NextGen UNFOLDING Reasoning Atrial Fibrillation/Heart Failure Suggested Answer Guidelines/Bill Hill, 71 years old SUGGESTEDANSWERGUIDELINES/BILLHILL,71YEARSOLD)

NextGen UNFOLDING Reasoning Atrial Fibrillation/Heart Failure (2/2) Suggested Answer Guidelines Bill Hill, 71 years old Primary Concept Perfusion Gas Exchange Interrelated Concepts (In order of emphasis) • Clinical judgment • Patient education • Communication • Collaboration NCLEX Client Need Categories Covered in Case Study NCSBN Clinical Judgment Model Covered in Case Study Safe and Effective Care Environment Step 1: Recognize Cues • Management of Care Step 2: Analyze Cues • Safety and Infection Control Step 3: Prioritize Hypotheses Health Promotion and Maintenance Step 4: Generate Solutions Psychosocial Integrity Step 5: Take Action Physiological Integrity Step 6: Evaluate Outcomes • Basic Care and Comfort • Pharmacological and Parenteral Therapies • Reduction of Risk Potential • Physiological Adaptation Present Problem: Part I: Initial Nursing Assessment Bill Hill is a 71-year old male with a past medical history of benign prostatic hyperplasia (BPH), peripheral vascular disease and myelodysplastic syndrome two months ago after a bone marrow biopsy. Six weeks ago Bill was admitted because he had a syncopal episode. He was diagnosed with paroxysmal atrial fibrillation and acute anemia with a Hgb of 6.9 and received a transfusion of one unit of PRBCs. Bill presents to the emergency department today with increasing weakness, fatigue, sinus congestion, fever, and chills the past week. He was around grandchildren with colds two weeks ago. Bill woke up at 6 am today feeling short of breath, harsh coughing with clear sputum. He had difficulty wa