Topic: Cardiology Clinical Case

Order Description
THE CASE STUDY AND THE CARE PLAN TEMPLATE TO HELP DESIGN A HOLISTIC PATIENT CARE PLAN.
Your care plan should be formatted as a Microsoft Word document. Follow APA style. Your paper should be 2 to 4 pages double-spaced and in 12pt font.

PLEASE USE THE COURSE TEXTBOOK AS A REFERENCE: Primary Care by Terry Mahan Buttaro; JoAnn Trybulski; Patricia Polgar Bailey; Joanne Sandberg-Cook. 4th Edition. Publisher: Elsevier – Health Sciences Division ISBN: 9780323075015

ADDITION RESOURCES MUST BE LESS THAN 5 YEARS OLD.

Create a holistic care plan for disease prevention, health promotion, and acute care of the patient in the clinical case. Your care plan should be based on current evidence and nursing standards of care.

Visit the online library and research for current scholarly evidence (no older than 5 years) to support your nursing actions. In addition, consider visiting government sites such as the CDC, WHO, AHRQ, Healthy People 2020. Provide a detailed scientific rationale justifying the inclusion of this evidence in your plan.

Next determine the ICD-10 classification (diagnoses). The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) is the official system used in the United States to classify and assign codes to health conditions and related information.
USE WEBSITE: https://www.cms.gov/medicare-coverage-database/staticpages/icd-10-code-lookup.aspx

You are expected to develop a comprehensive care plan based on your assessment, diagnosis, and advanced nursing interventions. Reflect on what you have learned about care plans through independent research and peer discussions, and incorporate the knowledge that you have gained into your patient’s care plan.

Grading Criteria
Care plan demonstrated involvement of the client in the process of recognition, planning, and resolution of the problem.
Care plan included effective nursing interventions that are customized for the client and appropriate to the goal.
Care plan included diagnostic work-up, medications, conservative measures, and follow-up plan.
Care plan provided rationale for choosing a particular treatment modality.
Care plan demonstrated logical diagnosis that was substantiated with relevant evidence.
Care plan focused on patient education and maintained a fine balance between major and minor health issues of the patient.
Care plan included nursing interventions that are specific, appropriate, and free of essential omissions.
Used APA standards consistently and accurately.

Cardiology clinical case
Subjective Data:

Client Complaints:

HPI (History of Present Illness):

PMH (Past Medical History—include current medications, any known allergies, any history of surgery or hospitalizations):

Significant Family History:

Social/Personal History (occupation, lifestyle—diet, exercise, substance use)

Description of Client’s Support System:

Behavioral or Nonverbal Messages:

Client Awareness of Abilities, Disease Process, Health Care Needs:

Objective Data:

Vital Signs including BMI:

Physical Assessment Findings:

Lab Tests and Results:

Client’s Support System:

Client’s Locus of Control and Readiness to Learn:

ICD-10 Diagnoses/Client Problems:

Advanced Practice Nursing Intervention Plan (including interdisciplinary collaboration, community resources and follow-up plans):
References