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. I was placed on a cardiac ward within the Trust for my phase four placement. The ward deals with patients who have acute cardiac conditions including myocardial infarction. The ward also accommodates those with chronic cardiac conditions such as congestive cardiac failure, pulmonary oedema and triple vessel disease. Patients awaiting cardiac surgery may have to wait quite a while on the ward. There are both male and female patients on this ward and the ages range from sixteen to very elderly. A sixty three year old lady named Ann was admitted to the ward on my first week on this placement. She was admitted to the ward via Accident and Emergency. Ann had taken ill at home previously that day and her husband had called for an ambulance. Ann presented with chest pain radiating down her left arm, shortness of breath, nauseated, fatigue and weakness. Investigations later showed that Ann had experienced an Acute Myocardial Infarction. Acute Myocardial Infarction, also known as heart attack, is characterised by the ischemic death of myocardial tissue (Porth, 2005). Diagnosis of an Acute Myocardial Infarction is based on the presenting signs and symptoms, Electrocardiogram changes and serum cardiac markers (Porth, 2005). Whilst Ann is on the ward she will be monitored continuously via Electrocardiogram. I chose Ann for my care because I was on duty when she was admitted to the ward and I assisted with her admission. As this was my first week I knew I would have a six week opportunity to follow Ann’s journey of care. As Ann was very anxious and nervous when she arrived on the ward I spent a lot of time talking to her to make her feel at ease. I built up a good rapport with this patient. Mehrabian (1981) states that developing a rapport with the patient involves being professionally friendly, showing interest and actively using non verbal and verbal communication skills. I also chose Ann because from doing her assessment I could see she had other underlying problems aside from her cardiac condition. Ann was hypertensive, high cholesterol, type two diabetes and was overweight. After being told Ann was going to be awaiting for inpatient cardiac surgery I agreed along with my mentor that Ann would be a good case for my care study as she is at high risk of developing pressure sores whilst in theatre and recovery.
Taking a patient history is arguably the most important aspect of patient assessment (Crumbie, 2006). Ann is married forty years to her husband Jim who is a bricklayer. Ann recently retired as an office worker. They have two daughters and one son together and three young grandchildren whom she occasionally looks after. Ann smokes 20 cigarettes a day and drinks 2-3 units at the weekends. Ann was diagnosed with diabetes type 2 seven years ago and is medication and diet controlled. Ann also suffers from hypertension and high cholesterol. At five foot four inches and thirteen stone Ann is overweight. Ann has a history of three Acute Myocardial Infarctions and has had PCI stenting three times. There is a history of myocardial infarctions in her family as her father died at the age of seventy following an acute Myocardial Infarction. This is a brief history of Ann from what I have taken from her assessment; a full assessment can be seen in the appendix. According to Barret D (2009), in order to care for patients individual needs there must be a nursing process by which nurses can deliver patient centred care supported my nursing models or...
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