Reflective Account.

Topics: Angina pectoris, Nursing, Coronary circulation Pages: 9 (3366 words) Published: December 4, 2012
For this assignment I will be writing a reflective account which will identify a significant episode of care in which I had been involved with, by identifying the pathophysiology and the disease process for the chosen patient; this will be presented by giving a brief outline of the psychosocial influences of the illness for the patient and others who may have been involved with the care. I will also reflect upon this episode by using a reflective model and examining the nursing process, using a holistic perspective throughout the reflective framework. Maintaining confidentiality is a key element, outlined in the Nursing Midwifery Council the Code (2008).

The care for this patient was assessed using Roper Logan and Tierney, being the most used nursing models. It is described by (Newton.C, 1991, 15). “the concept is based on four components with the nature of the individual, the nature of health and illness the role of nursing in health and illness and also the nature of the environment” these all cover the 12 activities of daily living. With many of the twelve affecting the patient some were more ideal for the patient individually. These will be assessed during the in-depth description of the patient.

The client admitted onto the ward, a Male of 58 years of age, with a past medical history of diabetes, hypertension, a BMI of over 28.4, which is recorded as overweight and also unstable angina, and also a patient who smokes 20 cigarettes daily. His family were keen visitors and always wanted to be involved with the care. This patient lived with their wife and was mobile. The client was admitted with unstable angina and this surrounded the care episode.

Firstly I will now discuss the pathophysiology of angina to give the reader an insight into the disease and reference it within the client and the episode of care. Looking at the cardiovascular system it comprises of the heart arteries, capillaries and veins. “This is what transports blood around your body, carrying oxygen, glucose and nutrients to the tissues”. (Brewer.S, 2010, 97). As described in the (Conway B, Fuat A., 2007, volume 21) “The coronary arteries deliver oxygenated blood to the cardiac muscle”. “Chronic Heart Disease occurs when atheroma which are fatty plaques develop in the coronary arteries. This process is called atherosclerosis. In time, the artery may become so narrow that it cannot deliver enough oxygenated blood when the demand is high, such as when exercising.” “Angina pain is experienced as sensory neurones innervating the heart are richly endowed with an iron channel that is increased in the lactic acid concentration” Within (Margret.A, 2006. 15) pathopysiological description is provided describing angina as an “obstruction previously described as atheromas. This providing insufficient oxygen delivery for local metabolic demand and this releases lactic acid as cells switch to anaerobic metabolism”. “Angina is the pain or discomfort experienced. Angina may also be brought on by emotional upset, cold and windy weather, extreme heat or after a heavy meal. MI occurs if there is plaque rupture and a thrombus develops, blocking the artery”.

I assessed two main reflective models, which were Johns (1994) and Gibbs (1998) these both are described within common foundation studies in nursing (Jenny.S, 2008, 59) “Johns model is linear in its nature whereas Gibbs’s model is always being described as a cycle. Despite their structural differences, Johns and Gibbs’s models are similar in character and have the same core components”. (A. Margaret, 2006, 1108) reflective accounts within the book are of Gibbs’s (1998) cycle which is described “I decided to analyse the incident using Gibbs, which provided cathartic experience” leading to myself choosing this certain model.

The aim to Gibbs model is that reflection of the event can be assessed clearly in points. By describing what had occurred and recalling the...
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