Winningham CS #15.docx - Case Study #15 Name: Sue Vande...

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Case Study #15Name:Sue Vande KampClass:N340 – Medial SurgicalDate:November 27, 2018ScenarioThe time is 1900. You are working in a small, rural hospital. It has been snowing heavily all day,and the medical helicopters at the large regional medical center, 4 hours away by car (in goodweather), have been grounded by the weather until morning. The roads are barely passable. W.R.,a 48-year-old plumber with a 36–pack-year smoking history, is admitted to your floor with adiagnosis of rule out myocardial infarction (R/O MI). He has significant male-pattern obesity(“beer belly,” large waist circumference) and a barrel chest and reports a dietary history of high-fat food. His wife brought him to the emergency depart- ment after he complained of unrelieved“indigestion.” His admission vital signs (VS) were blood pressure (BP) 202/124 mm Hg, pulse(P) 106 beats/min, respirations 18 breaths/min, and oral temperature 98.2 ° F (36.8 ° C). W.R.was put on oxygen (o2) by nasal cannula (NC) titrated to maintain Spo2 over 92% and started on
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