R.D., 87 years old, female, was admitted to the health facility primarily due to onset of “jerky movements” in her upper extremities, occurring only brief and intermittent in the past three months. Further assessment revealed acute dyspnea after a physical activity, and…
As in this case, initial clinical presentations of some patients are often complicated with several individual factors such as age and physical activity. In fact, signs and symptoms as headache and dyspnea can be extremely subjective and may significantly vary with each patient judgment. Furthermore, some conditions do not immediately present to instantly warrant a thorough investigation, only manifesting when much damage has already occurred to be clinically evident. Possible aggravation of a previously known condition also contributes to the complexity of the case. As such, arriving at a logical and rational medical diagnosis may at times be challenged with the inconsistencies of observed and reported manifestations by the patient compared with the results of diagnostic and laboratory procedures performed.
Even so, appropriate education remains to be one of the most important roles of the nurse in meeting this patient’s physical and psychological needs and prepare her for the foreseen battery of tests necessary to confirm or refute a diagnosis. Maintaining physiological integrity through dependent and independent nursing interventions is necessary for a comprehensive patient care. Besides that, it is also imperative to maintain being an advocate so that the patient is not subjected to unnecessary danger during the performance of these tests (Best, 2002).
Although the patient’s manifestations strongly suggest an underlying heart condition, laboratory and diagnostic studies reveal otherwise. Radiographic results indicate dextroscoliosis and degenerative disc disease of the thoracic spine, degenerative bilateral arthritis of acromioclavicular joints, degenerative arthritis of the left glenohumeral joint, a normal heart size, and focal arteriosclerosis of the thoracic aorta. The constellation of these findings along with breathing problems implies a progression of a previously undiagnosed restrictive lung disease or a ...
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