Assignment on Nursing Care of a Patient with a Medical Condition

NURSING CARE OF A PATIENT WITH A MEDICAL CONDITION
NUR250 Assessment 1 S1 2020
Assessment One Template
Task 1
Mr Robert Lalara was 42 years old man belong to the indigenous community,
living in a remote community was presented in the CDU medical ward with chest
pain and irregular and fast heartbeat. Upon conducting ECG as well as
conducting an assessment of the vital signs, it was observed that he was
suffering from Atrial Fibrillation (AF) where the heart rate was 115 beats per
minutes (bpm).
According to Staerk et al. (2017), AF is an abnormal rhythmic beating of the
heart that is characterised by irregular and fast beating in the atrial chambers. It
can be stated that there is a brief period of the irregular beating of the heart that
may extend and become longer and continuous period over time. Another
important factor in AF is it usually starts with other forms of arrhythmia, such as
atrial flutter that later get transformed into AF. In another study by Burashnikov
and Antzelevitch (2017), it was stated that in most of AF cases that are
permanent and persistent, valvar, hypertensive, ischaemic and other structural
heart diseases lead to it. It was estimated that only 15% of the total cases were
caused by AF itself and others are caused by other underlying conditions. There
is an involvement of the interaction of the initiating triggers that causes rapid-
firing ectopic foci which are located in one of the pulmonary veins. Thus, the
abnormal substrate of the atrial tissue was responsible for creating the
arrhythmia. Even though there is an overlapping, however, it can be stated that
the pulmonary vein has an important role relatively among the young patients
who have normal heartbeats and a short period of AF (Nhs.uk, 2017). On the
other hand, abnormal atrial tissues play a significant role in patients who have
structural heart disorder and permanent. It was found in most of the episodes
that are no significant symptoms and may cause palpitation, chest pain,
shortness of breath, light-headedness and fainting. The disorder is associated
with a high risk of heart failure, stroke and dementia. Reddy et al. (2017) opined
that AF is a type of supraventricular tachycardia. The most common and
alterable risk factors associated with AF are high blood pressure and valvular
heart diseases. In normal case, the electrical conduction system of the heart
permits the impulse to be generated by the sinoatrial node. This is propagated

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NURSING CARE OF A PATIENT WITH A MEDICAL CONDITION
and simulates the myocardium when it contacts. Thus, it is a systemic and
ordered simulation of myocardium that helps in the contraction of the heart;
thus, allowing the body to pump the blood all over the body. In case of AF, the
electrical impulses are generated by the sinoatrial node in the right atrium of the
heart that is disorganised in nature and usually originates from the pulmonary
veins. Therefore, it leads to irregular conduction of the ventricular impulse that
generates rapid and irregular heartbeat.
In the past, Mr Robert has a medical history, including type 2 diabetes, chain-
smoking, hyperlipidaemia, rheumatic heart disease, hypertension and mitral
valve regurgitation. From the understanding of AF, it can be stated he had
structural heart disease that was affected by sedentary lifestyle and smoking
that leading to complications in term of chest pain that was diagnosed to be AF.
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NURSING CARE OF A PATIENT WITH A MEDICAL CONDITION
Task 2
Nursing Care Plan: Mr Robert Lalara
Nursing problem: Risk of infection
Related to: As stated in the case study that Mr Robert was a smoker who
consumed ten cigarettes per day; thus, it can be stated that there is an increased
risk of infection.
Goal of care Nursing
interventions
Rationale Evaluation
It is important to
address the areas
related to the risk
of infection as an
infection in the
heart in the given
case may
complicate the
situation, thus
The nursing
intervention that
needs to be taken
in order to reduce
the risk of
infection is to
understand the
patient and offer
aseptic condition
From the opinion of
Gundlund et al.
(2018), it can be seen
that infection
associated with AF
increase the risk of
thromboembolic
events. This involves
clotting of blood that
Constant
monitoring and
follow-up need
to be done in
order to assess
the risk of
infection.
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NURSING CARE OF A PATIENT WITH A MEDICAL CONDITION
leading to more
complicated heart
dysfunctioning. The
goal of care is to
reduce the risk
factors associated
with infection in Mr
Robert.
throughout his
hospital stays to
reduce the risk of
infection,
especially viral
infection.
breaks loose and
enters the
bloodstream to affect
other vessels.
Nursing problem: Impaired tissue perfusion
Related to: Impaired tissue perfusion is caused due to the low cardiac input that is
related to the condition of AF, Rheumatic heart disease and hyperlipidaemia in the
case study.
Goal of care Nursing
interventions
Rationale Evaluation
The goal of care is
to increase the
oxygen level in the
body that will help
in treating the
To elevate the
body as
recommended by
the physician that
will help in
As per the study
conducted by Opacic
et al. (2016), it was
stated that impaired
tissue perfusion is
The blood flow
can be
monitored by
evaluating the
blood pressure
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