NSG6001 Advanced Practice Nursing I
NSG 6001
SU_NSG6001_Case_Study_W1_
A3
Week 1: Cardiology Clinical Case
HPI
A 52-year-old Irish American male is discharged from the hospital. He was hospitalized for four
days after a stent placement, following admission from the emergency room with angina
symptoms. This patient presented to the emergency room with four hours of crushing chest pain.
He was short of breath with exertion and diaphoretic. The patient thought he was having a heart
attack and was afraid to come to the hospital. The symptoms lasted for four days before the
patient sought help. The patient had been suffering from similar symptoms for the past six months
but thought that he just out of shape. It was worse upon admission to the hospital. Prior to this,
the symptoms disappeared with rest.
His symptoms were relieved in the emergency department with medication and he was
transferred to the cardiac floor for catheterization.
The patient’s symptoms were highly debilitating upon his admission to the emergency
department.
Prior to his admission to the hospital for this event, the patient was not very active because of his
angina symptoms. The pain that he had was substernal and crushing and radiated to his neck
and jaw. His symptoms resolve with rest only. He has not sought any therapeutic maneuvers.
He is currently asymptomatic and is here for a follow-up visit from his hospitalization to discuss
his risk factors. The patient is still concerned that he may have other episodes of angina, even
after the stent placement.
PMH
The patient has not sought care for his problems in the past. He had been treated for
hypertension and high cholesterol in the past but stopped medication on his own. Besides that,
he has had no other significant illnesses.
He was hospitalized for a cholecysectomy ten years ago.
Page 1 of 5
© 2015 South University
, NSG6001 Advanced Practice Nursing I
This patient had a baseline EKG at his doctor’s office when he was first prescribed his blood
pressure medication. Otherwise he’s had no other investigations for heart disease besides his
cholesterol levels checks.
Results of Laboratory Investigations Following Hospitalization
Total cholesterol - 210
LDL- 200
HDL- 25
Triglycerides – 250
Fasting blood sugar – 140
HgbA1c – 7.5
CXR – hyperinflation of the lungs – no infiltrate
EKG – no change from baseline.
Risk Factors:
• High blood pressure
• Hypercholesterolemia
• Type 2 diabetes
• Android obesity
• Cigarette smoker
• Positive family history
Past surgical history of Cholecysectomy, almost 10 years age without any complications.
ROS
Review of systems is otherwise negative
DISCHARGE MEDICATIONS
Tenormin XL 50 mg daily
Lipitor 10 mg daily
Glucophage – 500mg BID
Baby ASA daily
Patient is now compliant with the prescribed regimen, but wasn’t in the past. The medicines were
prescribed by the physician who discharged him from the coronary care unit.
Page 2 of 5
© 2015 South University
NSG 6001
SU_NSG6001_Case_Study_W1_
A3
Week 1: Cardiology Clinical Case
HPI
A 52-year-old Irish American male is discharged from the hospital. He was hospitalized for four
days after a stent placement, following admission from the emergency room with angina
symptoms. This patient presented to the emergency room with four hours of crushing chest pain.
He was short of breath with exertion and diaphoretic. The patient thought he was having a heart
attack and was afraid to come to the hospital. The symptoms lasted for four days before the
patient sought help. The patient had been suffering from similar symptoms for the past six months
but thought that he just out of shape. It was worse upon admission to the hospital. Prior to this,
the symptoms disappeared with rest.
His symptoms were relieved in the emergency department with medication and he was
transferred to the cardiac floor for catheterization.
The patient’s symptoms were highly debilitating upon his admission to the emergency
department.
Prior to his admission to the hospital for this event, the patient was not very active because of his
angina symptoms. The pain that he had was substernal and crushing and radiated to his neck
and jaw. His symptoms resolve with rest only. He has not sought any therapeutic maneuvers.
He is currently asymptomatic and is here for a follow-up visit from his hospitalization to discuss
his risk factors. The patient is still concerned that he may have other episodes of angina, even
after the stent placement.
PMH
The patient has not sought care for his problems in the past. He had been treated for
hypertension and high cholesterol in the past but stopped medication on his own. Besides that,
he has had no other significant illnesses.
He was hospitalized for a cholecysectomy ten years ago.
Page 1 of 5
© 2015 South University
, NSG6001 Advanced Practice Nursing I
This patient had a baseline EKG at his doctor’s office when he was first prescribed his blood
pressure medication. Otherwise he’s had no other investigations for heart disease besides his
cholesterol levels checks.
Results of Laboratory Investigations Following Hospitalization
Total cholesterol - 210
LDL- 200
HDL- 25
Triglycerides – 250
Fasting blood sugar – 140
HgbA1c – 7.5
CXR – hyperinflation of the lungs – no infiltrate
EKG – no change from baseline.
Risk Factors:
• High blood pressure
• Hypercholesterolemia
• Type 2 diabetes
• Android obesity
• Cigarette smoker
• Positive family history
Past surgical history of Cholecysectomy, almost 10 years age without any complications.
ROS
Review of systems is otherwise negative
DISCHARGE MEDICATIONS
Tenormin XL 50 mg daily
Lipitor 10 mg daily
Glucophage – 500mg BID
Baby ASA daily
Patient is now compliant with the prescribed regimen, but wasn’t in the past. The medicines were
prescribed by the physician who discharged him from the coronary care unit.
Page 2 of 5
© 2015 South University
