Introduction
Myocardial infarction is one of the best-known heart issues, yet, ironically, the levels of awareness about preventing it are drastically low in vulnerable groups. In the case under analysis, the patient, Mr. Vlog could use the support of a nurse who would not only provide the necessary treatment but also shed light on the skills to identify a health risks and manage it effectively in patients. Apart from the required dose of aspirin for addressing the issue of plaques in the patient’s blood vessels, further promotion of patient education is strongly required and highly encouraged.
Notably, the problem of MI has been quite prominent in the UK lately. Despite the focus on patient education and the active promotion of health lifestyles among the target population, MI remains one of the leading causes of death in the UK. Specifically, the latest statistical data indicates that MI caused death in 51,979 cases in 2020, which, compared to other causes of death prevalent in the UK at the time, accounted for 16.38% of cases (Office for National Statistics, 2021). Therefore, the issue of MI is not to be taken for granted as one of the major risk factors that may lead to an untimely death (Qureshi et al., 2018). For this reason, the patient needs to be educated about the risks that he is currently facing, particularly, the possibility of an MI with the resulting adverse consequences.
Overview and Analysis
Nurse’s Role
The role of a nurse in the management of a MI case is often underestimated. However, nurses play a pivotal role in addressing the cases of MI, as the situation under analysis shows. Specifically, nurses must identify a threat of a MI promptly and perform patient assessment accordingly to identify the level of threat and determine the next steps to be taken in managing the heath issue (Aeyels et al., 2018). Specifically, nurses are obliged to administer the immediate treatment (nitroglycerin and aspirin intralingually, if needed). Additionally, nurses must perform the further patient assessment to evaluate the extent of a threat to the patient’s health by performing a 12-lead EKG (Stanfield, 2018). Finally, a nurse must notify a cardiologist or a physician, providing the collected data and reporting the actions taken to manage the health risk (Aeyels et al., 2018). Therefore, nurses play a vital role in assisting patients suffering from MI and minimizing the risks to their health by managing the immediate risks to their health and creating long-term treatment opportunities.
Holistic Model
The case under analysis requires a comprehensive approach due to the need to manage the patient’s condition as a psychosomatic problem. Specifically, while the current state of Mr. Vlog’s health is predicated on the successful management of the pathophysiological aspects of his condition, namely, the introduction of medications and, possibly, a surgery for addressing his MI issue, the genetic issues and the presence of psychological distress should be considered as well. Due to an increase in the extent of psychological distress, the patient may develop severe complications, which, in turn, will expose him to an increased risk of another instance of MI (Jackson et al., 2018). In fact, genetic predisposition to MI has been studied expensively and confirmed by Zhang et al. (2019)., who pointed out the changes in the performance of MicroRNAs, or MiRNAs causing regeneration and proliferation of the cardiomyocyte tissue in an MI patient. Additionally, the importance of enhancing genetically the performance of LncRNAs in MI patients has been established (Shi et al., 2020). For this reason, a holistic approach that will embrace the psychological and physiological aspects of the condition will have to be adopted. Specifically, the application of the hybrid model as suggested by Jasesemi et al. (2017) should be considered to improve the management of the patient’s needs, particularly the introduction of tools for facilitating patient education and patient-nurse communication in the clinical environment.
Holistic assessment must incorporate several crucial factors to remain adequate for usage and contain the full extent of information regarding the patient and their health status. For this reason, the Calgary-Cambridge Consultation guide is recommended for consideration by healthcare professionals (Jugdoyal, 2019). This model focuses on gathering strictly structured information for a patient while simultaneously building a trusting relationship with them (Jugdoyal, 2019). The assessment process is a conversation that requires input from both sides, making explanations for patients crucial for consideration.
Therefore, in this case, the patient will be asked for any information that they would like to add during each step of the assessment. Moreover, information will be double-checked through the repetition of questions. The patient’s perceptions of the disease must also be taken into account. The analysis of the provided data will be shared with the patient to ensure that they remain fully aware of the situation.
Pain Assessment
Pain assessment is a vital step that can provide valuable information for the involved healthcare professionals. However, the value of this data depends on the accuracy and extensiveness of the acquired results. Pain is a highly individualized experience, making its expressions sometimes difficult to pinpoint (Gregory, 2019). For this method, questions from the mnemonic acronym SOCRATES are proposed for use. Although the SOCRATES questions do not take into account mental aspects of pain perception, they provide the most optimal way to explore such a subjective feeling (Gregory, 2019). Questions must be asked during the initial assessment and refer to the description of both current and past pain.
Critical Appraisal and Decision-Making
The strategies that can be adopted in the case under analysis need to focus on several aspects of health issue management. Namely, apart from addressing the immediate threat that the stroke implies, a nurse must develop a long-term plan and offer the patient extensive education on the issue of identifying threats to his health, particularly the factors that may lead to another instance of MI. Namely, the issues such as the presence of a family history of heart disease should be incorporated into the model so that the patient’s genetic predisposition to developing an MI should be considered as an important factor. Additionally, the fact that the patient has a habit of heavy smoking (15 cigarettes per day) and works in a highly stressful environment of the financial industry must be incorporated into the decision-making to build a holistic model that allows alleviating the impact of the factors in question (Paul et al., 2018). Thus, as a framework that helps to address not only physiological but also genetic and psychosocial factors affecting the patient’s life, the hybrid model will represent a viable approach to handling the needs of the patient and reducing the threat of developing further health-related concerns (Vivekanandan and Iyengar, 2017).
Action Plan
To address the threats that the patient is currently facing, it is vital to introduce several critical measures. First and most importantly, appropriate diagnostic tools must be introduced to determine the source of the heart failure exactly. Afterward, immediate measures for alleviating the patient’s condition must be undertaken; specifically, a nurse must administer medications such as aspirin and nitroglycerin to the patient sublingually (Tyson Le et al., 2020). As soon as the specified steps are taken, a nurse must inform the physician and provide crucial information about the patient and his medical history so that the physician could continue the treatment process and manage the patient’s condition and needs accordingly (Wanga et al., 2020). Thus, the continuity of care will be maintained, and the patient will be provided with appropriate holistic care addressing different aspects of his life. Finally, as soon as the patient’s condition is alleviated, a nurse must offer a patient critical information about addressing possible risk factors, and managing health, thus increasing his health literacy on the subject of an MI.
Treatment Options
The range of treatment strategies that can be used to address the issue of MI is quite large, ranging significantly based on the extent of their invasiveness. While it is preferable to reduce the level of invasiveness to a minimum in order to contain the extent of trauma an and negative health outcomes that the patient may face in the future, the possibility of a surgical intervention will still have to be considered. Currently, several treatment opportunities can be suggested for managing Mr. Vlog’s case.
Fibrinolytic Therapy
Creating an opportunity to lyse acute blood clots so that they could not create premises for another instance of an MI in Mr. Vlog, fibrionic therapy should be considered a vital tool in handling the current situation and preventing the further development of the condition. Specifically, the application of the fibrionic therapy approach will lead to a drop in the number of thrombi in the patient’s arteries. Namely, the introduction of the fibrionic therapy approach leads to the development of plasmin, which allows dissolving blood clots and making the development of thrombi particularly slow (Kirtane & Bangalore, 2020). Therefore, give the current state of Mr. Vlog, fibrionic therapy should be recommended as the next step in handling the disorder. Implying a lesser level of invasion than other surgical procedures, the specified approach will also minimize the risk of complications (Kirtane & Bangalore, 2020). Therefore, fibrionic therapy should be recommended as the most accessible and beneficial approach.
Complications
A nurse should also keep in mind that MI is fraught with several major complications. Specifically, disturbances in the heart rate and rhythm can be expected. Therefore, measures for improving the heart rate and rhythm must be introduced into the healthcare process.
Differential Diagnosis
Given the data provided by the patient, other issues apart from MI could be seen as the cause of the health issues. namely, painful sensations in the chest could be attributed to musculoskeletal chest pain (Wertli et al., 2019). Additionally, the presence of chest pain and difficulties breathing could be seen as the sign of pneumonia (Htun et al., 2019). Therefore, further assessment should be conducted.
Diagnostic strategies
It is also worth noting that the range of diagnostic tools that can be used to detect an instance of a MI in a patient is quite vast. While each tool has its own degree of precision and rationale for the usage, all of them can be considered a viable framework for identifying a MI case.
Trop
Troponin measurement plays a vital role in diagnosing an MI, which is why the specified tool must be introduced into the range of strategies to be utilized in ties case. Namely, the assessment of the levels of troponin in the patient’s bloodstream will provide the data that will signify whether an instance of am MI has taken place.
CK
Additionally, when considering the patient’s propensity toward a heart attack, one will need to deploy the analytical tools that provide a more nuanced approach to the assessment of risks. Specifically, the use of the creatine kinase (CK)levels assessment approaches to be a legitimate and rather viable solution. The use of the CK analysis as the assessment tool should be seen as a fairly reliable way of determining the presence of an MI in a patient Indeed, given that MI inevitably leads to the damage of the tissue that contains CK and the resulting increase in the threat of a muscle contraction failure in a patient’s health, CK should be considered a fairly useful tool for determining the levels of challenge in addressing the issue of MI,
CK MB
Creatine kinase-MB (CK-MB) has also been long viewed as the tool for managing the risk of a heart failure d reducing the probability of a heart attack. As an isoenzyme, CK-MB emerges soon after the development of an MI in a patient (Guo et al., 2017).
CRP
Serum C-reactive protein (CRP) levels assessment is another tool broadly used to determine the presence of a threat to a patient’s heart, particularly, the propensity toward an MI. Also allowing to define the extent of a patient’s exposure to a heart attack, the CRP rates assessment could be seen as another important tool in defining the level of a potential threat (Stumpf et al. 2017). However, studies show that the specified approach may not be as accurate as one might want it to be in order to obtain the data needed for the further choice of an appropriate intervention (Stumpf et al. 2017). Namely, the study by Vanhaverbeke et al. (2018) admits that the application of the CRP tool as the measurement of the risk of an MI in a patient may leave rather ambiguous and inaccurate results. Therefore, the specified approach toward assessing MI risks should only be used in tandem with other frameworks.
Echocardiogram
Another approach of determining the presence of MI in a patient, echocardiogram is often seen as a significant improvement compared to pother frameworks for diagnosing the issue of MI in a patient. Being credited for its accuracy and high precision rates, echocardiogram is known as one of the best ways of determining the presence of an MI in a patient. Namely, the sue of the speckle-tracking approach guarantees the chance of identifying the traces of MI in a patient (van Mourik et al., 2019). Therefore, the application of an echocardiogram to the case under analysis should be regarded as an absolute necessity in order to determine the patient’s propensity to another instance of an MI.
CX-Ray
Similarly to the previous method, the sue of chest X-ray allows revealing a range of data that helps diagnose MI with higher prevision. Specifically, pulmonary diffusion and similar manifestations of MI in a patient can be identified, which is why chest x-ray should be regarded as a viable method of diagnosing an MI situation (Hinterseer et al., 2021).
In Mr. Vlog’s case, the application of other blood markers combined with the use of the phybrinolytic therapy can be suggested to increase the extent of accuracy of the diagnosis. Specifically, the application of Fybrionic therapy should be considered an important introduction into the current range of treatment options as the means of removing blood clots from his bloodstream and, thus, preventing another instance of MI.
Nursing Collaboration
In order to manage the issues faced by the patient, a nurse will need to establish collaboration with other experts in the field. Specifically, cooperation with the physician, cardiologist, and geneticist in order to introduce proper continuity into the action plan and the treatment strategy will be needed.
The focus on cooperation between nurses and doctors in the process of tending to the needs of a patient with an MI should be seen as the first step toward providing proper healthcare. Wihastuti et al. (2019) explains that the inclusion of the focus on nurse-doctor collaboration promotes better information management and, therefore, improved healthcare. Specifically, the promotion of nurse-doctor cooperation, as well as other types of interdisciplinary relationships between nurses and healthcare staff members, allows reducing the extent of workload that nurses must manage as a part of their workplace responsibilities (Han et al., 2021). Consequently, the opportunities for improved care and more careful attitude toward the individual needs of each patient are created.
Additionally, as a nurse, one will need to promote active patient education, which calls for strong collaboration between a patient and a nurse. For this purpose, a communication channel based on the principles of both verbal and non-verbal communication must be established so that patients could provide detailed information about the changes in their well-being (Bårdsgjerde et al., 2020). Additionally, family involvement in the treatment process is vital to the outcomes of the treatment (Curry et al., 2018). Namely, family members must be provided with detailed and accurate instructions for preventing a patient from encountering any factors that may lead to another instance of an MI (Birtwistle et al., 2021). The proposed measures are expected to minimize the risk to the patient’s health and improve the overall efficacy of the intervention.
Interprofessional collaboration also poses a challenging task for nurses to facilitate. Since the data gathered from the holistic assessment will be expanded during the tests, gaps in knowledge from the initial assessment must be filled in a timely fashion and made available for all involved professionals (Schot, Tummers and Noordegraaf, 2019). The perspective of each involved member must be considered as vital and gathered through the hospital’s network into a readable format. The role of nursing personnel in this process lies in keeping the most relevant information freely available for other professionals.
Conclusion
By introducing combined therapy approach that allows determining the extent of the patient’s genetic predisposition to a heart failure and the assessment of the patient-specific factors such as his propensity toward smoking and his unhealthy lifestyle, a nurse will be able to administer the treatment options and patient education approach that will allow Mr. Vlog to recover faster. Moreover, the understanding of the patient’s family background will reduce the risk of him suffering from another MI in the future since another level of threat will be addressed properly therefore, a combined holistic approach based on the assessment of the genetic factors and the evaluation of the extraneous issues that determine the level of threat to patient’s health will be needed.
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