Question

Mrs. Jones is a 63-year-old patient who has come to the ED after awaking this morning at 8:00 AM experiencing symptoms after eating. She has a 5-year history of hyperlipidemia, hypertension, type 2 diabetes, and osteoarthritis. She states that she had a total hysterectomy 10 years ago, and that her gallbladder was removed 2 years ago. At this time, the patient states that she has fatigue, shoulder pain, indigestion, a moderate ache in the chest that is worse on inspiration, nausea, and a headache.

1. Which portion(s) of Mrs. Jones’s health history should the nurse identify that require priority assessment?

2. Based upon the symptoms that Mrs. Jones expressed and the nurse’s identification of priority assessment, what actions should the nurse take?

3. What would be the indication for Aspirin in this case?

4. Provide a brief introduction of yourself to the class. (Share 3-4 facts).

Answer 1

1. Mrs. Jones health history of hyperlipidemia, hypertension and type 2 diabetes requires priority assessment.
• hyperlipidemia causes narrowing of blood vessels. This forces heart to work faster.
• type 2 diabetes also causes endothelial dysfunction leading to narrower vessels.
• hypertension also puts more workload on the heart
These indicate that Mrs Jones is at a higher risk of a cardiovascular event , so these should be first brought under control.

2.The nurse should do the following -
• Take the vital signs of the patient - blood pressure, temperature, pulse , respiratory rate, etc.
• place her on ecg machine.
• call the doctor for blood draw. It will tell us
✓ presence of cardiac markers like troponin , which indicates myocardial damage.
✓lipid levels - triglycerides, LDL and HDL
• Check patient's blood glucose level.
• further course of action depends upon test results

3. Aspirin is a cyclooxygenase 1 inhibitor.it is indicated in patients with dyslipidemia and other heart diseases.
It's indications in this case -
•low doses of aspirin are known to improve blood pressure.
•aspirin prevents formation of blood clots in vessels, thus decreasing risk of a stroke.
•it is indicated in diseases like angina and myocardial infarction.
•recommended dose - 81 mg per day.
• it is also prescribed for cases of osteoarthritis.

4.My name is (your name). I am a professional nurse. I provide healthcare services to people.
•Currently, I help in assisting an aged female named Mrs. Halah at her home. She is community health support beneficiary.
• i also do a lot of volunteer work , which has helped me develop passion for this job