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Case Study Resuscitation Clinical Dilemma, Agnes Peters, 82 years old, (Latest 2021) CLINICAL WEEK 12 Correct Study Guide, Download to Score A$11.49
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Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
• Collaboration
• Ethics
• Clinical Judgment
• Communication
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
, I. Initial Scenario
History of Present Problem:
Agnes Peters is an 82-year-old Caucasian female with a medical history of heart failure, COPD, and chronic kidney
disease who resides in a skilled care facility. Agnes puts her call light on and says she is having chest pain and difficulty
breathing. Upon entering the room, you notice that she is pale, diaphoretic and has labored breathing. Her breath sounds
are diminished bilaterally and she has coarse bibasilar crackles. Her VS are T: 97.9 F/36.6 C (o) P: 98 (irreg) R: 32 BP:
148/90 O2 sat 86% room air.
Recognizing a problem, you push the call for immediate assistance button and delegate another nurse to call 911.
Oxygen is administered per face mask. In ten minutes an ambulance arrives and the paramedics are given report. A
peripheral IV is placed by the paramedics and a 12 lead EKG reveals sinus rhythm with frequent multifocal PVCs and 3-4
mm ST elevation in leads V1-V4. She receives ASA 325 mg PO, nitroglycerin 0.4 mg subl. and is transported emergently
to the emergency department (ED).
Personal/Social History:
Agnes is widowed and has no children. She has a brother, Dennis, who is 78 years old and visits her once a week. She has
a living will which states that she is a DNI (do not intubate) but wants to be resuscitated if her heart stops.
What data from the histories is important & RELEVANT; therefore it has clinical significance to the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
heart failure, COPD She is already immunocompromised and her O2 is at 86%
with heart failure she doesnt have a probable positive
outcome, she is near her end stage of life
RELEVANT Data from Social History: Clinical Significance:
widowed with no children, brother If no one is there to verify her wishes she will be intubated if
visits once a week, has living will the DNI is not on record
stating DNI
II. The Dilemma Begins… Current
Concern:
During transport to the ED, Agnes went into the following rhythm:
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