CASE STUDY

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Case Study

Case Study

Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physician’s notes indicated a temp of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints.”

Laboratory values are as follows:

Hemoglobin = 8 g/dl
Hematocrit = 32%
Erythrocyte count = 3.1 x 10/mm
RBC smear showed microcytic and hypochromic cells
Reticulocyte count = 1.5%
Other laboratory values were within normal limits.

Question
Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In an essay of 500-750 words, explain your answer and include rationale.

Case Study #2
Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. There is no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question
Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:
• Describe your approach to care.
• Recommend a treatment plan.
• Describe a method for providing both the patient and family with education and your rationale.
• Provide a teaching plan; avoid using terminology that the patient and family may not understand.

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Case Study


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Case Study

Details

Case Study

Carol 35 year old female who has presented to accident and emergency brought in by ambulance
after collapsing at

the local supermarket complaining of chest pain.

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She presents with red flushed face, increased respirations, hervital sign results are as

follows: T,

36.8, P, 90, BP, 135,80, O2 Saturation 99%. Ambulance officer stated she had become hysterical at
the shopping centre and

needed to be reassured quite a bit before they could transport herto the

hosphal

Carol was accompanied to hospital by two friends who

stated,”She hasn’t been herse ffor a while.

She had a lot of sick leave lately and her boss isthreatening to fire her.”

When

asked about her family and childhood; Carol states”Dad used to drink a lot and would verbally
abuse me and my mother. My childhood was

a bit stressful. When my Mum finally had enough of my

father, she left. She left me with dad, cause I didn’t wantto move schools,l

felt abandoned”

On further questioning Carol stated ”I am just like my mother, she used to worry lot as well”. Carol
also reveals

to you that when she was about25 she had a relationship break-up and became very

down and stayed in bed for a few days. When asked about

her job she said it all relatesto the trains,

as she findsthe traveling to work really stressful. Some days she feels like the train

will crash. She

also states some days she has an overwhelming urge to jump offthe train while it is moving. When
she is not on the

train she is anxious, worried and thinking aboutthe next day’strav el.

Carol tells you that about 6 months ago she was on herwayto

work on the train and had experienced

a friglhtening surge of adrenaline and her”heart wentfast” and she felt hot 8. sweaty, had

trou e

getting her thoughtstogether, but most importantly a great sense of fear and panic aboutwhat was
happening. She also reports

that people would say she was an anxious child.

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She eeps asking repeatedly “Am I having a heart attack, or am I going mad?

Using the above Case Study; please answer the following six (6) questions:

1. Using the DSM V criteria for Panic Disorder;

provide evidence from the case study that indicates

that Carol may meet the criteria for an Anxiety Disorder. (Marking Criteria:

Demonstrates an understanding of DSM-V criteria of Panic Disorder as exhibited in case study)-(1 00-150 words)
2. Investigate and outline

the epidemiology of Anxiety Disorders in Australia.

Your answer needsto coverthe following areas: prevalence/incidence; possible causes;
hospitalisation rates and burden of disease. (Marking criteria: Presents and outlinesthe epidemiology; prevalence; possible causes;
hospital rates and burden of disease related to Panic Disorders in Australia) (150-200 words)

3. Discuss two (2)possible factors behind

the development o Carol’s Anxiety/Panic disorder

(using current literature). (Marking criteria: Discuss TWO (2) possible factors behind

the development of a Panic Disorder by Carol supported by current literature)-(350-400 words)

4. Carol is currently experiencing a

number of medical and mental health problems; using evidence

from the case study list three 3 MAJOR problems or risks.

Your problem/risk

identification should focus on providing nursing interventions for Carol over the

next 5 days. (Marking criteria: Clearly identifies

THREE (3) MAJOR problems or risks related to case study (70-100 words)

5. For each ofthe 3 major problems identified in question 4,

outline and describe three 3 nursing

interventionsfor the management ofthese , resulting in a total of9 nursing interventions

Your

interventions should be focused on nursing Carol overthe next 5 days. (Marking criteria: THREE 9) nursing interventions for each problem
or risk identified in question 4 (with reference to literature) Total of N NE (9) interventions (250-30 words)
6. With 7-10 reference to

current literature (within the last 5 years); provide a rationale for each ofthe

nine 9 nursing interv entions. (Marking criteria:

Rajttijogatlje fqjr each nursing intervention related to the identified problems with reference to the literature Total of NINE (9) Rationale

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