Kanchi Patel
Mrs. Prather is a 54 year old female who arrived at the emergency department,
complaining of nausea and dizziness that came on suddenly while working out at the
gym this morning.
Identifying Information:
54yr old female
History of Present Illness:
54 yr old female presented to the ED c/o of severe nausea & dizziness while running
on a treadmill this morning. She states she had eaten breakfast this morning before
working out. She states “I have never been this nauseous in my life and I felt like I
was going to faint.”
Past Medical History:
Hypertension
Diabetes
Past Surgical History:
Surgical resection-c-section with first child
Current Medications:
• Lisinopril-hypertension
• Insulin-NPH
• Insulin-Regular
Allergies:
No allergies
Family History:
Mother-alive-arthritis
Father-deceased-CAD, hypertension, myocardial infarction, heart failure
Social History:
Occupation: High school teacher
Tobacco Use: never
Illicit Drug Use: never
Alcohol Use: occasional use
Review of Systems: (what patient tells you)
Skin: no changes in hair, no changes with nails
Mental Health: no current feelings of sadness, no sleep disturbances, no suicidal
ideations
Neurological: + light-headedness, + dizziness, no paresthesia to feet & hands, no
balance problems
Head and neck: no headache, no neck pain, no stiffness
Eyes: no vision changes, no eye discharge, no redness, no edema
Ears: no change in hearing, no tinnitus, no discharge
Nose: no change in sense of smell, no nasal discharge or congestion
Throat and mouth: + toothache, no pain, no trouble swallowing
This study source was downloaded by 100000838234991 from CourseHero.com on 07-21-2022 14:14:14 GMT -05:00
https://www.coursehero.com/file/44761879/NR283-July-Case-Study-2-Cardiac-Disorderspdf/
, Lymphatic: no swelling, no tenderness
Cardiovascular: no chest pain, no leg swelling, no palpitations, no sob, no orthopnea
Blood Vessels: no leg cramps, no leg swelling
Pulmonary: no difficulty breathing, no cough
Gastrointestinal: + nausea, no vomiting, no abdominal pain
Genitourinary: no urinary burning, no urinary difficulty, no nocturia, no flank pain
Musculoskeletal: no muscle cramps in legs, no present back pain, no joint stiffness
Physical Exam/Findings: (Your findings)
General: thin female, looks uncomfortable
Weight-115lbs
Height-5’4
Vital Signs: T-98.1, Pulse-88, RR-17, BP-118/68, O2 Sat-96% on room air, Pain-4/10
Skin: + diaphoresis, skin color normal, no rashes, skin warm, skin turgor WNL, hair-
unremarkable, nails-unremarkable
Neurological: alert, oriented to person, place, & time, + anxiousness, speech normal,
facial movements symmetric, pupils equal and reactive, gait not assessed
Head and neck: symmetrical, full rom of neck, no neck swelling
Eyes: conjunctiva clear and free of erythema or exudate, pupils round, regular, equal
and reactive, sclera is white
Throat/mouth: pink & moist mucous membranes
Cardiovascular: Heart sounds WNL, Pulse regular, no edema, no JVD
Pulmonary: respiratory rate normal, normal respiratory effort, lungs clear, equal
expansion
Abdomen: no distention, bowel sounds active x4, no guarding
1) Based on the assessment, what disorder do you think this is patient
experiencing?
- patient might be expecting classic/exertional angina pectoris.
2) Describe the pathophysiology of the disorder you have chosen.
- Increased in myocardial oxygen demand due to imbalance between oxygen
supply and demand causes myocardial ischemia and insufficient oxygen supply to
the muscle. Some of the manifestation can be physical/emotional stress.
3) What diagnostic tests (blood tests or machine) would be ordered for this
patient?
This study source was downloaded by 100000838234991 from CourseHero.com on 07-21-2022 14:14:14 GMT -05:00
https://www.coursehero.com/file/44761879/NR283-July-Case-Study-2-Cardiac-Disorderspdf/
Mrs. Prather is a 54 year old female who arrived at the emergency department,
complaining of nausea and dizziness that came on suddenly while working out at the
gym this morning.
Identifying Information:
54yr old female
History of Present Illness:
54 yr old female presented to the ED c/o of severe nausea & dizziness while running
on a treadmill this morning. She states she had eaten breakfast this morning before
working out. She states “I have never been this nauseous in my life and I felt like I
was going to faint.”
Past Medical History:
Hypertension
Diabetes
Past Surgical History:
Surgical resection-c-section with first child
Current Medications:
• Lisinopril-hypertension
• Insulin-NPH
• Insulin-Regular
Allergies:
No allergies
Family History:
Mother-alive-arthritis
Father-deceased-CAD, hypertension, myocardial infarction, heart failure
Social History:
Occupation: High school teacher
Tobacco Use: never
Illicit Drug Use: never
Alcohol Use: occasional use
Review of Systems: (what patient tells you)
Skin: no changes in hair, no changes with nails
Mental Health: no current feelings of sadness, no sleep disturbances, no suicidal
ideations
Neurological: + light-headedness, + dizziness, no paresthesia to feet & hands, no
balance problems
Head and neck: no headache, no neck pain, no stiffness
Eyes: no vision changes, no eye discharge, no redness, no edema
Ears: no change in hearing, no tinnitus, no discharge
Nose: no change in sense of smell, no nasal discharge or congestion
Throat and mouth: + toothache, no pain, no trouble swallowing
This study source was downloaded by 100000838234991 from CourseHero.com on 07-21-2022 14:14:14 GMT -05:00
https://www.coursehero.com/file/44761879/NR283-July-Case-Study-2-Cardiac-Disorderspdf/
, Lymphatic: no swelling, no tenderness
Cardiovascular: no chest pain, no leg swelling, no palpitations, no sob, no orthopnea
Blood Vessels: no leg cramps, no leg swelling
Pulmonary: no difficulty breathing, no cough
Gastrointestinal: + nausea, no vomiting, no abdominal pain
Genitourinary: no urinary burning, no urinary difficulty, no nocturia, no flank pain
Musculoskeletal: no muscle cramps in legs, no present back pain, no joint stiffness
Physical Exam/Findings: (Your findings)
General: thin female, looks uncomfortable
Weight-115lbs
Height-5’4
Vital Signs: T-98.1, Pulse-88, RR-17, BP-118/68, O2 Sat-96% on room air, Pain-4/10
Skin: + diaphoresis, skin color normal, no rashes, skin warm, skin turgor WNL, hair-
unremarkable, nails-unremarkable
Neurological: alert, oriented to person, place, & time, + anxiousness, speech normal,
facial movements symmetric, pupils equal and reactive, gait not assessed
Head and neck: symmetrical, full rom of neck, no neck swelling
Eyes: conjunctiva clear and free of erythema or exudate, pupils round, regular, equal
and reactive, sclera is white
Throat/mouth: pink & moist mucous membranes
Cardiovascular: Heart sounds WNL, Pulse regular, no edema, no JVD
Pulmonary: respiratory rate normal, normal respiratory effort, lungs clear, equal
expansion
Abdomen: no distention, bowel sounds active x4, no guarding
1) Based on the assessment, what disorder do you think this is patient
experiencing?
- patient might be expecting classic/exertional angina pectoris.
2) Describe the pathophysiology of the disorder you have chosen.
- Increased in myocardial oxygen demand due to imbalance between oxygen
supply and demand causes myocardial ischemia and insufficient oxygen supply to
the muscle. Some of the manifestation can be physical/emotional stress.
3) What diagnostic tests (blood tests or machine) would be ordered for this
patient?
This study source was downloaded by 100000838234991 from CourseHero.com on 07-21-2022 14:14:14 GMT -05:00
https://www.coursehero.com/file/44761879/NR283-July-Case-Study-2-Cardiac-Disorderspdf/
