Application of Clinical Reasoning Skills
Added on 2021-01-08
11 Pages2813 Words40 Views
Disease and DisordersNutrition and WellnessHealthcare and Research
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APPLICATION OFCLINICAL REASONINGSKILLS FOR CLINICALPATIENT SCENARIO
Table of ContentsCASE STUDY.................................................................................................................................11.1 Pathophysiology of Angina..............................................................................................11.2 Physical Nursing Assessments.........................................................................................21.3 Nursing Interventions for improving physiological outcomes ........................................31.4 Analysis of administration of sublingual Glyceryl Trinitrate...........................................41.5 Abnormal findings needed to be reported immediately...................................................6REFERENCES................................................................................................................................7
CASE STUDY1.1 Pathophysiology of AnginaCardiovascular disease is the prime cause of deaths in Australia. Annually, more than353,000 Australians are affected by this disease and nearly 72,000 hospitalized (SuzanneAlbrecht, 2013). Angina or angina pectoris is a type of predictive heart condition that ariseswhen the heart is not able to supply sufficient amount of oxygen and blood to myocardium formeeting its needs (Boden and et.al. 2012). It is caused by myocardial ischaemia or emotionalstress and exertion. Coronary arteries are responsible for supplying oxygen and blood to heartmuscles, in case these arteries narrow down, the heart muscle is unable to function properlyleading to development of fatty plaques in the walls of arteries. This phenomenon is known as'Atherosclerosis' (Economou and et.al,2015). A patient can experience stable or unstable angina,however, it should not be confused with a heart attack as the former is only temporary in natureand does not damage one's heart muscles. In the given case scenario, Jon Edwards has beendiagnosed with Angina condition for last 3 years. Symptoms of Angina include chest pain with afeeling of squeezing, pressure or tightness, pain in arm, shoulder, neck or back, unable to breatheproperly, fatigue, sweating, dizziness and nausea. Jon's past history shows that he has been aregular smoker consuming 20 cigarettes per day for 25 years until now with fairly healthy eatinghabits and regular consumption of red wine (four times) per day.1
Risk factors of angina – Out of 90% Australians, at least one has risk factor for heartdiseases. These risk factors associated with this disease are both modifiable and unmodifiable innature including tobacco use, diabetes, high blood pressure and blood cholesterol, older age, lackof exercise, stress and obesity. Preventive strategiesThus, in terms of preventative pharmacology, Jon has been suggested to quit smokingwhich he has recently and in order to reduce stress he walks his dog daily. Some of the preventative measures that can be adopted by a patient of such diseaseinclude quitting smoking, maintaining a healthy diet, reducing stress, limit alcoholconsumption, regular check-ups and increased physical activities (Harskamp and et.al.,2013). Since he is 64 years old, his condition cannot be treated completely although it ispreventable.Angina can be treated through medication and surgery as well as adopting healthierlifestyle choices. Medication usually includes nitrates that dilate blood vessels and increase blood flow toheart. Jon is prescribed Aspirin that helps in preventing clots in narrowed arteries, heshould reduce alcohol consumption and include additional exercise to treat high bloodpressure and stress.1.2 Physical Nursing AssessmentsAssessment is a crucial part of nursing practice regulated by Nursing and MidwiferyBoard of Australia (NMBA). A physical nursing assessment helps in obtaining completeassessment of the patient. These assessment includes history, observation and inspection,palpation and auscultation (Jukema and et.al., 2012). As chest pains can be false alarms it isimportant to confirm angina by assessing other symptoms that trigger it. Typically, angina showssign of discomfort or pain in chest, arms, shoulders with tightness and burning sensations. ECG – The most important diagnostic tool to evaluate angina is ECG. However, ECGcannot be used in isolation to fully evaluate the left ventricle's posterior, lateral and apical walls.Jon has been hospitalized with cellulitis and has a medical history that shows signs ofalcoholism, smoking, hypertension, hypercholesterolemia and Angina for past 3 years. Astandard 12 lead-ECG or Electrocardiogram report is a medical test that can help in diagnosing2
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