Case Study NextGen UNFOLDING Reasoning, Atrial
FibrillationHeart Failure (24), Bill Hill, 71 years old,
(Latest 2023) Correct Study Guide, Download to Score A
Owner
[COMPANY NAME] [Company address]
, lOMoARcPSD|5967629
lOMoARcPSD|596762
easoning
Atrial Fibrillation/Heart
Failure (2/2)
Answer Suggested Answer
KEY-(2- Guidelines
2)AF-HF
Next Gen-
Unfolding
Reasonin
g
N
e
x
t Bill Hill, 71 years old
G Primary Concept
Perfusion
e Gas Exchange
n Interrelated Concepts (In order of emphasis)
Clinical judgment
Patient education
Communication
U Collaboration
N NCLEX Client Need Categories Covered in
Case Study
NCSBN Clinical
Judgment Model
F Safe and Effective Care Step 1: Recognize Cues
Environment
O Management of Care Step 2: Analyze Cues
L Safety and Infection Control
Health Promotion and Maintenance
Step 3: Prioritize Hypotheses
Step 4: Generate Solutions
D Psychosocial Integrity
Physiological Integrity
Step 5: Take Action
Step 6: Evaluate Outcomes
I Basic Care and Comfort
N Pharmacological and
Parenteral Therapies
G Reduction of Risk Potential
Physiological Adaptation
R
, lOMoARcPSD|5967629
Copyright © 2020
Keith Rischer, d/b/a Part I: Initial Nursing Assessment
KeithRN. All Rights
reserved.
Present Problem:
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 walking back to bed after getting up to the bathroom. His wife who is
a retired nurse noted that he was much more pale, took his vital signs, which were BP: 96/62, HR: 140 irreg, RR: 24. Bill
admits to losing 15 lb (6.8 kg) over the last 2-3 months.
Personal/Social History:
Mr. Hill is retired and lives at home with his wife in a rural area. His two adult children live out of state. He has been an
active, healthy male who enjoys gardening, hunting, and splits wood to heat his home in the winter. Since he has been
dealing with changes in his health he has not been able to participate in these activities as much. In the past, he has been
employed as a minister who has a strong Christian faith. He denies smoking, alcohol use, and illicit drug us
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(NCSBN: Step 1 Recognize cues/NCLEX Reduction of Risk Potential)
RELEVANT Data from Present Clinical Significance:
Problem:
FibrillationHeart Failure (24), Bill Hill, 71 years old,
(Latest 2023) Correct Study Guide, Download to Score A
Owner
[COMPANY NAME] [Company address]
, lOMoARcPSD|5967629
lOMoARcPSD|596762
easoning
Atrial Fibrillation/Heart
Failure (2/2)
Answer Suggested Answer
KEY-(2- Guidelines
2)AF-HF
Next Gen-
Unfolding
Reasonin
g
N
e
x
t Bill Hill, 71 years old
G Primary Concept
Perfusion
e Gas Exchange
n Interrelated Concepts (In order of emphasis)
Clinical judgment
Patient education
Communication
U Collaboration
N NCLEX Client Need Categories Covered in
Case Study
NCSBN Clinical
Judgment Model
F Safe and Effective Care Step 1: Recognize Cues
Environment
O Management of Care Step 2: Analyze Cues
L Safety and Infection Control
Health Promotion and Maintenance
Step 3: Prioritize Hypotheses
Step 4: Generate Solutions
D Psychosocial Integrity
Physiological Integrity
Step 5: Take Action
Step 6: Evaluate Outcomes
I Basic Care and Comfort
N Pharmacological and
Parenteral Therapies
G Reduction of Risk Potential
Physiological Adaptation
R
, lOMoARcPSD|5967629
Copyright © 2020
Keith Rischer, d/b/a Part I: Initial Nursing Assessment
KeithRN. All Rights
reserved.
Present Problem:
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 walking back to bed after getting up to the bathroom. His wife who is
a retired nurse noted that he was much more pale, took his vital signs, which were BP: 96/62, HR: 140 irreg, RR: 24. Bill
admits to losing 15 lb (6.8 kg) over the last 2-3 months.
Personal/Social History:
Mr. Hill is retired and lives at home with his wife in a rural area. His two adult children live out of state. He has been an
active, healthy male who enjoys gardening, hunting, and splits wood to heat his home in the winter. Since he has been
dealing with changes in his health he has not been able to participate in these activities as much. In the past, he has been
employed as a minister who has a strong Christian faith. He denies smoking, alcohol use, and illicit drug us
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(NCSBN: Step 1 Recognize cues/NCLEX Reduction of Risk Potential)
RELEVANT Data from Present Clinical Significance:
Problem:
