Heart Dysfunction, Research Paper Example

Myocardial infarction (MI), or heart attack, is a serious health condition that requires immediate medical attention in order to address the needs of the patients who are affected, as patients may be at risk of serious complications or even death. The treatments that are commonly used for patients with MI provide relief and minimize the damage that is incurred for some patients, depending on the severity of the situation and what is required to treat the MI effectively. It is necessary to understand the nature of the MI, including its causes and possible options for treatment that will have lasting benefits for patients and may also prevent future repeat occurrences. The patient in the case example is experiencing a number of challenging symptoms and complications associated with her condition, including a limited ability to perform physical activities, chest pain upon exertion, and severe dyspnea. Therefore, her condition must be addressed in an immediate fashion in order to prevent further complications and other risks that could contribute to further decline.

Myocardial infarction is caused by a number of factors that contribute to necrosis of the myocardium and may be either nonreperfusion, which is characterized by a permanent blood flow obstruction, or reperfusion, which is characterized by a lack of blood flow for an extended period of time that may be reversed once the condition subsides (Burke, 2015). To be specific, when the myocardium does not receive the appropriate level of oxygen, the myocardial infarction is acute in nature and may be caused by an acute thrombus that affects a coronary artery (Burke, 2015). For an individual who has experienced MI on the left side, such as the patient in question, there is a greater likelihood of extensive damage that may cause significant physiological impairment (Burke, 2015). A number of other factors must also be considered that include 1)arrythmogenesis, which is caused by a reduction of potassium, calcium, free radicals, and amphophillic lipids, all of which contribute to potentially lethal forms of arrhythmia; 2) pericarditis, which includes epicardial inflammation; 3) Lower systolic function, due to a reduced oxygen supply and reduced level of metabolites; 4)abnormal wall motion and systolic contractile function; 5)cardiogenic shock, due to reduced coronary blood flow and an increased heart rate; and 6) an impact on diastolic function, which includes ventricular dilation and pulmonary edema, among other complications (Burke, 2015). The patient with MI struggles with some of these concerns, based upon the nature of the attack and how it has impacted ventricular function. The complexities of myocardial infarction are well known; however, the specificity of each individual case is challenging and requires a comprehensive evaluation in order to address care and treatment concerns.

For patients who have experienced myocardial infarctions, it is important to address the challenges of this condition and what steps are required to ensure that patients receive the best possible support and guidance in order to treat each respective situation. In this context, patient education is critical and provides a basis for exploring the different dimensions of the practice setting and what is required to treat patients effectively in order to prevent future attacks and other related complications. Therefore, patient education must be thoughtful, practical, insightful, and based upon prior evidence-based research in order to achieve the best possible results with the chosen care and treatment plan. This will also demonstrate the value of expanding education to accommodate each individual patient and to address specific examples that will impact decision-making regarding a patient’s overall health status.

Patients who survive MIs must be provided with a comprehensive approach to care and treatment that will have a lasting impact on their health and wellbeing. This is best accomplished through an educational intervention that provides the patient with information that will be useful in treating the existing condition and in preventing any future concerns. For example, a patient with advanced heart failure, similar to the patient in the case example, it is important to address the risk factors associated with this condition and what may have a significant impact on health outcomes for the patient. In this case, the patient must understand the reasons why she is experiencing these symptoms and to determine what is required to alleviate them as best as possible to prevent further complications.

Heart failure requires a comprehensive approach that educates the patient regarding the risks, symptoms, causes, and treatments associated with the condition. Although the patient’s myocardial infarction is in the past, her heart failure is very present; therefore, she must be able to understand the risks that she faces, the symptoms that may occur, and how to best treat the condition effectively in order to promote greater quality of life. Providing an education plan that is simplistic and is easy to understand will enable her to recognize her current symptoms and overall health status. At her advanced age, the primary approach to her condition is to provide her with the necessary medications and to make her experience a high level of comfort in order to manage her heart condition. This is a difficult task to accomplish, given the patient’s age and declining health, yet it must serve as the key priority for the nursing team. At this stage of the patient’s advanced condition, it is important to advise her and her family members regarding the nature of her condition and the need to receive all required medications in a timely manner in order to prevent further complications and to limit the risks associated with the disease.

Since the patient has been prescribed a number of medications, it is important to provide information regarding each pharmacological therapy, including its mechanism of action and purpose in treating the patient’s advanced heart condition at this stage. The patient’s prescribed medications are as follows:

Digoxin: This medication is prescribed in order to address the symptoms and risks associated with heart failure, and it is also used to treat different forms of irregular heartbeat that may be a contributing factor to this condition (WebMD, 2015). Also, the medication is known as a cardiac glycoside and may impact sodium and potassium levels that are located within heart cells in order to stabilize the heartbeat and return it to a state of normalcy (WebMD, 2015).

Atenolol: This medication, also known as Tenormin, is a beta1-selective adenoreceptor blocker and is used in order to improve hypertension management in patients; the medication is used in patients post-myocardial infarction in order to reduce the risk of mortality as a result of this event (RxList, 2015). The medication may be administered to the patient once her condition has stabilized and tolerance is likely to occur so that its mechanism of action may work most effectively (RxList, 2015).

Lasix: This mediation, also known as Lasix, is a form of diuretic which is responsible for the removal of excess salt and water, using an absorption technique to block water, sodium, and chloride from kidney fluid, which contributes to an increase in urinary output for a patient; typically, this action begins in approximately one hour and may be prolonged up to eight hours (MedicineNet.com, 2015).

Captopril: Also known as CAPOTEN, this medication is responsible for preventing the transition of angiotensin I to angiotensin II by also eliminating the action of ACE, thereby reducing blood pressure in the patient; in addition, the medication may also prohibit the action of bradykinin, a vasodepressor (RxList, 2015). Prior evidence indicates that blood pressure is typically reduced approximately 60-90 minutes after a dose has been given (RxList, 2015).

Sublingual Nitroglycerin: This medication is prescribed in order to promote relaxation of vascular smooth muscle; in addition, postcapillary vessels must facilitate peripheral pooling of the blood, a reduced level of venous return, and a reduced level of left ventricular end-diastolic pressure in order to improve overall heart function (RxList, 2015). In addition, this medication promotes the reduction of diastolic, systolic, and mean arterial blood pressure for patients, while also reducing the symptoms associated with angina (RxList, 2015).

For this patient, addressing her current health status and heart condition requires an understanding of the actions of the aforementioned medications and to determine what is required to ensure that the patient receives them in a timely manner to prevent further complications. At this stage, the patient’s quality of life is severely disrupted and she is unable to carry on with some basic activities, thereby limiting her level of physical activity. Therefore, she must be educated regarding the extent and nature of her condition and must be educated regarding the reasons why she is required to take these medications in a timely manner. The prevention of further complications and possibly another myocardial infarction must be of critical importance in this process and must demonstrate her ability to comprehend the need for these medications as part of her daily routine.

Nurses must be able to provide the appropriate education and guidance in order for the patient to receive the appropriate attention and focus in order to address her condition effectively and in a timely manner. There must be a greater emphasis on the patient’s level of comfort and her overall acceptance of her health status, while also considering her ability to take her medications as prescribed and to work with her healthcare team in order to prevent further complications. This process is important because educating the patient regarding this type of heart condition is a significant step forward in expanding the knowledge and resources that are required to meet the expectations of the treatment plan and the overall plan of care to improve her quality of life.

References

Burke, A.P. (2015). Pathology of acute myocardial infarction. Retrieved from http://emedicine.medscape.com/article/1960472-overview#a2

MedicineNet.com (2015). Furosemide, Lasix. Retrieved from http://www.medicinenet.com/furosemide/article.htm

RxList.com (2015). CAPOTEN. Retrieved from http://www.rxlist.com/capoten-drug/clinical-pharmacology.htm

RxList.com (2015). Nitrostat: clinical pharmacology. Retrieved from http://www.rxlist.com/nitrostat-drug/clinical-pharmacology.htm

RxList.com (2015). Tenormin. Retrieved from http://www.rxlist.com/atenolol-drug.htm

WebMD (2015). Digoxin. Retrieved from http://www.webmd.com/drugs/2/drug-4358/digoxin-oral/details