Question

History of Present Problem: E.W., a 76-year-old white man, comes to the emergency department after a syncopal episode and complaint of mild chest discomfort at a local restaurant. He is accompanied by two friends. Subjective Data • Has been feeling weak for a few days • Became dizzy and fainted while awaiting his dinner • Takes one medication, a “water pill” for high blood pressure

1. What psychosocial/holistic care PRIORITIES need to be addressed for this patient?

2. How can you engage and show this patient matters to you?

Develop 2 Nursing Care Plans for this patient: Priority Nursing Diagnoses Goals (one goal per diagnosis) Interventions (list at least 2 interventions) Evaluation (write what you imagine could happen.)

Answer 1

1.The psychological/holistic care priorities needed to be assessed are

• Provide the patient a mental support by making an environment favorable for him ,to relax at first
• Initiate a cultural competent care
• Assess the emotional status of the patient and treat patient empathetically
• Trying to inform to the family members
• Provide a sense of hope and trust

2.Some of the ways to show the engagement are

• Meeting the basic and simple needs of the patient
• Establishing a therapeutic relationship by good communication
• Treating the patient symptoms effectively and providing a comfort zone out from the illness
• The patient is able to interact and ask for their needs in regards to their issues

Nursing Diagnosis

• Impaired cardiac output related to decreased blood supply as evudenced by dizziness,chest discomfort secondary to hypertension

Goal:

• To establish normal cardiac function and prevent dizziness ,chest discomfort

Intervention

• Monitor the vital signs, to get baseline data and plan for patient care
• Follow safety measures as the risk for fall is possible due to dizziness
• Monitor the cardiac enzymes as per order
• Monitor intake and output as water pill can lead to increased urine output to decrease blood pressure resulting in hypotension

Evaluation

• The patient will have no chest discomfort

Nursing diagnosis

• Risk for fall related to vasodilation as evidenced by dizziness

Goal

• To prevent dizziness

Intervention

• Monitor vital signs
• Assess the mental status, HCS to rule out any problems associated with CNS
• Follow fall prevention techniques

Evaluation

The patient will be able to do activities normally without ant any dizziness