: Analysis of Assessment Data
- Areas for focused assessment
The medical history of the patient indicates that there are no significant areas of weakness from the past. C.K. has had a life free of diseases and can be said to be generally healthy. However, there is a need for focused assessment in only two areas in relation to cardiovascular disease and hypertension. The focused assessment would be aimed at developing a diagnosis for the two conditions given that symptoms have already been observed. C.K. has previously been hospitalized because of a presumed congestive heart failure, and conducting an assessment for cardiovascular disease risk would be the only way to ensure there is no risk of future recurrence.
- Client’s strengths
One of the key strengths is the patient’s past as a nurse. Having been a nurse, C.K has knowledge that would be instrumental in supporting her healthcare improvement. Additionally, she has not exhibited any risk behaviors for cardiovascular disease. According to Sun, Lee, Zahra, and Park (2015), the risk of cardiovascular disease is high in individuals who engage in behaviors such as smoking and are elderly. She also engages in exercise daily hence the risk of cardiovascular and other lifestyle diseases is low due to physical fitness. Having worked as a counselor is also a strength that can contribute to the well-being of the patient, specifically through emotional and psychological strength.
- Areas of concern
The only area of concern for the patient is cardiovascular disease. According to Snaterse et al. (2016), cardiovascular disease is a definition associated with a wide range of conditions affecting the respiratory system and can be chronic. Early detection of any cardiovascular disease can be instrumental in preventing its escalation and the development of multiple morbidities, which is a common characteristic of cardiovascular disease syndrome (Snaterse et al., 2016), through the adoption of non-risky lifestyle behaviors. For C.K the probability of having experienced congenital heart failure is a cause for concern because congenital heart failure is one of the diseases covered within the scope of cardiovascular diseases. The only way to rule out the possibility of cardiovascular disease is therefore to conduct a comprehensive assessment.
- Health teaching topics
Although the patient has both a diploma and a degree in nursing, she is currently retired and it cannot be assumed that she still has all the knowledge for self-care. The most important health teaching topics would include nutritional practices for hypertensive individuals and those at risk of cardiovascular disease. C.K. could also be taken through training on lifestyle practices that can be useful towards optimizing the quality of life in old age. The primary problems experienced by the patient include hypertension and possibly cardiovascular disease and education on lifestyle practices for risk reduction will be essential. Additionally, she could be taken through end-of-life preparation training because of old age. Chan et al. (2019) report that advanced care preparation for the aged is one of the areas that are rarely addressed as part of general patient care yet it is quite important and a role that nurses could initiate and facilitate. Since C.K. is in her old age, advanced care preparation would be important for her and her family.
2: Nursing Plan of Care
- Diagnosis
For C.K. the following two diagnoses have been made and the treatment plans developed are based on the objective of addressing them.
- Readiness for enhanced physical activity as a health promotion activity based on the patient’s limited physical exercise regime and hypertensive diagnosis.
- Cardiovascular disease risk related to physical activity and general status of health as evidenced by the patient’s past experience of probable congenital heart failure.
- Plan
The goals for the intervention process include:
- To improve risk factor prevention and patient compliance for cardiovascular disease. The outcome associated with this goal is an improved awareness of the risk factors for cardiovascular disease as indicated by an increase in the scores for the self-reporting survey that will be prepared for the patient within 3 months.
- The second goal is to enhance the patient’s engagement in more intense physical activity as part of the wellness improvement activity. The measurable outcome for increased physical activity will be involved in more strenuous cardiovascular activities at least three times a week from the time of educational intervention.
The outlined goals and outcomes are important and considered a priority for this patient because of the already existing observed risk factors and symptoms. To develop an effective treatment plan, cultural considerations will have to be made. Cultural considerations influence perceptions towards health and well-being. Having identified C.K as a Christian and an active member of the church implies that whatever goals are set for the patient to have to be within the scope of her beliefs. Since both exercise and educational intervention do not violate any cultural or religious beliefs, C.K. should not face any challenge in implementing given recommendations.
- Intervention
Patient education – patient education will be the primary intervention here to increase awareness of the need for lifestyle changes and their potential effect on various risk factors for cardiovascular disease and patient lifestyle changes. Patient education has been used extensively as an intervention for improving treatment outcomes where the patient is required to be involved in the treatment such as in behavior change interventions (Berra, Miller, & Jennings, 2011). It will therefore be suited for this case.
Behavior change interventions targeting health promotion will also be conducted. As part of the health promotion goal, C.K will be directed towards increasing her physical activity. Behavior change interventions will focus on providing directions for step-by-step improvement in physical activity.
- Evaluation
To evaluate the effectiveness of the interventions, the stated outcomes will be measured. The two most important indicators of improvement will be changed perceptions towards cardiovascular disease risk and improvements in the physical activity frequency and types.
References
Berra, K., Miller, N. H., & Jennings, C. (2011). Nurse-based models for cardiovascular disease prevention: From research to clinical practice. Journal of Cardiovascular Nursing, 26(4), S46-S55. Retrieved from https://www.nursingcenter.com/journalarticle?Article_ID=1211772&Journal_ID=54006&Issue_ID=1211735
Chan, C. W. H., Ng, N. H. Y., Chan, H. Y. L., Wong, M. M. H., & Chow, K. W. (2019). A systematic review of the effects of advance care planning facilitators training programs. BMC Health Services Research, 19(362). Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4192-0
Snaterse, M., Dobber, J., Jepma, P., Peters, R. J. G., ter Riet, G., Boekholdt, S. M., Buurman, B. M., et al. (2016). Effective components of nurse-coordinated care to prevent recurrent coronary events: a systematic review and meta-analysis. Heart, 106, 50-56. https://heart.bmj.com/content/102/1/50
Sun, L-Y., Lee, E-W., Zahra, A., & Park, J-H. (2015). Risk Factors of Cardiovascular Disease and Their Related Socio-Economical, Environmental and Health Behavioral Factors: Focused on Low-Middle Income Countries- A Narrative Review Article. Iranian Journal of Public Health, 44(4), 435-444. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441956/