Case Study: Chest Pain the Presenting Patient

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Chest Pain Case Study

The presenting patient in the present case scenario is Mr. Hay, an 82-year-old male with an existing diagnosis of Cardiac Obstructive Pulmonary Disease (COPD). This existing diagnosis will prove relevant in a care plan for Mr. Hay, who has been admitted following a loss of consciousness. Having been discovered by a neighbor after some sustained period of unconsciousness, Mr. Hay would be admitted with an array of treatment issues. The three most pressing would prove to be the patient's Activity Intolerance, his Ineffective Airway Clearance and his Pain management. The discussion here below considers these treatment challenges.

Patient Problem 1: Activity intolerance

In any case where an elderly patient is admitted to the hospital, sedentary conditions can lead to an exacerbation of existing illness or to the formulation of new and problematic health concerns. This is especially true for the patient for whom excessive activity may produce negative health consequences as well. This is the case for the Mr. Hay, whose vital signs demonstrate the need for light but regular activity engagement.

For Mr. Hay, several factors are responsible for his activity intolerance and must therefore be accounted for even in the stimulation of activity. First, the fall caused by the patient's loss of consciousness has produced injuries to hip, ankle and shoulder. These injuries are likely to be an obstruction in the patient's attendance of daily physical engagement.

Additionally, the symptoms of Mr. Hay's COPD present a distinct challenge to ambulatory behavior. Shortness of breath, to be addressed in greater detail in the section below, may lead to dizziness, fatigue or disorientation and must therefore be monitored closely during the engagement of physical activity. Likewise, all evidence points to a mounting cardiac issue -- in all probability related to the existing COPD diagnosis -- that must itself be managed with care. Any physical activity must be offset by recognition of the patient's immediate cardiac state. The patient's heart-rate is recorded at 106 beats per minute (BPM). This is high relative to the normal rate of 60 to 100 BPM. This is consistent with MRIs showing the patient's moderately enlarged heart and a blood pressure reading placing the patient in the hyptertension risk index with a reading of 160 over 95.

These conditions collectively produce an intolerance to physical activity that must be managed and overcome in order to protect the patient from the danger of physical decline that may accompany hospitalization. The condition calls for assisted, light physical ambulation several times a day with constant monitoring of vital signs for indications of over-stimulation.

Patient Problem 2: Airway clearance, ineffective

The second problem of pressing importance is the patient's airway clearance difficulties. Here, a range of presenting symptoms suggest a worsening of Mr. Hay's COPD. The patient has experienced and, at the time of admission, continued to experience, respiratory difficulty. The patient's pursed lips and shallow breath suggest that he is struggling to breathe without assistance. Having performed medication reconciliation, caregivers have determined that the subject is already taking antibiotics for treatment of this condition. However, the progressive nature of COPD denotes that the subject's breathing difficulties are accelerating even with the administration of medication.

This is likely the leading cause of the patient's loss of consciousness and denotes a pressing health problem. At the point of presenting, it is incumbent upon… [END OF PREVIEW]

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Chest Pain the Presenting Patient.  (2013, April 23).  Retrieved June 19, 2019, from https://www.essaytown.com/subjects/paper/chest-pain-case-study-presenting-patient/9397064

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"Chest Pain the Presenting Patient."  23 April 2013.  Web.  19 June 2019. <https://www.essaytown.com/subjects/paper/chest-pain-case-study-presenting-patient/9397064>.

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"Chest Pain the Presenting Patient."  Essaytown.com.  April 23, 2013.  Accessed June 19, 2019.
https://www.essaytown.com/subjects/paper/chest-pain-case-study-presenting-patient/9397064.