Week 1 Discussion Cardiovascular Discussion
University:
SOUTH UNIVERSITY
Week 1 Discussion Cardiovascular Discussion
Paper Instructions
This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned. To support your work with evidence bases references. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. In addition you must respond to your professor if applicable. Complete your participation for this assignment by end of the week.
For this assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
The Aquifer assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases may be present in the quizzes, the midterm exam, and the final exam.
Click here for information on how to access and navigate Aquifer.
This week, complete the Aquifer case titled “Internal Medicine 02 60-year-old woman with chest pain”
Apply information from the Aquifer Case Study to answer the following discussion questions
Discuss the history of present illness that you would take on this patient in preparation for the clinic visit. Include questions regarding Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors, Treatment, Severity (OLDCARTS).
Describe the physical exam and diagnostic tools to be used for Ms. Johnston. Are there any additional you would have liked to be included that were not?
What plan of care will Ms. Johnston be given at this visit; what is the patient education and follow-up?
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Sample Answer
Week 1 Discussion
The questions that I would ask Ms. Johnson in the HPI include the following
- When did the chest pain begin?
- Where is the pain? Can you point to it?
- What were you doing when the pain began?
- How long does the pain last?
- How would you describe the pain?
- Is it like the pain you had before?
- Has the pain been constant?
- Can you feel the pain anywhere else?
- Did anything make the pain better?
- What factors worsen the pain?
- How would you rate the pain on a 0-10 scale with 0 being no pain and 10 being the most amount of pain?
Physical Exam and Diagnostic Tools
The physical exam will include monitoring vital signs, weight, and BMI. A general exam will be taken to assess the patient’s general condition. A neck exam is necessary to assess for venous distention and hepatojugular reflux.
The neck will also be palpated for carotid pulses, lymphadenopathy, or thyroid gland abnormality. The carotid arteries will be auscultated for bruit. In addition, the lungs will be percussed and auscultated to assess the presence and symmetry of breath sounds, adventitious breath sounds, consolidation, pleural friction rubs, and effusion (Harskamp et al., 2019).
A cardiac exam will be used to note the intensity and timing of S1 and S2 and assess for pericardial friction rubs, murmurs, and gallops. Diagnostic tests will include an ECG and chest x-ray. A 12-lead ECG is vital in assessing patients with suspected ischemic chest pain (Harskamp et al., 2019).
The plan of care for the angina pain will be administering Nitroglycerin. It dilates coronary arteries to increase oxygen to the myocardium and dilates peripheral vessels so the heart does not have to work so hard to pump blood into them (Ford & Berry, 2020). The patient will be educated that when she experiences angina pain, she should stop all activities and sit or rest in bed in a semi-Fowler’s position to reduce the oxygen requirements of the ischemic myocardium. After two weeks, she will be followed up to assess her response to treatment.
References
- Ford, T. J., & Berry, C. (2020). Angina contemporary diagnosis and management. Heart, 106(5), 387-398. https //doi.org/10.1136/heartjnl-2018-314661
Harskamp, R. E., Laeven, S. C., Himmelreich, J. C., Lucassen, W. A. M., & van Weert, H. C. P. M. (2019). Chest pain in general practice a systematic review of prediction rules. BMJ open, 9(2), e027081. https //doi.org/10.1136/bmjopen-2018-027081
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