NRSG265 Principles of Nursing Medical Assessment Answer

Justification and Epidemiology

The chosen chronic disease is "Aortic Stenosis." The choice of this illness was made because of its serious effects on cardiovascular health and the aging population. Due to its progressive nature and potential problems, aortic stenosis, which is characterised by the narrowing of the aortic valve, presents difficulties (Zheng et al., 2020). By talking about this illness, we may delve into its complex impacts and consider how thorough care approaches can enhance patients' quality of life. The prevalence of aortic stenosis is strongly correlated with aging populations, which is an important demographic trend in Australia. It affects roughly 1.48% of people over the age of 55, and its prevalence rises to about 4-5% in people over the age of 85 (Strange et al., 2021). This age-related tendency is a result of risk factors accumulating over time and degenerative changes occurring with time. The requirement for efficient management is highlighted by the age distribution.

Aortic stenosis also places a heavy demand on healthcare services. Aortic valve replacement may be necessary when the illness worsens since it can cause heart failure. Despite being life-saving, these procedures increase the demand for hospital resources. Because of this, treating aortic stenosis affects the sustainability of the healthcare system in addition to patient results (Paleri et al., 2019). Aortic stenosis affects both men and women equally, albeit men are somewhat more likely to get it than women. This demonstrates the value of gender-inclusive healthcare strategies that take into account potential variations in disease presentation and management (Saeed et al., 2020). The need for proactive care, early detection, and customised interventions is highlighted by an understanding of these epidemiological characteristics of aortic stenosis in the Australian setting.

Impact of Chronic Disease

The patient's health and quality of life are significantly affected by aortic stenosis, which is characterized by the narrowing of the aortic valve. The heart struggles to force blood through the constricted aperture as the aortic valve narrows. As a result, the heart's left ventricle grows larger, acting as a compensating mechanism (Zheng et al., 2020). The patient consequently exhibits signs like angina, exhaustion, and shortness of breath. The heart's failure to supply the body with the oxygen it needs makes it difficult to engage in physical activity, which lowers exercise tolerance. This restriction has a substantial impact on the patient's quality of life because it may prevent them from engaging in activities they once enjoyed, which could lead to social isolation and emotional misery (Pujari & Agasthi, 2020).

If left untreated, aortic stenosis can result in catastrophic issues like heart failure and arrhythmias. However, therapies like aortic valve replacement can significantly improve the prognosis and signs. Prompt identification and treatment are essential to address the multifaceted impacts of aortic stenosis on the patient's cardiovascular wellness and general well-being (Kodali et al., 2018). Healthcare providers need to be aware of the condition's wide-ranging consequences on patients' physiological and psychological well-being in addition to their cardiac function. By adopting an integrated approach to care and developing interventions that address these many qualities, healthcare professionals can enhance the individual's quality of life and reduce the risk of repercussions associated with aortic stenosis (Kovacs et al., 2022).

Long-term Management and Health Promotion Strategies

Long-term management strategies for a patient with aortic stenosis, considering the identified factors impacting the patient, involve a comprehensive approach to promote health and independence while addressing the complex nature of the condition. Regular medical follow-up with a cardiovascular specialist is crucial, enabling ongoing assessment and adjustment of the management plan (Stefanakis et al., 2021). Lifestyle modifications are essential, including a heart-healthy diet low in sodium, regular physical activity tailored to the patient's capacity, and stress management techniques. Adherence to prescribed medications, particularly antihypertensives and angina medications, is fundamental for symptom alleviation and complication prevention (Lee et al., 2019). Given the patient's history of smoking, prioritising smoking cessation interventions is vital to improve cardiovascular health. Collaboration with a physical therapist for a personalised exercise program can enhance the patient's physical fitness and endurance, counteracting the reduced exercise tolerance caused by aortic stenosis (Franklin et al., 2020).

Patient education empowers informed decision-making and active participation in self-care. Additionally, psychosocial support through counselling or support groups helps manage the emotional impact of lifestyle changes and reduced physical capacity. Advanced care planning discussions ensure the patient's preferences for treatment and end-of-life care are respected (Barbosa et al., 2021). Regular screenings for associated conditions, involving the patient's support system, and engagement with available Australian healthcare services, such as Medicare, general practitioners, cardiac rehabilitation programs, and community health centres, are crucial components of the long-term management plan. These strategies collectively aim to optimise the patient's health, preserve independence, and enhance the overall quality of life, reflecting the comprehensive care approach of the Australian healthcare system (Davidson et al., 2022).

Justification of Nursing Care

Acute Issue 1: Hypertension

Rationale

Hypertension commonly coexists with aortic stenosis due to the intricate interplay between the narrowed aortic valve and the heart's efforts to overcome increased resistance. As the aortic valve narrows, the heart faces heightened resistance when ejecting blood into the aorta, prompting a compensatory response characterised by intensified contractions. This response raises blood pressure in an attempt to overcome the restricted valve opening. However, this elevated blood pressure places undue strain on an already compromised heart and exacerbates the adverse effects of aortic stenosis, potentially precipitating heart failure (Rassa & Zahr, 2018). Addressing hypertension becomes paramount as it significantly contributes to cardiac workload reduction, the optimisation of cardiac output, and the mitigation of potential cardiac complications (Driggin et al., 2020).

Goal:

The objective of maintaining blood pressure within the range of 120/70 mm Hg to 140/90 mm Hg is strategically aligned with well-established hypertension management guidelines. This target range ensures a delicate equilibrium between diminishing the heart's exertion against vascular resistance and guaranteeing sufficient perfusion of critical organs (Salam et al., 2023). By adhering to this goal, healthcare providers aim to mitigate the deleterious effects of elevated blood pressure on the cardiovascular system, enhance oxygen delivery to tissues, and bolster overall cardiovascular health.

Acute Issue 2: Restricted blood flow

Rationale:

Aortic stenosis profoundly hampers the heart's capability to effectively propel oxygenated blood throughout the body, engendering symptoms like angina, fatigue, and reduced exercise tolerance. These symptoms stem from the compromised cardiac output and inadequate perfusion that result from the narrowed aortic valve. This insufficiency in blood delivery to organs and tissues underscores the necessity for targeted interventions aimed at mitigating restricted blood flow (Fritz, 2021). By addressing this issue, healthcare providers seek to ameliorate the patient's overall well-being, enhance the distribution of oxygen to vital tissues, and alleviate the distressing symptoms of angina, fatigue, and exercise intolerance (Tanguturi et al., 2020).

Goal:

The overarching objective of alleviating angina symptoms and enhancing exercise tolerance bears paramount significance in enhancing the patient's overall quality of life and functional capacity. Attainment of this goal necessitates multifaceted interventions that collectively bolster cardiac output, augment oxygen availability to tissues, and optimize the heart's pumping efficacy. This goal is rooted in the aspiration to empower the patient with the physical capacity to engage in daily activities without undue fatigue or discomfort, fostering an improved sense of well-being and a greater degree of independence.

References

Barbosa, H. C., de Queiroz Oliveira, J. A., da Costa, J. M., de Melo Santos, R. P., Miranda, L. G., de Carvalho Torres, H., & Martins, M. A. P. (2021). Empowerment-oriented strategies to identify behavior change in patients with chronic diseases: An integrative review of the literature. Patient Education and Counseling , 104 (4), 689-702. https://doi.org/10.1016/j.pec.2021.01.011

Davidson, A. R., Kelly, J., Ball, L., Morgan, M., & Reidlinger, D. P. (2022). What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: An integrative review. BMC Primary Care , 23 (1), 1-12. https://doi.org/10.1186/s12875-021-01595-6

Driggin, E., Madhavan, M. V., Bikdeli, B., Chuich, T., Laracy, J., Biondi-Zoccai, G., & Parikh, S. A. (2020). Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. Journal of the American College of cardiology , 75 (18), 2352-2371. https://www.jacc.org/doi/abs/10.1016/j.jacc.2020.03.031

Franklin, B. A., Thompson, P. D., Al-Zaiti, S. S., Albert, C. M., Hivert, M. F., Levine, B. D., & American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Stroke Council. (2020). Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: placing the risks into perspective–an update: A scientific statement from the American Heart Association. Circulation , 141 (13), e705-e736. https://doi.org/10.1161/CIR.0000000000000749

Fritz, C. M. (2021). Exercise Capacity in the Context of Training, Heart Rate Variability and Lung Function in Patients with Congenital Heart Disease (Doctoral dissertation, Technische Universität München). https://mediatum.ub.tum.de/1534813

Kodali, S. K., Velagapudi, P., Hahn, R. T., Abbott, D., & Leon, M. B. (2018). Valvular heart disease in patients≥ 80 years of age. Journal of the American College of Cardiology , 71 (18), 2058-2072. https://www.jacc.org/doi/abs/10.1016/j.jacc.2018.03.459 Kovacs, A. H., Brouillette, J., Ibeziako, P., Jackson, J. L., Kasparian, N. A., Kim, Y. Y., & American Heart Association Council on Lifelong Congenital Heart Disease and Heart.

You Might Also Like:-

Adult Health and Health Alterations Assignment Help

Nursing Care Plan Assignment Help

Nursing Assignment Sample Online

Looking For Complete Assignment Sample Get It On WhatsApp