NSB231: Integrated Nursing Practice- Chronic Heart Failure- Nursing Case Study
Giovanni is a 72 year old man with Chronic Heart Failure who has presented to the Emergency Department at 3am complaining of shortness of breath and a sensation of suffocating. Even though he sat up using 3 pillows in bed, this did not relieve his dyspnoea. He tells you that over the last few days he has found it difficult to walk around the house without feeling “puffed” and even showering causes him increased breathlessness. Over the last few weeks he has noticed difficulty getting his shoes on because of his swollen feet. On questioning, he states he continues to
smoke and has been unable to modify his diet or undertake exercise. On assessment his vital signs were T 36.9 ° C, HR 115/minute, normal ECG, BP 118/60, RR 26/minute and oxygen saturations of 91% in room air. He has widespread course crackles upon auscultation. You note pitting oedema in both of his lower limbs. Giovanni’s chest x-ray reveals: an enlarged cardiothoracic ratio, white patchy areas with Kerly B lines in the lower lobes. Giovanni is diagnosed with acute manifestation of heart failure.
1. Apply and integrate knowledge of the key NMBA Registered Nurse Standards for Nursing Practice, National Safety and Quality Health Service Standards, and National Health Priorities to enable effective clinical decision making, planning and action in a range of situations that reflect the diversity of contemporary health care settings and challenge.
2. Apply knowledge of anatomy, physiology and pathophysiology to support evidence-based decisions for planning and action in a range of clinical situations.
3. Demonstrate clinical reasoning and clinical decision making in line with safe and quality person-centred care across the lifespan.
4. Apply knowledge and skills to communicate and collaborate effectively with consumers and Families.
5. Reflect on the clinical placement experience and care provision, using feedback from a range of sources, to
identify opportunities to enhance individual practice.