SU_NSG4055_W5_Project_Tanner_W

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South University, Savannah *

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NSG4055

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Health Science

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Feb 20, 2024

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docx

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Uploaded by CommodoreSpiderMaster1080

1 Coronary Heart Disease Windy L. Tanner South University NSG 4055 Illness and Disease Management across Lifespan CP02 Professor Kara Bral MSN, RN April 25, 2022

2 Coronary Heart Disease Heart disease is the number one cause of death in the United States (U.S.). People are at higher risk of developing heart disease due to dietary habits and lifestyles. Smoking, hypertension, diabetes, and obesity are risk factors associated with poor diet and a sedentary lifestyle. Heart disease affects the cardiac output and can cause shortness of breath, edema, congestive heart failure, atrial fibrillation, angina, myocardial infarction, and peripheral artery disease. It has a significant bearing on someone's quality of life and impacts the family or caregiver. Heart disease is a chronic illness that has contributed to 17.6 million deaths globally (Benjamin et al., 2019). Heart disease has a massive impact on my community. According to the CC, 4.6% of adults have been diagnosed with coronary heart disease (CDC/National Center for Health Statistics [CDC], 2022). The participants chosen for this project is dear to my heart, and I want to learn more and help create a healthy environment and behavior changes for people living with heart disease. Holistic Plan of Care Participant J. L. Has been diagnosed with coronary artery disease for several years. It was discovered after a short hospitalization for chest pain and an irregular heart rate. Her ejection fraction on the echo was > 55%. However, it did reveal large thrombus clots in the left atrium. During the interview portion of the project, it was identified that J. L. did not fully understand the importance of medication adherence. She occasionally had difficulty in affording her medicine when she fell into the doughnut gap with Medicare Part D. Items J. L. expressed to improve in her health include seeking more information on exercise to strengthen her ability to perform activities of daily living (ADLs), the ability to walk around in the grocery store and have the endurance to complete light yard. Cardiac rehabilitation is an excellent program to help

3 improve physical endurance. Healthy lifestyle choices include smoking cessation education and encouragement to support a reduction plan in smoking, diet changes to lower fried foods in the diet, increase in fresh fruits and vegetables, and decrease in foods high in fat. J. L. has a vast support system with a healthy husband, and three children are involved with her health care plan. Her daughters can express the need for medication compliance, and both demonstrate a strong understanding of the increased risk of stroke with smoking and stopping her direct oral anticoagulant. J. L. verbalizes that walking around the house isn't active enough to qualify as therapeutic cardiac therapy. Each member of the family is effectively coping with the diagnosis. Practical coping skills are validated by verbalizing risk factors of hypertension, smoking, and dietary habits for coronary heart disease, peripheral artery disease, and stroke. The plan of care is determined by the needs identified by the participant and goals that she felt were essential for her to accomplish. Holistic care methods involve the patient and family or caregiver to devise objectives that can be measured and patient-centered goals collaboratively. Summary Week 1 Week 1 project, a complete discussion of coronary artery disease (CAD) was conducted. Hypertension narrows the arteries, and smoking increases the risk of developing it (Mohan et al., 2019). Hypercholesteremia is when deposits of a sticky substance called plaque buildup in the arteries causing partial or total blockage of blood flow. Modifiable health factors for increasing the risk of developing CAD are obesity, unhealthy diets, smoking, and decreased physical activity. Risk factors that cannot be altered include gender, ethnicity, age, and genetics. Hypertension, diabetes, obesity, and an elevated cholesterol level are comorbidities seen with

4 CAD (Benjamin et al., 2019). Different types of heart disease were reviewed, including heart failure, atrial fibrillation, and peripheral artery disease. Heart Healthy goals include reducing hospitalizations, improving medication adherence, complying with diet changes, and adapting to healthy behavior changes. Depression and ineffective coping mechanisms are frequently seen in this chronic illness. Education to the patient and family or caregiver must include the disease progress, trajectory, and treatment options, including medications used for treatment (Sidney et al., 2022). Reducing hospitalizations, readmissions, disabilities, and the mortality rate is vital in improving the quality of life of any individual learning to live with CAD. Week 2 In week 2, the benefits of individualized care plans were researched after a complete analysis of the questionnaire administered in week 1. The health assessment included a health history and a family support system. The impact of the chronic illness was included in the discussion with an understanding of how to incorporate patient objectives and goals instead of medically therapeutic interventions and goals (Bayliss et al., 2014). Shared decision-making with the entire health team is vital to devise a workable plan of care to improve the quality of life that the patient or caregiver gauges (Park et al., 2018). Knowledge gaps were identified in week two concerning medication adherence and how to seek help for medical assistance. Preventive health and the identification of medical issues are ways to manage CAD and increase the health quality and must include the patient and family or caregiver to positively impact the lifestyles of patients learning to live with chronic illnesses. Week 3

5 Patient-centered care plans, education, and nursing advocacy are indispensable activities for nursing objectives. In week three, information was obtained on the hierarchy of needs. Maslow identified that until the basic needs were met of food, shelter, clothing, and sleep, no progress could be seen in a higher category (Taormina & Gao, 2013) . A deeper analysis of the participants' needs was evaluated and included the financial impact of the illness. Objectives identified on the Healthy People 2030 website have vast information on heart disease. Strategies to improve cardiovascular health include dietary changes, increasing physical activity, and smoking cessation. One Healthy People 2030 objective for improving the health of this population consists of the reduction of risk factors for heart disease by controlling hypertension and lowering cholesterol levels. Excellent topics on pharmacy-based adherence intervention programs identified by the Community Preventive Services Task Force (CPSTF) were evaluated this week. Barriers were identified to specific patient populations that could not follow their prescribed medication plan (Guide to Community Preventive Services, 2019). Social and environmental factors play a huge role in outcomes for chronic illnesses. Support systems, insurance programs, community resources, access to health care, and transportation back and forth are considerations during the planning phase to properly manage health outcomes (Graffigna & Barello, 2018). Objectives and goals must be centered around items that motivate change behaviors in the patient. Advocating, educating, and being a change agent is the role nurses play in developing patient-centered plans of care using a holistic approach. Week 4 Week 4 cardiac rehabilitation, smoking cessation, and medication adherence focused on the week four project. A complete analysis and discussion of objectives and goals for each topic for the participant were conducted. The benefits of cardiac rehab include behavior changes,

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