Selected Case Description
Coronary heart disease is a widely diagnosed physiological impairment that adversely impacts human well-being healthy functioning and often leads to increased mortality. One of the historical figures who suffered from coronary heart disease was President William Howard Taft. The cause of his death was a heart attack on March 8, 1930, in Washington, DC. Taft was the 27th President of the United States from 1909 till 1913; after his presidency, Taft was appointed to the position of Chief Justice in the Supreme Court; he died in 1930 (Fallon, 2019). This disease is particularly dependent on lifestyle choices, especially unhealthy diet, substance use, and limited movement (Severino et al., 2020). The illness is a prevailing heart problem that requires adequate prevention and treatment methods advancement.
Normal Physiological Functioning
The healthy functioning of the heart is based on the non-disrupted work of the organ when pumping blood to all body systems. Under normal circumstances in a healthy individual, the blood is transmitted to the heart through coronary arteries, which provide nutrients and oxygen to body organs (Severino et al., 2020). In a healthy individual, the coronary arteries are clear without any formations that obstruct blood flow to the heart. In such a manner, the delivery of blood with oxygen and nutrients to the whole body is timely and undisrupted, which guarantees the healthy functioning of the entire physiological system.
Coronary heart disease is an impairment in the functioning of arteries that obstructs the delivery of oxygen to the heart. It occurs under the influence of plaques in the coronary arteries. The disease is caused by “the presence of an obstructive atherosclerotic plaque, which causes a blood flow reduction to the myocardium” (Severino et al., 2020, p. 2). The build-up of plaque on the inside of arteries that makes them narrower and more difficult for blood to pass is called atherosclerosis, which is a factor contributing to coronary heart disease (Severino et al., 2020, p. 2). Atherosclerosis further results in myocardial ischemia, which might result in a heart attack and may lead to disability or death.
The clinical manifestations of coronary heart disease include symptoms and signs that might signalize the problem. Firstly, the signs that might indicate coronary heart disease in a patient include dizziness, cold sweat, pain in the neck, shortness of breath, difficulty sleeping, and weakness (“Coronary heart disease,” n. d.). Secondly, chest pain is a common sign of heart problems in general and coronary heart disease in particular. However, women are “less likely than men to experience chest pain” but more often experience fatigue, nausea, pressure in the chest, and stomach pain (“Coronary heart disease,” n. d., para. 5). These signs and symptoms might vary from patient to patient and be manifested more or less severely.
Influence on Body Systems
Since coronary heart disease disrupts the heart, this impairment affects other vital body systems. Firstly, it might disrupt the functioning of the cardiovascular system due to possible complications. They include “acute coronary syndrome, including angina or heart attack, arrhythmia, heart failure, cardiogenic shock, and sudden cardiac arrest” (“Coronary heart disease,” n. d., para. 5). With the obstructed blood flow to the heart, the blood supply to the digestive, respiratory, muscular systems, and brain is insufficient. That is why these systems might not function properly. Moreover, coronary heart disease adversely impacts the nervous system by disrupting its balanced functioning, which deteriorates heart function in the future. Thus, coronary heart disease is a severe health problem that might disturb the normal physiological work of the whole body or its particular systems.
Coronary heart disease, or coronary artery disease, or ischemic heart disease are all the names of the prevalent heart issue that has been identified in the selected case. Although it has been experienced by people since ancient times, its discovery with proper clinical manifestations articulated is dated by the 19th century with the invention of the coronary arteriography (Hajar, 2017). This disease is often faced by many people representing a variety of professions, cultural and lifestyle backgrounds, family histories, and psychological circumstances.
In particular, among some famous people who have suffered from coronary heart disease are American journalist and TV presenter Larry King, a renowned TV show host David Letterman, and an actress Elizabeth Taylor (Porter, 2017). Moreover, some politicians have had heart disease, including former US President Bill Clinton and former Vice President Dick Cheney (Porter, 2017). The variations of the disease in these cases included a different number of heart attacks in individuals, a variety of causes, ranging from heavy smoking to family history, and differences in treatment outcomes. Thus, the historical variations of the selected case indicate that the disease is highly prevalent in the United States and has multiple risk factors and manifestations.
Psychological Stressors and Mechanisms Impacting the Disease
Psychological stressors are perceived to be a significant risk factor causing the onset and development of coronary heart disease. Research shows that excessive and continuous exposure to stress increases cortisol levels and further causes the growth of cholesterol levels with ultimate artery plaque-forming (Beer et al., 2020). In addition, anxiety, depression, and post-traumatic stress disorder are considered significant psychological factors contributing to coronary heart disease (Beer et al., 2020; Fallon, 2019). Moreover, sleep deprivation and low quality are found to have an impact on coronary artery disease. In particular, “poor sleep causes changes in circulating levels of leptin and ghrelin, which can facilitate the development of obesity and impair glycemic control,” ultimately leading to artery plaques and the development of heart disease (Lao et al., 2018, p. 116). Thus, psychological factors have a high level of influence on the onset of ischemic heart disease in different patient groups.
As for the adaptive psychological mechanisms attributed to coronary heart disease, they include patients’ adjustment to the manifestations of the illness and change in lifestyle to minimize the symptoms and treat the condition. In particular, improvement of sleep, minimization of stress, anxiety, and unhealthy food, increased mindfulness in diet and physical activity contribute to adaptation to coronary heart disease (Beer et al., 2020; “Coronary heart disease,” n. d.; Lao et al., 2018). Through such mechanisms and actions, patients are capable of adjusting their perception of their condition and facilitating their lifestyles in a way that allows them to improve their state of health.
Historical Impact of Patient Care Technology
The case of President William Howard Taft demonstrates a significant impact of the historic setting on the patient’s health outcomes. Indeed, since Taft suffered from coronary heart disease in the 1920s, the diagnosis and treatment of the disease were insufficient compared to modern technologies (Fallon, 2019). The formulation of the causes of the disease, such as “hard work” or “overworking,” implies the lack of an in-depth analysis of the causes of the disease and its proper treatment (Fallon, 2019, p. 585). Over time, the development of patient care technologies significantly improved due to the use of computer-based tools and arteriography diagnosis (Hajar, 2017). Prior underdevelopment of the patient care technologies had tragic outcomes for the selected case’s individual since President William Howard Taft died of a heart attack.
Planning, Intervention, Evaluation, and Research
|Nursing Diagnosis||Expected Outcome||Nursing Interventions||Rationale||Evaluation|
|Coronary Artery Disease||The treatment of coronary heart disease necessitates a thorough plan for care that would incorporate addressing the risk factors, manifestations, individual patient particularities, and best treatment practices. A well-tailored care plan should be based on an accurate and measurable goal statement. || |
Monitoring of vital signs.
The medication types that should be administered to the patient include the following:
When implementing a patient plan of care, nursing staff should ensure that the patient is not only properly instructed but also equipped with patient technologies enabling them to manage their condition independently. Multiple patient technologies have been developed to assist individuals suffering from coronary heart disease with tools and applications for treatment consistency and monitoring. For example, the patient might be advised on using a step and heart rate tracker to monitor activity and heart rate, as well as to conduct self-assessment and learn about the condition management (CDC, 2021). Overall, the advancement of technologies related to patient care for individuals with coronary artery disease is sufficient for promoting health. In particular, screening, diagnosing, and treatment technologies are based on non-invasive computer-assisted technologies that allow for timely detection of the impairments and their elimination (Jarvis & Saman, 2017; Ramadhani et al., 2019). Overall, it is essential to disseminate information about the available technologies to empower patients for timely screening and treatment.
|The nursing concerns that are associated with the patient’s condition include the manifestation of coronary heart disease that threatens the patient’s health and life. |
According to the suggested plan, the technologies that might be used to assist in the treatment of the patient should include both monitoring and treatment tools. Firstly, to monitor the development of the disease and the changes in the heart, health care providers might use electrocardiograms and coronary angiograms in the hospital setting, as well as heart rate self-assessment (CDC, 2021). Moreover, the patient might be advised on using some e-Health tracking devices and applications to adhere to a healthy diet and physical activity.
|In order to evaluate the outcomes of the implemented plan for care for the patient from the selected study, one should identify some measurable criteria indicating improvements or deterioration of results. The data that would be the most indicative of the plan’s success might include the following. |
Self-assessment might be a relatively subjective measure; however, in the context of the patient’s education and counseling during the treatment process, it is anticipated that the patient will demonstrate objectivity and clarity in the identification of the improvements. Overall, the listed measures will allow for an objective evaluation of the results of the treatment process and the success of the interventions for the patient’s health.
Conclusively, the proposed patient care plan is anticipated to yield positive patient outcomes due to the consistency in the set goals, nursing interventions, medications, and technologies integration. The proposed plan incorporates multifaceted and interdisciplinary interventions, including pharmacology, psychotherapy, self-monitoring, and conventional treatment, which is why it is expected to benefit the patient in multiple ways. According to Mao et al. (2019), the treatment of coronary heart disease delivered by a multidisciplinary team yields successful outcomes for patient recovery and long-term health benefits. Therefore, the anticipated goal achievement and overall patient healing following the implementation of the proposed patient care plan is justified and supported by evidence.
Beer, K., Kuhlmann, S. L., Tschorn, M., Arolt, V., Grosse, L., Haverkamp, W., Waltenberger, J., Strehle, J., Martus, P., Muler-Nordhorn, J., Rieckmann, N., & Ströhle, A. (2020). Anxiety disorders and post-traumatic stress disorder in patients with coronary heart disease. Journal of Affective Disorders Reports, 1(100009), 1-8. Web.
Coronary heart disease. (n. d.). National Heart, Lung, and Blood Institute. Web.
Fallon, C. K. (2019). Husbands’ hearts and women’s health: Gender, age, and heart disease in twentieth-century America. Bulletin of the History of Medicine, 93(4), 577-609.
Hajar, R. (2017). Coronary heart disease: From mummies to 21st century. Heart Views: The Official Journal of the Gulf Heart Association, 18(2), 68-74.
Jarvis, S., & Saman, S. (2017). Diagnosis, management and nursing care in acute coronary syndrome. Nursing Times, 113(3), 31-35.
Lao, X. Q., Liu, X., Deng, H. B., Chan, T. C., Ho, K. F., Wang, F., Vermeulen, R., Tam, T., Wong, M. C. S., Tse, L. A., Chang, L., & Yeoh, E. K. (2018). Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults. Journal of Clinical Sleep Medicine, 14(1), 109-117.
Mao, Q., Zhou, D., Li, Y., Wang, Y., Xu, S. C., & Zhao, X. H. (2019). The triglyceride-glucose index predicts coronary artery disease severity and cardiovascular outcomes in patients with non-ST-segment elevation acute coronary syndrome. Journal of the American Heart Association, 9, 1-10.
Porter, E. (2017). Famous faces of heart disease. Web.
Ramadhani, F. B., Liu, Y., Jing, X., Qing, Y., Rathnayake, A. K., Kara, W. S. K., & Wu, W. (2019). Investigating the relevance of nursing caring interventions delivered to patients with coronary artery disease at a teaching hospital in China: A retrospective study. Cureus, 11(5), 1-14.
Severino, P., D’Amato, A., Pucci, M., Infusino, F., Adamo, F., Birtolo, L. I., Netti, L., Montefusco, G., Chimenti, C., Lavalle, C., Maestrini, V., Mancone, M., Chilian, W. M., & Fedele, F. (2020). Ischemic heart disease pathophysiology paradigms overview: From plaque activation to microvascular dysfunction. International Journal of Molecular Sciences, 21(21), 1-30.