Approaches to Nursing Practice Samples †MyAssignmenthelp.com

Question: Discuss about the Approaches to Nursing Practice. Answer: Written Explanation The patient has been reported to have been suffering from chronic ailments such as diabetes mellitus and hypertension that were diagnosed successively within an interval of 10 years. The onset of metabolic disorder like diabetes in the patient 20 years earlier predisposed him to acquire condition related to high blood pressure that was eventually diagnosed in him 10 years later. High blood pressure in the patient accounted for greater working of the heart to pump blood to the respective organs for oxygenation (Khatibzadeh et al., 2013). Moreover, greater force applied by the heart to pump blood caused decreased efficiency of the heart to supply oxygen to the concerned organs in the body. Hormonal imbalance due to lack of insulin in the patient lead to the development of diabetes mellitus that further raised concerns for triggering obesity like condition where excessive gain of weight is evident in the person. Obesity in addition to diabetes and hypertension has been identified as pot ential risk factors for certain cardiovascular anomalies that in turn impair the functioning of the heart. The detection of myocardial infarction in the patient that caused diminished supply of arterial oxygen to the organs thus may be attributed to be a combined resultant effect due to the risk factors. Causation of myocardial infarction further aggravated the risk of encountering cardiovascular disease in the patient due to progressive loss of functioning of heart muscles, narrowing of arteries that culminated in reduced supply of oxygen due to reduced cardiac output (Ersbll et al., 2013). Thus, all these risk factors and etiology represented the disease pathophysiology related to left heart failure in the patient. The disease related to left-sided heart failure as diagnosed in the patient has been found to be manifested through various signs and symptoms. Overall impairment of functioning of the heart to supply blood and oxygen represents for the reduced cardiac output following diminished efficiency of the myocardial tissues because of damage or overloading. Compromise of the aortic flow of blood to the body and brain is accounted in case of left-sided heart failure. A life threatening condition develops due to left-sided heart failure whereby the left ventricle gets affected. Left ventricle is responsible for receiving the oxygen rich blood from the lungs and then distributes it to the remainder of the body. Due to this decreased capacity of pumping blood from the left ventricle, the supply of oxygen to the body parts gets restricted especially during strenuous physical activity like that of exercise. As a consequence, fatigue ensues owing to the blockage of the pulmonary vasculature that ac count for the onset of symptoms concerning the pulmonary system (Heusch et al., 2014). These effects may be corroborated with the exhibition of symptoms related to shortness of breath, persistent tiredness and fatigue coupled with cough in the patient. Further the patient expressed difficulty in lying down and reported of sleeping with the head elevated for abating the shortness of breath that may be cited as vita indicators of the presence of the disease. Further waking up due to shortness of breath has been elucidated that may be related to the clinical condition of paroxysmal nocturnal dyspnea, a known predictor of cardiovascular abnormality (Yagishita-Tagawa et al., 2013). Thus the signs and symptoms are harbingers of the altered pathophysiology relevant to the patient. Chest X-ray along with electrocardiogram (ECG) is the suggested diagnostic tests for the diagnosed disease of left-sided heart failure. It has been confirmed through empirical findings that condition of the heart and lung may be detected through X-ray images. An enlarged heart and fluid build-up in lungs may be detected by virtue of this imaging that in turn will aid in understanding of the signs and symptoms relevant to the cardiovascular disorder of left-sided heart failure. Further the electrical activity of the heart that demonstrates the underlying pathogenesis of the disease may be accurately detected through electrocardiogram. Placement of electrodes at the desired locations of the skin will generate data that will help to indicate the functioning of the heart during the various phases of cardiac cycle. Other relevant data pertaining to the rhythms of the heart and the time elapsed during the systole and diastole may be known from ECG (Ponikowski et al., 2016). Therefore progn osis of heart failure may be represented through ECG and chest X-ray. Moreover, pertinent to the patient condition, coronary bypass surgery that accounts for open heart surgery may be suggested as the choicest mode of treatment for left-sided heart failure. In this procedure, the cardiothoracic surgeon takes a healthy piece of artery from leg, arm or chest and attaches or bypasses it to the blocked artery in the heart for allowing more free movement of blood through the organ (Al-Ghamdi et al., 2016). Thus, blood flow is ensured through the new blood vessel by bypassing the damaged or blocked artery. Moreover pacemakers may be introduced as adjunct therapy to coronary bypass for regulating the heart rhythms in combination with medications. References Al-Ghamdi, B., Mallawi, Y., Shafquat, A., Ledesma, A., AlRuwaili, N., Shoukri, M., ... Al Sanei, A. (2016). Predictors of Permanent Pacemaker Implantation After Coronary Artery Bypass Grafting and Valve Surgery in Adult Patients in Current Surgical Era.Cardiology Research,7(4), 123. Ersbll, M., Valeur, N., Mogensen, U. M., Andersen, M. J., Mller, J. E., Velazquez, E. J., ... Kber, L. (2013). Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction.Journal of the American College of Cardiology,61(23), 2365-2373. Heusch, G., Libby, P., Gersh, B., Yellon, D., Bhm, M., Lopaschuk, G., Opie, L. (2014). Cardiovascular remodelling in coronary artery disease and heart failure.The Lancet,383(9932), 1933-1943. Khatibzadeh, S., Farzadfar, F., Oliver, J., Ezzati, M., Moran, A. (2013). Worldwide risk factors for heart failure: a systematic review and pooled analysis.International journal of cardiology,168(2), 1186-1194. Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., ... Jessup, M. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.European heart journal,37(27), 2129-2200. Yagishita-Tagawa, Y., Yumino, D., Takagi, A., Serizawa, N., Hagiwara, N. (2013). Association between sleep apnea and overnight hemodynamic changes in hospitalized heart failure patients with and without paroxysmal nocturnal dyspnea.Journal of cardiology,61(5), 348-353.