Scenario Based Assignment Nursing

Topics: Cardiology, Heart rate, Myocardial infarction Pages: 5 (1727 words) Published: June 23, 2013
In this scenario-based assignment I am going to write about a patient, for whom I have cared for whilst I was in placement. I am going to refer to the patient as Mrs. X due to confidentiality as the Nursing and Midwifery Council, 2008 states, that you must respect people right to confidentiality.

Mrs X was a 74-year-old lady, who was very weak and could hardly mobilise. She had a history with falls and chest pain and she came into the hospital because of severe chest pain and high pulse rate. She was moved to our ward from Accidents and Emergencies, as her chest pains were not stable and as she could not mobilise by herself, which meant she needed to stay in hospital further and be closely observed.

My mentor gave me the task to admit Mrs X and during the admission, I learned more about Mrs X and was able to find out that she was having Heart Palpitations along with the chest pains. Palpitations are heartbeat sensations that feel like your heart is pounding or racing. It is like an unpleasant awareness of your heart beat, Medline Plus, 2010.

After completing her admission, I reported my findings to the nurse in charge, from which the nurse in charge decided to investigate further and went on to talk with the patient to gain further information on what was happening to Mrs X. After that, the Charge Nurse decided to put Mrs X on a Cardiac monitor to observe her.

I was also given the task to do her observations and due to her fragile and serious condition, the Nurse in charge told me to do record the observations hourly, so she gets top care and so that we get precautions if something was to wrong with her. As I did my Observations, I found that her heart rate was quite high along with the respirations.

When I asked Mrs. X what sorts of other symptoms she got while having fast heart rate, she said she had shortness of breath, dizziness along with chest pain. The other symptoms patients with tachycardia finds are light headedness, fainting (syncope) and heart palpitation and sometime people get no symptoms until any physical examination or with heart monitoring test called electrocardiogram.

From the research back then, I found out that Heart rate is the number of heartbeats per unit time, usually per minute. Also found out that, the heart rate is based on the number of contractions of the ventricles (the lower chambers of the heart). The heart rate may be too fast which is called tachycardia or too slow which is known as bradycardia and finally the pulse is bulge of an artery from the wave of blood coursing through the blood vessel as a result of the heartbeat. The pulse is often taken at the wrist to estimate the heart rate, Medicine Net, 2011. A normal heart rate for average person is 60-100 times a minute whereas in a high pulse rate, which is also called tachycardia the heart, beats more than the average heart does (Mayo Clinic, 2011). If the heart keeps on pumping oxygen-rich blood fast to the body like that then it won't be able to do it efficiently.

From this, I recalled when Mrs X said that she smoked in the admission and just went to double check in the admission folder to confirm it was written there, as it was very important because whilst when I had a quick time to spare I researched about Palpitation and chest pain and I found out that smoking was one of the causes of palpitation, so I went further to research about it and later on I decided to just have a chat with Mrs X in which, I explained about her condition and I also advised her about smoking, told her about the harms that smoking can do and told her the different kind of options available to her if she was willing to quit smoking.

Also from the cardiac monitor I could see that her Heart rate was high and her respirations were a bit high too, as I knew this was dangerous I quickly informed the Charge Nurse, who called up a doctor and the doctor arrived and after a few checks, prescribed some Beta blockers (medication) also known...

References: BUPA (2011) Beta-Blockers[online], available from: http://www.bupa.co.uk/individuals/health-information/directory/b/beta-blockers [Accessed on 1st November 2011]
Mayo Clinic (2011) Tachycardia Treatment and drugs[online] Mayo Clinic
Mayo Clinic (2011) Tachycardia Symptoms [online] Mayo Clinic. Available from:http://www.mayoclinic.com/health/tachycardia/DS00929/DSECTION=symptoms [Accessed on 3rd November 2011]
Mayo Clinic (2011) Treatment and drugs [online] Mayo Clinic
http://www.mayoclinic.com/health/tachycardia/DS00929/DSECTION=treatments-and-drugs [Accessed on 3rd November 2011]
MedicineNet.com (2011) Definition of Heart rate [online] MedicineNet.com
MedlinePlus (2010) Heart Paalpitation [online] MedlinePlus. Available from:
http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm [Accessed on 3rd November 2011]
Medtronic (2010) About Tachycardia (fast Hearbeat) [online] Medtronic. Available from:
http://www.medtronic.com/health-consumers/tachycardia/index.htm [Accessed on 29th October 2011]
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