Patient C. Z Case Study Nursing

The patient's comorbidities include Hypertension, hyperlipidemia, CAD, and GERD. The patient had a CABG operation a few days back from admission day on 4-10-2017. In addition to the CABG surgery, other procedures such as TEE, cardiopulmonary bypass, vein harvest, and a thoracotomy with a chest tube and JP drain. Significant surgical procedures also include angioplasty and left and right knee arthroplasty.

“The patient is Adam Rudd, a 78 y/o white male with a history of hypertension. He has been diagnosed with hypertension past 15 years and is on anti-hypertensive medications and aspirin. He is very weak and short of breath. He is accompanied with his longtime friend Jennifer, who reports that Rudd was looking very weak and was complaining of severe headache and blurred vision before coming to the hospital. He is 5’9” and weighs 270 lb. Vital signs recorded were: oral temperature 98.20 F, BP 224/120 mm Hg with a heart rate of 102 beats/minute and respiration of 24 breaths per minute. The pulse oximetry reading was 94% on room air. He is complaining of severe headache and blurred vision. Rudd said that he did not take his antihypertensive medication or aspirin since he ran out of pills. He has not been taking his medication for past 15 days. He reports no known allergies to any medications or other substances.”

R.O. is a 43-year-old female Latino patient who has been living at home alone since she got divorced three months ago. She does not have any living or available family in the United States. She is the oldest of three children. Her parents died of an accident when she was little. Two of her sisters live in Mexico. She has lost contact with her family in Mexico when she got married and move to the United States. She also has stopped communicating with her ex husband since they got divorced. Although she does not have any support from her family, she states that her church member has been very supportive. Moreover, R.O. states she was a homemaker until the divorce. Currently, she has been working as a dishwasher near her house.

Mrs. Wilson is seen in her room at Glenbridge Nursing Home on 02/28/2018. She had an episode last night of chest pain. She is so ebullient and distracted that it is hard to get a straight history, it came on when she was asleep but she may been sitting up. She was seen by a nurse, a sat was taken. I am not sure if there were other orders taken, but there is none on the chart. She says that she spent most of this morning in the bed and still feels tired, but she does not think she broke out in a sweat. She was more short of breath. She is calling it is a "stroke." I had tried to begin tapering her diazepam by discontinuing the morning dose and apparently all daytime clorazepate was discontinued by error and she gets it only at night.

Patient C.B. is a 32 –year-old African American female, G2P2 who came to clinic with complaint of burning and frequency with urination and foul odor urine that she said began four days ago.

Due to delay in meeting with Mr. Reid, the adjuster approved submitting the report after our initial meeting.

Varying patients may present to their clinician or the emergency department for treatment with heart failure. It is important to understand that there is more than one type of heart failure; primarily the focus is placed on diastolic heart failure and systolic heart failure. Depending upon the cause of heart failure and what areas are affected dictates the treatment plan needed. While there are similarities with both kinds of heart failure, there are also differences that can help the clinician distinguish the diagnosis needed to fit the patient. Once a diagnosis is made the clinician can move forward in determining if the patient is at risk for use of diuretics and then look towards prescribing ACEIs, ARBs, and beta-blockers.

Multiple studies have shown that high dose nitrates are superior to furosemide in the treatment of acutely decompensated heart failure (5, 6, 7, 8). Mattu et al

Religion is one of the most constant targets of Twain's satirical pen. In Adventures of Huckleberry Finn, Mark Twain portrays contemporary religion as shallow and hypocritical. He criticizes the hypocrisy of conventional religion by comparing it with the true religion of Huck.

There are a plethora of treatments available for patients with heart failure including but not limited to diuretics, ACE inhibitors, angiotensin receptor blockers, and oral nitrates. The Vasodilator heart failure (V-HEFT) studies show that enalapril has less cumulative mortality among study participants when compared to patients taking a combination of isosorbide dinitrate and hydralazine. (MGMT) This is not to say that the combination of isosorbide dinitrate and hydralazine is not efficacious because when compared to placebo, mortality rates improved with the combination treatment.

(Ramani, Uber, & Mehra, 2010). My grandmother had heart failure and I saw how she had a time trying to breath and her ankles were swollen all the time. She thought the medicine was hurting her instead of helping. She took several different medications to try to control her symptoms, but she eventually succumbed to heart disease.

An elderly male with congestive heart failure was brought to a clinic because he was experiencing atrial fibrillation and had a ventricular response of 110 beats/min with palpitations and shortness of breath1. Medications that he was taking includes angiotensin-converting enzyme inhibitor, Lisinopril, Carvediol, Digoxin, and Furosemide1. His left ventricular ejection fraction has been reduced to 25%1. Further examinations showed that he had edema in his legs and crackles at the base of his lungs1. He was then told to increase the dosage of Furosemide by taking the drug twice daily instead of once, and doubling the dose per administration1. One week later, the electrocardiogram revealed that he had ventricular arrhythmias such as premature

The profession of nursing includes: promoting health, preventing illness, as well as providing care. NUR 102 teaches student nurses, like myself, a wide range of information and knowledge needed in order to become a successful nurse and also aids in the preparation for clinical placement. Nonetheless, this course teaches essay writing, critical thinking, nursing theories, as well as the roles and responsibilities that I will have as a nurse.

‘I’ve been feeling weird all day.’ Shawn thought while lying down on the hospital bed fully awake. Upon hearing a sound, Shawn’s head shot up. ‘Sounds like someone’s coming, wait, it sounds like more than one person. I’m counting two. Huh, that’s weird, it’s 3:30 in the morning and the nurse already went through here on her rounds half an hour ago, strange.’ Shawn mused surprised. The footsteps were coming closer to his room so Shawn closed his eyes feigning sleep.

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed.