Guide Questions On Cardiovascular Disorders And Liz's Case Study

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Part 1: Chronic Illness Risk Factors For Liz Based On Her Health Profile

Discuss the guide questions that follow the scenario using three (3) short essays. Each essay must be supported by at least two (2) relevant journal articles. That means that you will be using at least six (6) relevant journal articles in total.

Full name: Elizabeth Permadi Preferred name: Liz

Liz is a 49 year old woman from the East Java province of Indonesia. She weighs 87 kg and is 165 cm in height. She was diagnosed with chronic bronchitis five years ago and has been trying to cut down on the number of cigarettes she smokes since then. At present, she smokes an average of 3 sticks of cigarette per day, usually after meals. She drinks occasionally (average of 2 standard drinks per week) and denies use of illicit drugs. She exercises by walking their dog around the neighbourhood for 15 minutes each day. Liz has ongoing hypertension and high blood cholesterol, for which she takes Metoprolol 50mg every morning and Pravastatin 10mg every night. Liz reports that elevated cholesterol levels are very common among the members of her father’s family.

Liz has migrated to Australia with her 22 year old son, Bernard, to get away from her partner from whom she has experienced domestic violence. Bernard works as a cook in a popular local café but Liz is struggling to find a job. As such, she has started driving their car for Uber to generate income for their household. They live in a rented apartment near the café where Bernard works.

At present, Liz is admitted in the acute care adult medical ward where you are working as a registered nurse. According to the admission documents, she was rushed to the emergency room 3 days ago due to sudden onset of dizziness and weakness of the right side of her body that lasted for 6 hours. She underwent a CT scan, ECG and blood tests and was told that she had a transient ischaemic attack (TIA) and atrial fibrillation. Warfarin has been added to her medications and is being prepared for discharge. Guide Questions On Cardiovascular Disorders And Liz’s Case Study

Liz has been free from symptoms in since the TIA episode. She appears quiet and withdrawn. When asked how she is, she provides short responses such as “I’m good” and “I honestly feel normal.” In private, Bernard tells you that Liz started acting this way since she was instructed by her doctor that she cannot drive until her next appointment with the neurologist 2 weeks from now. Liz has told Bernard that she regrets going to the emergency room because she thinks that the symptoms would have just gone away on its own like it did in the emergency room. Guide questions:

Part 1: What chronic illness is Liz at risk of developing? Explain by using details from the scenario.

Part 2: Identify the health services available in Australia that could help Liz selfmanage her risk of developing the chronic illness you’ve identified in part 1. Clearly describe what the services involve and who are the health professionals that can help? Discuss why you think Liz would benefit from having access to these.

Part 3: Reflect on the services you’ve identified in Part 2. Discuss what challenges there could be for Liz to access the services you’ve discussed. What are the gaps in our healthcare services for people like Liz that could be addressed?

Part 1: Chronic Illness Risk Factors For Liz Based On Her Health Profile

The analysis of the case study shows that the patient named Liz is highly vulnerable to the development of cerebrovascular disorders. Heart diseases mainly range over a number of conditions that affect the heart and are mainly an umbrella term that can include blood vessel disorders like coronary artery diseases. This term also includes the issues with the heart rhythm problems called the arrhythmias and many others. Often healthcare professionals use the two terms like the heart disorders and cardiovascular disorders interchangeably. Cardiovascular disorders are mainly seen to be referring to the conditions that involve blocked or the narrowed blood vessels that can lead to heart attacks, chest pain as well as stroke. Liz is exposed to the risk of developing any of the disorders,

A number of risk factors are seen to be highly associated with the occurrence of the disorder and many of the risk factors are seen to be present in the patient named Liz. High blood pressure is one of the most important risk factors for the cardiovascular disorder. Liz is seen to be having high blood pressure or hypertension and therefore she is vulnerable to develop this. A number of factors like poor lifestyle interventions like lack of physical exercises as well as smoking and alcohol consumption might cause an increase in the blood pressure. Therefore, the factors increase the chance of heart disorders in different patients (Chen et al., 2015). The patient named Liz is physically inactive. She is only undertaking 15 minutes of walking with her dog every day that is not the sufficient amount of exercises that needs to be taken by individuals. Researchers are of the opinion that 30 minutes of moderate to vigorous exercises are very much important to ream fit and healthy. Therefore, lack of an adequate amount of physical exercises might act as one of the contributing factors for the disorder. Physical exercise helps in maintaining the blood pressure and body weight control. It helps in the reduction of the waist circumference and thereby helps in reducing the risks for cardiovascular disorders.

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Researchers are of the opinion that smoking cigarettes even a few per day can increase the chance of the patients to develop heart disorders. Smoking results in clogging of the arteries and is known to contribute towards the development of the atherosceloris. It mainly results in the narrowing and the clogging of the arteries that can reduce the supply of the blood and affects the amount of the oxygen available throughout the body (Mandviwala, Khalid & Deswal. 2016). The chemicals in the smoke can harm the blood vessels, have the ability to damage the structure and function of the blood vessels, and affect the functions of the heart. Consumption of alcohol can result in weight gain, high triglycerides, high blood pressure, stroke and many others. Therefore consuming too much alcohol play an important role in the development of cardiovascular disorders. Although Liz is taking the restricted amount of alcohol in each week, she needs to be careful about the amount so that these lifestyle behaviours of her do not result in such disorders.

Part 2: Identifying Health Services In Australia For Self-Management Of Cardiovascular Disorders

The patient is also seen to have a body weight of 87 kg and a height of 165 cm. therefore, she had a basal metabolic index or BMI of 32 that shows that she falls into the category of obese individuals. She does not possess a healthy body weight that is yet another contributor to the risk of development of cardiovascular disorders. Excessive amount of weight, especially around the abdomen, increase the risk for high blood pressure, high blood cholesterol and diabetes and in turn, increases the risk of the heart disorders indirectly. Liz is obese and this factor increases the risk for her development of cardiovascular disorders.

Liz is also seen to have a high level of cholesterol. Studies have shown that cholesterol levels increase the risk of building up of walls in the arteries and this causes atherosclerosis. It results in narrowing of the arteries affecting the flow of blood to the heart and disrupts heart functioning. This causes heart disorders. Another important factor that also contributes to the development of CVD in patients is the ethnic background of the patient. South Asian people are more prone to development of the heart disorders and are likely to have higher chances of being affected by high blood pressure as well as type 2 diabetes. As Liz is from such Asian background coming from Asia, there is a higher chance that she might also develop the disorder.

Stress can also contribute to the disease as stress increases the release of stress hormone. Exposure of the body towards unhealthy, persistently elevated levels of stress hormones like adrenaline as well as cortisol are related by researchers the changes in the ways by which blood clots (Carlisle et al., 2018). This factor increases the risk of the heart attack. Liz was stressed about their financial situations and this stress might have contributed them to the disorder.

Therefore, all these factors show that Liz is at the higher risk for the development of cardiovascular disorders.

The primary health care services are mainly seen to encompass a large range of providers and different care services in the nation of Australia. This service domain comprises care provided across public, private as well as governmental sectors. At the clinical level, this form of service is mainly seen to involve the first or the primary layer of the services that are encountered in the healthcare and comprises of different types of experts. Teams of healthcare professionals providing primary care are the different types of nurses as well as allied health professionals, midwives, dentists, pharmacists and other Aboriginal health workers. The nurses working in the primary care services might include general practice nurses, community nurses and even nurse practitioners. All of them are found to work together for providing comprehensive, continuous as well as person-centered care. Different types of care services are provided along with health promotion, prevention as well as screening, early intervention, treatment as well as management. Such services are mainly seen to target specific types of health as well as lifestyle conditions. The primary healthcare professionals handle various types of disorders like a sexual health issue, cardiovascular disorders and drug and alcohol services, oral health, diabetes, asthma, obesity, cancer as well as mental health services. Services are provided in the home as well as the community-based settings like that in the general practices as well as other private practices, community health, local government as well as non-government settings.

Part 3: Challenges And Gaps In Healthcare Services For Individuals Like Liz

The patient named Liz has been identified with a higher vulnerability towards the development of the cardiovascular disorders in the acute care when she was admitted to the ward due to transient ischemic attack. The nursing professionals should refer her to the primary health care centre in the community she resides. The general practitioner or the GP along with the primary health care nurses would undertake a screening procedure to identify the risks she possesses and accordingly help her identify the vulnerability of the heart disorder she might develop. Following the advice of the GP, the primary healthcare nurse would be developing a care plan for her about the medication she would need to initiate. She would be also helping her to identify the health behaviors she needs to change for overcoming such risks. The primary health nurses would educate her about the disorder and make her understand the risks associated with them. She would also refer her to the other community services from where she would get further support regarding her-self care strategies and management.

Community-based healthcare centers have experts and nurses who ensure CBR or the community-based rehabilitation services to the patients in the nation of Australia. The World Health Organization supports these services, as they believe that these services enhance the quality of life for the people with disabilities as well as their families, helping them to meet their basic needs and for ensuring participation as well as inclusion in the society. The community-based experts from whom Liz can get services are the dieticians who would be helping her to develop a diet plan helping get to decrease her weight. Another service that she can also get are the social workers. She had already faced stroke and are identified with a huge number of risk factors like high cholesterol high blood pressure, stress and many others. Therefore, social workers will be helping her in her everyday activities along with taking extra care for her regarding her medications and motivating her constantly for ensuring healthy lifestyle and behaviors. Occupational therapy session can also be taken by Liz helping her to cope with the present situations can come back to normal lives. This would help her to join Uber and continue her livelihood.

The services, which are discussed act as act the frontline, care services. The patients who attend to these care centers can not only identify the disorders that had occurred to them but also understand the disorder that they are vulnerable to and can develop in future. Therefore, the best aspect of these forms of treatment is that it has the capability to provide preventive services besides curative services and these preventative services help the patients by saving them from sufferings and warning them beforehand. Guide Questions On Cardiovascular Disorders And Liz’s Case Study The advice provided by them help in not only the development of their physical health but also their mental, emotional and financial conditions by providing care following the bio-psycho-social model. They provide a holistic care that covers their physiological, social and psychological determinists of health. Hence, these services bring out the best outcome for patients.

The challenges that Liz might face are the financial constraints and her poor health literacy skills, which might affect her accessing care, form the primary healthcare and community services. One of the challenges is the financial issue. Liz is very concerned about the financial situation and this is evident from the stress she is facing on the advice of not joining Uber for driving from healthcare professionals. The poor financial condition might not make her able to afford all the services that she is referred to and this might affect her health and well-being. Another challenge that I believe can create issues is her poor health literacy. She believes that she does not require treatment and she would have got well even if she was not admitted to the emergency ward. This shows her poor health literacy. Health literacy helps individuals to make correct healthcare decisions (Lyles & Sarkar, 2015). These two factors can act as challenges.

One of the healthcare gaps that can be identified in the care service is the lack of culturally competent care services. Often there are reports by the culturally and diverse linguistic communities that they cannot get care services that align with their cultural traditions, exceptions as well as inhibitions (Truong et al., 2017). Therefore, there remain high chances that Liz might not get culturally competent care form the healthcare professionals, might feel disrespected, and dishonored. Hence, care services need to be improved to meet the cultural needs of diverse communities.

References:

Carlisle, K., Farmer, J., Taylor, J., Larkins, S., & Evans, R. (2018). Evaluating community participation: A comparison of participatory approaches in the planning and implementation of new primary health?care services in northern Australia. The International journal of health planning and management. https://doi.org/10.1002/hpm.2523

Chen, W., Thomas, J., Sadatsafavi, M., & FitzGerald, J. M. (2015). Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. The Lancet Respiratory medicine, 3(8), 631-639. https://doi.org/10.1016/S2213-2600(15)00241-6

Lyles, C. R., & Sarkar, U. (2015). Health literacy, vulnerable patients, and health information technology use: where do we go from here?. ttps://doi.org/10.1007/s11606-014-3166-5

Mandviwala, T., Khalid, U., & Deswal, A. (2016). Obesity and cardiovascular disease: a risk factor or a risk marker?. Current atherosclerosis reports, 18(5), 21. https://doi.org/10.1007/s11883-016-0575-4

McKittrick, R., & McKenzie, R. (2018). A narrative review and synthesis to inform health workforce preparation for the Health Care Homes model in primary healthcare in Australia. Australian journal of primary health, 24(4), 317-329. Guide Questions On Cardiovascular Disorders And Liz’s Case Study