NURS 428 Adult Health III Clinical Case Study with Teaching Plan Presentation & Video
Demonstration Assignment Outline
Significant Diagnosis #1
Pathophysiol Anemia is a deficiency in the
ogy number of erythrocytes (red blood
cells [RBCs]), the quantity or
quality of hemoglobin, and/or
volume of packed RBCs
(hematocrit). It is a common
condition with many diverse
causes, such as blood loss,
impaired production of RBCs, or
increased destruction of RBCs.
Because RBCs transport O2,
RBC disorders can lead to tissue
hypoxia (Kwong et al., 2023.).
Anemia is when your body doesn’t
have enough red blood cells and it
makes it hard for your body to get
enough oxygen, regardless of how
much or how hard you breathe.
Significant Diagnosis # 2
Angina, or chest pain, is the
clinical manifestation of myocardial
ischemia. It is caused by either an
increased demand for O2 or a
decreased supply of O2. The most
common reason for angina to
develop is significant narrowing of
one or more coronary arteries by
atherosclerosis. This leads to
insufficient blood flow to the heart
muscle. (Kwong et al., 2023.) This
angina is secondary to the hypoxia
caused by anemia.
Angina, otherwise known as chest
pain, is caused by either a lack of
oxygen or an increased demand of
oxygen by the body. A common
reason would be atherosclerosis,
which is the buildup of fats and
cholesterol in the blood vessels,
which narrows them and makes It
harder for the blood to get to where it
needs to.
Pharmacolog List here: medications associated Donepezil Tablet - (Aricept) 10mg
Once daily orally in the morning
y with significant diagnosis #1 Decreased symptoms of Alzheimer’s disease
(5 total) including:
Contraindications:
× Name (generic and hypersensitivity to donepezil or piperidine
brand) derivatives
× Route
Side Effects or Adverse Reactions:
× Dose nausea, vomiting, hypo/hypertension, syncope,
× Frequency seizures

× Therapeutic effect Try and make sure to get in a routine of taking

× Side effects,
contraindications, and
education pertinent to the
patient.
Education is provided at the level of
the patient’s understanding.
this medication at the same time every morning
so you don’t accidentally forget to, let your
doctor know if you have any blood in your poop
or if you have major pain or discomfort in your
belly.
-------------------------------------------
Isosorbide Mononitrate Extended Release
Tablet - (Imdur) 60mg
twice daily orally
relief and prevention of angina pectoris

Pantoprazole Delayed Release Tablet -
(Protonix) 40mg
Once daily at 0800
absence of epigastric fullness, pain, swelling
Contraindications:
hypersensitivity to pantoprazole or
benzimidazole
Side Effects or Adverse Reactions:
abdominal pain, fatigue, headache, diarrhea
Nursing Interventions:
adult: 40 mg/day
1) assess stools for blood 2) assess
abdomen for pain, swelling 3) monitor for
weakness, dizziness, signs of hypovolemia
Contraindications:
hypersensitivity to isosorbide or nitrates, severe
anemia closed-angle glaucoma
Side Effects or Adverse Reactions:
tachycardia, flushing, headache, weakness,
nausea, vomiting, syncope/orthostatic
hypotension
Keep a journal of whenever you have that
angina/chest pain. Keep track of when, how
long, and what you were doing when it started,
this will help to determine future ways to help
control your pain. Be careful standing up quickly
from lying down and use any assistive mobility
devices like canes or walkers if you need to.

Medication:
Sertraline Tablet - (Zoloft)
Classification:
Antidepressant: serotonin/norepinephrine
reuptake inhibitor
Route:
Oral
Dose:
50mg
Frequency:
once daily
Date Ordered:
01/01/1900
Comments and Additional Medication Info:
 Therapeutic Effect:
-
Relief of depression, obsessive-compulsive
disorder (OCD), posttraumatic stress
disorder (PTSD), panic disorder
Action:
Contraindications:
Inhibits serotonin reuptake in CNS, thus
increasing action of serotonin; does not
affect dopamine, norepinephrine
hypersensitivity to sertraline
hypersensitivity to SSRIs
Side Effects or Adverse Reactions:
Life Threatening Considerations:
serotonin syndrome, anxiety, neuroleptic
malignant syndrome-like reactions, diarrhea,
nausea
suicidal ideation, chest pain, and
palpitations
Recommended Dose Ranges:
Nursing Interventions:
adult: ​PO 25-50 mg/day; may increase to a
maximum of 200 mg/day, do not change
dose at intervals of <1 week
1) assess for hypertension 2) monitor for
urinary retention 3) monitor for delirium,
coma, and hyperthermia

Medication:
Sucralfate Tablet - (Carafate)
Classification:
ulcer
Route:
Oral
Dose:
1gm
Frequency:
1 tablet before meals and at bedtime
Date Ordered:
10/15/2023
Comments and Additional Medication Info:
Therapeutic Effect:
Class - Antiulcer
healing and prevention of ulcers
Action:
Contraindications:
forms a complex that adheres to ulcer site,
adsorbs pepsin
hypersensitivity to sucralfate or other
anti-ulcer medications hypersensitivity to
sucrose
Side Effects or Adverse Reactions:
Life Threatening Considerations:
constipation, nausea, vomiting,
hyperglycemia
aluminum intoxication due to mild renal
insufficiency
 Recommended Dose Ranges:
Nursing Interventions:
adult: 1gm 1 hour before meals and at
bedtime
1) monitor accurate intake and output 2)
monitor for pt reported pain, burning, or
extreme fullness in stomach or tenderness
upon palpation as this may be signs of an
ulcer 3) assess for blood in stools 4)
instruct to take on an empty stomach

Health You will want to increase your daily Signs/symptoms of persistent angina
Wellness & iron, whether that is from food or at rest, call HCP
Promotion from supplements. Healthy lifestyle/exercise
(6 total) You should try and alternate your rest Healthy diet
and activity periods
Arrange physical activities to avoid Support the information with
competition for oxygen supply (avoid evidence-based practice from
activity after meals) scholarly sources less than 10 years
old.

Support the information with

evidence-based practice from
scholarly sources less than 10 years
old.

References