What is nursing
Myocardial Infarction (MI) is a medical condition also referred to as a heart attack that occurs when the blood flow stops or decreases to a part of the heart resulting in damage to the heart muscle. As a nursing practitioner, it is important to be alert to some of the symptoms and conditions that are likely to lead to MI as they are easily misinterpreted causing patients not to seek the appropriate care when they should. Treatment of MI is time critical yet caused by quite a number of risk factors. This paper will discuss the biological, psychological and social risk factors of MI as well as the impact on the various members of the society and examine the role of the nurse in caring for an MI victim with the aid of Mr. Khan’s case study.
Mr. Khan is a 78 year old man admitted in hospital for sustaining a Myocardial Infarction. His descriptive symptoms included chest pains that were crushing in nature that extended to his arm, neck and jaw which are consistent with a heart attack (Alumni et al., 2015). Prior to this attack, he had been advised on switching up his diet and shedding some weight, both of which he did not follow. An MI is likely to result to an irregular heartbeat, heart failure, cardiac arrest or cardiogenic shock (Petrovic et al., 2017). Mr. Khan is undergoing end of life care with the clinical staff wondering whether the patient should be resuscitated or not. Legally, an MI can at times be considered a line of duty injury by policy if it is as a result of work-related exertion or emotional stress but in most cases it is treated as a disease. However, since Mr. Khan’s condition is not as a result of unusual exertion from the workplace, his condition is not covered in the administration of no-fault schemes. The patient is therefore likely to be neglected if resuscitated and not in a position to cover his own medical fee at a time when safe nursing care is his main priority.
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A biological risk factor that contributed towards Mr. Khan’s myocardial infarction is an unhealthy diet. High cholesterol consumption results in gradual build up of plaque along the walls of arteries, especially coronary arteries leading to atherosclerosis. The atherosclerotic plaque may then rapture over decades of accumulation and if located in an artery supplying to a heart muscle, myocardial infarction is most likely to occur. Given that Mr. Khan was instructed by is physician to check on his diet and his weight, it is accurate to deduce that he had unhealthy practices. Patients like Mr. Khan should be under close monitoring by healthcare providers in order to make sure that dietary modifications are adhered to strictly, helping with both the body mass index and blood pressure. Not observing a patient’s body mass index can also lead to obesity which is another precursor to myocardial infarction (Windecker et al., 2015). Blocking, clotting, and inflammation of the walls of the coronary arteries are the primary causes of myocardial infarction among others. Obesity is a known cause for blocking of the arteries that are squeezed and narrowed by the excess body fat, high triglyceride (a fat related to human diet) levels as well as high blood cholesterol levels (Anderson and Morrow, 2017; Gress et al., 2000).
Social determinants of health are defined as the health impacts of the social environment on people living in a community. These include circumstances such as where people are born, live, grow, age, work and systems installed to cope with the illness. Based on Mr. Khan’s situation, social risk factors that have led to his myocardial infarction include his age and gender. Male individuals suffer a higher rate of developing coronary artery diseases compared to female individuals. Men become most vulnerable and susceptible to myocardial infarction at the age of 45 while women are most vulnerable at the age of 55 (Hakulinen et al., 2018). Knowing that Mr. Khan is 78 years old, he is part of the endangered community and therefore more prone to the disease. Nurses thus motivate patients to increase their physical activity and in return, they get to burn off calories that will decrease their chances of developing heart conditions (Chudyk & Petrella, 2011).
No information is provided to indicate that Mr. Khan was undergoing a period of depression, social isolation, anxiety or chronic life stress when he was checked in the hospital for myocardial infarction as a result of an obtuse response to stressful stimuli. However, Mr. Khan ends up in his death bed as a result of ignoring the instructions given to him to change his diet and lose weight too in the process. This is a reflection of Mr. Khan’s disobedient character trait which is a psychological risk factor for myocardial infarction. If he had followed the doctor’s instructions by increasing his fruit and vegetable consumption or researched about his diet, chances are Mr. Khan could have balanced his body mass index without having to struggle to increase his physical activity (Head et al., 2017).
After watching her husband go through the painful scenario to the verge of succumbing to the pain from the heart attack, Mrs. Khan is now worried that she might have to suffer the same fate and make her children and grandchildren to suffer because she was also given the same directive as her husband and like him she also did not follow the instructions. It is for this reason that Mrs. Khan results to seeking advice from a nurse in order not to obtain a myocardial infarction. Safe and sufficient patient care can only be offered if there is effective communication between the healthcare providers and the patients. Effective communication also serves as a great tool towards achieving patient satisfaction. Treatment for cholesterol has specific guidelines that insist on the significance of involving patients in a risk-benefit discussion prior to exposing them to therapy (Ibanez et al., 2017).
In the case of Mrs. Khan, before signing her off to physical or nutritional therapy, it is important that she is engaged in the decision-making process of the kind of therapy as well as the mode of its provision for the purpose of her personal satisfaction. First and foremost, the nurse and the patient need to evaluate the priorities of the patient, risks involved and any prior experience with the reduction of cardiovascular risks. Participation in this assessment will work to make sure that the patient is fully conscious of the causes of myocardial infarction where the nurse knows the patient’s level of knowledge about the disease and gets to offer more insight incase, she lacks some relevant information. Secondly, the healthcare practitioner recommends therapy depending on the risk factors the patient is most exposed to as well as preferences to therapy that the patient might appreciate more. With reference to Mr. Khan’s case, it is important to consider any obstacles that Mrs. Khan is possibly to face especially with the onset of other risk factors from post-diagnosis clinical results. Thirdly, the healthcare provider is expected to provide more information concerning the preferable form of therapy together with the benefits, risks, and options as well based on best practices. At this stage, Mrs. Khan expects the nurse to provide more details that will disclose vividly what the patient should expect throughout the process while offering alternatives where necessary. Finally, the patient and the caregiver reach a final decision about the path to be followed during the treatment period. However, the assessment of plausible risks is not disregarded because treatment and prevention of myocardial infarction is a continuous process whose priorities are likely to change over the treatment period. Via the shared decision-making model, healthcare providers are therefore able to interact at a personal level with the patients by being empathetic and consequently providing the feeling of quality care. With heart conditions in the lead with the highest mortality and morbidity rates in both developing and developed countries, it is necessary that the diseases are prevented by providing sufficient health education in order to significantly reduce the risk of contracting myocardial infarction (Neumann et al., 2018). By educating the Khans, the whole family will be alert and looking out for heart diseases since genetics poses as a risk factor for the future Khan generations.
In conclusion, Mr. Khan’s diagnosis of myocardial infarction is as a result of a number of risk factors that could have been avoided if only, he took the personal initiative to follow the instructions from the physician. The patient was advised to change his diet and check on his weight. Disregarding these instructions led him to be exposed to biological, social, and psychological risk factors that are known to result to myocardial infarction. Mr. Khan’s unhealthy diet and overweight condition pose as the biological factors that contributed to the diagnosis. Social factors include his age and gender, both of which are significant risk factors since he is a male and above the age of 45 years. Finally, the psychological risk factor that led to myocardial infarction is his disobedient or ignorant personal trait. Effective communication between healthcare providers and MI patients requires that both parties engage in a shared decision-making process in order to make sure that the treatment process is smooth, cordial, and acceptable to the physician as well as the patient and it is based on best practices.
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