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    Clinical Exemplar

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    This clinical exemplar describes a patient experiencing a myocardial infarction. The author was working with their preceptor when their patient, a 60-year old Asian woman two days post-op for small bowel obstruction, began experiencing trouble breathing, chest pain, and a sense of doom. Her oxygen levels were in the low 80s. An EKG showed evidence of a possible MI and her troponin levels were elevated, so she was transferred to the cardiac unit. This unexpected MI in a relatively stable post-op patient demonstrated to the author the importance of experience in allowing nurses to identify issues and make quick decisions to help patients.

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    Clinical Exemplar

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    api-316161401
    73 views4 pages
    This clinical exemplar describes a patient experiencing a myocardial infarction. The author was working with their preceptor when their patient, a 60-year old Asian woman two days post-op for small bowel obstruction, began experiencing trouble breathing, chest pain, and a sense of doom. Her oxygen levels were in the low 80s. An EKG showed evidence of a possible MI and her troponin levels were elevated, so she was transferred to the cardiac unit. This unexpected MI in a relatively stable post-op patient demonstrated to the author the importance of experience in allowing nurses to identify issues and make quick decisions to help patients.

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    clinical exemplar

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    This clinical exemplar describes a patient experiencing a myocardial infarction. The author was working with their preceptor when their patient, a 60-year old Asian woman two days post-op for small bowel obstruction, began experiencing trouble breathing, chest pain, and a sense of doom. Her oxygen levels were in the low 80s. An EKG showed evidence of a possible MI and her troponin levels were elevated, so she was transferred to the cardiac unit. This unexpected MI in a relatively stable post-op patient demonstrated to the author the importance of experience in allowing nurses to identify issues and make quick decisions to help patients.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    73 views4 pages

    Clinical Exemplar

    Uploaded by

    api-316161401
    This clinical exemplar describes a patient experiencing a myocardial infarction. The author was working with their preceptor when their patient, a 60-year old Asian woman two days post-op for small bowel obstruction, began experiencing trouble breathing, chest pain, and a sense of doom. Her oxygen levels were in the low 80s. An EKG showed evidence of a possible MI and her troponin levels were elevated, so she was transferred to the cardiac unit. This unexpected MI in a relatively stable post-op patient demonstrated to the author the importance of experience in allowing nurses to identify issues and make quick decisions to help patients.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    Running head: Clinical Exemplar

    Clinical Exemplar: Patient Experiencing an MI


    Audrey Bradley
    University of South Florida

    Clinical Exemplar

    2
    Clinical Exemplar: Patient Experiencing an MI

    The use of clinical exemplars allow nurses to process and analyze patient cases that have
    left an impression on them. Even in nursing school, theres multiple opportunities to enhance
    clinical thinking and the ability to make quick decisions. As Tingen and others describe the
    primary role of the nurse, regardless of the location or setting that the nurse works, as the patient
    advocate while providing optimal care with evidenced based research (2009). With more
    experience the nursing student or new graduate nurse begins to develop better critical thinking
    and decision making skills. The case I will be discussing in this exemplar regards an Asian
    woman (referred to as Ms. M) who had experienced a myocardial infraction during the shift I
    was working alongside my preceptor.
    Ms. M was a 60 year old Asian woman who was day two post-op of a restriction of the ileum
    due to a small bowel obstruction. During the beginning of the shift she was receiving a unit of

    RBCs and would receive another unit afterwards. She showed no reaction from the blood
    transfusion and her vitals were all within normal limits. I had been rounding on her every hour
    and seeing how she felt, due to receiving the blood and she reported no complaints. After
    returning from lunch, the nurse and I went to check in on Ms. M and she was reporting trouble
    breathing, chest pain, and an increasing sense of doom. I immediately hooked her up to the pulse
    oxygen machine and her stats were in the low 80s. She was placed on oxygen with 2 liters, and
    my preceptor called for a respiratory therapist. Ms. Ms other vitals were normal but we still kept
    an eye on her oxygen stat. The charge nurse was notified of the situation happening and a call
    was placed for labs (Troponins), and an EKG to be taken. By involving the charge nurse it took
    some of the burden off of the nurse and also kept the charge nurse informed to a critical situation.

    Clinical Exemplar

    It could have been many different processes that could have caused this, but it seem most likely
    to be a myocardial infraction but all bases have to cover to ensure that nothing is missed.
    My preceptor left to make calls out and I stayed with the patient. I let Ms. M know I was
    there and what was happening. While the respiratory therapist came and evaluated Ms. M we
    increased her oxygen to 10 liters and her stats were still ranging from low 80s to mid-90s. Once
    the EKG came it showed that there was some evidenced of a possible myocardial infraction. The
    labs showed that her troponins were elevated and it was ordered that she be transferred to a
    cardiac unit so she could be monitored.
    This patient had no previous cardiac history and was relatively stable for a post-op
    patient, making her MI even more unpredictable. She had no MONA (morphine, oxygen,
    nitroglycerin, and aspirin) therapy ordered, so that left my preceptor with limited options to help
    before providers could arrive to evaluate the situation. I would have never thought to call the
    respiratory therapist, to rule out a pulmonary embolism or fluid overload. To see the difference
    from a nursing student to an experienced nurse was clear and it with experience that allows
    nurses to grow.

    Clinical Exemplar

    4
    References

    Tingen, M. S., Burnett, A. H., Murchison, R. B., & Zhu, H. (2009). The Importance of Nursing
    Research. The Journal of Nursing Education, 48(3), 167170.

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