Jocelyn Andrews, 65 years old was transferred to the medical ward (where you are on
Jocelyn Andrews, 65 years old was transferred to the medical ward (where you are on placement) two days ago around lunch time from the coronary care unit. She was diagnosed with a Non-ST segment elevation myocardial infarction (NSTEMI) and treated with Antiplatelet Therapy and anticoagulants. She had no complications during recovery and has been pain free for the last 24 hours. It is planned that she remains in the medical ward for the next 24 hoShe was admitted the day before yesterday via coronary care following a NSTEMI. She had Antiplatelet Therapy (aspirin + clopidogrel) and anticoagulants (enoxaparin) in CCU with no dysrhythmias. Mrs Andrews has been pain-free since arrival here but is ordered GTN patches if necessary. She has been afebrile since arrival. Her BP has been 130/70 – 135/85 mm Hg, her heart rate 80-100/ min. and regular. Her respirations have been 18-24 and regular. Her colour has been fine since she arrived. If she stays stable, Mrs Andrews is to be discharged tomorrow PM. I have started her discharge planning. Can someone chase up the registrar to ask him to complete his section, please? While you are conducting your ‘check’ of the patients you are allocated for your shift, you are called by Mrs Andrews who tells you she has “…the same sort of pain she had before”. Her skin is ashen but still dry. Demonstrate the hypothetical clinical reasoning processes you would follow to address Mrs Andrews’ needs using all eight steps of the clinical reasoning cycle
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