NUR250 Medical Surgical Nursing: Patient Care and Discharge Planning

This report focuses on the nursing care of a 42-year-old indigenous man, Robert, admitted with chest pain and atrial fibrillation. The report details the patient's medical condition, pathophysiology, and past medical history, including T2DM, smoking habits, and other cardiovascular issues. It includes a comprehensive care plan addressing shortness of breath, heart health, and overall patient well-being, outlining nursing interventions, rationales, and evaluation methods. The report also emphasizes discharge planning, including managing anxiety, infection control, and patient education strategies, such as lectures and audio-visual aids, to ensure effective implementation of health practices. Furthermore, it discusses the medications prescribed, Azithromycin and SAlbutamol, their functions, and potential side effects, providing a complete overview of the patient's care from admission to discharge.

Medical Surgical Nursing
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Table of Contents
Topic: Nursing care of a patient with a medical condition..............................................................3
TASK 1............................................................................................................................................3
Current patients medical condition/disease.................................................................................3
Pathophysiology of the disease....................................................................................................3
The current presentation related to the patients past medical history..........................................4
TASK 2............................................................................................................................................4
Care plan......................................................................................................................................4
TASK 3............................................................................................................................................5
Discharge planning......................................................................................................................5
TASK 4............................................................................................................................................7
Medication...................................................................................................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9
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Topic: Nursing care of a patient with a medical condition
Medical surgical nursing is an important aspect of medical professional that is related to
the care of adult patients in a large range of environment. In fact, it tends to provide specific
information in the nursing practices. However, it is associated with the path physiology as well
as assessment together. It deals with the various critical diseases cure as well as role of nurses in
providing their care to that particular patient (Lewis and et,al., 2016). The primary objective of
nursing practitioner is to provide all sorts of care, treatments to ill, injured person that are having
critical diseases. Therefore, this project report highlights specific information regarding one of
the medical case situations of an indigenous man that belongs to a remote community.
TASK 1
Current patients medical condition/disease
This case is intent to provide specific information regarding a 42 years indigenous man
Robet that belong to a remote community. It has been seen Robert was admitted to the CDU
medical ward with a critical chest pain along with a racing heart. According to the ECG report, it
was seen that Atrial Fibrillation. During the assessment procedure, it has been determine that the
breathing rate is recorded as RR18 with a oxygen saturation percentage of 96 on room air,
whereas circulation level is HR 115bpm that happens to be irregular, its BP pulse is
120/80mmHg. The disability reports is marked as GCS 15/15, 2/10 central chest pain, he feels
tied and more worried.
Pathophysiology of the disease
Chest pain is basically termed as a discomfort occurs in a chest that consists of a dull
ache along with a crushing or a high rate of burning feeling. Further, it is associated with a sharp
stabbing pain. The major causes of this symptom can have causes that are not due to causal
diseases (Ignatavicius and Workman, 2015). This discomfort also refers in the patient shoulders,
arms, neck problems. However, it will lead to create a heart issues which is basically impact the
coronary heart diseases. Heart palpitation could have major cause that could arise because of
stress, smoking and use of excessive alcohol as well as some time medication. In almost every
movements of the heart within the chest could lead to impact the condition of the patient. The
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heat palpitation are generally termed as feeling of having a fast-beating or pounding heart. In
maximum situation, it will create major stress or anxiety problems, because the patient would
had too much nicotine or alcohol. These are happens to be a sensory symptom that are often
determine or as skipped beat, fast fluttering in the chest and many more.
The current presentation related to the patients past medical history
It has been seen that the earlier background of Robert is quite miserable because he tends
to live in a single story home along with his wife, 4 children and 2 grandchildren. The most
important parts of the Robert life are that he is independent with his own cares. According to the
Robert parts medical history, it has been seen that T2DM, a chain smoker who usually smoke 10
cigarettes in a day. However, Robert was also facing problems with the HTN, Hyperlipidaemia,
rheumatic heart problems and mitral valve regurgitation. The most important benefits for Roberts
are not having any known drug allergies problems. The current medical condition of Robert is
occurring because of its parts medical history. The chest problems are tends to be arises because
of having maximum smoking ability (Hinkle and Cheever, 2013). Since, inhaling cigarette
smoke will create acute changes in the lung fluctuation in resistance to cough and irritation of the
unhealthy airways. It will directly make impact on the respiratory function of Robert.
TASK 2
Care plan
Nursing
problem
Relation Goal of care Intervention Rationales
for
interventions
Evaluation
Shortness of
breathing
It is related to
chest pain
Secondary
review is also
required to be
maintain in
the form of
physical
examination
The main
motive is to
continuous
look after the
breathing
problem of
the patients.
Oxygen level
needs to be
It will be
monitoring
every 30
minutes by the
nurse.
Chew Aspirin
325mg,
regardless if
they took one
Nurse will
take control
of
Nitroglycerin
in 0.4mg in
every 5
minutes for
chest pain.
It is provide
valuable care
on regular
basis so that
the condition
can be
controlled.
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check on
frequent
level.
earlier.
Health
screening
It is related to
the heart
problems
It is
important to
check the BP
rate, RR, HH
and GCS
Analyse the
heart rate and
record the
impact on the
real time.
An IV blood
investigation is
needed to be
done.
It is required
to provide
medicine for
the high BP
or pain.
The will lead
to control the
further
impact or
stabilize the
condition of
Robert.
Promotion of
recovery
Based on
patient
mental
condition
Overall
health
analysis that
consists of
expiratory
wheeze note.
It would help
to maintain
normal sinus
rhythm during
the time of
hospitalization.
Troponins
stage would
be given at
0200 and
0800 per md
over.
It will assist
in overall
cure for the
patient by
examining
the condition
in every 5-10
minutes time.
TASK 3
Discharge planning
It happens to be most crucial stage for the nursing practices which is effectively
communicate specific data regarding the ongoing diseases prevention during the discharge of
patient. However, it involves taking into consideration likes as follow-up tests and appointments.
Hospital discharge planning is an essential process that could determine the specific kind of care
their need after the patient should leave the hospital. It can assist in prevent future readmissions
as well as they should make patient move from the hospital to their home. However, it is a
crucial part of patient care in acute care hospital wards (Williams and Hopper, 2015). The nurse
would have a pivotal role in discharge plan so that the patient would become safer and recover
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more quickly. The primary focus of discharge plan is to develop a patient to promote active
participation in delivering right care to them. Family members are essential links in the transition
from hospital to their home care. They must include in discussion and formulation of active plan
that can provide right care to the patient during their home care. Before nurses starts the
discharge procedure, it has been asked for a paper that consists of the detail information
regarding the essential condition of patient with the appropriate medicine or care techniques
(Tabari, Ebadi and Jalalinia, 2014). The family members would have the list of printed
information regarding their discharge. In case the patient those are going to home, they have a
ride home from the hospital that are arrange for the additional assistance at home for the patients.
The two of the most important point which is required to be taken into account in the patient
preparation of discharge are:
 Manage Anxiety & stress: It has been seen that stress during the time of infection
disease outbreak could lead to various problems. Thus, it is important to take valuable
actions such as healthy meal, exercise on regular basis, get plenty of waters or sleep and
avoid taking drugs or any kind of smoke that can lead to impact the respiratory system.
 Infection control measure: Another important point that is needed to be considered
during the preparation of discharge for the patient. It is an essential role of nurses to take
care of the patient more wisely so that future infection cannot get affect the condition of
the people.
During hospital discharge:
At the time of discharge, the member of patient healthcare team would required to
provide with the key information that are required to make transition more effectively (Atalla,
Aboalizm and Shaban, 2016). Below mentioned are some important detail those are needed to be
followed at the time of discharge for the chest pain patients:
In the Hospital:
In the case patient is suffering from chest pain or heart related problems they need to follow
below mentioned instruction:
 Check the chest pressure
 Record the breathing pressure
 Blood pressure, oxygen level in the body
 Provide them regular medicine
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 Avoid unhealthy food during the intervention process
At home:
 Check the medical condition at the time of discharge
 Follow-up care that are required such as physical therapy
 Do not smoke
 Eat a wide range of healthy food that contain low-fat and low salt food
 Drink huge amount of water on regular basis
 Ask regarding the activity that can help them to recover faster
 Maintain a healthy weight
Strategy to assist the patient to implement the education into their daily routine
The patient along with their family education consists of audio-visual methods as well as
verbal instruction. The primary motive is to examine the verbal information that are considered
as a key element of the patient that make suggestion for the best practices for healthcare
providers that are suffering from some kind of health problems (Mahmoud and Bayoumy, 2014).
Health education is an essential strategy that can be used to implement health promotion as well
as disease prevention plans. Health education related to chest pain or heart problems tends to
provide effective learning experience on the mental condition of the patients.
Lectures learning: This particular strategy tends to provide specific information
regarding ways to improve the breathing problems that are required to avoid heart diseases.
However, these lectures are organized by the experience doctors or medical professional to that
patient that are having critical issues that are affecting their respiratory system. The patient need
to make use of these learning notes during their regular routine so that they can sustain their life
in effective manner (Perrin and et.al., 2012). They need to avoid going into the polluted areas,
maintain social distance from the smoker and eat healthy food.
TASK 4
Medication
According to the case scenario of Robert, it has been seen that the doctors has prescribed
two valuable medications that can help them to get recover from the problems. The new
medication is Azithromycin 500mg OD PO and one usual medication is SAlbutamol MDI 100
mcg PRN INH.
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Work of medication: Azithromycin 500mg OD PO is basically used to treat a large
range of bacterial infections. It consists of a macrolide-type antibiotic that works by block the
expansion of bacteria. This specific medication would not work for a crucial infection such as
common cold and flu. The health care tends to provide the use of this particular drug to treat the
infection that is related to lungs, skin and other body organs. SAlbutamol MDI 100 mcg PRN
INH tend to work to get relive from the symptoms of asthma as well as other chronical
pulmonary disease such as feeling breathless or coughing (Hess and et.al., 2012). It begins to
work within a certain minutes as well as effect between 3-5 hours after taking this medicine.
Reason for giving this medicine
It has been noticed that the doctors has prescribed these particular medicine to Robert
because it would provide quick recovery from the breath loss or pain from which Robert was
suffering during that particular time. The SAlbutamol MDI 100 mcg PRN INH is termed as a
bronchodilator medicine because it dilates patient airways. It generally open-up the air passages
in the lungs. Azithromycine generally stop growing of unwanted bacteria that has been affecting
the patient health (Hershcovici, Achem, Jha and Fass, 2012).
Side effects of these medicines: Azithromycine tablets are would not work for any kind
of viral infection. However, unnecessary use of these tablets will lead to affect the composition
of using this drug. The most common side-effect of this tablet is related to feeling sick,
headaches and changes to patient growing infection. SAlbutamol MDI 100 mcg PRN INH is
having certain side-effect like as itching, rash and swelling of the eye lids, low blood pressure as
well as shortness of breath after taking immediate doses.
CONCLUSION
From the project report, it has been concluded that medical problems are lead to impact
the health condition of various people. However, certain key problems such as chain pain and
heart racing are major affect on the health of the patient. Thus, it is important to have proper care
plan and medication so that chances of infection can be avoided in the future.
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REFERENCES
Books and Journals:
Atalla, H. R., Aboalizm, S. E., & Shaban, H. A. (2016). Effect of nursing guidelines compliance
to infection control among nursing student. IOSR Journal of Nursing and Health
Science. 5(1). 23-34.
Hershcovici, T., Achem, S. R., Jha, L. K., & Fass, R. (2012). Systematic review: the treatment of
noncardiac chest pain. Alimentary pharmacology & therapeutics. 35(1). 5-14.
Hess, E. P., & et.al., (2012). The chest pain choice decision aid: a randomized trial. Circulation:
Cardiovascular quality and outcomes. 5(3). 251-259.
Hinkle, J. L., & Cheever, K. H. (2013). Study Guide for Brunner & Suddarth's Textbook of
Medical-surgical Nursing. Lippincott Williams & Wilkins.
Ignatavicius, D. D., & Workman, M. L. (2015). Medical-Surgical Nursing-E-Book: Patient-
Centered Collaborative Care. Elsevier Health Sciences.
Lewis, S. L.,& et,al., (2016). Medical-Surgical Nursing-E-Book: Assessment and Management
of Clinical Problems, Single Volume. Elsevier Health Sciences.
Mahmoud, M. H., & Bayoumy, H. M. (2014). Barriers and facilitators for execution of nursing
process from nurses’ perspective. International Journal of Advanced Research. 2(2).
300-315.
Perrin, J. M., & et.al., (2012). Complementary and alternative medicine use in a large pediatric
autism sample. Pediatrics. 130(Supplement 2). S77-S82.
Tabari, F., Ebadi, A., & Jalalinia, S. F. (2014). Pathology of the Clinical Education of Medical-
Surgical Nursing Courses: A Qualitative Study. Education Strategies in Medical
Sciences. 6(4). 209-215.
Williams, L. S., & Hopper, P. D. (2015). Understanding medical surgical nursing. FA Davis.
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