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Asked by PresidentOwlPerson350

Mr. Frank Jura is a 54 year old male, currently admitted to the cardiac unit
in response to an exacerbation of his unstable angina. Mr. Jura also
presents with uncontrolled Type II diabetes, hypertension, and is currently
obese.
As a pregraduate PN student on the unit, you are assigned to Mr. Jura’s
care for the duration of your shift. You have negotiated the plan of care
with your RPN preceptor (who is also assigned to Mr. Jura), and divided the
responsibilities of his care for the remainder of the 12-hour shift.
After completing your AM vitals, you notice that Mr. Jura’s blood pressure
has been hovering just above high-normal range (around 145/90) as long as
he has been admitted. Curious at this trend, you examine his medication
administration record and note that he is currently prescribed the following
cardiac and diabetes related medications/treatments:
ï‚· Ramipril 2.5mg PO OD
ï‚· Metoprolol 100 mg PO BID
ï‚· Hydrochlorothiazide 20 mg PO OD
ï‚· Transderm nitropatch 0.2 (0.2 mg/hour) – apply patch at 0800 and
remove at 2000
ï‚· Nitrospray, 1 spray (0.3-0.6mg) SL q5 mins up to 3 times; use at first
sign of angina
ï‚· Metformin 500 mg 2 tablets PO BID
ï‚· Gliclazide MR 30 mg 3 tablets PO OD
ï‚· Empagliflozin 25 mg PO OD
You inform your preceptor of your findings regarding his elevated blood
pressure. In response, your preceptor states:
“Ah well, the poor guy is probably nervous….you know, being in the
hospital and all. I’ll just pop a PRN Ativan into his AM meds and that
should help with his elevated blood pressure.”

 

Review the case scenario (read it multiple times). Explore the scenario from
both the nursing, health, and psychosocial perspectives.
2) Generate relevant and timely actions and recommendations to assist the patient
(and their family) in the situation to obtain the highest level of wellness
possible.
3) Discuss your process of finding, retrieving, and analyzing best practice information to
develop an approach to a care plan for the patient and their family in the given
case narrative (the assignment is not a Nursing Care Plan).
4) Include discussion of at least one College of Nurses of Ontario Practice Standard or
Guideline (http://www.cno.org/learn-about-standards-guidelines/publications-
list/standards-and- guidelines/), and how the Standard or Guideline is relevant to
the case scenario.

 

RUbric : provides a summary of the
situation in own words.
 Includes background information
and key issues related to the
selected case.
 Describes and prioritizes the
presenting issues that are most
important in the care of the
patient and their family.
 Content is evidence based.
 Reflects application of critical
thinking throughout.
 Information is pulled from
credible sources and referenced.
 Information is well laid out and
constructed in a logical pattern for
optimal readability.

 Includes a description of an
approach to developing a care
plan for the patient and the
family.
 Describes the major/significant
issues in the situation that require
immediate attention.
 Describes other issues that should
be addressed later in the care of
the patient.
 Discusses how the CNO Practice
Standards or Guidelines are
relevant to the case scenario and
provides specific examples.
 Content is evidence based.
 Reflects application of critical
thinking throughout.
 Information is well laid out and
constructed in a logical pattern for
optimal readability.

 Presents a review of the literature
and best practice guidelines that
support actions described in the
previous Criteria 2 – Development
of Therapeutic Goals.
 Describes the process of the
literature search and resource
collection.
 Content is evidence based.
 Reflects application of critical
thinking throughout.
 Information is well laid out and
constructed in a logical pattern for
optimal readability

SCIENCE
HEALTH SCIENCE
NURSING

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