Critical Care Analysis for Acute Patient

CRITICAL CARE ANALYSIS FOR ACUTE PATIENT
CRITICAL CARE ANALYSIS FOR ACUTE PATIENT
Name of the Student:
Name of the University:
Author note:

1CRITICAL CARE ANALYSIS FOR ACUTE PATIENT
Introduction
This essay will introduce a patient Mrs Eleanor Hale, a 56-year-old female who was
suffering from pneumonia. The patient had suffered from Ischemic heart disease (IHD),
peripheral vascular diseases and hypertension and was a chain smoker for past 30 years,
starting from the age of 19 to 49. The health analysis of the patient states that the patient was
suffering from major heart problem of coronary heart disease (CAD), where the heart artery
is incapable of delivering sufficient oxygen-rich or oxygenated body fluid to the heart
(Nhlbi.nih.gov, 2019). This condition leads to the development of coronary or ischemia heart
disease due to accumulation of waxy constituent known as plague inside coronary artery.
This essay will focus on the treatment approach used for the patient including percutaneous
trans-luminal coronary angioplasty (PTCA), which is an invasive surgical procedure for
opening the blocked artery of the heart for unobstructed circulation of the blood
(Aihw.gov.au, 2019). Hence, this essay will give a detail insight in the critical analysis of the
patient health including pathophysiology of the disease, treatment and psychosocial approach
of the patient.
Changes in Mrs Hale’s clinical presentation and link of these changes to the
pathophysiological processes
Clinical manifestation
The patient weighed 88 kg and was 158cm tall. In this case study, the patient was
observed with the clinical symptoms of little higher pulse rate from normal with normal
blood pressure and body temperature. After administrating the patient medication, it was
observed that she was diaphoretic, which states the condition of excess sweating or
perspiration in-patient due to abnormal trigger in sweat glands (Health.gov.au, 2019). The
patient was also suffering from pain in her chest with minor ache in inner side of upper left

2CRITICAL CARE ANALYSIS FOR ACUTE PATIENT
arm, which was making her feel nauseous. The clinical analysis of the patient was done and
the vital sign were observed after 10 minutes of her symptoms, which stated that her pulse
rate was not normal like before and she was facing problem in breathing (Heusch et al.,
2014).
Sign and symptoms of the disease
The sign and symptoms of coronary or ischemia heart disease are as follows
(Healthywa.wa.gov.au, 2019):
 Chest pain (angina)
 Pain in arms, back, shoulders and upper abdomen
 Dizziness and nausea
 Fatigue and weakness
 Rapid heartbeat
 Sweating
 Shortness of breathe
 Palpitations
Pathophysiology of the disease
Coronary heart disease (CAD) is the heart condition developed due to damaged or
diseased blood vessel, which fail to supply adequate amount of oxygenated blood to the heart.
This condition takes place due to deposition of plaque (cholesterol deposit) in the heart artery
leading to narrowing of the blood vessels (nhs.uk, 2019). This condition results in poor or
decreased blood supply to the heart, which eventually leads to angina or chest pain and
shortness of breath. The patient was showing some major symptoms of coronary heart disease
due to deposition of plague such as chest pain, rapid heartbeat, difficulty in breathing and

3CRITICAL CARE ANALYSIS FOR ACUTE PATIENT
palpitations. The accumulation of plague occurs due to the damage in the artery known as
endothelium. Once the endothelium is injured, it leads to accumulation of debris, fats and
cholesterol in the damaged artery. Due to high concentration of LDL the damaged artery,
atherosclerotic plague deposition takes place, which further causes constriction of the blood
vessels (Ambrose & Singh, 2015). Angiogenesis takes place, which is the primary reason of
coronary heart disease. Hence, this narrowing of blood vessel majorly result in chest pain or
angina. Further deposition of plague in the damaged blood vessel causes shortness of breath
and pain in inner side of her arm. The primary reason of hypertension and diaphoresis was
the fluctuating heart rate, which was due to the uneven and inadequate blood flow. The
patients was a chain smoker and because of her smoking habit the harmful chemicals such as
carbon monoxide and nicotine had set a pressure strain on her heart, which in turn increased
the palpitation rate of her rate (kyu at al., 2016). The sensation of vomiting or nausea was due
to the amplified parasympathetic tone resulted from the discomfort of the narrowed blood
vessel lacking oxygenated blood.
Critical analysis of the priorities of nursing care for the management of Mrs Hale’s
chest discomfort
Nursing care plan
The major risk of coronary or ischemia artery disease is congestive heart failure
(CHF), which is a functional state resulting due to the incapability of the heart to supply
adequate amount of blood in order to meet up with the metabolic requirements of the human
body (Urden, Stacy & Lough, 2017) . The systolic and diastolic activity of the ventricle (left)
changes, which lead to congestive heart failure. Nursing care plan is developed to support
patients with effective treatment approaches in order to improve the function of heart.
Nursing care plan includes identification and prevention of the problem by providing the
patient with an appropriate care plan to change their everyday activity or lifestyle for