NUR 606 Week 7 Assignment 1 Written Case Study

Submission status

NU606 Week 7 Cardiovascular Case Study

Part 1

Ms. X, age 55 years, has been complaining of severe fatigue and “indigestion” on and off, but it seems to be getting worse over the past several hours. Her son is quite concerned and decides to take her t

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed

• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• The is a great resource

o the emergency department. On arrival, she appears very anxious, and her facial skin is cool and clammy; her blood pressure is 90/60, and the pulse is around 90, weak and irregular. She is given oxygen, an intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. Her son provides information that indicates Ms. X is a long-time smoker, has a stressful job as a high school teacher, is recently separated after 20 years of marriage, and is fearful of losing the family home. She has also seemed to be more fatigued, and stopped going to the gym about 18 months ago. She has begun to rely on “fast foods” like pizza and fried chicken and cooks infrequently. Her father died of a heart attack at age 50. She has also noticed more fatigue and intermittent leg pain when walking or climbing stairs at work. Generalized atherosclerosis is suspected.

1. List the high-risk factors for atherosclerosis in this patient’s history. For each risk factor, identify whether that would be measured/reported subjectively, objectively, or both.

2. Assuming Ms. X does, indeed, have atherosclerosis, how would this lead to the condition she is experiencing today?

3. What do you suspect Ms. X was experiencing when she reported “indigestion”? Was this true indigestion or related to her cardiac condition? Explain the pathophysiology behind this pain.

4. Think about the normal or typical presenting signs of myocardial Infarction. What is atypical in Ms. X’s symptoms? How does this affect treatment and prognosis?

5. What serum enzyme and electrolyte levels do you anticipate being checked in the ED. How are these levels related to the changes happening in Ms. X’s cardiovascular system?

Part 2

Since Ms. X is now stable and you are waiting on labs, you review some of her medical records. At her last several office visits with her PCP, her blood pressure was noted to be 145/90, 138/96, 150/94, and 142/96. She is not taking any medications for blood pressure at this time.

6. Do you think Ms. X has essential hypertension? Evaluate her blood pressure readings and use them to support your position.

7. Describe the pathophysiology of essential hypertension.

8. Identify and describe two possible problems associated with prolonged high diastolic pressure.

Part 3

After some diagnostics, it is determined that Ms. X has a large infarct in the anterior left ventricle; she continues to be monitored on telemetry.

9. What ECG changes would you expect to support left ventricular involvement and infarction?

10. X is showing increasing PVCs on the ECG. What is causing these and what can happen if these continue to increase in frequency.

11. X is preparing to go home with her son. Write her discharge instructions.

12. What lifestyle measures should be included to prevent a recurrent cardiac event?

13. It is determined by the team that she should be started on an antihypertensive agent, as her blood pressures have remained elevated during her admission. Identify two medications helpful in treating hypertension and describe their actions.

Part 4

Unfortunately, Ms. X’s condition becomes less stable, and she is unable to go home. Several days later, she is found unconscious on the floor of her hospital room bathroom. Her pulse is weak and elevated, and her skin is moist with pallor evident. Her BP is 50 systolic. A diagnosis of cardiogenic shock is made, and resuscitation efforts are started.

14. What signs and symptoms is Ms. X exhibiting that support cardiogenic shock? Label each as subjective (symptom) or objective (sign).

15. Describe the pathophysiology of cardiogenic shock and the effects of cardiogenic shock on the organs of the body.