Case Study 3: The Patient with Tachycardia
Arjun Bakta is a 58-year-old gentleman of Hindu heritage. He came to England from Punjab with his parents when he was a child. He is married to Nisha and they have 4 adult children. Two of their children live at home, along with Arjun’s mother who is 82. They live in a 4-bedroom terraced house.
Arjun has a PhD and works as a laboratory technician for a pharmaceutical company. He finds his work incredibly stressful due to staff shortages and is expected to work long hours. This has resulted in him having episodes of anxiety and depression which he does not like to discuss. Gradually, he is beginning to lose interest in his job and phones in sick regularly.
He has come into A&E via his GP with tachycardia, palpitations and shortness of breath.
Observations
Airway: Patent, no issues. Able to talk in short sentences.
Breathing: RR – 22 breaths per minute, SpO2 – 95% on air. No wheezing or added sounds.
Cardiovascular: HR 120 bpm, BP 115/84 mmhg, (usual BP is 148/88). ECG shows fast AF. Peripherally warm. Passing urine via commode.
Disability: AVCPU Alert. GCS 15/15 but feeling lightheaded and dizzy. Exposure: Temperature 36.2°C.
Signs and Symptoms
Palpitations
No pain
Past Medical History
Hypertension
Obese – BMI 37 (180cm/120Kg)
Current Medication
Ramipril 2.5mg, BD
Family History
Father passed away from stroke 10 years ago.
Mother has hypertension and type 2 diabetes.
Social History
Ex-smoker, 30 pack years. Gave up 8 years ago.
Enjoys rich high fat foods.
Inactive lifestyle
No drug or alcohol use.
Summative Assessment – OSCE
Discuss one assessment strategy for this symptom/sign and explain the underlying pathophysiology.
Summative Assessment – Case Study
Critically evaluate the communication skills or strategy the nurse will engage in when caring for this patient.
Provide a critical exploration of one psychological response of this sign or symptom including a coping strategy and one evidence-based strategy.
Critically discuss the holistic role of the nurse in this scenario based on one evidence-based intervention to manage the care.
