Consider the following case study:
You are working as a staff nurse in a busy urban emergency room, and a 77-year-old Caucasian female is coming via Emergency Medical System (EMS). The EMS
team reports that a patient at a local casino suddenly felt ill and became short of breath. Her husband called 911 and they will be arriving via ambulance. When
she arrives, your team quickly gets her off the gurney onto a stretcher. Intravenous (IV) lines are placed, IV fluid is started, and the expected diagnostic labs are
drawn. The nurse practitioner covering orders an electrocardiogram (ECG) and it is obtained and shown below.
Reference Burns, E. (2019). Left Bundle Branch Block. ECG Library Diagnosis. Retrieved from https://litfl.com/left-bundle-branch-block-lbbb-ecg-library/
The following is pertinent data from assessment of the patient and her medical record:
Na=138mmol/L, K=3.9mmol/L, Glucose 118mg/dL, BUN 21mg/dL, Creatinine 1.3mmol/L, WBC 6,600/mm3
, BNP 1,200pg/ml
Chest x-ray: borderline cardiomegaly, infiltrates to right middle lobe of lungs.
Current vitals are as follows: BP 148/88 (L arm, lying in stretcher), RR 34, pulse 122, temp 37. 1°C.
She is breathing rapidly and using all of her accessory muscles. You noted the client to have +3-4 pitting edema from her lower legs (calves to ankles)
bilaterally.
In addition, you gather the following subjective data from the patient:
She took a Benadryl to help her sleep prior to the three hour bus ride from their home to the casino.
After playing the slot machines for about 20 minutes once she arrived at the casino, the became short of breath and started having ‘slight chest
discomfort’.
Prompt: In a short paper, answer the following questions from a pathophysiology perspective related to the cardiovascular system.
Provide a comprehensive rationale for this patient’s physical symptoms.
Identify at least one treatment option based on evidence-based research. Be sure to include detailed data to support the treatment option you identify.
Analyze risk factors associated with the treatment option for promoting better patient outcomes you identified above.
Discuss the current diagnostic test results. What would you consider an important diagnostic test to complete in order to make a clinical decision in this
case?
Describe any additional patient-care technologies that you would recommend based on the diagnostic test results discussed.
What are some potential discharge options for this individual? In answering this question, be sure to include some education material for her husband.
Support your answer with relevant evidence from the literature with proper APA formatting.
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