Sarah is a 66-year-old woman with a medical diagnosis of chronic bronchitis which has been stabilised on theophylline for the past 3 years. She has been labelled as non-adherent with medical therapy because she continues to smoke cigarettes (more than three packs per day) even though she is aware she has a progressive pulmonary disease.

Sarah is a 66-year-old woman with a medical diagnosis of chronic bronchitis which has been stabilised on theophylline for the past 3 years. She has been labelled as non-adherent with medical therapy because she continues to smoke cigarettes (more than three packs per day) even though she is aware she has a progressive pulmonary disease. ​​​​​​​
Each case study submission should be 500 words (+/- 10%), students can choose how they distribute the word count across question One and Two in each case study. This word count does not include the summary of evidence.

Question One

A student nurse who is on placement with a community health nurse has been working with Sarah. After several health education sessions using posters and pictures, as well as individualised support and encouragement, the student determines that Sarah has a good understanding of her problem and a plan was put in place to stop or at least cut down her smoking. ​​​​​​​
What information should the student nurse consider before planning the teaching program? How could they determine that Sarah does have a good understanding of the information presented? 

(Note: Your answer should consider all of Sarah’s medication that might impact on her current symptoms. Remember to include supporting evidence)

Question Two

Three days later Sarah presented to the emergency department with complaints of dizziness, nausea, vomiting, confusion, grouchiness and palpitations. Her admission heart rate was 96 beats/min with occasional premature ventricular contractions.

What probably happened to Sarah? What is the likely cause of her symptoms?   

(Note: Your answer should take into consider Sarah’s medical history and current medication list. Remember to incorporate latest evidence-based practice in your answer)

References

List all references used in the box below (references should also be cited in text where relevant). You must follow APA referencing requirements throughout.