NSG3201 Nursing Case Study Assignment
NSG-3201 Nursing Case Study Assignment 1
Length: 2000 words
Mark Loading: 50%
You should use your learning materials, texts, references and online resources to respond to one of the case study assignments.
Choose ONE case study for your assignment from the options below.
1) Case Study One – Mr Curtis
2) Case Study Two – Mrs Graham
Please use the three sub-headings below to organise your assignment.
{} Cardiac Arrhythmia
{} Pathology and Treatment
{} Systematic Patient Assessment
NSG3201 Nursing Case Study Assignment
Case Study One: Mr Curtis
You are caring for Mr Curtis, a 69-year-old man who has been admitted for a routine
laparoscopic cholecystectomy. He has a medical history of hypertension and angina over the last year that has previously responded to treatment with GTN spray.
NSG3201 Nursing Case Study Assignment
Question 1: Cardiac Arrhythmia
When performing your observations after Mr Curtis returned from theatre 6 hours ago, you find that Mr Curtis has an irregular heart rate (HR). You take an Electrocardiogram (ECG) and see the following cardiac rhythm and manually record a pulse rate of 135 bpm.
a) Interpret and explain the above cardiac rhythm
b) Discuss three (3) potential reasons for this cardiac rhythm to occur
c) Discuss three (3) treatment options for a patient in this cardiac rhythm
Question 2: Pathophysiology and treatment
You notice that Mr Curtis is coughing and short of breath. His respiratory rate (RR) is 26, his SaO2 is 91% on RA and Blood Pressure (BP) is 170/80. The met call team has
requested a chest X-Ray and an Arterial Blood Gas, suspecting Acute Pulmonary Oedema (APO). The results are as follows:
| ABG | Normal Range | |
| pH | 7.33 | 7.35 – 7.45 |
| PaO2 | 68 | 80 – 100 mmHg |
| PaCO2 | 58 | 35 – 45 mmHg |
| HCO3- | 25 | 22 – 28 mmol/L |
| SaO2 | 91% | 95 – 100% |
a) Provide a basic interpretation of the above ABG results and explain if these results
support the diagnosis of Acute Pulmonary Oedema
b) Discuss the pathophysiology of Acute Pulmonary Oedema
c) Discuss the medical and nursing interventions generally for a patient in APO and
specifically for Mr Curtis, taking into account the ABG and vital signs stated above.
NSG3201 Nursing Case Study Assignment
Question 3: Patient Assessment with a respiratory focus
You are providing a handover to the RN on the night shift.
a) Describe and outline each component of a secondary survey assessment
b) Discuss three (3) respiratory signs and symptoms of APO and why they occur including the assessment and monitoring techniques that can be used for Mr Curtis throughout the night shift
You are caring for Mrs Graham, a 78-year-old woman who has been on the ward for two days following an anterior resection for bowel CA. She has a history of COPD.
Question 1: Cardiac Arrhythmia
Mrs Graham tells you that she is having intermittent chest palpitations. You take an
Electrocardiogram (ECG) and see the following cardiac rhythm:
a) Interpret and explain the above cardiac rhythm strip
b) Discuss three (3) potential reasons for this cardiac rhythm to occur
c) Discuss three (3) treatment options for a patient in this cardiac rhythm
Question 2: Pathophysiology and Treatment
Mrs Graham has an increased respiratory rate (RR) of 26 and she appears restless. Her SaO2 has decreased to 88% on RA. Her blood pressure (BP) has decreased to 90/60 and she is febrile at 38.5. The met call team has ordered a chest X-Ray and an Arterial Blood Gas (ABG), suspecting an infective exacerbation of her COPD. The blood gas results are
below:
| ABG | Normal Range | |
| pH | 7.31 | 7.35 – 7.45 |
| PaO2 | 60 | 80 – 100 mmHg |
| PaCO2 | 78 | 35 – 45 mmHg |
| HCO3- | 27 | 22 – 28 mmol/L |
| SaO2 | 87% | 95 – 100% |
a) Provide a basic interpretation of the above ABG results
b) Discuss the pathophysiology of COPD
c) Discuss the medical and surgical interventions generally for a patient with COPD and specifically for Mrs Graham, taking into account the ABG and vital signs stated above.
Question 3: Patient Assessment with respiratory focus
You are providing handover to the RN on the PM shift.
a) Describe and outline each component of a secondary survey assessment
b) Discuss three (3) respiratory signs and symptoms of COPD and why they occur
including the assessment and monitoring techniques that can be used for Mrs Graham throughout the shift