Nursing CASE STUDY

Cardiovascular Disorders
As noted in this week’s introduction, cardiovascular diseases rank among the top leading causes of death in the United States. Hypertension is known as the silent killer; heart disease in women is often misdiagnosed; many cardiovascular illnesses are not quickly diagnosed for a variety of reasons. The good news is there are many pharmacological interventions for treating cardiovascular disorders. As a nurse, it is vital that you are aware of the characteristics of the drugs used to treat them.

Read the following case study. While reading, reflect on your own knowledge of the pathophysiology of the pharmacological interventions and your role as a nurse in assisting patients to maximize the effects of pharmacologic treatment.

Case Study:

You are the assigned nurse for Mrs. K, a 63-year-old Caucasian female admitted to the telemetry unit following a presentation to the ER 3 days ago with a 2-hour history of pain her left shoulder radiating up to her neck. EKG and enzymes ruled her in for AMI and she successfully completed a catheterization with a stent in the right coronary artery. Her past medical history was significant only for hypertension for 10 years which was managed with HCTZ 25 mg daily. She is slightly overweight, and reports that she does not have time to exercise regularly, as she commutes over 1 hour each way to her secretarial job daily. Her meals are irregular, and often consist of convenience foods.

Her physician enters the room while you are providing care to tell her that her labs have indicated that she now has type II diabetes mellitus and that he is adding Metformin 250 bid daily. In addition, he is adding atorvastatin (Lipitor) 80 mg daily, ASA 81mg daily, clopidogrel 75 mg daily, metoprolol 100 mg b.i.d. and enalopril (Vasotec) 10 mg daily for the newly diagnosed coronary artery disease.

Reflect on the patient’s personal scenario presented in this Case Study and address the following in a 2- to 3-page paper:

Based on the case study, respond to the following:
Evaluate and explain the rationale for the addition of each of these new medications and contraindications to their use.
What side effects of each medication will you caution the patient to be alert for?
What additional teaching will be required for the patient prior to discharge?
Support your ideas or those of others with references from the professional nursing literature. Refer to the “Cardiovascular Disorders Application Rubric” prior to submission.
Attachments:
CARDIOVASCULAR DISORDERS APPLICATION ASSIGNMENT RUBRIC

This rubric will be used to evaluate the Cardiovascular Disorders Application Assignment in this course. Week 2 Application Assignment will be assessed using this rubric. Carefully read this entire rubric before submitting your Application Assignment.

This Application Assignment is due by Day 7 of Week 2.
Scoring Instructions
• The Application Assignment is worth a maximum of 200 points each. Points for each assignment will be awarded as follows:
• 200–180 (Exemplary)
• 179–160 (Proficient)
• 159–140(Sufficient)
• 139 > (Developing)

Note: All written assignments should reflect academic writing standards and have few, if any, spelling, grammar, or syntax errors.

200–180 Points (Exemplary) Writing assignment exceeds the requirements and exceeds academic writing expectations. Each response:

• Evaluates and explains in detail the rationale for the addition of each of these new medications and contraindications to their use
• Clearly explains all of the possible the side effects of each medication for the patient
• Clearly explains all necessary knowledge and/or skills needed to be taught to the patient prior to discharge
• Incorporates and pays attention to all of the detailed information from the provided case study
• Exceeds the requirements of the application instructions and is submitted by the due date
• Is substantive, reflective, and evidence-based by the professional literature
• Demonstrates mastery and thoughtful/accurate application of skills or strategies presented in the course
• Uses language that is appropriate, and generally clear and concise
• Has few errors in spelling, grammar, and syntax

179-160 Points (Proficient) Paper or writing assignment meets the requirements and meets academic writing expectations. Each response:

• Evaluates and explains the rationale for the addition of each of these new medications and contraindications to their use
• Clearly explains the possible the side effects of each medication for the patient
• Clearly explains necessary knowledge and/or skills needed to be taught to the patient prior to discharge
• Incorporates and pays attention to the detailed information from the provided case study
• Meets the requirements of the Application instructions and is submitted by the due date
• Is substantive, reflective, and evidence-based
• Uses language that is appropriate, and generally clear and concise
• Has few errors in spelling, grammar, and syntax

159-140 Points (Sufficient) Paper or writing assignment is below the requirements and is below academic writing expectations. Each response

• Does not adequately evaluate and does not adequately explain the rationale for the addition of each of these new medications and contraindications to their use
• Explains some of the possible the side effects of each medication for the patient
• Explains some knowledge and/or skills needed to be taught to the patient prior to discharge
• Incorporates and pays attention to part of the detailed information from the provided case study
• Is submitted by the due date but is not always responsive to the requirements of the Application instructions
• Lacks substance, relies more on anecdotal than scholarly evidence
• Uses language that is unclear and/or inappropriate
• Makes more than occasional errors in spelling, grammar, and syntax

139 or Less Points (Developing) Paper or writing assignment fails to meet the requirements and is well below academic writing expectations. Each response

• Fails to evaluates and fails to explains the rationale for the addition of each of these new medications and contraindications to their use
• Fails to explain any possible side effects of each medication for the patient
• Fails to explain any knowledge and/or skills needed to be taught to the patient prior to discharge
• Does not incorporate and does not pay attention to the detailed information from the provided case study
• Is submitted past the due date, and/or does not address the requirements of the Application instructions
• Is unsubstantiated and anecdotal
• Provides inaccurate information
• Contains many omissions and/or critical errors
• Uses unclear and inappropriate language
• Makes many errors in spelling, grammar, and syntax

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