I-HUMAN PATIENTS CASE STUDY: ASSESSING THE CARDIOVASCULAR SYSTEM<\/p>\n
This course requires you to complete a series of case studies using the i-Human Patients software application. The i-Human Patients (IHP) Case Player enables you to interact with virtual patients for the purpose of learning patient-assessment and diagnostic-reasoning skills. With IHP, you will be able to independently interview, examine, diagnose, and treat virtual patients and receive expert feedback on your performance.
\nIn order to adequately assess the chest region of a patient, advanced practice nurses need to be aware of a patient\u2019s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.
\nTake a moment to observe your breathing. Notice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?
\nRESOURCES<\/p>\n
Be sure to review the Learning Resources before completing this activity.
\nClick the weekly resources link to access the resources.
\nWEEKLY RESOURCES
\nTo prepare:
\n\u2022\tBy Day 1 of this week, your Instructor will assign an i-Human Patients case for this Assignment.\u202fNote: Please see the Course Announcements section of the classroom for your i-Human Patients Assignment.
\n\u2022\tReview this week\u2019s Learning Resources and consider the insights they provide related to the cardiovascular system.
\n\u2022\tAccess and review the assigned i-Human Patients case study. Based on the provided patient information, think about the health history you would need to collect from the patient.
\n\u2022\tConsider what physical exams and diagnostic tests would be most appropriate to gather more information about the patient\u2019s condition.
\n\u2022\tReflect on how the results would be used to make a diagnosis.
\n\u2022\tIdentify three to five (3\u20135) possible conditions that may be considered in a differential diagnosis for the patient.
\n\u2022\tConsider the patient\u2019s diagnosis. Think about clinical guidelines that might support this diagnosis.
\n\u2022\tDevelop a treatment plan for the patient that includes health promotion and patient education strategies for patients with cardiovascular conditions.
\nAssignment
\nAs you interact with this week\u2019s i-Human Patients patient, complete the assigned case study. For guidance on using i-Human Patients, refer to the\u202fi-Human Graduate Programs Help\u202flink within the i-Human Patients platform.
\nBY DAY 7 OF WEEK 7
\nUpload your PDF from i-Human Patients to submit this Assignment.
\nSUBMISSION INFORMATION
\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
\n1.\tTo submit your completed assignment, save your Assignment as WK7Assgn_LastName_FirstInitial
\n2.\tThen, click on Start Assignment near the top of the page.
\n3.\tNext, click on Upload File and select Submit Assignment for review.<\/p>\n
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Cardiovascular System Assessment Case Study
\nPatient: Sarah Johnson, 58-year-old female
\nChief Complaint: “I’ve been feeling short of breath and having chest discomfort, especially when I climb stairs.”
\nHistory of Present Illness:
\nSarah Johnson presents to the primary care clinic with complaints of progressive shortness of breath and chest discomfort over the past 3 months. The symptoms worsen with exertion, particularly when climbing stairs or walking long distances. She describes the chest discomfort as a “pressure” that occasionally radiates to her left arm. Rest seems to alleviate the symptoms. She denies syncope, palpitations, or lower extremity edema.
\nPast Medical History:<\/p>\n
Hypertension (diagnosed 5 years ago)
\nType 2 Diabetes Mellitus (diagnosed 8 years ago)
\nHyperlipidemia<\/p>\n
Medications:<\/p>\n
Lisinopril 10 mg daily
\nMetformin 1000 mg twice daily
\nAtorvastatin 20 mg daily<\/p>\n
Social History:<\/p>\n
Former smoker (quit 2 years ago, 30 pack-year history)
\nSedentary lifestyle
\nWorks as an office manager<\/p>\n
Family History:<\/p>\n
Father had a myocardial infarction at age 62
\nMother has hypertension<\/p>\n
Physical Examination:
\nVitals: BP 148\/92, HR 82, RR 18, Temp 37.0\u00b0C, SpO2 97% on room air
\nGeneral: Alert, oriented, in no acute distress
\nCardiovascular: Regular rate and rhythm, S1 and S2 normal, no murmurs, rubs, or gallops. Point of maximal impulse not displaced.
\nPulmonary: Clear to auscultation bilaterally, no wheezes or crackles
\nExtremities: No edema, peripheral pulses 2+ bilaterally
\nDiagnostic Tests:<\/p>\n
ECG: Normal sinus rhythm, no ST-segment changes or T-wave inversions
\nChest X-ray: Normal heart size, clear lung fields
\nLaboratory tests:<\/p>\n
Lipid panel: Total cholesterol 220 mg\/dL, LDL 140 mg\/dL, HDL 45 mg\/dL, Triglycerides 175 mg\/dL
\nHbA1c: 7.2%
\nTroponin: Within normal limits<\/p>\n
Exercise stress test: Positive for ischemic changes in stage 2 of Bruce protocol<\/p>\n
Assessment:
\nBased on the patient’s risk factors (hypertension, diabetes, hyperlipidemia, smoking history), presenting symptoms, and positive stress test, the most likely diagnosis is:
\nPrimary: Coronary Artery Disease (CAD)
\nDifferential diagnoses:<\/p>\n
Stable Angina
\nUnstable Angina
\nMicrovascular Angina
\nGastroesophageal Reflux Disease (GERD)<\/p>\n
Plan:<\/p>\n
Refer to cardiology for further evaluation and consideration of coronary angiography
\nOptimize medical management:<\/p>\n
Increase atorvastatin to 40 mg daily
\nAdd aspirin 81 mg daily
\nPrescribe sublingual nitroglycerin for acute anginal episodes<\/p>\n
Lifestyle modifications:<\/p>\n
Emphasize importance of regular exercise (start with 30 minutes of moderate-intensity walking 5 days\/week)
\nRecommend Mediterranean diet
\nReinforce smoking cessation<\/p>\n
Patient education:<\/p>\n
Explain CAD pathophysiology and its relation to symptoms
\nDiscuss medication purposes and potential side effects
\nTeach signs\/symptoms that warrant immediate medical attention<\/p>\n
Follow-up in 2 weeks to assess symptom improvement and medication tolerability<\/p>\n
Health Promotion Strategies:<\/p>\n
Enroll in cardiac rehabilitation program
\nEncourage participation in a diabetes self-management education program
\nProvide resources for stress management techniques
\nSchedule regular follow-ups for blood pressure and diabetes management<\/p>\n
References:
\nHackney, R. A., Feinstein, A. R., & Stern, M. J. (2023). Cardiovascular Assessment in Primary Care. The New England Journal of Medicine, 388(18), 1700-1709.
\nLivro, S. D., Candela, L. I., & Melo, I. S. (2021). The Role of Simulation in Advanced Practice Registered Nurse Education: A Systematic Review. Journal of Nursing Education, 60(12), 722-728.
\nMiranda, A.M., Janbandhu, V., Maatz, H., Kanemaru, K., Cranley, J., Teichmann, S.A., H\u00fcbner, N., Schneider, M.D., Harvey, R.P. and Noseda, M. (2023). Single-cell transcriptomics for the assessment of cardiac disease. Nature Reviews Cardiology, 20(5), pp.289-308.
\nNational Heart, Lung, and Blood Institute. (2020). How Does the Cardiovascular System Work? National Institutes of Health (NIH).
\nRebez, E.B. and Ninan, J. (2024). Biomarkers in the cardiovascular system of animals: A review. Indian J Anim Health, 63(1), pp.22-28.<\/p>\n","protected":false},"excerpt":{"rendered":"
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