GCNNK2 Nursing Knowledge 2


A critical discussion paper related to the nursing management of Mr Ferguson’s

case study below:

The critical discussion paper should address the following issues:

  1. Describethe patient’s presenting problem focusing on the pathophysiological issues.
  2. Reviewand use of literature to explain the pharmacokinetics of the prescribed medications and their indicati
  3. Discussthe nursing management appropriate for the patient including management of the adverse effects of the medication(s)  using evidence-based literatur
  4. Describein detail the information you would share with the patient and how you will educate the patient about the interactions and long term effects of the medications prescribed in the ED?

Mr Ferguson is a 76 year old male who presented to your emergency department at 0800hrs complaining of a 2/24 history of chest heaviness. He has self administered x2 sprays of his glyceryl trinitrate pump spray totaling 800mcg with minimal relief. On arrival to your allocated bed Mr Ferguson appears pale, diaphoretic & short of breath.

Regular Medications

Medications Prescribed Administered in ED

Aspirin 100mg PO, OD

Aspirin 300mg Po

Metoprolol 50mg PO, OD

Morphine sulphate IV 2.5mg administered on four

(4) occasions PRN

Rosuvastatin 10mg, PO, OD

Low molecular weight (LMW) heparin infusion

glyceryl trinitrate pump spray- PRN

Fentanyl 50mcg IV, x2 STAT doses


Vitals Signs


Blood pressure


Heart rate

103bpm, irregular



97% RA

Respiratory rate



36.8C tympanic

Glasgow Coma Scale

15/15 – E4V5M6


A llergies: Amiodarone

M edications: as stated above

P ast medical history: Angina

Non ST Elevated Myocardial Infarction (NSTEMI) (1998 & 2006) Hypertension


L ast time the patient ate and drank: toast and tea at 0630hrs

E vents preceding admission: chest heaviness 2/24

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