lOMoAR cPSD| 56342273
Pharmacology Reasoning
Bradycardia
Student Copy
Marilyn Fitch, 78 years old
Medication Categories: Concepts/Content:
Antidysrhythmics Assessment
ACE Inhibitors Drug-drug interactions
Beta Blockers Evaluation of desired outcomes
Statins Monitoring for adverse effects
Oral Anticoagulants Emergency treatment of dysrhythmias
Diuretics Client education
Electrolytes Psychosocial support
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
• Management of Care 17-23% X
• Safety and Infection Control 9-15% X
Health Promotion and Maintenance 6-12% X
Psychosocial Integrity 6-12% X
Physiological Integrity
• Basic Care and Comfort 6-12%
, lOMoAR cPSD| 56342273
• Pharmacological and Parenteral Therapies 12-18% X
• Reduction of Risk Potential 9-15% X
• Physiological Adaptation 11-17% X
I. Initial Presentation:
Marilyn Fitch is a 78-year-old Caucasian woman with a history of hypercholesteremia, hypertension, and heart
failure and has NKDA. She was brought in by her daughter after Marilyn complained of feeling dizzy several
times this morning and then almost passed out at home. Marilyn has a six-month history of paroxysmal atrial
fibrillation. Her heart rate has been regular and she has had no episodic dizziness since she had a synchronized
cardioversion one week prior to this visit. Her initial VS in triage were: T: 98.9 F/37.2 C (oral) P: 52 R: 16 BP:
94/52 and O2 sat: 98% room air.
Personal/Social History:
Marilyn is a widow and lives alone in her own home. She denies smoking and admits to drinking one glass of
wine with her dinner.
1. What data from the histories are RELEVANT and must be NOTICED as clinically significant by the
nurse?(NCSBN: Step 1 Recognize cues/NCLEX: Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
Hyperlipidemia can cause plaque build up in arteries puts strain on
Hypertension the heart and arteries causes fluid hyervolemia and
Heart Failure strains the heart a chroic arrythmia of the atria
A-fib causing abn. heartbeat
BP
RELEVANT Data from Social History: Clinical Significance:
Lives independently risk of having a fall or a heart episode with no
immediate help available
Can effect her hypertenison
Up to 7 drinks a week
As the nurse responsible for this patient, you promptly review the medical
history and current home medications in the medical record:
2. What is the RELATIONSHIP of the past medical history and current medications? Why is your patient
receiving these medications? (Which medication treats which condition? Draw lines to connect)
Medical History (PMH): Home Medications:
© 2020 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN
Pharmacology Reasoning
Bradycardia
Student Copy
Marilyn Fitch, 78 years old
Medication Categories: Concepts/Content:
Antidysrhythmics Assessment
ACE Inhibitors Drug-drug interactions
Beta Blockers Evaluation of desired outcomes
Statins Monitoring for adverse effects
Oral Anticoagulants Emergency treatment of dysrhythmias
Diuretics Client education
Electrolytes Psychosocial support
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
• Management of Care 17-23% X
• Safety and Infection Control 9-15% X
Health Promotion and Maintenance 6-12% X
Psychosocial Integrity 6-12% X
Physiological Integrity
• Basic Care and Comfort 6-12%
, lOMoAR cPSD| 56342273
• Pharmacological and Parenteral Therapies 12-18% X
• Reduction of Risk Potential 9-15% X
• Physiological Adaptation 11-17% X
I. Initial Presentation:
Marilyn Fitch is a 78-year-old Caucasian woman with a history of hypercholesteremia, hypertension, and heart
failure and has NKDA. She was brought in by her daughter after Marilyn complained of feeling dizzy several
times this morning and then almost passed out at home. Marilyn has a six-month history of paroxysmal atrial
fibrillation. Her heart rate has been regular and she has had no episodic dizziness since she had a synchronized
cardioversion one week prior to this visit. Her initial VS in triage were: T: 98.9 F/37.2 C (oral) P: 52 R: 16 BP:
94/52 and O2 sat: 98% room air.
Personal/Social History:
Marilyn is a widow and lives alone in her own home. She denies smoking and admits to drinking one glass of
wine with her dinner.
1. What data from the histories are RELEVANT and must be NOTICED as clinically significant by the
nurse?(NCSBN: Step 1 Recognize cues/NCLEX: Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
Hyperlipidemia can cause plaque build up in arteries puts strain on
Hypertension the heart and arteries causes fluid hyervolemia and
Heart Failure strains the heart a chroic arrythmia of the atria
A-fib causing abn. heartbeat
BP
RELEVANT Data from Social History: Clinical Significance:
Lives independently risk of having a fall or a heart episode with no
immediate help available
Can effect her hypertenison
Up to 7 drinks a week
As the nurse responsible for this patient, you promptly review the medical
history and current home medications in the medical record:
2. What is the RELATIONSHIP of the past medical history and current medications? Why is your patient
receiving these medications? (Which medication treats which condition? Draw lines to connect)
Medical History (PMH): Home Medications:
© 2020 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN
