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  • Subject Name : Nursing

Case Study: Jessie Lin

Table of Contents

Introduction to Patient situation.

Cues Collection.

Processing information.

Further cues needed to assess the case.

Reference List

Introduction to Patient Situation

In the following report, the key focus is upon clinical reasoning of the case of a 16 years old school girl, Jessie, who has been assessed, right after 40 minutes bubble soccer play at her school. Under supervision of the school nurse, the student nurse has taken the vital signs and readings, for assessing whether Jessie is fit to go home or needs healthcare assistance.

Cues Collection

Assessing Jessie’s vital signs, the following subjective and objective cues have been identified.

Subjective cues

  • Jessie feels thirsty and tired, seek for cold water and a chair
  • She feels very hot
  • Informs her fast heart beat

Objective cues

Vital signs at 14:50 hours

  • Temperature - 38.5oC
  • Pulse rate - 140 beats/min
  • Respiratory rate (RR) - 29 breaths/min
  • Blood pressure (BP) - 130/70 mmHg
  • Flushed skin
  • Soaked t-shirt in sweat

Pervious observations






23rd March 2020





24th March 2020





Processing Information

It is revealed from the scenario that Jessie, the 16 years old girl has joined the school last week, upon shifting from another state and participated in the bubble soccer game in the school. After 40 minutes play, the student nurse has assessed her vital signs in to understand whether she is fine to go home or needs healthcare assistance. Now, it is noteworthy that the bubble soccer game is a type of sports, which needs massive activity of the entire body, requires a lot of energy to meet the exceeded need of the body, during the high activity level (Housh et al., 2016). Now, according to the anatomical and physiological perspectives, when body transition occurs from a resting state to a highly active state like exercise or outdoor play like soccer, body’s energy needs increase highly, which causes changes in the respiratory and circulatory systems, for adjusting the body’s physiological function, so it could meet additional oxygen need in the muscle.

In case of Jessie, the above mentioned pathophysiology has taken place, which causes changes in her physiological conditions, which further reflected in vital signs. For instance, assessment revealed her current body temperature is 38 degree C, higher than her previous two day readings. As body continues to work and exercise, core temperature of the body increases, because; body attempts to produce increased energy in contracting muscles, used for increased movement during exercise, so that homeostasis could be maintained. Approximately 20% energy is used for muscle contraction and 80% is converted into heat energy and thereby increasing the body temperature (Wingo et al., 2018).

Her RR was 29 breaths/minute, which was 14 and 12 in previous resting days. Her pulse rate approximately doubled, from 70 to 140 beats/ minute, during the exercise, along with significantly increased systolic BP. It is revealed from evidences that during exercise, body and working muscles need three times more oxygen. It is because; aerobic respiration is associated with the metabolism, which generates energy, for completing the physiological functions. In order to meet the increased need of oxygen, brain signals the respiratory system to intake more oxygen to fulfil the demand (Bringard et al., 2017).

As the respiratory system attempts to fill lungs with more oxygen at a time, respiratory rate increases to complete a cycle of “inhalation and exhalation” within less time, which is the key reason for enhanced Jessie’s RR after the bubble soccer game. At the same time, stimuli comes to circulatory system to make heart pumping faster, so that more oxygenated blood could be refilled in the blood vessels and transported to the muscles within less time, which is the key reason for doubling heart beat of Jessie (Dong, 2016). Further, as the heart filter more blood at unit time, pressure in blood vessels increases, due to higher rate of flow through the narrow vessels. Especially, the systolic pressure increases, as it measures blood vessel pressure, when heart beats. Therefore, in case of Jessie, as her pulse increases, systolic BP increased simultaneously. 

Further Cues Needed to Assess the Case

In the above section, it is revealed that the patient, Jessie’s vital signs are significantly deviation from the normal rate of these vital signs. In the case study, the key vital signs, i.e. “temperature, RR, pulse and BP” has been highlighted and analyzed in respect to the normal rate. In addition, some other vital signs, which are indicated as fifth and sixth vital signs, including pain, oxygen saturation, blood glucose level, shortness of breath or delirium are also measured. These further cues are needed for detailed analysis of Jessie’s current condition. These vital signs would help to understand whether Jessie is having any other chronic or acute health issues or not. Further, I would also ask Jessie whether she got any hit in arm or leg, while playing bubble soccer, which would need further pain assessment and management.

At the same time, numbness and presence of any inflammation or redness would also be assessed, which could be the sign of hit during the game (Bringard et al., 2017). Further, as a student nurse, I would ask Jessie about her medical history, which has a significant importance in care planning. In her medical history, Jessie could have chronic health issues, which might have contributed to present her current vital signs, like increased sweating or pulse rate. I would further asked Jessie whether she is feeling dizzy, fatigued; having headache or nausea like symptoms, which are significant signs of a range of health issues and could help in diagnosis. Further, I would ask about Jessie’s previous residence, family history, in order to identify any medical history that Jessie could have, which could further cause negative impact on her health.

In addition, I would also ask Jessie about her lifestyle, including diet, physical activity and schedule, which would help the nurse to understand the current health status of Jessie, indicating the health risk of the patient (Housh et al., 2016). Finally, this information could help in advance diagnosis of Jessie, which is important for understanding whether Jessie is fit for participating in such bubble soccer game sessions further or she needs some health assistance.

Reference List

Bringard, A., Adami, A., Fagoni, N., Fontolliet, T., Lador, F., Moia, C., Tam, E. and Ferretti, G., 2017. Dynamics of the RR-interval versus blood pressure relationship at exercise onset in humans. European journal of applied physiology, 117(4), pp.619-630.

Dong, J.G., 2016. The role of heart rate variability in sports physiology. Experimental and therapeutic medicine, 11(5), pp.1531-1536.

Housh, T.J., Housh, D.J. and DeVries, H.A., 2017. Applied Exercise and Sport Physiology, With Labs. Taylor & Francis.

Wingo, J.E., Crandall, C.G. and Kenny, G.P., 2018. Human heat physiology. In Sport and Physical Activity in the Heat (pp. 15-30). Springer, Cham.

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