Foundation University

COLLEGE OF NURSING
Dumaguete City

Nur 205: Care of Clients with Problems in Oxygenation,

Fluid and Electrolytes, Infectious, Inflammatory
and Immunologic Responses, Cellular Aberration,
Acute and Chronic

1. Course Description: This course deals with the principles and techniques of nursing care
management of sick clients across lifespan with emphasis on the adult and the older person,
population group in any setting with alterations/problems in oxygenation, fluid and electrolyte
balance, infectious, inflammatory and immunologic response problems, cellular aberrations,
and acute and chronic problems

Instructor: Judd Wilson T. Pasculado RN

Activities: Case Study on Pulmonary Hypertension

Instruction:

Utilize references as many as you can, this is an individual work.

Submit a hand written paper, use long bond paper

Write the question first and please answer in your own words.
Case Study
Pulmonary Hypertension
Patient Profile
T.S. is a 54-yr-old female patient who was diagnosed with idiopathic pulmonary arterial
hypertension at the age of 44. At that time she presented to her primary care HCP with a history of
increasing fatigue and recent onset of swelling in her feet and ankles. A chest x-ray revealed severe
cardiomegaly with pulmonary congestion. She underwent a right-sided cardiac catheterization,
which showed very high pulmonary artery pressures. Since then she has been treated with several
drugs, but her pulmonary hypertension has never been controlled and her peripheral edema has
progressively worsened.
Subjective Data
• Short of breath at rest and exercise intolerant to the extent that she had to quit her job
• Recently divorced from her husband
• Has two children: a girl, 15 years old, and a boy, 13 years old
Objective Data
• 3+ pitting edema from her feet to her knees
• RR: 28 at rest
• HR: 92 bpm and bounding
Discussion Questions
1. What drugs may T.S. have been given to treat her pulmonary hypertension? What is the rationale
for each of these drugs?
2. Could T.S. be a candidate for a heart-lung or lung transplantation? What will be included in
determining T.S.'s candidacy for transplantation?
3. What transplant procedure would best be considered for T.S.? What is the rationale?
4. What priority preoperative teaching is necessary for T.S. to prepare for a transplant procedure?
5. Based on the assessment data presented, what are the priority nursing interventions?