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Assignment-The main role of Nursing

   

Added on  2020-03-07

11 Pages3151 Words271 Views
Running head: NURSING ASSIGNMENTNursing assignmentName of the student:Name of the University:Author’s note

1NURSING ASSIGNMENTIntroduction: Evidence based practice is the process of integrating best evidence in nursingpractice to address specific clinical issues of patient and improve their health outcome. Anurse has the duty and responsibility to carry out patient assessment, interpret patient’sinformation and engage in critical decision making to determine the appropriate nursingintervention or specific clinical condition (DiCenso, Guyatt, & Ciliska, 2014).The processof assessment and planning of nursing intervention is demonstrated in this essay through thecase of Mrs. Valerie Jackson. She is a 65 year old patient who has been recently diagnosedwith cardiac arrthymia. She had been transferred to the HDU for open large bowel resection.Based on patient’s current symptoms and pathological information, the essay explains thereasons for the condition by means of discussion on the pathophysiology of cardiacarrhythmia. Secondly, the essay analyses the vital signs and pathology report to understandthe reasons for abnormalities and their impact. Based on this discussion, the specificassessment needs of patient are determined and three nursing interventions to improveValerie’s condition is discussed.Pathophysiology of presenting problem: Mrs. Valerie has been diagnosed with cardiac arrhythmia. It is a condition associatedwith abnormal heart rhythm. In some case, the heart beat is too fast that normal rate-100 beatsper minute (tachycardia) or too slow than normal rate- 60 beats per minute (bradycardia). Thischange in heart beat is seen due to the change in the normal sequence of electrical impulses(Schwartz, 2014). These impulses generate eratically resulting in too fast or too slow heartbeat. The pathophysiological explanation for this is explained by the process of enhanced orsuppressed automaticity and triggered activity. Automaticity is the normal property of allmyocytes and this property gets hampered due to ageing, ischemia, effect of certain

2NURSING ASSIGNMENTmedications and other factors (Tse, 2016). The advancing age of Valerie might be a reason forchange in property of automaticity. The condition of suppressed automaticity leads todysfunction of sinus node and the enhanced automaticity leads to multiple arrhythmia(Yabluchansky et al., 2016). This condition can be identified in patient by the symptoms ofdizziness, loss of consciousness, shortness of breath and chest discomfort. Triggered activity is another condition or mechanism behind cardiac arrhythmia. It isthe initiation of impulse on the basis of afterdepolarization. However, triggered activityoccurs when both early depolarization and after depolarization initiates at the same time. Thisform of abnormal impulse excitation results in reentrant excitation (Antzelevitch et al., 2014).In contrast with the condition of cardiac arrhythmia, normal cardiac rhythm is seen whenspontaneous impulse is generated from the sinoatrial node and transmitted to the myocardium(Ruthruff & Lien, 2016). Hence, in normal condition, impulse formation and transmission tothe atrial and ventricular mycocardium occurs in a synchronous pattern. However, myocardialdisease and certain cardioactive drugs disrupts the normal cardiac rhythm and changes theactivity of the sinus node. Major changes is observed in automaticity of the myocardium thatresults in compromised cardiac function and adverse symptoms in patients like Valeria (vander Lende et al., 2015). Interpretation of rhytm: The examination of the rhythm strips of Mrs. Valerie indicates the condition of sinustachycardia or abrupt increase of heart rhythm. This is defined by a value greater than 100beats/minute. The event is traced by the PQRST wave on the rhythm strip. P waverepresents the discharge of the SA node and depolarization of the atria. The pattern of thewave indicates condition of tachycardia in Mrs. Valerie and this might have occurredbecause of increase in demand of oxygen due to stress, infection or blood loss. Mrs. Valerie

3NURSING ASSIGNMENTmight be presenting with this condition because she had a bowel resection and it might havelead to blood loss (Baruscotti et al., 2016).Sinus Tachycardia is a condition of rhythm inwhich rate of impulse generating from the sinoatrial node increases. This kind of rhythm ismostly seen in patient with cardiovascular disease. The normal heart beat is seen in anindividual due to the mechanism of systematic interplay between sympathetic andparasympathetic nervous system (Ruthruff & Lien, 2016).. However, this system issignificantly affected by ageing. Due to ageing, the property of heart muscles cells and wallschanges. The wall of the arteries becomes thicker and elasticity is lost (Ho & Sánchez-Quintana, 2016). Hence, damage to heart tissue might the reason for the abnormal heartrhythm in Mrs. Valerie.It is very likely that this condition might have occurred in patient due to advancingage. Strait & Lakatta (2012) also gives the evidence that aging is one of the major risk factorfor cardiovascular disease because of declining cardioprotective system. Ageing leads tomany type of changes in older people. Firstly, structural changes in vascular wall and heartare seen due to aging. Secondly, functional changes reduce the ability to respond toworkload and cardiac mechanism for protection from injury is become defective. Thesefactors might be the reason for the presentation of bradycardia in heart rhythm strips. Discussion of normal or abnormal pathology results: The pathology results of Mrs. Valerie gave the following outcome:Sodium- 148 mmol/LPotassium- 3.1 mmol/LChloride- 90 mmol/LBicarbonate- 20mmol/L

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