Case study
Mrs Brown, a 78 year-old female, was admitted to the Emergency Department at 6am after waking up with severe breathlessness. Her family informed you that the patient has a history of heart failure that had been diagnosed two years ago. On admission to the Emergency Department the clinical manifestations were:
- Severe dyspnoea
- Respiratory rate of 24 breaths/minute
- SpO2 85%, on room air
- BP 170/95mmHg
- Pulse rate of 120 beats/minute
- Auscultation of lungs identifies bilateral basal crackles
Mrs Brown was connected to an ECG monitor that showed atrial fibrillation. A diagnosis of acute exacerbation of chronic left-sided heart failure was made.
Question 1. (500 words) Explain the pathogenesis causing the clinical manifestations with which Mrs Brown presented.
Question 2. (200 words) Discuss two high priority nursing strategies to manage Mrs Brown and provide evidence-based rationales for these strategies.
Question 3. (300 words) Two of the drugs that were given to Mrs Brown were IV furosemide and sublingual glyceryltrinitrate. a. Discuss the mechanism of action of these two drugs, and relate to the underlying pathogenesis of an acute exacerbation of chronic left-sided heart failure. And, b. Describe the nursing implications (monitoring for and responding to adverse effects, and evaluating therapeutic effect) when administering these two drugs to a patient with an acute exacerbation of chronic left-sided heart failure.
Responses are to use full sentences, paragraphs, correct spelling and grammar.
- The word limit for the guided questions is 1000 words. Use your computer to total the number of words used. In-text citations will be included in the additional 10% of the word count. If you exceed the word limit by more than 10% the marker will stop marking.
- Provide a reference list in APA 6th Edition style with a minimum of 6 academic references which could include journal articles, textbooks, government websites and reports, and creditable organisational websites such as the Heart Foundation.
- Appropriate resources must be selected and accurately used. The cited references must support your discussion or explanation.
- Formatting to follow that as listed on page 20 of Learning Guide.