Nurses play a very important role in managing a patient from the moment of his admission up to making a discharge plan. Each part of the nursing process is vital to the wellbeing of the person he is taking care of. Clinical reasoning is always essential in each part of the nursing process from assessment, setting up goals and intervention. Effective nursing management is done when a nurse looks for the early and right cues at the right patient and implementing it at the right time. This essay will delve deeper into the case of Rob Geis, a patient who was suffering from angina, given his history and the signs and symptoms he experienced up to the time when his condition worsened to Myocardial Infarction. This essay will also look into how the nurse should provide effective nursing care to the patient with this condition.
Etiology and Pathophysiology of Angina
Angina is pain felt in the chest area as a result of lack of inadequate supply to the myocardium (Better Health Channel, 2013) Atherosclerosis or the hardening and narrowing of arteries caused by the build-up of plaques, the insufficient supply of oxygen and its increasing demand are some of the factors that can cause ischemia in the myocardium (Lewis et al., 2012). When there is a total blockage of the coronary arteries for a few minutes, the myocardium cannot receive oxygen and glucose for aerobic metabolism thus anaerobic metabolism occurs (Lewis et al., 2012). The lactic acid builds up and stimulates the nerve fibres in the myocardium resulting to chest pain (Lewis et al., 2012). The cells are repaired and the aerobic metabolism and the contractility of the arteries are restored when there is return of blood flow (Lewis et al., 2012)
Subjective and Objective Data
Upon admission, subjective and objective data is very important to obtain pertinent and reliable information which will be the basis for implementing the suitable nursing care for Mr. Geis. Subjective data would include asking him what he was doing when the chest pain started, the quality of the pain, what parts of the body it is radiating, how severe it is and the time when the pain occurred and how long (Lewis et al., 2012). Second, ask for the past medical history noting his allergies, and previous illness and if there are any medications that he is currently taking. Third, ask about his family history taking into consideration their religious beliefs. Fourth, ask about his diet, lifestyle, exercise and his social history to map out a nursing plan from admission until his discharge. Meanwhile, objective data includes check baseline observations which include blood pressure, heart rate and peripheral pulses, respirations, neurological status, oxygen saturation rate. Secondly, take baseline ECG to check the heart’s electrical activity to note if there is an improvement or deterioration (WebMD, 2012). Thirdly, chest x-ray should be done to visualize the heart and lungs if there is any abnormality. Moreover,...