Evidence Based Nursing Care For A 57 Year Old Gentleman Who Has Been Recently Diagnosed With Acute Coronary Syndrome

There are multiple factors that lead to the development cardiovascular disease. While some individuals are born with conditions that predispose them to strokes or heart disease, a majority of people participate in a combination of risk factors that lead to the development of cardiovascular disease. A few of those risk factors include a lack of physical activity, smoking, and poor diet. The more frequently individuals expose themselves to these risk factors the higher their chances of developing cardiovascular disease.

Many risk factors can contribute to this process. Some of them like age, gender and genetics are non-modifiable, meaning there is not much that can be done about them. Others, like drug abuse, smoking, stress, diet and exercise are modifiable, meaning an individual has control over them.3

In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure. I will gather these evidences using a literature search which I will include an account of. Using a critiquing framework for support, I will appraise both primary and secondary evidences that I have chosen. I will also look at potential non-evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be drawn.

This assignment will take the form of a case study on a current patient with heart failure being nursed in a community setting. Due to confidentiality and patient privacy, the patient discussed will be referred to as John¹.

Nevertheless, there is an understandable and noticeable link between circulatory related diseases and lifestyle diseases, such as Coronary Heart Disease. Coronary heart disease can occur when fatty acids, such as cholesterol in an inadequate diet, build up in the walls of the coronary artery. These fatty deposits collect minerals and harden to become a plaque. Eventually, this plaque grows and can swells up, forming an aneurism. In some cases, this aneurism may burst leading to instant death. As it continues to grow and swell up, it finally blocks the artery completely and forms blood clots. This is known as coronary thrombosis. A myocardial infarction, or in other words as heart attack, occurs when no oxygen is able to reach the coronary artery and thus it is unable to fulfil its role in providing the heart muscle with a sufficient supply of blood. Heart attacks are very common in the society nowadays, especially occurring in smokers or obesity related diseases (Millar, June 2014)

In this case study, there is a patient named Mr. Wilson who is a 70 years old man. He stated that he had difficulty in breathing and caught a ‘flu’ a week ago. Currently, he has been observed pitting oedema on his lower legs. In addition, the patient had history of heart attacks, which has been diagnosed with congestive heart failure. The case study will provide a complete care plan for the patient. Its aim is to provide a better quality of care for the patient as well as promoting holistic treatment of the patient. The report will firstly assess the patient’s condition by two nursing assessment tools while offering rationale for choosing these assessment tools. The client’s health problems will then be identified and

The approach to care that would be delivered for Mr. P who is 76 years old is to ensure this patient has as much information and education for his diagnosis of cardiomyopathy and congestive heart failure. During this educational approach it is important to make sure the patient is able to return a demonstration of understanding of maintain a healthy diet and on his medications. To

The pathophysiology of ACS includes the stable plaque forms get converted into unstable plaque forms.2 These unstable plaque forms have numerous thin fibrous cap cells, inflammatory cells, activated macrophages, and smooth muscle cells. Sympathetic activity increases myocardial contractility, pulse rate, blood pressure, and coronary blood flow which leads to plaque rupture or fissure. As the artery ruptures, it causes thrombus formation and ischemia in this particular artery. Depending on the condition, different thrombi could form. The unstable angina forms a small thrombus formation, NSTEMI forms a partial thrombus formation, and STEMI forms a complete and persistent thrombus. The risk factors involved in ACS are age, physical inactivity, and history of hypertension, diabetes, or angina. The signs of acute coronary syndromes are an acute heart failure, tachycardia, bradycardia, or heart blockage, and the symptoms of ACS consist of chest pain, pain in the extremities, nausea, shortness of breath, heavy

One of the most frightening medical diagnoses a patient can receive from a physician is a malfunctioning heart, a diagnosis that will eventually lead to death if correction of the issue is not attempted. The heart supplies the entire body with oxygenated blood in addition to requiring its own supply of oxygen rich blood. This is why coronary arteries are vital to the hearts ability to pump. A final option to correcting non-patent coronary arteries is a surgical procedure, coronary artery bypass grafting (CABG). Every year approximately 450,000 patients have CABG surgery in the United States (Mullen-Fortino & O 'Brien, 2008). Based on continuing healthcare trends, more and more people each year are having coronary artery issues causing the need for CABG surgery to rise. Also patient demographics are changing, they are older, sicker, coronary artery blockage / damage is more extensive, and likely have a decrease in functioning of the hearts ventricles (Sidebotham, McKee, Gillham & Levy, 2007). The nursing profession not only has a critical role in caring for these patients, but also in teaching and educating them before and after the procedure. Education and teaching has been implemented into evidence-based practice for years to facilitate better patient outcomes. The goal of this literature

The aim of this essay is to explore evidence based nursing intervention in the care and management of chronic obstructive pulmonary disease (COPD) in an acutely ill patient. The acutely ill patient involved in this essay was admitted to hospital due to cerebrovascular accident and had a past medical history of myocardial Infarction, left Ventricular failure, peripheral vascular disease and duodenal ulcer as well as chronic obstructive pulmonary disease. This essay will provide a rationale for the chosen aspect of care (COPD) and reason will be given why it is a priority. In particular the essay will examine the significance of the underlying pathophysiology of the disease relating to the acutely ill patient other

The module presented by Professor Beckie was aimed in preparing nursing students to provide appropriate, evidence based care to older adult with heart disease. I learnt the face of heart disease is changing and more American die from heart disease than any other diseases combined. And also women are twice to die from heart disease than men. I also learned how to use motivational interviewing techniques which will promote collaborative of care. Genetic and environmental factors that contribute to heart diseases such as family history, hypertension, diet, smoking, obesity, and also psychosocial factors such as stress and depression. She talked about management of heart disease which include lifestyle modifications and how to modify the patient

Nurses play a very important role in managing a patient from the moment of his admission up to making a discharge plan. Each part of the nursing process is vital to the wellbeing of the person he is taking care of. Clinical reasoning is always essential in each part of the nursing process from assessment, setting up goals and intervention. Effective nursing management is done when a nurse looks for the early and right cues at the right patient and implementing it at the right time. This essay will delve deeper into the case of Rob Geis, a patient who was suffering from angina, given his history and the signs and symptoms he experienced up to the time when his condition worsened to Myocardial Infarction. This essay will also look into

In healthcare industry nurses represent bigger number compared to other healthcare providers. Nurses play a vital role in patient’s management during the process of disease. Researchers had proven that nursing education in cardiac rehabilitation had improved health outcomes and reduce the risk of worsening cardiac events. Patient’s that had obtained health education from nurses had stated that they gain knowledge and awareness of their disease as well behavioural changes are documented (Cynthia, 2006).

This assignment will present a nursing care study of a patient on a cardiac ward. The patient will be referred to as Ann to maintain confidentiality (NMC, 2008). Ann’s consent was gained prior to starting this care study. The care study will be developed using the Nursing process and the Roper, Logan and Tierney model. These will both be outlined. The assignment will focus on the assessment process and one problem identified during the assessment and the nursing care which followed this.

Acute coronary syndrome is a term used for any condition brought on by sudden, reduced blood flow to the heart. Acute coronary syndrome symptoms may include the type of chest pressure that you feel during a heart attack, or pressure in your chest while you 're at rest or doing light physical activity (unstable angina). The first sign of acute coronary syndrome can be sudden stopping of your heart (cardiac arrest). Acute coronary syndrome is