SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
JoAnn Smith is a 72-year-old woman who has a history of myocardial infarction (MI) four years ago and systolic heart
failure secondary to ischemic cardiomyopathy with a current ejection fraction (EF) of only 15%. She presents to the
emergency department (ED) for shortness of breath (SOB) the past three days. Her shortness of breath has progressed
from SOB with activity to becoming SOB at rest. The last two nights she had to sleep in her recliner chair to rest
comfortably upright. She is able to speak only in partial sentences and then has to take a breath when talking to the nurse.
She has noted increased swelling in her lower legs and has gained six pounds in the last three days. She is being
transferred from the ED to the cardiac step-down where you are the nurse assigned to care for her.
Personal/Social History:
JoAnn is a retired math teacher who is unable to maintain the level of activity she has been accustomed to because of the
progression of her heart failure the past two years. She has struggled with depression the past two years and has been
more withdrawn since her husband of 52 years died unexpectedly three months ago from a myocardial infarction.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
RELEVANT Data from Social History: Clinical Significance:
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 98.6 F/37.0 C (oral) Provoking/Palliative:
P: 92 (irregular) Quality: Denies Pain
R: 26 (regular) Region/Radiation:
BP: 162/54 MAP: 90 Severity:
O2 sat: 90% (6 liters n/c) Timing:
What VS data is RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
T
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https://www.coursehero.com/file/128831866/Heart-Failure-Case-Study-pdfpdf/
, SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
T
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https://www.coursehero.com/file/128831866/Heart-Failure-Case-Study-pdfpdf/
Part I: Recognizing RELEVANT Clinical Data
SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
JoAnn Smith is a 72-year-old woman who has a history of myocardial infarction (MI) four years ago and systolic heart
failure secondary to ischemic cardiomyopathy with a current ejection fraction (EF) of only 15%. She presents to the
emergency department (ED) for shortness of breath (SOB) the past three days. Her shortness of breath has progressed
from SOB with activity to becoming SOB at rest. The last two nights she had to sleep in her recliner chair to rest
comfortably upright. She is able to speak only in partial sentences and then has to take a breath when talking to the nurse.
She has noted increased swelling in her lower legs and has gained six pounds in the last three days. She is being
transferred from the ED to the cardiac step-down where you are the nurse assigned to care for her.
Personal/Social History:
JoAnn is a retired math teacher who is unable to maintain the level of activity she has been accustomed to because of the
progression of her heart failure the past two years. She has struggled with depression the past two years and has been
more withdrawn since her husband of 52 years died unexpectedly three months ago from a myocardial infarction.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
RELEVANT Data from Social History: Clinical Significance:
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 98.6 F/37.0 C (oral) Provoking/Palliative:
P: 92 (irregular) Quality: Denies Pain
R: 26 (regular) Region/Radiation:
BP: 162/54 MAP: 90 Severity:
O2 sat: 90% (6 liters n/c) Timing:
What VS data is RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
T
©his 2st0ud1y8soKureciethwaRs idsocwhnelora/dwedwbwy .1K00e0i0th08R50N2.9c9o97m2
https://www.coursehero.com/file/128831866/Heart-Failure-Case-Study-pdfpdf/
, SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
T
©his 2st0ud1y8soKureciethwaRs idsocwhnelora/dwedwbwy .1K00e0i0th08R50N2.9c9o97m2
https://www.coursehero.com/file/128831866/Heart-Failure-Case-Study-pdfpdf/
