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Adult Health Care1 Semester 1/2020 _________________________________________________________________________

Assessment details

Assessment 2: Case study essay

Weighting: 40%

Word count: There is a word limit of 1500 words.

Due date: Monday 11th May at 1200hrs

Submission details: via Blackboard> Assessments>Turnitin link.

Aim of assessment

The purpose for this case study is to enable students to produce a nurse-led case management plan,

using evidence-based information relevant to nurses and up-to-date Australian statistics, for

improving the health and quality of life for an older adult who have suffered a myocardial infarction.

Content should include discussion on pathophysiological treatment options, based on national

guidelines and implications for nursing practice.

Patient profile

Kath Harris is a 65-year old lady who lives alone. Kath was doing light cleaning around the house,

prior to the onset of her pain. Mrs. Harris has a history of unstable angina, hypertension and

diabetes mellitus type 2. She is a cigarette smoker, smoking two packets of cigarettes a day, for

approximately 40 years. A recent history of indigestion suggests an active peptic ulcer. She is also

obese (her body mass index is 32). She has had a history of head trauma due to an incident a few

months ago, where she fell down a set of stairs. Mrs Harris’ current medication includes; GTN,

carvedilol, and metformin.

Subjective data

• She had taken three glyceryl trinitrate tablets, which had little effect on reducing her chest

pain.

• Has an 6/10 chest pain

• Pt is nauseated

• Appears distressed

Objective data

Physical examination

• GCS 15

• BP 92/58mmHg, HR 92 bpm, Temp 370Celsius, Resp 28 bpm, SaO2 91% RA,

• Skin was pale

• Peripheries were cool

Diagnostic studies

Lipid Studies

• Total lipid 9.2

• Triglycerides 6.5

• Total cholesterol 7.95

 HDL cholesterol 2.1

 LDL cholesterol 5.97

2

Electrolytes

 Sodium 138

 Potassium 4.9

 Chloride 97

 Bicarbonate 21

 Glucose 11.2

 Iron 5.4

 HbA1c 7.9

Your assignment is to produce a written piece of work addressing the following areas;

PATHOPHYSIOLOGY

 Briefly explain the pathophysiology of myocardial infarction in this patient. In your answer

identify the clinical manifestations of an MI demonstrated by Kath Harris and why these are

occurring. Identify the risk factors evident within this case study. How would you manage

Mrs Harris’ care?

MANAGEMENT

 Outline the immediate nursing and medical management Mrs Harris requires in the

treatment of an acute MI. In your answer include the pharmacological management

required by a patient with an acute coronary syndrome.