Presentation: Realistic Clinical Case Study

Develop a presentation on a realistic clinical case on a topic that is of interest to you. Develop your presentation based on a clinical case that was seen during your experience or a topic that is of interest to you.
Content Requirements
You will create a PowerPoint presentation with a realistic case study and include appropriate and pertinent clinical information that will be covering the following:

  1. Subjective data: Demographics; Chief Complaint; History of the Present Illness (HPI) that includes the presenting problem and the 8 dimensions of the problem; Medications; Allergies; Past medical history; Family history; Past surgical history; Social history; Review of Systems (ROS)
  2. Objective data: Vital signs; Physical exam, Labs (reviewed from the patient’s medical records, if no lab/diagnostic tests were done recently to review, you must indicate that to receive credit).
  3. Assessment: Differential diagnosis; Primary Diagnosis
  4. Plan: Laboratory and diagnostic tests; Pharmacologic treatment plan; non-pharmacologic treatment plan; Anticipatory guidance (primary prevention strategies); Follow up plan.
  5. Other: Incorporation of current clinical guidelines; Integration of research articles; Role of the Nurse practitioner

Submission Instructions:
• The presentation is original work and logically organized, formatted, and cited in the current APA style, including citation of references.
• The presentation should consist of 10-15 slides and less than 5 minutes in length.
• Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).

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Sample Answer

 

 

 

Case Study: Atypical Presentation of Acute Coronary Syndrome in a Female Patient

Slide 1: Title Slide

  • Title: Atypical Presentation of Acute Coronary Syndrome in a Female Patient
  • Presenter Name: [Your Name]
  • Date: [Date of Presentation]

Slide 2: Subjective Data

  • Demographics:
    • Name: Jane Doe
    • Age: 58 years old
    • Sex: Female
    • Race/Ethnicity: Caucasian
    • Occupation: Retired school teacher

 

Full Answer Section

 

 

 

 

    • Date of Birth: [Date]
    • Date of Presentation: [Date]
  • Chief Complaint: “Chest discomfort and fatigue for the past 2 weeks.”
  • History of Present Illness:
    • Location: Intermittent chest discomfort described as “pressure” or “tightness” located in the center of the chest.
    • Quality: Dull, achy, non-radiating.
    • Onset: Gradual onset over the past 2 weeks.
    • Duration: Episodes last for 15-30 minutes.
    • Severity: 3/10 on a 0-10 pain scale.
    • Aggravating Factors: Exertion, emotional stress.
    • Relieving Factors: Rest.
    • Associated Symptoms: Fatigue, intermittent shortness of breath, occasional dizziness.
  • Medications:
    • Aspirin 81 mg PO daily
    • Atorvastatin 40 mg PO daily
    • Lisinopril 10 mg PO daily
    • Levothyroxine 100 mcg PO daily
  • Allergies:
    • Penicillin (rash)
  • Past Medical History:
    • Hypertension
    • Hypothyroidism
    • Hyperlipidemia
    • Osteoarthritis
  • Past Surgical History:
    • Tonsillectomy and adenoidectomy as a child
    • Hysterectomy 5 years ago
  • Family History:
    • Mother: History of myocardial infarction at age 65
    • Father: History of stroke at age 72
  • Social History:
    • Non-smoker
    • Occasional alcohol use (1-2 glasses of wine per week)
    • Sedentary lifestyle
    • Retired
    • Lives alone
  • Review of Systems:
    • General: Fatigue, occasional dizziness.
    • Cardiovascular: Chest discomfort as described above, palpitations.
    • Respiratory: Shortness of breath on exertion.
    • Gastrointestinal: Occasional constipation.
    • Neurological: No headache, numbness, or weakness.
    • Musculoskeletal: Occasional joint pain.
    • Psychosocial: Mild anxiety, occasional feelings of loneliness.

Slide 3: Objective Data

  • Vital Signs:

    • Temperature: 98.6°F (37°C)
    • Pulse: 82 beats/min, regular
    • Blood Pressure: 138/88 mmHg
    • Respirations: 18 breaths/min
    • Oxygen Saturation: 98% on room air
  • Physical Examination:

    • General: Appears age-appropriate, alert, and oriented.
    • Cardiovascular: Regular rate and rhythm, no murmurs, rubs, or gallops.
    • Respiratory: Clear to auscultation bilaterally.
    • Abdomen: Soft, non-tender, non-distended.
    • Neurological: Cranial nerves intact, no focal neurological deficits.
    • Extremities: No edema.
  • Laboratory Data:

    • Complete Blood Count (CBC): Within normal limits.
    • Basic Metabolic Panel (BMP): Within normal limits.
    • Lipid Panel: Total cholesterol: 210 mg/dL, LDL-cholesterol: 140 mg/dL, HDL-cholesterol: 45 mg/dL, Triglycerides: 150 mg/dL.
    • Troponin I: Pending
    • ECG: Sinus rhythm, ST-T wave changes suggestive of ischemia.

Slide 4: Assessment

  • Differential Diagnosis:

    • Acute Coronary Syndrome (ACS): Unstable angina, non-ST-elevation myocardial infarction (NSTEMI)
    • Anxiety
    • Gastroesophageal Reflux Disease (GERD)
    • Costochondritis
  • Primary Diagnosis:

    • Suspected Acute Coronary Syndrome (NSTEMI)

Slide 5: Plan

  • Laboratory and Diagnostic Tests:

    • Troponin I: Serial measurements (at presentation and 3-6 hours later).
    • Electrocardiogram (ECG): 12-lead ECG.
    • Cardiac enzymes: Creatine kinase (CK) and CK-MB.
    • Complete Blood Count (CBC) with differential.
    • Comprehensive Metabolic Panel (CMP).
    • Cardiac biomarkers: B-type natriuretic peptide (BNP).
  • Pharmacologic Treatment:

    • Aspirin 325 mg PO chewable immediately.
    • Clopidogrel 300 mg PO loading dose, then 75 mg PO daily.
    • Low-molecular-weight heparin (enoxaparin) subcutaneous injection.
    • Nitroglycerin sublingual as needed for chest pain.
  • Non-pharmacologic Treatment:

    • Bed rest with continuous cardiac monitoring.
    • Oxygen therapy as needed to maintain oxygen saturation above 94%.
  • Anticipatory Guidance:

    • Instruct the patient to contact emergency services immediately if chest pain worsens or if she experiences shortness of breath, dizziness, or fainting.
    • Emphasize the importance of adhering to the prescribed medications.
    • Discuss lifestyle modifications, including smoking cessation, dietary changes (low-fat, low-sodium diet), regular exercise, and stress management techniques.

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