Myocardil Effusion

This case study aims to critically analyse an episode of care in relation to a patient suffering from complex health care needs. The focus of the assignment includes three aspects of care: depression, malnutrition and their relationship to lung cancer.

Nurse’s care for several patients in a day and it is important to understand the patient as a whole person to treat them effectively. The purpose of this assignment is to explore a patient’s disease to understand the nursing judgments and interventions involved, the medications for this diagnosis, and to understand the disease. The patient described in this paper will be referred to as Jonathan to ensure patient confidentiality.

With the aging population at an all time high and continuing to climb there had been a spike in patients with chronic illness. Due to this the way in which patients are cared for and educated must change, chronic illness follows the patient out of the healthcare setting and they must be aware of how to care for themselves and their illness at home. This is a drastic shift in what healthcare used to be about, treating the acute illness. The Center for Disease Control defines acute illnesses as, severe and sudden in onset, for example a broken bone or the common cold. A chronic condition by contrast is a long- developing syndrome like osteoporosis or diabetes (CDC.gov). Treatment and education of a patient with chronic illness is at high demand and nurses must now gear their care towards these needs.

This assignment shall focus on a patient called Audrey Smith, a 75 year old lady who has been transferred to the ward from the emergency department with a fractured neck of femur, small haematoma to the left forehead, soft tissue injury and bruising to the left shoulder following a fall at home involving her dog. On admission to the ward at 14.00 hours, Audrey has an intravenous transfusion in progress, an indwelling catheter insitu, she is alert and orientated to time and place and is responsive with a GCS of 14. The plan is for Audrey to go to theatre for arthroplasty of left hip at 17.00 hours. She is nil by mouth and requires hourly neurological observations. The author shall discuss the holistic nursing interventions Audrey shall receive to ensure she is safe, her hygiene and comfort, elimination and nutritional needs are met.

Tobacco use is an important contributor to PAD, as smoking promotes atherosclerotic changes in the endothelium of blood vessels. Almost 90% of patients diagnosed with PAD are current or former smokers; smokers’ risk of PAD is positively correlated with the number of cigarettes they smoked each day, and the number of years they smoked for.1

Despite technological and medical advances today, chronic disease and resultant co-morbidities are prevalent in the Australian Healthcare System. As a result, patients, especially in the acute care setting, have more complex care needs. The management and care of patients with these complex care needs present a challenge for the contemporary nursing professional. Positive patient outcomes will be dependent on a number of factors, such as the assessment of the patient’s condition, the identification of potential risks for the patient, the planning of appropriate care and the management of the subsequent interventions that may be required.

Atherosclerosis, the underlying cause of coronary heart disease which can affect any artery in the body, is essentially the narrowing of arteries due to excessive build up of cholesterol-rich lipids known as plaque (Insull 2009). Once the arteries become narrow, the flow of blood will be constricted, and the amount of blood, nutrients and oxygen that are able to reach the heart are reduced. As a consequence, the heart becomes increasingly hypoxic resulting in ineffective contraction. The aftermath of narrow arteries often poses serious consequences as it has a high probability of causing heart attack, angina, or even stroke (Marieb & Hoehn 2010; Insull 2009). Despite the fact that arteries will harden naturally as people age, the rate of plaque development is determined by the number of risk factors (Insull 2009). This essay will discuss and review the procedure in which the risk factors: hypertension, abnormal level of blood lipids, and smoking took to assist in the development of atherosclerosis.

The objective is to observe and pseudo-experience the care provided to an individual. We will evaluate to practices of the clinician's as professionals. In the evaluation we will discuss whether, patient-centered care, a holistic and relationship based approach have been implemented. Evidence-based practices will be recommended to improve the care of future patients. The process will require a conscious effort to look through the eyes of the patient and remove ourselves from the caregiver role or perspective.

From this we can judge that obesity is one risk factor caused by upbringing which makes heart disease a more likely illness for someone. In addition, smoking is another activity which is self inflicted that increases the likelihood of getting coronary heart disease. The exposure to the fumes produced from the smoke cause free radicals (homolytic fission: bond breaks evenly leaving two reactive radicals) (1). These radicals promote the growth of plaque inside arteries causing atherosclerosis.

Another risk factor of heart attacks and many other diseases is smoking. By smoking you speed up the process of atherosclerosis, and so will have a heart attack sooner. Smoking also decreases the amount of oxygen that is absorbed from your lungs to your blood, meaning that it is more likely for your heart not to have enough. This means that when you exercise your heart is going to be under more stress, and it is much more likely for damage to occur. Quitting smoking not only reduces your risk of a heart attack, but also of many other conditions such as lung disease and many

Pericardial effusion appears as anechoic stripe that is surrounding heart (Fig.26). Smaller effusions appear as a thin stripe in the pericardial space, frequently not spreading fully around the heart and often layering out posteriorly with gravity

the family gave stresses unconsciously to the patient by scolding). Then the nurse “explained the features that occurred in the disease to the family” and “let the patient and the family perceive the unconscious”. They were done after making “agreements formation by the patient, the family and the nurse”. After that, the nurse “asked the family to let the patient keep the lifestyle in the hospital also after discharge”. Thereby, the patient had been able to keep the same lifestyle as in the hospital and “live in the community with the family without the

This has the unfavourable consequence of increased healthcare expenditure, which was over 1.8 billion dollars for CHD in 2004-2005 (AIHW, 2009). This is of particular concern due to the highly-modifiable risk factors which are significantly responsible for the rates of ischemic heart disease. Smoking, physical inactivity, poor diet, high LDL cholesterol, low HDL cholesterol, stress and diabetes are all lifestyle related and can increase the likelihood of other risk factors developing (Santulli, 2012). If these risk factors are not addressed as part of a multi-faceted healthcare approach it could have dire financial and quality of life implications for all Australians (Patel et al., 2014). It is far less expensive to address these underlying causes and risk factors behind CHD than to treat an acute patient once they have already had an acute myocardial infarction (AMI). Thus it is the preventable nature and total mortality and financial burden of CHD and as a whole, CVD, which justifies its inclusion as a

Another cardiovascular malfunction that cigarette smoking may cause are strokes. A stroke is damage to the brain caused by leakage from a ruptured blood vessel or an interruption in blood supply. Nicotine and carbon monoxide in cigarette smoke affect the adhesives of blood platelets, the main clotting factor in blood. This can cause blood vessels to harden and form blood clots that can flow to the brain, a major cause of strokes. Nicotine can also cause the blood vessels to constrict. When a smokers arteries become too constricted,

Smoking creates toxins in the blood. This greatly contributes to the development of atherosclerosis. Atherosclerosis is a condition in which fatty material is deposited along the walls of the arteries. This fatty material thickens, hardens, and can eventually block the arteries if not treated. Clots may also form around the plaque deposits. Smoking raises the levels of proteins that cause the blood to clot and also increases platelet production, making the blood stickier which further creates risk for clots. This also interferes with the blood flow and poses an added danger if they were to break off and travel through the body causeing assorted health problems such as heart attack, stroke, or gangrene.