Clinical Scenario Mr. David Robert Jones is a 58-year-old male living in rural South Australia. He is the primary carer for his wife Angela who has…

Question Answered step-by-step Clinical ScenarioMr. David Robert Jones is a 58-year-old male living in rural South Australia. He is the primary carer for his wife Angela who has recently been diagnosed with early onset Dementia.Mr. Jones has been transferred to the Sisters of Mercy Memorial Hospital (SMMH) Adelaide, South Australia for investigation of chest pain and it is planned to undergo a coronary angiogram with iodinated radiocontrast medium. Mr. Jones has been diagnosed with a long history of Ischaemic Heart Disease, otherwise known as Coronary Heart Disease (CHD). Past Medical HistoryType 2 diabetes mellitusHypercholesterolaemiaChronic Kidney Disease stage 3b (CKD)HypertensionCurrent smoker 25 cigarettes a dayObesityETOH 50grams dailyMedicationsAspirin (300mg daily)Losartan (50mg daily)Atenolol (100mg bd)Atorvastatin (80mg daily)Hydrochlorothiazide (25mg daily)GTN spray as neededMr. Jones states that he sometimes has difficulty remembering when to take his medication. He commented that he does not like taking his fluid tablets before he goes out because it makes him go to the toilet too often. Upon admission, Mr. Jones is alert and orientated but appears slightly anxious. During his admission assessment, his vital signs seem unremarkable however, he has noted pitting oedema in both legs with an associated diminished pedal pulse. He states that he gets breathless on exertion and has used his GTN spray on average about 4 times a day. He states that he is worried about his wife and who will care for her while he is in hospital. Mr. Jones has been scheduled for a coronary angiogram the following morning. Nursing notes 48 hours following the coronary angiogram which showed worsening coronary artery disease and poor left ventricular function, Mr. Jones’ fluid balance chart indicates that his previous 24-hour urine output has dropped from 1200 mL to 450 mL. Urgent blood tests for kidney function demonstrated a rise in creatinine and a fall in eGFR and Mr. Jones is diagnosed with worsening CKD induced by the contrast used for the coronary angiogram.​Upon commencement of your shift, Mr. Jones’ vital signs are as follows: Pulse 100bpm, BP 170/90, RR 22, SaO2 94% on room air and temperature 36.5 oC.​His fluid balance chart demonstrates a positive balance of over one Litre in the past 24 hours.​It is noted that Mr. Jones has a haematoma on his right wrist from the previous angiogram and he is now complaining of chest pain which started ten minutes ago. Mr. Jones is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) the following day.Describe the nursing problem: Increased risk of peripheral vascular disease in a patient suffering from coronary heart disease, it’s nursing assessments, nursing interventions and medication management by the RN. Health Science Science Nursing NURS 2023 Share QuestionEmailCopy link Comments (0)