NR 305 Week 3 Assignment: Cardiovascular Assessment
Student Name
Chamberlain University
NR-305: RN Health Assessment
Prof. Name
Date
NR305 Week 3 iHuman Nurse Notes Template
Directions
Before beginning this assignment, review the NR305 Week 3 assignment directions thoroughly. Complete the Week 3 Cardiovascular Assessment: Michael Granger case in iHuman, ensuring the case is submitted for grading. Two submission attempts are permitted before the deadline.
Do not remove any content or questions from this template. Ensure that each item is addressed completely, using information gathered during the iHuman case as needed. Submit the completed template on the Week 3 assignment page. Grammar and spelling accuracy are part of the grading rubric.
SBAR Summary of Mr. Michael Granger’s Current Health Status
Situation (S)
Mr. Michael Granger, a newly admitted patient, is experiencing an exacerbation of congestive heart failure (CHF). He reports significant shortness of breath and an approximate weight gain of 8 pounds in recent days.
Background (B)
The patient has a medical history of hypertension, hyperlipidemia, myocardial infarction, and CHF. Family history reveals similar cardiovascular conditions. He is a long-term smoker, averaging one pack per day, and is currently attempting smoking cessation with nicotine patches. He has struggled with adherence to heart failure management recommendations, leading to recurrent episodes of weight gain requiring diuretic intervention. He reports sleeping with the head of the bed elevated and experiencing frequent nocturia.
Assessment (A)
Vital signs reveal normal blood pressure and heart rate. Oxygen saturation is 89%, with supplemental oxygen being administered and adjusted as ordered. Lung auscultation detects coarse crackles bilaterally. Lower extremities present with 2+ pitting edema bilaterally, without edema in other regions.
Recommendation (R)
The patient is likely experiencing heart failure exacerbation with pulmonary edema and fluid overload. Recommended interventions include:
NR 305 Week 3 Assignment: Cardiovascular Assessment
| Intervention | Rationale |
|---|---|
| Administration of diuretics | Reduce fluid overload and relieve pulmonary congestion |
| Strict sodium and fluid restriction | Prevent further fluid accumulation and reduce cardiac workload |
| Intake/output monitoring | Avoid transition from fluid overload to dehydration |
| Diagnostic chest X-ray | Assess pulmonary congestion and rule out other causes of respiratory distress |
| 12-lead ECG | Evaluate for arrhythmias or ischemic changes |
| Oxygen via nasal cannula until SpO₂ ≥ 95% | Improve oxygenation and reduce dyspnea |
Priority Discharge Teaching Topics
1. Dietary and Lifestyle Modifications
Mr. Granger should adopt a low-sodium diet, strictly avoiding processed, canned, packaged, and fried foods. Fluid intake should be monitored and limited as prescribed. Smoking cessation remains critical, as tobacco use worsens CHF outcomes (Packard et al., 2010). Daily weight monitoring should be performed for early detection of fluid retention.
2. Medication Management and Symptom Recognition
Education should include correct dosing, timing, and understanding potential side effects of prescribed medications. Mr. Granger should be trained to recognize early CHF warning signs—such as sudden weight gain, increased shortness of breath, or edema—and to seek prompt medical attention.
Rationale for Selected Teaching Topics
The patient’s presentation of weight gain, dyspnea, and history of non-adherence to dietary recommendations indicate a need for education on nutrition, fluid restriction, and lifestyle adjustments. Past patterns of recurrent fluid overload highlight the importance of medication adherence and early symptom recognition to prevent acute exacerbations.
Teaching Plan and Resources
Patient education will be conducted through one-on-one discussions, supported by visual aids illustrating portion sizes, sodium content in common foods, and the relationship between fluid intake and CHF symptoms. Collaboration with a registered dietitian will provide personalized meal planning and substitution strategies for high-sodium foods. Educational handouts from the American Heart Association (AHA) will be provided, along with a daily weight log template. The patient will also receive instruction on proper use of a home blood pressure monitor and digital scale.
Emphasis will be placed on self-monitoring for symptoms, including rapid weight gain (≥2–3 lbs in 24 hours or ≥5 lbs in a week), new or worsening edema, and increased fatigue. Resources such as mobile health apps for medication reminders and symptom tracking may be recommended to improve adherence (Yancy et al., 2017).
References
Packard, K. A., Lenz, T. L., & Destache, C. J. (2010). Teaching heart failure treatment guidelines and assessing heart failure therapy. American Journal of Pharmaceutical Education, 74(6), 103. https://doi.org/10.5688/aj7406103
NR 305 Week 3 Assignment: Cardiovascular Assessment
Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Drazner, M. H., … & Wilkoff, B. L. (2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure. Journal of the American College of Cardiology, 70(6), 776–803. https://doi.org/10.1016/j.jacc.2017.04.025