Nursing Situation Case Study
Nursing Situation COVID-19 and Cardiac Events
Name: Ms. Corna Vee DOB: 03/26/1955 Ht: 158 cm Wt: 78 Kg
Ethnicity: African American Religion: Christian Marital status: Widowed
Allergies: NKA Code status: Full code
Hospital: Lynn Simulation Hospital Unit: Medical-surgical/Telemetry
Admitting diagnosis: SARS-CoV-2 (COVOD-19)
PMH: Diabetes Mellitus (DM), Coronary Artery Disease (CAD), Hypertension (HTN), Sleep Apnea
PSH: Implantable Cardioverter Defibrillator (ICD), 2018
Chief complaint: Severe shortness of breath and fever with chills
HPI: Corna had new onset shortness of breath accompanied by fever and chills. She called 911 and was brought to the ED via ambulance. She was admitted to the ICU for 3 weeks. A nasopharyngeal swab returned positive for COVID-19. Her acute status improved resulting in her transfer to the medical-surgical/telemetry unit 3 days ago.
Labs: CBC: WBC 10.1; RBC 4.7; Hb 9.7; Hct 29; Plat 118
CMP: Na 130; K 3.2; Cl 94; BUN 9; Cr 0.9; CO2 ; Gluc 256; Mg 2.2; Phos 4.5; total protein ; Albumin ; AST ; Total bilirubin ; direct bilirubin .
Orders:
Accu check AC & HS
Notify provider if blood glucose is greater than or equal to 400
Maintain standard, contact and airborne precautions including use of eye protection
1800 Calorie ADA diet
Continuous telemetry monitoring
Medications:
Remdesivir 100 mg in 100 mL NS IVPB infuse over 60 minutes
Amiodarone 200 mg PO daily
Diltiazem 120 mg ER PO 2 times per day
Insulin glargine (U100) 8 units subcut at bedtime
Regular insulin per moderate dose sliding scale
Assessment: Subjective “palpitation”
Objective T 99.62 P 113 R 22 BP 132/90 O2Sat 91% Pain 2/10 [headache]
sliding scale for insulin.png
Rhythm strip.jpg
Please upload your response to the following (use the rubric as a guide).
You are leading the interdisciplinary huddle this evening who will you invite (name other disciplines)? Why?
Select the PPE to wear when entering Corna’s room
What is the order for donning and doffing the PPE?
There is a sudden change on Corna’s ECG rhythm on the continuous ECK monitor (see strip above). What will you record as the name of the rhythm?
Write an SBAR to report to the provider (use chart data as necessary)
Based on your knowledge of holistic nursing, what aspects of care might you want to include that are not necessarily on Corna’s orders. Identify at least 1 call for nursing and describe how to meet the client’s needs in the nursing situation using holistic nursing approaches.