nursing

A 45 year old business woman visited the hospital with complications that I deduced to be angina pains following the assessment results. Before carrying out any intervention activity, I carried out an assessment on her using patient questionnaires, and measurements to determine her physical health. On assessing her condition, I found out that she has a history of cardiac arrest and high blood pressure. She also has a family history of cardiac issues. On obtaining her weight and height measurements, the BMI ratio indicated that she was overweight. A look into her occupation and daily activities explained why she was overweight. She sits in so many meetings and travels a lot such that she does not engage in any healthy physical activity. I also noted that she has a high consumption rate of high cholesterol foods in a day with less water intake. Though she has tried severally in the last two years to observe a balanced diet, it has never bore any fruits. Through the assessment, I also found out that she is a “Type A” personality which makes her prone to cardiac arrest problems.

This assessment indicated that this patient was prone to a heart attack if intervention is not taken immediately. Though the angina pain was not severe nor frequent, her history and current lifestyle proved that she needed immediate intervention. Weekly educational sessions impacting her awareness on cardiac issues was mandatory. This would be complimented by relaxation and guided imagery procedures that would directly and positively affect her blood pressure and heart rate. Cognitive and behavioral methods for stopping unhealthy diet, and initiating an exercise lifestyle was to be recommended too.

Section 2: Pathophysiological processes that affected her care

This patient would have eliminated the angina complications she is experiencing right now were it not for certain pathophysiological process. A cardiac arrest occurs due to cardiac valves or arteries disorders. According to (Desilva, 2020), heart attack due to disorders of the valves, occur when the valve is leaky such that the blood flow does not happen as required. Blood vessels supplying the heart with blood ought not to be constricted so as to allow for efficient blood flow. When they become narrower, this is when the pumping becomes too difficult that a cardiac arrest ensues. These aspects are those which people with family history of cardiac issues are prone to develop. Their valves might become weak and create a leak within the circulatory system, while the vessels may become too narrow to facilitate efficient blood flow.

Blood flow in this case refers to that which goes into the heart muscles. Where the vessels supplying the heart muscles with blood become too constricted. This particular patient may have started developing these features within her circulatory system, therefore causing the angina pains. Angina pain is as a result of reduced blood flow to a person’s heart muscle. The blood circulation to the heart muscles ensures that the heart has enough energy to survive while pumping blood. When these muscles are undersupplied with oxygen, they become ischemic. When someone comes from a family with cardiac issues, these complications develop automatically, and require activeness and intentionality by a patient to make sure that they stay healthy, and that these features do not worsen.

According to (Binorkar & Guruprasad, 2017), the cause of cardiac artery disease is a condition called atherosclerosis. This is where the walls of the coronary arteries has a plague buildup. This buildup makes the artery narrower than normal therefore making the pumping of blood difficult. The plague that builds up on the coronary artery walls causing narrowness is made up of cholesterol deposits. When looking at this patient’s lifestyle, one realizes that her eating habits contributes largely to the creation of these deposits. The patient at hand consumes foods with high cholesterol amounts mostly, without even taking enough water. This, together with fact that her family has a history of cardiac issues, makes her proneness increase. In addition to poor eating habits, is the fact that she does not engage in physical activities. This therefore means that the extra energy from her food intake is stored in form of fats in various parts of her body to include the walls of the coronary artery.

With the continued increase in her weight, carrying out exercises becomes an issue. To such a body weight, effective exercise that would keep her fats level low and healthy becomes a strenuous activity. According to (Reis et al., 2017), heart attack is sometimes caused by strenuous physical activity, as it leads to the shortage of blood in the coronary arteries, making the heart ischemic. Therefore instead of physical activity becoming a life-saving act, it becomes a threat to one’s life. The pathophysiological processes affecting her care are being overweight and atherosclerosis caused by poor diet. Being overweight goes ahead to create inefficiency in conducting physical activities. This patient had received care before, but due to these issues, the unwanted developments came through.

Section 3: Best Practice nursing care for this patient

The practice standards for nursing care on patients with coronary issues are limited to education and counselling, (Ramadhani et al., 2019). The best way to provide care for this type of patient involves educating them first. A nurse has to bring the patient to the understanding of what they are facing. This involves making them aware of the nature and the cause of their condition. In this case, care would start by informing this patient of the causes of her angina pain. Informing her that though she has a family history of cardiac problems, she also has a direct effect to her health through her lifestyle. That her eating habits and dormancy in carrying out physical activity are effects under her control that makes the condition worse. This education goes all the way to the treatment and management options available for them. Through this act of educating a patient, she becomes aware and psychologically prepared to manage this condition. So that they do not continue with their lives like nothing happened, but they become active participants toward their healthy living.

According to (Ramadhani et al., 2019), counselling is the other standard of nursing care towards a patient with a heart condition. After knowing the cause and nature of their ailment, encouragement on how to manage their condition is mandatory. A nurse therefore explains to the patient the importance of a healthy lifestyle. This will involve discussing with the patient about the necessity of a balanced diet, together with physical exercises. The care practice of counselling works toward ensuring that the patient gains the courage to manage the condition. The nurse will suggest these healthier lifestyle practices to the patient, and if there are medicine to be administered, the nurse will also make sure that the patient understands how to consume them. Additionally, the nurse will also encourage the patient to avoid or reduce stress levels, (Binorkar & Guruprasad, 2017).

Education and counselling works toward making the patient an effective source of personal care. Armed with knowledge of how they contribute to their illness, a patient becomes conscious of what is happening to them. When counselling is administered to him or her, a patient does not enter the intervention process blindly, but are intentional in their attaining wellness. Therefore going ahead to avoid the practices that affect their health adversely.

All the care practices will be rooted in the assessment findings. This means that a practitioner has to be very cautious with the assessment process to ensure that all the important factors have been captured and considered before deciding on the intervention process. This is because, the assessment findings usually establish the cause and the contributing factors of a disease. When studied carefully, they guide the next course of action that a nurse will take. If the assessment indicates severity of the condition, this might lead to an admission, but if not then a discharge with interventions will be advisable. In this case, the condition of the patient was not severe. That is why a discharge with the appropriate interventions was put in place. The patient was advised on changing their diet and incorporating physical activities in their daily life with weekly checkups to monitor their progress.

Reference List

Binorkar, S., & Guruprasad, K. (2017). Coronary Artery Disease: Ayurveda Perspective (pp. 14 -17). Bilaspur: Educreation Publishing.

Reis, C., Akyol, O., Araujo, C., Huang, L., Enkhjargal, B., & Malaguit, J. et al. (2017). Pathophysiology and the Monitoring Methods for Cardiac Arrest Associated Brain Injury. International Journal of Molecular Sciences, 18(1), 129. DOI: 10.3390/ijms18010129

Desilva, R. (2020). Heart Disease (pp. 43 - 64). Oxford: Greenwood.

Ramadhani, F., Jing, X., Qing, Y., Rathnayake, A., Kara, W., Wu, W., & Liu, Y. (2019). Investigating the Relevance of Nursing Caring Interventions Delivered to Patients with Coronary Artery Disease at a Teaching Hospital in China: A Retrospective Study. Cureus, 11(2). doi: 10.7759/cureus.4672