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NURS1103 Clinical Nursing Practice 1

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Nursing Practice & Decision-Making Scenario Adult – Cardiac Condition: Mr Khan

Patient History:

Mr Amir Khan is a 68 year old man who is married and has four children.

Past Medical History:

Mr Khan was diagnosed with diabetes 12 years ago he takes Metformin 1g twice daily. Most recent HbA1c levels were 8.5%. Last year he had depression which was managed by his practice nurse. Mr Khan gave up smoking 2 years ago, prior to this he had smoked 20-30 cigarettes daily from the age of 18. He weighs 100Kg and has a BMI of 31.

Family history: 

Mr Khan’s father was blind and died of a stroke 4 years ago.

Drug history: 

Metformin 1gm twice daily. No recreational drugs, No over the counter medications, No herbal remedies. 

Present Situation:

Mr Khan presented to the practice nurse to review his diabetes. He reports to the nurse that he is experiencing ‘crushing’ central chest pain, which radiates to the left side of his neck and jaw. The nurse notices that he has a ‘horrible blue-grey colour’ in his face. He says the pain began that morning and he thought it would go away, but it is getting worse. His initial observations are:

RR: 22

SpO2: 95%

HR: 66

BP: 88/54 mmHg

Pain 4/10

Mr Khan is given nitro-glycerine 0.4mg SL x2 every five minutes. An ECG is performed which shows ST-segment elevation in leads II,III and aVF indicating an acute inferior wall myocardial infarction (MI).  Fifteen minutes later, after the 3rd nitro-glycerine SL was administrated, he stated that his chest pain was now ‘almost gone’. An ambulance is called and Mr Khan has to be convinced to go to the Accident and Emergency Department.

Accident and Emergency:

Upon arrival at A&E Mr Khans observations are as follows:

RR 28 

SpO2 91%

HR 88

BP 72/42

Cardiac Rhythm: Sinus rhythm with ST segment elevation

Pain 5/10

Alert, slow to respond


Pupils equal 

Temp 37.8°C 

Pupils round and reacting to light 

Colour dusky, cool, dry

In the care study students will discuss and critique the decision-making processes required in the assessment and delivery of care for their selected patient.

Your reflective case study should include the following:

An introduction;

  • Briefly describe the purpose of the assignment with clearly stated aims and objectives
  • Explain how these aims/objectives will be addressed
  • A brief background to include;

    • Brief discussion of the theory of decision making
    • Explain the significance and importance of this topic to nursing practice and/or your development as a student nurse (rationale)
    • Set the scene for the case-study and offer a rationale offering evidence regarding the significance of the chosen case-study.
    • Present a short summary highlighting the important points of the case study (if choosing a patient from practice, include more detailed information as an appendix. Remember to maintain patient confidentialityand remove any identifiable information throughout).
  • The main body of the work should demonstrate an understanding of clinical reasoning and decision-making processes applied to the following themes;

  • A systematic, comprehensive and holistic assessment of your case patient

  • An interpretation and response to the assessment including appropriate symptom management and a plan of on-going care. You mustconsider any signs of actual or potential deterioration of physical and/or mental health.

  • A plan of care and appropriate interventions that promote an environment in which human rights, values, customs and spiritual beliefs of the person and family are respected.

You should be able to support your interventions, plan of care and nursing practice with appropriate evidence-based decisions

A conclusion;

  • Summarize the main point of this assignment. Pulling out the main points from your essay
  • Identify any implications for practice and/or identification where more evidence (research) is required to inform best practice.
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My Assignment Help. 'Clinical Nursing Practice 1' (My Assignment Help, 2021) <https://myassignmenthelp.com/free-samples/nurs1103-clinical-nursing-practice-1/cardiac-condition-a-case-of-mr-khan.html> accessed 15 April 2021.

My Assignment Help. Clinical Nursing Practice 1 [Internet]. My Assignment Help. 2021 [cited 15 April 2021]. Available from: https://myassignmenthelp.com/free-samples/nurs1103-clinical-nursing-practice-1/cardiac-condition-a-case-of-mr-khan.html.

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