Reggie Case Study: Analysis of Priority Problems and Interventions

This report presents a comprehensive analysis of Reggie's case study, a 42-year-old mine worker diagnosed with hypertension and oedema, stemming from rheumatic heart disease. The report delves into the priority problems of hypertension and fluid retention (oedema), exploring their pathophysiology and interconnectedness. It examines the critical evaluation process of nursing care, including assessment, diagnosis, planning, intervention, and evaluation. The report highlights the importance of medication administration (Metoprolol, Captopril, Frusemide, Paracetamol, Morphine), lifestyle modifications (diet, exercise), and the role of ACE inhibitors in managing these conditions. It emphasizes the need for continuous monitoring and evaluation to adjust treatment plans based on patient response and the gathering of experience by the healthcare professional. The report also discusses the impact of Reggie's work environment and mental state on his condition, advocating for counseling and motivational support as part of the care plan.

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

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REGGIE CASE STUDY
Reggie Simpson is a 42 year old person who has a family of 3 children and a wife and he
is the sole worker of the family. Reggie is a mine worker thus his physical strain is high and from
childhood he diagnosed with rheumatic heart disease and recently he was fatigued at the time of
examination. On the basis of his past medical history and his present condition it can be said that
he has hypertension and oedema as the primary problems which would be intervened. In terms of
intervention of these problems the nurse needs to administer proper medication such as
Frusemide, Morphine and also Paracetamol for pain reduction and also needed to plan life style
changes such as healthy diet incorporation, aerobic exercises and others (Kobrin et al., 2016). As
for intervention of the hypertension the Angiostenin-converting enzyme (ACE) inhibitor drug
would also be used as well. The whole data collection and assessment would be dependent on the
critical evaluation process of the nursing care. In the following essay the problems of priority
problems of Reggie would be discussed and the interventions mentioned would be proved to be
the effective treatment for his diseases.
Reggie has the primary problem of hypertension as a result of his childhood rheumatic
heart disease and it has been seen when he was fatigued as a result of his cardiac examination
(Parks et al., 2017). He also works in a mine thus his respiratory problems could be understood
that shows his respiratory rate as 28 per minute and oxygen saturation rate was 92%. It can be
stated that his hypertension caused by his body stress and also the improper heart function. This
condition of Reggie can be the cause of the left ventricle hypertrophy as a result of which the
blood pump from the heart is higher than normal rate and thus his blood pressure rise up to
184/75. His left ventricle hypertrophy could be resulted by his childhood cardiac disease that is
the rheumatic heart disease in which one of the heart valves got damaged or the heart gets into an

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inflamed condition (Grabner et al., 2015). As a result of the valve damage the blood pump
function of the heart got disrupted as well which can be identified as the pathophysiology of the
left hypertrophy of Reggie and thus the hypertension in his body can be described. Other than all
these his body showed ascites that can be stated as the fluid buildup in the abdomen and this
could be caused by the counter mechanism of the blood pressure rise in the body (Brinkley et al.,
2018). The counter mechanism would be the Renin-Angiotensin-Aldosteron system (RAAS) and
it is a hormonal system which would regulate the blood pressure, electrolyte and the fluid
balance of the body. When the blood pressure remains lower than normal rate the body would be
activate the system and thus the sodium and water reabsorption starts by the kidney and the
potassium exertion also starts in order to balance the electrolyte balance of the body (te Riet et
al., 2015). However, there is a mechanism called the ACE inhibitor that inhibits the RAAS
mechanism and if the ACE inhibitor mechanism disrupts then the extra incorporation of the
sodium and the water which leads to the hypertension and ascites development in the body.
These would be the possible causes or the pathophysiology of the hypertension and the ascites
development of Reggie’s body and also the cause of his sudden weight gain up to 10 to 15 Kg
(Angeli et al., 2015). According to these possible assessments and the information from past
medical history of Reggie the health professional would be able to evaluate the condition of him.
The intervention plan would be comprised with the proper medication administration, healthy
diet incorporation and also life style changing in a positive way. The positive changes in life
style would incorporate the daily aerobic exercises and also provide with proper sleeping as well.
Also the diet would incorporate the vegetables, fruits in order to production of antioxidants and
also removing red meat from the diet would be recommended as well. However, the medication
administration would be the most important aspect for his treatment. His treatment would be

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comprised of the medication that is the Metoprolol which reduces the hypertension of the body
and also Captopril which is an ACE inhibitor drug used for the hypertension treatment (García-
Prieto et al., 2017). Other than all these the health care professional needs to monitor Reggie’s
daily routine on the basis of the medication and diet in order to observe the changes in his body
to determine the positive outcomes of the treatment or assessing the negative effects of the
medication on his body as well. All these factors needed to be evaluated and on the basis of the
evaluation the plans for the intervention and further treatment would be adjusted on the basis of
the patient’s need. On the basis of the situation and the intervention plans the health care
professional would be able to gather experience and knowledge about the problem as well. This
would be done through the whole situation assessment and also reflection process which are the
phases of the critical evaluation of nursing and help in the planning of proper intervention. Thus
the proper evaluation of the patient’s condition and the intervention needed to be done by the
professional and the whole process would help in the experience gathering for the health care
professional. Evaluation and assessment are the critical aspects of nursing care as on these two
factors the nursing intervention planning depends and with the help of diagnosis and assessment
of past data of the patient the nurse can devise the intervention. In case of Reggie his past
rheumatic heart disease is the factor that helps in the intervention planning properly and detects
the cause of the disease as well. However, assessing the patient’s condition and the intervention
plan in case of Reggie is needed mostly over the reflection on the case here (Marsh & Zarda,
2016).
The second problem that can be identified as Reggie’s priority problem that is the
oedema which can be caused by the fluid retention in the knee to the leg of Reggie and he feels
pain. As a fluid retention problem in the lower limb the oedema would raise the problem of

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extensive pain in the legs and thus the intervention of this problem would be needed with priority
(Best et al., 2018). The pathophysiology of oedema would be dependent on the fluid retention
system of the body and the formation of this problem happens as a result of the diuretic
hormonal function and also the reabsorption of sodium and water in the body (Cheung et al.,
2016). The effects of the blood pressure problem in the body cause the activation of the RAAS
and thus the extensive fluid retention occurs. The rennin hormone released in the blood and thus
activates the angiotensin I and it would be converted to the angiotensin II by the ACE. This
angiotensin II influences the aldosteron hormone which ultimately enhances the sodium and the
water reabsorption process in the body (Srivastava & Dwivedi, 2016). It is a counter measure in
the body in order to increase the blood pressure by means of regulating the electrolyte, fluid and
the sodium content of the body. However, the ACE inhibitors play a key role in stopping this
counter mechanism at the time when the blood pressure at the normal condition and if this
hormonal function disrupted then the regulation fluid reabsorption would be in jeopardy and thus
the fluid retention in different body parts could be seen. In case of Reggie it could be understood
that his hypertension condition plays a key role and the ACE inhibitors could not work in the
normal way thus his body experiences the situation of the fluid retention in the lower limb of him
and this leads to extensive pain as well. This oedema of Reggie can also be determined on the
basis of his occupational hazard that is he is a mine worker and his body experiences extensive
muscular pressure. Thus Reggie’s muscles of the lower limb face several unequal pressures as a
result his fluid retention process primarily affected the lower limb (Pires et al., 2017). All these
factors can be termed as Reggie’s pathophysiological problems in the oedema development.
However, all the assessment of his oedema problem can be assessed on his occupational disease
and the hormonal problem as the result of his hypertension as well. The health care of Reggie

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would be assessed and the intervention would be planned on the basis of this assessment. The
intervention plan would be comprised of proper medication administration and also by means of
the life style changing along with resting his muscles. The medication of Reggie in case of
oedema would be comprised of Frusemide as his condition also indicates the congestive heart
failure and this drug associated in the treatment of these diseases, Paracetamol for the pain
reduction and also the Morphine used for the pain reduction as well. The Captopril also used as
it is the ACE inhibitor drug in order to control the function of the fluid retention of the body (Baş
et al., 2015). The evaluation process would help the health care professional in the experience
gathering about the situation. The health care professional would also be able to understand the
problems of the person in a critical way and plan the intervention plan properly. However, the
evaluation would also comprise of the monitoring process of the patient and thus changes of the
patient would be properly determined.. The oedema of the patient can be intervened on the basis
of the above discussion however, the intervention process needed to incorporate the life style and
the employment type change as well. As Reggie’s work place environment and the ergonomics
of his work also have their stake in the generation of his oedema. Evaluation process would help
the health professional in the determination all the understanding of the patient’s condition and
on the basis of this understanding the professional would device the care and the intervention
processes. The health care professional help the patient in terms of the counseling process as it
would help in the control of the hypertension as well and both the priority problems of the
patient are interconnected the thus the health care professional needs to administer the
medication and the dosage of the drugs in the proper way to control the diseases of the patient.
The pathophysiological analysis of the problems of Reggie would be the base of the treatment
and the health care professional needs to incorporate the evaluation and assessment process in

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terms of the proper evaluation and assessment of the process of intervention (Aaron et al., 2017).
However, the oedema and the hypertension are the primary priority of care of the patient these
two problems are interrelated and needed assessment with correlation of the ACE inhibitor drugs
as this is the common drug in the intervention of both the problems (Elavarasan et al., 2016). The
intervention plan of the patient on the other hand needs the assessment of the diet and the life
style changes as well in order to help critically change the condition of the patient Reggie. As a
sole worker for the family the mental condition of Reggie also play a key role in the
hypertension development of him and it needs mental care as well. Thus the care policy of the
patient needed to comprise of counseling and motivational empowerment as well in order to help
the patient recover from the negative condition. Thus it can be said that in terms of all these
aspects of intervention the health care professional needs to use critical evaluation to assess,
evaluate and also reflect on the situation and intervention plan.
On the basis of this above discussion it can be concluded that the pathophysiological
assessment of the patient’s condition needed to be assessed prior to the treatment of the patient.
The assessment is the basic and primary need for the health care professional in order to provide
a proper care to the student. Thus the need of evaluation would clearly be visible as the model
helps in the determination of the problems in a critical way and help in producing the
intervention plan in a manner that would be helpful in the positive treatment of the patient. In
case of Reggie the oedema and the hypertension are the correlated problems and these problems
have similar kind of intervention however, the medication administrations are different in some
factors. Although there are different medication for the treatment procedure but other
intervention plans such as the life style change, incorporation of the aerobic exercise in the
routine, healthy diet incorporation and the employment change also would be needed in order to

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treat the patient as well. All these factors of intervention would be devised with the help of the
evaluation process and the reflection of the health care professional also would be helpful for his
or her future experience and the intervention that was planned with the help of the critical
evaluation would help Reggie to sustain against the problems as well. On the basis of Reggie’s
case study it can be said that his rheumatic heart disease plays the key role in the hypertension
and the oedema development and the interventions of his diseases needs to be assessed on the
basis of his past cardiac condition. Thus it can be said that the medical information assessment
and evaluation is the basis need in order to treat a patient properly.

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