NUR2204 Acute Care Across The Lifespan B: Clinical Reasoning Case Study Assessment 3 Answer

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Assessment 3: Clinical Reasoning Assignment Case Study Task Overview

NUR2204 Acute Care Across the Lifespan B
Assessment name
Clinical Reasoning Case Study
Brief task description
Critically analyse the case study of a patient presenting with chest pain, to plan nursing assessments and interventions.
Word count of 1200 words ± 10% (including in-text referencing and excluding reference list)
Weighting and marks
Marks out of 50 (Weighted at 25%)
Course Objectives

Task Information

Task detail
Your responses will be assessed on the provision of relevant clinical content, evidence of critical thinking, adequate standard of academic writing, referencing formatting and quality of sources used.
Marks for academic writing and referencing will be awarded as per marking criteria (attached). Each question on the case study has been allocated with individual marks— please refer to questions in case study
Writing style
Responses to this assessment task must:
  1. Use the NUR2204 Clinical Reasoning Assignment Case Study
  2. Use the template provided on the NUR2204 Study Desk underthe Assessment 3 tab to answer the questions. Do not include the assessment questions as part of your response.
  3. Be written in formal academic sentence structure (complete paragraphs that are grammatically correct, with in-text referencing and no dot points). Due to the small word limit, an introduction and conclusion paragraph is not required. The use of headings is allowed but will contribute to your word count. Every question must be written in third person.
  4. Use Times New Roman size 12 font and 1.5 line spacing
  5. Use USQ APA 7th referencing for citing academic literature
  6. Include a separate page for references. The reference list is not included in the word count.
  7. Include in-text citations in the body of your work. Each new point or piece of evidence must be attributed (via in-text citation) to the source. In-text citations are included in the word count.
Referencing requirements
A minimum of ten (10) academic sources should be used. Your textbooks may be used as references BUT you also need to use relevant, contemporary, peer reviewed journal articles no older than seven (7) years (published from 2014 onward) as supporting evidence.
Blogs such as Medical News Today, sponsored websites such as Better Health Channel, Premier Health, Harvard Medical Health, Nurse Labs, Aus Med, WebMD, healthdirect, rnpedia and lecture/ course materials are NOT acceptable sources. You will be graded on the quality of the sources.
In addition, you could use:
  1. Textbooks (Maximum four [4] text books, and no older than five [5] years old)
  2. Guidelines for health professionals that are peer reviewed
  3. Authoritative websites and government websites such as NHMRC, AIHW, ABS
  4. Organisation resources intended for health professionals
References within 7 years are acceptable for this assignment (other than text books, see above).
Any responses (answers) that are not referenced to academic sources will receive a mark of zero (0).

Submission Information

What you need to submit:
You must submit ONE document. Please note:
  1. Use the template provided on the NUR2204 Study Desk under the Assessment 3 tab: Clinical Reasoning Assignment to write your responses (answers) for each question
  2. Questions do not need to be rewritten/ included but clearly label your responses (answers) with the question number
  3. Include a reference list starting on a new page at the end of your responses (answers)


DOB: 28 Jun 1961 | GENDER: FEMALE

Mrs Donna Hovey is a 60-year-old female who was admitted to the ward two (2) days ago for pneumonia. She is now complaining of mild pressure in her chest (rated 4/10) that started 10 minutes ago while she was lying on the bed. Mrs Hovey states she also has a slight ache in the underside of her upper left arm.
She is diaphoretic and feeling a little nauseated. Mrs Hovey has developed slight shortness of breath. Her peripheries are a little cool to touch
Mrs Hovey has a history of Ischaemic Heart Disease (IHD), hypertension and beginning Peripheral Vascular Disease (PVD). She had Coronary Artery Bypass Graft (CABG) surgery six (6) years ago with Saphenous Vein grafts to her Left Anterior Descending (LAD) coronary artery and diagonal branch. Mrs Hovey also had a Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting to her Right Coronary Artery (RCA) and Posterior Descending Artery (PDA).
Her observations at 0700 hours were as follows: Temperature: 37.3ᵒC
Pulse: 74bpm, regular, volume strong Respiratory rate: 14/min, regular, normal depth BP: 165/90mmHg (normal for her)
SpO2: 98% on room air
Her observations NOW:
Temperature: 37.2ᵒC
Pulse: 116 bpm, regular, volume not as strong as previously Respiratory rate: 26bpm, regular, a little shallower
BP: 105/70 mmHg SpO2: 92% on room air
You have informed the Team Leader of Mrs Hovey’s complaints and vital signs and the Team Leader will be contacting the treating team. You continue to stay with Mrs Hovey while waiting for the treating team to arrive.

Caring for a patient with chest pain

Setting the scene

Donna Hovey’s holistic assessment by the Doctor indicates:Donna Hovey’s


  • Weight 95 kg
  • Height 158 cm
  • BP 105/65 mmHg
  • HR 116 bpm
  • Temp 37.2⁰C
  • SaO2: 92% (Room Air)
  • 12 lead ECG: No new changes (previous ECG showed ST depression in leads V3-V6, III and aVF)

Past medical history:

  • Ischaemic Heart Disease (IHD)
  • Hypertension
  • Peripheral Vascular Disease (PVD)\

Past surgical history:

  • Coronary Artery Bypass Graft (CABG) six (6) years ago
  • Percutaneous Transluminal Coronary Angioplasty (PTCA) two (2) years ago


  • Telmisartan 80mg OD
  • Rosuvastatin 40mg ON
  • Aspirin 100mg OD
  • Spironolactone 25mg OD
  • Clopidogrel 75mg OD
  • Venlafaxine hydrochloride (Efexor-XR) 150mg OD
  • Glyceryl Trinitrate 400mcg (1 spray) when required


Mrs Hovey says she no longer smokes. She used to smoke 2 packs per day, starting at the age of 19 and ceasing at 49 years old when she was first diagnosed with Coronary Artery Disease (CAD). Mrs Hovey lives alone in a rented flat and has recently retired on a superannuation pension as her only source of income. Her only son lives in Melbourne and due to the pandemic and border closures, has not seen him for nearly a year which is making her depressed. Mrs Hovey is also worried about going home as her chest pain has occurred several times recently when she was doing the housework. Mrs Hovey states that she hates asking anyone to help.

Your Task:

Use the Clinical Reasoning Cycle on the following pages to review the nursing priorities in relation to the care of Mrs Donna Hovey.Clinical Reasoning Cycle

Gain an initial impression of your patient
Question 1:
Mrs Hovey’s BMI puts her at the ‘Obese’ category. Discuss the impact of obesity on the cardiovascular diseases in relation to Mrs Hovey’s presentation. Ensure ALL your statements are supported with&am Show More

Answer :

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