- Internal Code :
- Subject Code : NUR250
- University : Charles Darwin University Assignment Help Era is not sponsored or endorsed by this college or university.
- Subject Name : Medical Sciences
Case Study: Mr Robert Lalara
Task 1
The patient is Mr Robert Lalara who is 42 old of age. He is from a remote community. He was admitted to the hospital due to chest pain and with a condition of 'racing heart'.He lives in a single floored room with his wife. He has 4 children and 2 grandchildren.The patie nt has a respiratory rate of 28. A normal respiratory rate is between 12 and 25 respiratory rates. This shows that a patient has not a normal respiratory rate. High respiratory rate leads to a disease called Tachypnea. He is having an oxygen saturation of 96 per cent on room condition (Massey et al., 2017).
The normal oxygen saturation is between 96 per cent to 98 per cent. Anything below this could be a dangerous situation for the lung. This shows the patient lies very close to the margin. This is an alarming situation for the patient. The patient has a heart rate of 115 bpm. From 60 to 100 bpm is considered to be the normal heart rate for adults. That means the patient has a higher heart rate than the normal heart rate. Thus it shows that the patient is suffering from Tachycardia. The patient has an irregular heart rate. The blood pressure for the patient is 120/80 mm of hg. The optimum blood pressure is considered to be 120/80 mm of hg. Thus the patient has normal blood pressure. The ECG report of the person shows that he has Atrial Fibrillation. This also proves that he has an irregular heart rate. This can lead to blood clots, stroke and also heart failure. Glasgow coma scale of the patient has GCS 15/15. This is not a normal GCS level. The patient is having sharp chest pain of 2/10.
Tachypnea is a condition that occurs due to rapid and shallow breathing. This is mainly due to an increase in carbon dioxide in the lungs. The symptoms of Tachypnea include chest pain, fever and also difficulty to breath. The patient has the condition of high respiratory rate and sharp chest pain on the inspiration. This shows that the patient is suffering from Tachypnea. Tachycardia is the condition where it makes the heartbeat a hundred times faster. The symptoms of the Tach ycardia include chest pain, dizziness, shortness of breath and heart palpitations. An Ecg report can proof of evidence of having Tachycardia. The ECG report of the patient shows that the patient has the condition of the Atrial Fibrillation. This shows that the patient has a condition of Tachycardia.
Tachycardia is affected by the person having the smoking and drinking. From the past medical report shows that he is a smoker. Being smoker could be the cause of the condition of Tachycardia. The patient can have an irregular heartbeat due to having Atrial Fibrillation. Atrial fibrillation is the condition having irregular heartbeat that leads to stroke, blood clot and also other heart related other diseases. From the past medical history, it shows that he has rheumatic heart disease. This can be due to the condition of Atrial Fibrillation (Cuculich et al., 2017).
Task 2
Nursing Care Plan: Mr Robert Lalara
Task 3
After returning home from the hospital, Mr. Robert Lalara need to be very much conscious about his health. Because, only medication is not enough for the fitness of an cardiac patient. It may take some time to recover his energy. But instead of being depressed, he need to take proper care of himself at home. Here are some key points Mr. Robert Lalara need to follow in his daily routine (Gonçalves‐Bradley et al., 2016).
First of all he need to change his lifestyle for the betterment of his health. He may follow these guideline:
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The patient must need to reduce the usual quantity of salt while having food. Salt usually makes the situation more complex in the case of cardiac patient.
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The patient had smoking habit. He need to stop this habit. If he feels difficulty to quite it, he may take any expert's help.
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The patient need to stay away from restaurants to avoid any type of fast food, fatty foods even it may be prepared at home. He must have to avoid frozen foods too. Thus he can take a good care of his blood vessels as well as his heart (Young et al., 2018).
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According to the case history, the patient is not alcoholic. Even so he have to avoid alcohol even in occasional drinking. Because alcohol impairs the working ability of the muscles of heart. Consequently, it will worsen his heart's condition.
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The patient need to try to stay away from the stressful events, thoughts. Stress increases the level of blood pressure and thus it worsens the condition of heart. So it is good for him to be stress free. If it is not possible in any cause, he may visit a counsellor.
He needs to be careful about taking his drugs. Proper time maintaining is a crucial affair while taking heart drugs. Taking another drug or herb along with heart drugs may be harmful.
Task 4
ECG report shows that Mr. Robert Lalara has serious problem of irregular and rapid heart rate. It means there is no coordination among his heart's upper chambers and lower chamber's beats. This is why he feels central chest pain. So he need to take Ramipril 10 mg as usual and he also need to take Digoxin 125 mcg to avoid any kind of risk.
Both of these medications work to keep the condition of the patient's heart good. Digoxin is useful to treat the cases of heart failure. Usually it has been used with other medicines. Digoxin is also useful for different type of irregular heart beat issues. This medicine helps to enhance the strength of heart which helps to do exercise and even to walk (Hauptman et al., 2016). Ramipril is used for the treatment of high blood pressure. This medication prevents the patient from heart attacks, strokes, It is also useful for the improvement of the patient's survival capacity after heart attack. So it will be beneficial for Mr. Robert Lalara to continue these two medication maintaining proper time gap as prescribed by the doctor (Kothari, 2019).
As per his case history, taken by the doctor, Mr. Robert Lalara is suffering from hyperlipidaemia, rheumatic heart disease and mitral valve regurgitation. This means he has a high potentiality of heart attack or stroke. Both Digoxin 125 mcg and Ramipril 10 mg take good care of heart and prevent the risk of heart attack or stroke. This is why the patient has been prescribed with these medication.
In spite of their excellent usefulness in the case of heart related issues, these medications have some side effects as well. Mr. Robert Lalara need to be careful about those side effects. As it's side effect of Digoxin 125 mcg, vomiting, Nausea, loss of appetite, dizziness, headache may occur. As the side effect of Ramipril 10 mg, Dry cough, tiredness, light-headedness, Dizziness may occur (Dalla et al., 2019). These side effects occur when the patient's body tries to adjust with these medications. They patient do not need to be worried. Because all of these are temporary. Once well adjustment of these medication with the patient's body bring done, these side effects may be reduced. But, if the condition worsen, he must need to visit the doctor. In spite of side effects, these medications have been prescribed by the doctor for their benefits regarding heart issue is greater than the side effect risk which may occur to the patient temporarily.
References
Gonçalves‐Bradley, D. C., Lannin, N. A., Clemson, L. M., Cameron, I. D., & Shepperd, S. (2016). Discharge planning from hospital. Cochrane database of systematic reviews, (1).
Young, A. M., Mudge, A. M., Banks, M. D., Rogers, L., Demedio, K., & Isenring, E. (2018). Improving nutritional discharge planning and follow up in older medical inpatients: Hospital to Home Outreach for Malnourished Elders. Nutrition & dietetics, 75(3), 283-290.
Kothari, P. (2019). Health Care Provider Perspectives on Discharge Planning: From Hospital to Skilled Nursing Facility.
Hauptman, P. J., Blume, S. W., Lewis, E. F., & Ward, S. (2016). Digoxin toxicity and use of digoxin immune fab: insights from a national hospital database. JACC: Heart Failure, 4(5), 357-364.
Dalla Vestra, M., Pozza, G., Mosca, A., Grazioli, V., Lapolla, A., Fioretto, P., & Crepaldi, G. (2019). Effect of lercanidipine compared with ramipril on albumin excretion rate in hypertensive Type 2 diabetic patients with microalbuminuria: DIAL Study (Diabete, Ipertensione, Albuminuria, Lercanidipina). Cardiovascular Therapy and Prevention, 9(7), 41-48.
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