35-49.