Case Studies, Chapter 25, Vital Signs
1. You are a nurse caring for a 58-year-old ironworker who has been admitted to your unit with acute hypertension. He became extremely symptomatic at work and was brought to your emergency department (ED) via ambulance. After receiving a report from the ED nurse, he is brought to your unit asymptomatic (other than his BP of 178/106) and seems in good spirits. After completing his admission paperwork, he settles in and awaits his health care provider. Four hours later, you answer his call light and he reports headache (rated 6 on a 0- to-10 scale) and dizziness.
a. Outline the pertinent information within this case study.
Pertinent patient information includes: Patient’s age. Patient’s gender. Patient’s occupation (e.g., manual laborer). Patient’s symptoms: How long he’s had them, characteristics (intermittent, recurring, increasing in severity, and the like). Patient’s objective BP measurement.
b. How often would you expect to measure the patient’s vital signs based on his history?
Given the patient’s history, vital sign measurement would occur at least every 4 hours but would be dictated by physician order or unit policy.
c. What would be your first intervention upon his reporting increased symptoms? Include rationale.
As his nurse, your first intervention performed following reported increased symptoms would be to manually measure his blood pressure to obtain the most accurate measurement.
d. What is the patient’s pulse pressure?
The patient’s pulse pressure is 72 (systolic pressure * diastolic pressure = pulse pressure).
e. Describe risk factors that could be contributing to your patient’s hypertension.