Clinical Focus Assignment

TTU School of Nursing Nursing 4451 Week _____ Leadership and Management Clinical Focus Management of Multiple Patients or a Patient with Multiple Problems   Describe the patients / patient you cared for on a typical day on your unit:   Patient (age, race, gender) Medical Diagnosis/Significant Information (Brief) * Age: 72 * Race: African-American * Sex: Male Patient was admitted to the ER on 20/03/2024 c/o chest pain for the past 4 days. He presents with a history of increasing exertional chest pain, dyspnea, and nausea. He experiences left-sided chest pressure radiating down his left arm, which is relieved by rest and sublingual nitroglycerin. His medical history includes chronic obstructive pulmonary disease (COPD), well-controlled hypertension, and osteoarthritis. He is a former smoker with a significant smoking history. On examination, he appears slightly pale with normal vital signs except for tachycardia. Cardiac examination reveals a soft, early systolic murmur and an S4. Portable chest x-ray shows hyperinflated lung fields. The serum troponin level is elevated at 0.6 ng/mL. Further evaluation and management are warranted. * Age: 60 * Race: Caucasian * Sex: Male Patient was Admitted on 18/03/2024 to the ER with a chief complaint of chest pain. He has a history of a remote left inguinal hernia repair, gastroesophageal reflux disease (GERD), and hypertension. The pain initiated 2 months ago, associated with exertion, lasting 10 to 15 minutes, and relieved by rest. Patient denies concurrent symptoms of diaphoresis, nausea, or shortness of breath. On examination, vital signs were stable, and cardiovascular assessment revealed brisk carotid upstrokes with symmetrical pulses. His medication regimen includes chlorthalidone, lisinopril, omeprazole, and sildenafil as needed. Significant family history of cardiovascular disease noted, with his father experiencing a MI at age 43, and his mother having hypertension and type 2 diabetes.   Which patient did you see first after report? Why? I saw Patient 1 first after receiving the report. Their presentation suggests a potentially acute cardiac event due to chest pain for the past 4 days, increasing exertional chest pain, dyspnea, and nausea, along with an elevated troponin level and abnormal cardiac examination findings.   Was that the right decision? Should you have seen another patient instead? Seeing Patient 1 first was the correct choice. Their presentation indicated a higher acuity with symptoms suggestive of an acute cardiac event, requiring immediate evaluation and management. Which patient did you spend the most time with and why? I focused most on patient 1 because of the acute nature of his symptoms, which required thorough assessment, monitoring, and intervention to address the possibility of an acute cardiac event or exacerbation of underlying cardiovascular conditions. Focus on a Patient with a Major Medical Diagnosis Patient Information Description of the...