MS II Cardiovascular Case Study: Aortic Stenosis


Scenario: A 92-year-old male with a history of hypertension and osteoarthritis, yet no other

significant medical history arrived at the ED reporting shortness of breath with minimal exertion

and chest pain. Upon presentation to the ED, he was ambulatory with the use of a cane for

assistance. He was admitted into the hospital, alert and oriented, with a diagnosis of heart failure.

Nursing assessment upon admission reveals blood pressure 120/70, temperature 98.7, apical

pulse 92 with systolic murmur, respirations 24 and slightly labored, O2 saturation 89%, and fine

crackles bilaterally in lungs. The ECG indicates ventricular hypertrophy, and the echocardiogram

shows left ventricular hypertrophy with aortic stenosis.

NGN Item Type: Matrix

Use an X for the nursing actions listed below that are Indicated (appropriate or necessary),

Contraindicated (could be harmful), or Nonessential (makes no difference or not necessary)

for the Patient’s care at this time.

Rationale: Explain your reasons for your decisions

Nursing Action Indicated Contraindicated Nonessential

Request a prescription for

nitroglycerin for chest pain.

Bundle nursing care to allow

for maximum client rest


Administer beta blocker as


Request a consult with

physical therapy for range of

motion exercises.

Position patient on left side.

Auscultate bowel sounds

before each meal.

1. What diagnostic test/procedure should be included in this patient’s care?