Reference no: EM133039595

Anxiety or Spiritual Distress - Patient Dilemma

Scenario

History of Present Problem:

John James is a 77-year-old man who had coronary artery bypass graft (CABG) x 4 vessels three days ago for multi-vessel coronary artery disease. He lost over 1000 mL of blood shortly after surgery due to a bleeding graft site and almost died as a result. He is currently off all vaso-active drips, his arterial line has been discontinued and he is clinically stable. John is scheduled to transfer to the cardiac step-down unit later today.

Personal/Social History:

John's wife died six months ago after fifty years of marriage. He lives alone in his own apartment. He has one son who lives in the area and checks in at least once a week to see how he is doing. He is a Vietnam War veteran who has not been active in his church since he returned from the war over forty years ago.

What data from the histories is important & RELEVANT; therefore it has clinical significance to the nurse?

What data from the current concern is important & RELEVANT; therefore it has clinical significance to the nurse?

Resolving the Dilemma

1. Identifying data that is RELEVANT, what is the essence of this current dilemma?

2. What additional information is needed by the nurse that would help clarify the current dilemma?

3. What additional members of the healthcare team could be used in this situation? Why?

4. What is the nursing priority?

5. What nursing interventions and/or principles can the nurse use to successfully resolve this clinical dilemma? b. What is the expected response of the patient that indicate the nursing interventions were effective?

7. What response by the patient would indicate that a change in the plan of care and nursing interventions are needed?

8. What is the patient likely experiencing/feeling right now in this situation?

9. What can I do to engage myself with this patient's experience, and show that he matters to me as a person?

10. What was learned from this case study that you will incorporate into your practice?

Attachment:- Case study Worksheet.rar