Nursing diagnoses Case Study

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Mr. SB, 60-year-old male is a retiree and was admitted to the hospital accompanied by his daughter. He is 100kg at a height of 180 cm so his calculated body mass index (BMI) was 30.9 indicating that he was overweight. When admitted, patient was complained of shortness of breath for 2 weeks and was worsening on the day of admission. Besides, he also experienced orthopnea, fatigue, paroxysmal nocturnal dyspnea and leg swelling up to his thigh. Mr. SB was admitted to the hospital for to the same problem last year.
Mr. SB had known case of heart failure since 3 years ago and he had also diagnosed with hypertension for 5 years. Before admitted to the hospital, patient was taking furosemide 40mg, aspirin 150mg, metoprolol 50mg, amlodipine 10mg, and simvastatin 40mg for his hypertension and heart failure. Patient is not allergic to any medication and he does not take any traditional medicines at home. His family history revealed that his father had died of ischemic heart disease 4 years ago while his brother has hypertension. As for his social history, he smokes 2-3 cigarettes a day for 35 years and the calculated smoking pack years was 5 pack years. Besides, Mr. SB also drinks occasionally.
On examination, Mr. SB was found to be alert and conscious, but he was having pedal edema up to his knee. Besides, the patient was noted with bi-basal crepitations with no rhonchi. His body temperature was normal. However, his blood pressure was found to be elevated upon admission with a record of 159/100 mmHg with an irregular pulse rate at 85beats/min. His echocardiogram showed that he had left ventricle hypertrophy while chest X-ray was conducted and revealed that the patient had cardiomegaly.
Lab investigations such as full blood count, liver function test, urea and electrolyte test and cardiac enzyme were done upon admission. His creatinine concentration was found to be 143µmol/L. Therefore, the calculated creatinine clearance was 68.8ml/min. Besides, there was also blood found in the urine and the echocardiography showed that the patient has sinus tachycardia. In addition, ECG test was performed on day 1 and the result indicated that there was a T-wave inversion. The patient’s INR was 1.04 which was lower than normal while APTT was found to be slightly higher (59.4 seconds). Mr. SB’s random blood glucose was found to be normal during his hospitalization.
Mr. SB was diagnosed with congestive cardiac failure (CCF) with fluid overload. The patient also suffered from hypertension. The management plan included intravenous furosemide 40mg twice daily, aspirin 150mg once daily, simvastatin 40mg once at night and Ramipril 2.5mg once a day. Besides, patient was asked to restrict his fluid intake to 500ml per day and oxygen therapy was given to patient at high flow using a face mask when patient experiencing shortness of breath.
As for his clinical progression, on day 1, the patient was complained of shortness of breath, leg swelling and orthopnea. Echocardiogram showed that he had cardiomegaly. Treatment of CHF was given. Throughout the stay in the hospital, Mr. SB had responded well to the heart failure therapy as there was no more complaint of chest pain or shortness of breath on day 13 and his pedal edema had gradually improved. However, patient’s blood pressure throughout day 1 to 9 was fluctuating between the range of 102/67-160/100 mmHg and therefore, hypertension treatment was given and blood pressure on day 10 onwards had been seen fell within the normal range. Furthermore, Mr. SB’s renal function became progressively worse from 143µmol/L on admission to 175µmol/L on day 11 and the calculated creatinine clearance on day 11 was 56.2ml/min.
Please create a care plan for this patient. Requirements for this care plan
1. You need to identify 5 nursing diagnosis that are pertinent for this patient (1st priority etc)
2. You need to expand on only one of those nursing diagnoses (meaning you needs to tell me the nursing diagnosis, place 10 interventions for that diagnosis, rationale)
3. Stimulate short term goals and long -goals for that diagnosis
4. What labs do you need to assess for this patient? Why
5. Pathophysiology of the disease
6. What nursing assessment should be performed at this time for this patient?
7. What is going on with Mr. SB?
8. Medications (make sure you incorporate them into the care plan)
9. What is your teaching plan?

 

 

 

 

Sample Solution

 

Human progress isn’t Westernization

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Cao, Tian Y, Xueping Zhong, and Kebin Liao. Culture and Social Transformations in Reform Era China. Leiden: Brill, 2010. Web asset.

This book talks about how China built up its development with little impact from western culture. It takes a gander at the early long periods of human advancement in China around 400 years AD before China was attacked and colonized. The journalists unequivocally contend that China’s human advancement was not influenced by western progress and that the western social inclinations saw in China today are not a consequence of western development, however are because of multifaceted communication and therefore, embracing social standards from the West. The contentions in this book unequivocally advocate that China’s human advancement has not in any case been impacted by westernization.western progress

Osei, G K. African Contribution to Civilization. Baltimore, MD: Imprint Editions, 1999. Print.

Osei returns numerous years, even before the slave exchange, with an end goal to diagram the contrast between genuine human progress and westernization. Osei contends that well before the colonization of Africa by western nations, there was religion, training, craftsmanship, and innovation. He even says that the primary college was worked in Africa (Egypt). The explanation he expresses this is a direct result of his conviction that Africa is the mother of human progress. In any case, he unmistakably takes note of that development was supplanted by westernization in the nineteenth century when Africa was colonized. The colonizers carried with them their way of life, which Africans had to receive and that has been the situation right up ’til the present time. In his book, he appears in further detail the distinction among human progress and westernization, giving clear models.

Anthony, Ayala. Human advancement. Trafford on Demand Pub, 2010. Print.

Anthony gives all the data on human advancement from their basic nature as creatures. He gives all the fundamental data on their deliberate turn of events and how they moved on from crude creatures to the now refined, complex people. The book follows human development from route back in Mesopotamia to the current day. In his treatise, he plots contrasts among human advancement and westernization, in spite of the fact that from an aberrant methodology.

Atkins, Stephen E, and Stephen E. Atkins. The 9/11 Encyclopedia. Santa Clause Barbara, Calif: ABC-CLIO, 2011. Web asset.

In this reference book, significant realities are brought out by the writers. They for the most part contend how unique world developments will neutralize one another. This contention is a reasonable sign that human advancement isn’t westernization. The book traces the various types of developments that at present exist and concedes that western progress is the most well known, yet that, sooner rather than later, different civic establishments will battle against it. The reference book clarifies how human progress is not the same as westernization, contending that westernization is a culture that was embraced by numerous European-colonized countries, however since autonomy, they have been attempting to criticize it. Reprobation of westernization is in certainty the sign of progress and this draws out a reasonable differentiation among westernization and human advancement.

Von, Laue T. H. The World Revolution of Westernization

 

 

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