Nursing Assessment And Management Of Pain Essay Paper
Nursing Care For A Patient With Unstable Angina: A Case Study
Sarah Smith is an 82 years old lady who has been admitted to cardiology wards and has been diagnosed with a condition characterised by unstable angina. She suffered from chest pain and epigastric distress when she was gardening. She has been prescribed medication for her condition along with specified dosage, however, due to her fear of injections, she is not keen to take some of the medicines. She had a medical history characterised by hypertension, anxiety, smoking and hypercholesteremia. Her abnormal objective data includes blood pressure, heart rate and respiratory rate.
The aim of the paper is to discuss about the case study of Sarah along with different aspects related to it. These includes general nursing care, prevention of hospital acquired complications, promotion of hydration and nutrition, provision of emotional and psychological support, discharge planning and education related to her condition. The paper concludes with a summary of the points that is mentioned in the paper.
Sarah has been diagnosed with unstable angina and therefore she requires nursing assessment along with the management of pain she has been suffering from. The immediate intervention that is required for Sarah is managing her pain. That is why she is to be prescribed with pain killers that might improve her condition by reducing the chest pain. The anginine tablets would help to reduce her chest pain and prevent the occurrence of angina in her (Bullock & Manias, 2017). The aspirin tablet would help to continue the blood flow and prevent its clotting in the blood vessels. Following the administration of medicine to reduce her chest pain, her vital signs is to be monitored frequently for recording any changes of the vital signs and cardiovascular assessment is to be done (Berman et al., 2017). Next, she should be administered with other prescribed medicine which would help to improve her condition. Nursing Assessment And Management Of Pain Essay Paper Morphine would help to reduce her chest pain and enoxaparin is an anticoagulant that would prevent blood clotting leading to any further complications (Burton, 2017). It has been evident that patient with angina usually suffer from shortness of breath and therefore, requires oxygen therapy to provide sufficient oxygen in her body. In case of Sarah, her SpO2 is 95% in room air and so at that moment she might not require oxygen therapy. However, frequent monitoring is required for recording her SpO2, as she may require oxygen supplementation at any moment sue to her condition. Electrocardiogram is to be done in order to evaluate her health condition due to angina (Tollefson & Hillman, 2021).
Sometimes it has been observed that with the use of several medicines, certain medication complications might develop in the patient. In case of Sarah, she has been prescribed with morphine that usually cast severe adverse side effects. Respiratory depression is one of the commonly noted side effects of morphine. It is to be observed that Sarah do not develop any kind of respiratory distress due to the drug, or she would require oxygen supplementation as the intervention of the shortness of breath (Brown et al., 2020). Enoxaparin also possesses the risk for the development of several medical complications in the patient. These complications include renal failure and obesity. Sarah is already suffering from obesity which was recorded in her objective data. Therefore, her condition is to be monitored carefully along with the function of the kidneys so that she might not develop renal problems as a risk of medication complications. It is evident from several cases, that patient suffering from unstable angina usually develop deep vein thrombosis or DVT due to blood clotting in veins of lower legs (Shaffer, Bucher & Rolley, 2020). Sarah is administered with aspirin and enoxaparin that would help to reduce the chances of blood clot and developing DVT. Proper monitoring is to be done, so that she might not develop any kind of pressure injuries in her body which might result in deep wounds mainly on the posterior side (Mansfield, Obraczka & Roy, 2019). Proper prevention measures are to be taken so that she might not develop hospital acquired infections or any kind of fall injuries while staying in the hospitals.
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Prevention Of Medication Complications
Water is regarded as the essential part of the body system and so maintaining the required balance of fluidity in body is important for maintaining proper health of an individual. However, according to some recent report, patient in hospitals have been suffering from dehydration for insufficient supply of water. Evaluation of fluid balance helps to ensures proper hydration of the body that is required to maintain the physiological functions of the body. The regular water intake for an adult is around 2500 to 3000 ml per day (Wang et al., 2019). This is to be maintained for Sarah so that she remains hydrate. The dietary type of Sarah should be rich in essential fatty acids; however, she should be devoid from consuming foods rich in saturated fat. This is because, consumption of saturated fats might promote narrowing of coronary arteries that is responsible of supplying blood to the hearts (Ojo, 2017). In case of unstable angina, intervention of several allied health professionals is required in order to stabilise the angina of a patient. In case of Sarah, intervention of cardiologist, endocrinologist, dietician, psychologists, and counsellors along with the nurses are required who would be able to control the situation. Intervention of cardiologists is required to assess her cardiac system and endocrinologist would help to analyse her pulmonary system which are the main assessment for angina. She has a medical history of hypercholesteremia, which needs to be checked and improved for preventing relapse of angina. Dietician would help to suggest her a diet plan that would be free from saturated fat which might stabilise her unstable angina condition (Hill & Bordoni, 2021).
Sarah has a medical history of hypertension and anxiety and is a smoker. During assessing her medical condition, it was recorded that she has been feeling anxious and tearful. These might affect her health condition in negative way. She also reported that she is not willing to take her medicines that has been prescribed as she is scared of injections. It has been observed that patients suffering from angina requires constant support emotionally for overcoming the anxiety , stress and depression (Su, Chang & He, 2018). Therefore, excessive stress and anxiety might affect their health and quality of life. Similarly, Sarah is also suffering from similar condition.. therefore, she required emotional and psychological support in order to overcome such situation. The allied health professionals would help to provide emotional as well as psychological support Sarah (Tollefson & Hillman, 2021). This can be achieved by simply establishing an effective communication with the patient. another way is by establishing therapeutic nurse patient relationship that would help Sarah to clearly and freely discuss about her problems with the nursing professionals. Establishing effective communication with the nurse is easier for the patient since they are the ones who spends a greater amount of time than the other health professionals (Chang et al., 2020). By establishing a personal support network might help Sarah to reduce her tension that is a result of stress and anxiety. They would be dedicated in order to provide her with emotional support. She has been feeling anxious about her condition and so her stress level might have been increased and so the psychologists would help to reduce the level of anxiousness in her.
Prevention Of Hospital-Acquired Complications
The involvement of interprofessional health members is required for discharging the patient from the health care organizations. It has been evident from the fact that nurses and intern physician had the most important role during discharging a patient. They have been responsible for providing education to the patient during their discharge (Kourbelis et al., 2020). Other health care professionals include pharmacists, dietician or nutritionist, care coordinator and counsellors. In case of Sarah, since she was not keen to take her medicines required for her health condition and better health outcome, she must be explained the importance of medicines for her health. The pharmacist would help her for medication management purpose that has been prescribed by the cardiologist and the endocrinologists. Since, she has hypertension and her blood pressure was much higher, she might carry a portable blood pressure machine for monitoring her in case she might come across any symptom of the same (Whelton et al., 2018). She should turn up for follow up appointment that would help to prevent the relapse of angina in her. She should seek medical assistance if she might suffer from chest pain in any instance of time. She can also seek help from the local social workers if required in case of any medical emergency. The predisposing factors that she should consider as an emergency condition includes shortness of breath, dizziness, light headedness, unexplained sweating, exhaustion, restlessness, weakness and many more (Jabri, Assad & Al-Jumaili, 2020). If she come across such sign she should immediately seek help from health care professionals. Next she is to be handed over the discharge summary along with medication list for further assistance.
Conclusion
From the above discussion it can be concluded that, Sarah is an old lady who has been diagnosed with angina and epigastric distress. Therefore, she was admitted in the cardiology department. The immediate intervention required was to reduce her chest pain and so she was administered with anginine tablets along with enoxaparin. Next, in order to prevent blood clot in her blood vessels and occurrence of DVT, she has been administered with aspirin and morphine. More stress was given so that she might not develop possible hospital acquired complications along with maintenance of adequate hydration and nutrition. She was provided with emotional support for improving her anxiousness, she was provided with detailed discharge summary along with proper education about the same.
References
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