George Orwell Case Study 2022

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George Orwell Case Study
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George Orwell Case Study
Introduction
Mr. George has been transferred to Farquharson Memorial Hospital (FMH) Adelaide to
be investigated with the chest pain condition. The patient has a medical history of heart-related
diseases having undergone a coronary artery bypass five years and suffering from anterior
myocardial infarction six years ago. He is on EtOH daily dose. Apart from this, the patient has
type 2 diabetes, hypercholesterolemia, hypertension, obese and he is also a current smoker who
takes fifteen cigarettes daily. Chest pain requires a proper clinical plan based on identifying
nursing problems and developing a treatment plan to restore the client (Mekaj, Daci & Mekaj
2015, p. 1452). This relates to understanding the condition of the patient and other medical issues
that they have to develop a treatment plan and at the same time a discharge plan to guide the
patient and nurse in managing the condition.
Primary admission diagnosis
From the clinical notes the patient was admitted for chest pain and shortness of breath.
This condition is mostly caused by blocked arteries as a result of fats, cholesterol, and
lipoproteins that form fatty acids which produce extracellular matrix forming atherosclerotic
plaque that narrows the luminal space (Mansour, Reda, Mena, Ghaleb & Elkersh 2016, p. 7).
When the arteries are blocked, blood circulation is reduced making the patients feel squeezing
and uncomfortable pressure that sometimes extends to the shoulder, neck, and jaw. Chest pain is
easily identified and mostly develops due to some physical activity that creates the requirement
for the heart to pump faster than expected.
Usta & Bedel (2017, p. 459) suggest that the onset of chest pain depends on the medical
history of the patient and the challenges that they have been experiencing. The fact that the

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patient experienced anterior myocardial infraction five years ago means that his heart is
vulnerable and can be affected easily. Another issue that can be seen from the case of Orwell is
the fact that he had coronary bypass as a way of reducing the symptoms of heart disease.
According to Li, Kong, Jiang, & Dong (2017, p. 350), this surgery does not cure heart problems
but only reduces the signs and symptoms like chest pain through improved circulation. The fact
that the patient has been on heart problem medications and has used the GT spray four times a
week means that the feeling of chest pain is related to the heart problems that he has had in the
past.
In addition to that lifestyle issues and conditions can exacerbate the signs and symptoms
of heart problems that a patient feels. The fact that Orwell is diabetic the condition presents risk
factors can lead to increased damage of blood vessels which can block the blood vessels thus
creating circulation problems. Further, his lifestyle as seen in the number of cigarettes taken can
be one of the reasons why the symptoms are high. Smoking is a risk factor since it damages the
lining of arteries, which leads to atheroma thus narrowing the arteries (Kamimura, Cain, , Mentz,
White, Fox, Butler & Robertson 2018, p. 2577). The fact that the patient had undergone a
coronary bypass but failed to manage his lifestyle means that this is the genesis of the heart
problems being experienced. Therefore, from the condition of the patient, the main cause of the
problem that has led to the admission of the patient is chest pain which can be caused by many
factors. The patient is on heart disease medication which is used to reduce the symptoms of the
disease (Yasue, Nakagawa, Itoh, Harada, & Mizuno 2014, p. 12). Since the patient is scheduled
for a coronary angiogram the medical team is focused on determining whether the coronary
arteries are blocked.
Nursing problems

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Managing of the heart problem symptoms
Orwell has a heart problem and has been on different medication doses to control his
situation. The reason why he was admitted is the feeling of chest pain and breathlessness during
exertion. Young & Melander (2013, p. 4) suggest that chest pain is a common symptom for heart
problem patients since it arises from the inability of the heart to function normally. This
condition arises from blocked arteries that create difficulties in blood circulation which leads to
tightness, squeezing or crushing pain. Chow, Chan, Ho & Chun (2017) suggests that patient
lifestyle is one of the major reasons for chest pain or the possibility of breathlessness. As seen in
the case of the patient, he is diabetic and smokes fifteen cigarettes daily which all lead to
atheroma that increases heart problems. Further, the patient seems to have difficulty maintaining
the required dose since he forgets taking the medication and complains of the effects of fluid
medications. Lemone, Burke, Bauldoff, Gubrud-Howe, Levett-Jones, Hales, Berry, Carville &
Reid-Searl (2016, p. 19) suggests that the role of patient cenyered care is to design a care plan
that reflects the needs of the patient. This means that a care plan is supposed to be developed to
assist Orwell overocome the risks associated with heart failure.
The second medical problem is lifestyle management to avoid readmission.
According to the American Heart Association (2019, pp. 4), one major problem in heart-
related patients is the lack of commitment to healthy lifestyles. In most cases, heart problem
patients are supposed to lead a strict lifestyle that adheres to the condition management plan that
is given in the hospital. From the patient notes, Orwell is diabetic and smokes 15 cigarettes daily
which could be one of the reasons why he is prone to the symptoms of the condition. Fleg (2016,
p. 5) argues that having diabetes means that there is the likelihood to develop a heart disease
since high glucose damages the blood vessels which can lead other fatal causes.