Laoag City, Ilocos Norte

Name: Ulep, Marianne Genevieve Date: ______________

Year and Section: ___________________ Score: _____________

Activity 2 Case Study

Instruction: Below is a case situation related to our previous topic. Please answer them and
send them back via canvas after you finished.

SITUATION: A 45 year of age and works as a newspaper editor rushed to the emergency
department of GRBASMH complaining of chest pain radiating into both arms, accompanied
by diaphoresis and shortness of breath. He has been having episodes of transient substernal and
shoulder pain over the past week. Upon history taking, he is being treated for hypertension and
is currently taking 100 mg metoprolol twice per day. He does not exercise and he smoked a
pack of cigarettes daily for 20 years. He reports considerable job stress and is overweight with
a body mass index of 35. His vital signs are as follows; BP 190/100 mmHg, a body temperature
of 98.6 F, heart rate 97 bpm, and respiratory rate 21 bpm. The physician diagnosed him with
Angina pectoris and admitted him to the CCU.
Study Questions
1. In taking the health history of the client, what etiologic factors should you discover?
Identify 3 etiologic factors and explain the mechanisms by which they contribute to the
development of his disorder.
Hypertension, smoking, morbidly obese

2. The patient asks the nurse, “What is causing this pain?” What is the best response by the
nurse?
The cause of the chest pain that you felt is that due to Angina pectoris, it is caused by
reduced blood flow in to your heart muscle. And because of the hgypertension that you
have, high blood pressure can damage your arteries by making them less flexible and that
causes the decreses the flow of the blood and oxygen to your heart and by that it will
cause chest pain.

3. List specific nursing measures regarding medications, diet, activity, lifestyle changes,
and emotional support that should be implemented for the patient. Discuss them briefly.

Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory and Immunologic Response,
Cellular Aberrations, acute and chronic and Peri-operative Nursing

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 Laoag City, Ilocos Norte

Medication
1. Provide Education – Teach the patient the right dosage and what does the medication
intended for.
2. Medications with similar names or similar packaging - Generic and brand names must
be unique to prevent one drug from being mistaken for another when drugs are
prescribed and prescriptions are dispensed.
3. Check and verify allergies. - Always ask the patient about their medication allergies,
types of reactions, and severity of reactions. Verify the patient’s medical record for
documented allergies.
4. Perform appropriate patient assessments before medication administration. - Assess
the patient prior to administering medications to ensure the patient is receiving the
correct medication, for the correct reason, and at the correct time. For example, a
nurse reviews lab values and performs a cardiac assessment prior to administering
cardiac medication. See more information regarding specific patient assessments
during parenteral medication administration in the “Applying the Nursing Process”
section.
5. Ensure medication has not expired.- Check all medications’ expiration dates before
administering them. Medications can become inactive after their expiration date.

Diet:
1. Obtain a thorough history - The most appropriate patients for the nursing
intervention of Weight Management are adults with no major health problems who
require diet therapy.
2. Evaluate patient’s physiological status in relation to weight control. - Nondieting
approaches focus on changing disturbed thoughts, emotions, and body
image associated with obesity to help obese persons accept themselves and resolve
concerns that prevent long-term weight maintenance.
3. Observe for situations that indicate a nutritional intake of more than
body requirements. - Such observations help gain a clear picture of
the patient’s dietary habits.

Activity:

Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory and Immunologic Response,
Cellular Aberrations, acute and chronic and Peri-operative Nursing

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 Laoag City, Ilocos Norte

1. Assess the physical activity level and mobility of the patient

2. Assess the patient’s nutritional status. - Adequate energy reserves are needed
during activity
3. Observe and monitor the patient’s sleep pattern and the amount of sleep achieved
over the past few days. - Sleep deprivation and difficulties during sleep can affect
the activity level of the patient – these needs to be addressed before successful
activity progression can be achieved.

Lifestyle changes:
1. Reduce Stress - Stress impacts everyone, but chronic stress is particularly
problematic. Digestive problems, high blood pressure, depression and anxiety are
just a few of the ways long-term stressors affect the body.
2. Supply individuals with devices, like pedometers, to encourage movement and track
activity levels.
3. Offer handouts and digital resources that provide further education on
recommended lifestyle changes.

Emiotional support:
1. Dealing with the Illness - Nurses should help them deal with their symptoms by
providing emotional support to them. By meeting their patients’ physiological and
emotional needs, they also improve the healing process and help patients feel safe
and more empowered with managing their own recovery.
2. Preparing for Treatment - It’s normal that patients take some time to get used to the
hospital life since it’s different from their life at home. This can be quite disturbing
for some patients, but nurses should be here to help them acclimatize to the new
environment.
3. Adjusting to Hospital Life- creating a comfortable place for patients, nurses help
them adjust to hospital life more quickly. As Patient Engagement Hit explains, this
affects the overall patient experience, satisfaction, and psychological and emotional
state.

Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory and Immunologic Response,
Cellular Aberrations, acute and chronic and Peri-operative Nursing

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 Laoag City, Ilocos Norte

Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory and Immunologic Response,
Cellular Aberrations, acute and chronic and Peri-operative Nursing

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