Role of a Nurse in Chronic Illness Management

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Role of a nurse in chronic illness management
Student’s name
Institutional

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Role of a nurse in chronic illness management
Introduction
Chronic condition are diseases that last more than three months and cannot be prevented by
vaccines or relieved by medication. This kind of diseases tend to occur in adults and cannot be
cured or prevented in anyway. The common type’s chronic illness include arthritis, cancer,
stroke, heart diseases and diabetes (Rosamond, Flegal, Furie, & Greenlund, 2012). Chronic
diseases are the leading cause of fatal burden of disease in most age group and sex groups and
the leading cause of illness, disability and death in Australia. The main objectives of this essay
will include pathophysiology of the chronic illness, how the signs and symptoms affect a
person’s life and lastly role of a nurse in delivering inter professional person centered care,
promoting self-management and response to changing patient needs. The chosen chronic
condition is myocardial infarction (MI) in women of age group 60-70 years.
Myocardial infarction
Myocardial infarction is a permanent damage to a part of the heart or the myocardial tissue
that is caused by ischemia and hypoxia eventually necrosis of the myocardial cells. Hypoxia is as
a result of blockage of the coronary arteries that supply blood to the heart. This condition is
mostly caused by ecstasy of an atherosclerotic lesion found in the coronary artery. This causes
the thrombus to block the artery, preventing it from supplying blood to some regions of the heart.
Myocardial infarction is one of the leading killer in Australia. Women of age 60-70 years are at
high risk of getting myocardial infarction than men of their same age. A woman’s heart may
resemble a man’s heart but there are significant differences. For example, the interior chambers
of a woman’s heart are usually smaller. The walls that separate these heart chambers are also

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thinner. Her heart pumps blood faster than a man’s expelling 10 percent less blood at each
squeeze. During stress the pulse rate of a woman rises pumping more blood as compared to a
man whose blood vessels of the heart constrict elevating the blood pressure. This differences
matter because gender plays a grate part in the symptoms, therapy and consequences of coronary
artery disease (Coventry, Finn, & Bremner, 2014).
Some conditions that only affect women increases the risk of coronary artery disease which is
the leading cause of MI. they include high blood pressure during pregnancy, endometriosis,
diabetes, and polycystic ovary disease. Estrogen provide protection in women from heart
diseases until after menopauses, when estrogen severely decreases. The reason why there is a
higher rate of women dying of MI is because coronary artery disease is sometimes hard to
diagnose. Coronary artery disease mostly affects the small arteries which cannot be checked
clearly on an angiogram.
Pathophysiology
Development of atherosclerosis
Atherosclerosis is a disease caused due to disturbance of lipid and protein metabolism with
formation of atheroma in the large and medium sized blood vessels (Virman, Burke, & Farb,
2012). Risk factors of atherosclerosis include obesity, smoking, high arterial blood pressure,
hereditary and ethnic factors and hormonal factors. Atherosclerosis starts by accumulation of
lipid known as a fatty streak on the endothelial layer of the artery. As the disease progresses
there is a chronic inflammation which cause the fatty streak to develop to fibro atheroma
(Simoons & Saelman, 2014). The fatty streak is composed of smooth muscle cell, a fibrous
connective tissue and fats. Vigorous blood flow due to the thickening of the vessel hinder the

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secretion of nitric oxide a strong vasodilator and provoke attraction of inflammatory cells to the
site (Libby, 2015). T cells and monocyte attach to the endothelial cells and begin to take up the
oxidized low density lipoprotein changing their name to foam cells. The T lymphocytes also
secrete cytokine which cause smooth muscle cell to migrate from the media to the intima which
proliferate under the influence of growth factors (Rodriguez, Agostoni, & Garcia, 2013). The
collection of lipids, smooth muscle cells and the growing lesion decrease the lumen of the artery.
Once the plaque raptures due to increase in blood pressure, it may activate thrombosis by
triggering platelet production (Pedrigi, Silva, & Bovens, 2014).
Myocardial cell death
Platelet production may trigger formation of blood clots which may travel to the coronary
arteries and cause blockage leading to a decrease in oxygen supply to the tissues. Ischemia
develops due to deprivation of myocardial cells with oxygen, the cells are damaged, and after
some time due to continuous lack of oxygen leads to infarction or the cell death
Signs and symptoms
They include fatigue, weakness, shortness of breath, abnormal heart beats, sweating, anxiety,
feeling of indigestion, abnormal headache, nausea and vomiting, sudden chest pain that is felt
behind the sternum and sometimes travels to the left arm or the left side of the neck.
How the signs and symptoms impact a person’s life
Social impacts
The signs and symptoms resulting from MI may affect an individual’s lifestyle that is what
we eat, how we exercise and the kind of activities done during the holiday. After the condition