Critical analysis of a selected scenario from Caseworld: Elizabeth Green

Order Description
This assignment is based on the Mrs. Elizabeth Green scenario from Case world. Students need to read the sections between admission and discharge. This assignment will be based on the post-angioplasty phase of the scenario. Students are required to work in groups to critically analyse the scenario and identify actual or potential issues relevant to nursing practice, including rationales and evidence to support their decisions. The students’ rationales must demonstrate knowledge of best practices, pathopharmacology, relevant clinical pathways, interprofessional roles, law and ethics, and mental health. Students should also refer to relevant independent learning pods in developing their rationales.
Students are required to reflect on how their critical analysis provides support for their achievement of ANMC competency unit 3: Practices within an evidence-based framework.
Identification of four actual or potential issues/nursing priorities relevant to nursing practice
Purpose of this paper. Introduce the patient, and the scenario. Introduce what will be discussed in this paper.
The patient, and the scenario.
Patient
information MRN:
1045927 Surname:
Green Given names:
Elizabeth Rose DOB:
01/01/1936 Sex:
Female
?Personal details?Patient: Elizabeth Rose Green??DOB: 1/1/1936?Age: 78 years old?Address: Unit 3, 95 Angus St, Plympton, SA, 5038?Weight: 80kg??Height: 155cm??BMI: 33?MRN:1045927??
Family/significant others
?Mrs Green has one daughter (Rose) and one son (James) who are very supportive and pay for the cleaner. Her son and daughter live some distance away and work full time and are only able to visit on weekends. Elizabeth has 5 grandchildren (Eloise, Bianca, Elizabeth, Matthew and Jeremy). Her beloved pet is Matilda a Terrier cross.
?Background?Mrs Green is a retired widow, living alone in her own ground floor unit. She utilises a Webster pack for medication, and employs a private cleaner once a week. She does not drive and prefers to use a taxi for transport.?Elizabeth was washing the dishes at home this morning when she experienced 10 minutes of unrelieved central chest and left shoulder pain. After calling an ambulance Elizabeth was admitted to the ED and after review by the Cardiac Team Elizabeth has been admitted for an Angiogram plus or minus stenting. We follow her journey from pre-hospital to discharge post a cardiac event.
?Past medical history?Former smoker (quit 5 years ago), GORD, HT, hypercholesterolemia, osteoarthritis, type 2 diabetes (diet controlled).
?Past surgical history?Hysterectomy 30 years ago.?
Past family history?Mother had cardiac disease (deceased), Father had rheumatic fever as a child which contributed to long term health problems (deceased), Sister had breast cancer (deceased).?
Medication?Esomeprazole 20mg nocte?Metoprolol 25mg mane?Simvastatin 20mg nocte?Vitamin D and calcium tablet 1 daily?Paracetamol 1g 6/24 prn no more than 4g per day

Introduce what will be discussed in this paper. (The complication) maximum 200 words
– GTN – (Actual risk) A GTN infusion is commenced at 1ml/hr (IV 6ml/30mg GTN in 100mls 0.9/% normal saline (RAH policy, 2013)
– Sheath Removal – (Actual risk) Cardiac monitoring to continue for 24hrs. Elizabeth’s medical orders state that she is to remain supine for 4 hours, then sheath removal. Post sheath removal Elizabeth can sit up 30° for 2 hours, and then at 45° for 2 hours and then to mobilise as tolerated
– Diabetes – (Potential Risk) type 2 diabetes (diet controlled).
– Mental Health – (Potential Risk) stress regarding her life situation

This assignment is based on the Mrs. Elizabeth Green scenario from Case world. Students need to read the sections between admission and discharge. This assignment will be based on the post-angioplasty phase of the scenario. Students are required to work in groups to critically analyse the scenario and identify actual or potential issues relevant to nursing practice, including rationales and evidence to support their decisions. The students’ rationales must demonstrate knowledge of best practices, pathopharmacology, relevant clinical pathways, interprofessional roles, law and ethics, and mental health. Students should also refer to relevant independent learning pods in developing their rationales.
Students are required to reflect on how their critical analysis provides support for their achievement of ANMC competency unit 3: Practices within an evidence-based framework.
Identification of four actual or potential issues/nursing priorities relevant to nursing practice
Purpose of this paper. Introduce the patient, and the scenario. Introduce what will be discussed in this paper.
The patient, and the scenario.
Patient
information MRN:
1045927 Surname:
Green Given names:
Elizabeth Rose DOB:
01/01/1936 Sex:
Female
?Personal details?Patient: Elizabeth Rose Green??DOB: 1/1/1936?Age: 78 years old?Address: Unit 3, 95 Angus St, Plympton, SA, 5038?Weight: 80kg??Height: 155cm??BMI: 33?MRN:1045927??
Family/significant others
?Mrs Green has one daughter (Rose) and one son (James) who are very supportive and pay for the cleaner. Her son and daughter live some distance away and work full time and are only able to visit on weekends. Elizabeth has 5 grandchildren (Eloise, Bianca, Elizabeth, Matthew and Jeremy). Her beloved pet is Matilda a Terrier cross.
?Background?Mrs Green is a retired widow, living alone in her own ground floor unit. She utilises a Webster pack for medication, and employs a private cleaner once a week. She does not drive and prefers to use a taxi for transport.?Elizabeth was washing the dishes at home this morning when she experienced 10 minutes of unrelieved central chest and left shoulder pain. After calling an ambulance Elizabeth was admitted to the ED and after review by the Cardiac Team Elizabeth has been admitted for an Angiogram plus or minus stenting. We follow her journey from pre-hospital to discharge post a cardiac event.
?Past medical history?Former smoker (quit 5 years ago), GORD, HT, hypercholesterolemia, osteoarthritis, type 2 diabetes (diet controlled).
?Past surgical history?Hysterectomy 30 years ago.?
Past family history?Mother had cardiac disease (deceased), Father had rheumatic fever as a child which contributed to long term health problems (deceased), Sister had breast cancer (deceased).?
Medication?Esomeprazole 20mg nocte?Metoprolol 25mg mane?Simvastatin 20mg nocte?Vitamin D and calcium tablet 1 daily?Paracetamol 1g 6/24 prn no more than 4g per day

Introduce what will be discussed in this paper. (The complication) maximum 200 words
– GTN – (Actual risk) A GTN infusion is commenced at 1ml/hr (IV 6ml/30mg GTN in 100mls 0.9/% normal saline (RAH policy, 2013)
– Sheath Removal – (Actual risk) Cardiac monitoring to continue for 24hrs. Elizabeth’s medical orders state that she is to remain supine for 4 hours, then sheath removal. Post sheath removal Elizabeth can sit up 30° for 2 hours, and then at 45° for 2 hours and then to mobilise as tolerated
– Diabetes – (Potential Risk) type 2 diabetes (diet controlled).
– Mental Health – (Potential Risk) stress regarding her life situation

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