Holistic Nursing Care for Coronary Artery Disease Patient - Case Study

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Case study number and title [eg. (v) Community / Palliative Nursing ]:
Gathering evidence
Identify where you will search for literature and evidence: Recent articles, government reports
Name the various databases you will access: Nursing database
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Case study structure Introduction, elaboration on the case study of Trevor followed by coronary artery
disease description
Main body
 Pathophysiology of coronary artery disease and its complications
 Assessments of heart disease
 The medical diagnosis of the patient
 Holistic Nursing care approach for treating Trevor identifying his needs,
treatment, education, documentation, working collaboratively with other
health care workers to ensure proper care
 Health promotion strategies and their relationships to NMBA
Introduction
Trevor has been diagnosed with a coronary artery disease, which resulted due to narrowing of the
arterial vessels(Nhlbi.nih.gov, 2020). He felt pain and discomfort in the upper left portion of the chest
frequently. The X-ray report showed that he had suffered a silent heart attack without his knowledge
and might be suffering from a major vessel disease.
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Trevor was a fit 61 years old man, one day he felt pain and discomfort in the upper left chest area, and
this pain arised and set down periodically. When the X-ray report showed that he has suffered a heart
attack, Trevor was very surprised and shocked, as he did not expect this at all. Studies suggest that
there could be some hidden risk factors which can lead to heart attack even in individuals who lead a
virtuous life style.
Main body
Pathophysiology of Coronary Artery Disease
 Coronary Artery Disease is a disease characterised by blockage in the arteries and blood
vessels of the heart due to plaque formation, leading to reduced oxygen supply within the
chambers of heart(Pino, Shi & Werstuck, 2018). As a result, the person suffers myocardial
infarction or a heart attack.
 Plaque is formed due to cholesterol and lipid deposition on the walls of the arteries leading to
narrowing of the arteries and blood vessels. This condition is known as
“atherosclerosis”(Pothineni et al, 2017).
Complication
 Heart attack: Blockage in the arteries causes less oxygenated blood supply within the heart,
leading to heart attack
 Chest pain or Angina: Reduced blood flow in the coronary arteries can give a sensation of pain
or discomfort called angina.
 Heart failure: Heart failure results due to improper or insufficient blood pumping from the heart
to the rest of the body, leading to breathing trouble.
Diagnosis
 Ineffective cardiopulmonary tissue perfusion related to reduced coronary blood flow from the
coronary thrombus and atherosclerotic plaque
 Potential impaired gas exchange related to fluid overload from left ventricular dysfunction
 Anxiety related to fear of death(Bayrak & Tosun, 2018)
 Deficient knowledge about post myocardial infarction self-care
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 Acute pain
 Activity intolerance
Holistic Nursing Care
 The registered nurses must collaborate with the multidisciplinary team and other associates to
ensure a positive outcome for Trevor.
 They should assess, analyses the condition of Trevor and develop different strategies based on
evidence to provide efficient healthcare to him.
 The nurses should encourage his wife, Sheila, to be present with him throughout the treatment
period and support him in this difficult time. Family support or support of loved ones is very
crucial in the fast recovery of a patient(Hajbaghery & Mokhtari, 2018).
 The Registered nurse should educate Trevor about health risks and complications that are
associated with cardiac disease.
 The nurse should prescribe drugs to him for lowering cholesterol level, and medications to
regulate the rhythm of heart, lower blood pressure, and prevent the formation of blood clots in
the coronary arteries.
 The nurse should encourage him to take part in physical activities like physical exercise, yoga
and meditation to nourish both physically and emotionally, reducing stress and relaxing.
 The nurse should follow an ethical framework to make clinical decisions when treating Trevor.
 In the rehab, nurse should be involved in the assessment of the physical, mental and socio-
economic condition of the patient and vocational status(Pino, Shi & Werstruck, 2018)
 Diagnosis of the therapeutic, physiotherapeutic and vocational education and training of the
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