[Verified Answer]: Jocelyn Andrews, 65 years old was…

Jocelyn Andrews, 65 years old was transferred to the medical ward (where you are on placement) two days ago around lunch time from the coronary care unit. She was diagnosed with a non-STEMI (myocardial infarction without ST elevation) and treated with thrombolytic therapy. She had no complications during recovery and has been pain free for the last 24 hours. It is planned that she remains in the medical ward for the next 24 hours and if there are no further problems, she is to be discharged home. You commence an afternoon shift (1330-2100) in the ward where Jocelyn is being cared for and receive this handover: This is Mrs Jocelyn Andrews. She is 65 years old. She is married to Tom, has two married children and three grandchildren. She has a history of mild hypertension but nothing else of concern. She used to be a nurse and is now retired. She was admitted the day before yesterday via coronary care following a STEMI. She had Alteplase (thrombolytic therapy) in CCU with no dysrhythmias. Mrs Andrews has been pain-free since arrival here but is ordered GTN patches if necessary. She has been afebrile since arrival. Her BP has been 130/70 – 135/85 mm Hg, her heart rate 80-100/ min. and regular. Her respirations have been 18-24 and regular. Her colour has been fine since she arrived. If she stays stable, Mrs Andrews is to be discharged tomorrow PM. I have started her discharge planning. Can someone chase up the registrar to ask him to complete his section, please? While you are conducting your ‘check’ of the patients you are allocated for your shift, you are called by Mrs Andrews who tells you she has “…the same sort of pain she had before”. Her skin is ashen but still dry. Demonstrate the hypothetical clinical reasoning process/es you would follow to address Mrs Andrews’ needs Provide an word discussion of the rationales for the reasoning