Question

2. Diagnosis: Once the nurse has all the information on the patient and after analyzing next step in the process is the diagnosis. Diagnosis. as the name sugests, involves the clinical judgment of a nurse on the response of a patient to the actual (happening right now) of potential (risk for/concern) health condition. The diagnosis is done by a skilled nurse, and so it should be very detailed. For example, it should not just indicate that the patient is in pain but should also state that the pain has caused other problems like poor nutrition, anxiety and even a social effect like causing conflict in the family if that is the case. A detailed diagnosis should provide as much information as possible as it is critical for any interventions. Your experience: 3. Planning: After the diagnosis or once the patient and the nurse agree on it, a plan of action is created. The purpose of the plan is to make the intervention that will follow to meet a goal. A care plan helps the nurse determine what needs to be done, how it should be done and when it is to be done so as to make sure that the care offered meets the medical requirements and expectations of the patient. Here the diagnosis should be addressed, and the nurse will look at the symptoms and classify them according to their severity (prioritize). Each of the problems is also assigned a measurable goal for the expected outcome. The assessment data is then written on the patient's care plan so that nurses and everybody else caring for the patient has access to it. Your experience:

Answer 1

1. Assessment:

Once my father experience discomfort in the epigastric region and felt tiredness in left arm. We went to hospital where health care providers asked multiple questions like

What is your complain? My father told same about discomfort and left arm tiredness. They asked any pain and tightness? Father said no. Any sweating ? Yes. Immediately they performed ECG. Took Blood preasure, pulse. ECG was showing ST elevations in some leada. They asked for same event earlier ever in life? Same event with any other family member? Asked about is he smoker or drinker? How many cigarettes in a day ? Is he consume non-veg or not? Any other medication he taking? Any other existing disease? They took blood sample and send the sample for complete blood count, random blood sugar level, HbA1C and lipid profile.

2. Diagnosis:

In the above case they found that my father is on medication of Diabetes Mellitus type 2. Cholesterol was more than 250mg/dl . HbA1C was 8%. ECG shown ST elevation.

They diagnosed "ST elevation Myocardial infraction with Diabetes Mellitus 2"

3. Planning:

In above case they planned to relieve the discomfort and medication for decrease the oxygen demand of heart. In this case there would be blockage in the coronary vessels so they planned thrombolysis by streptokinase in the cardiac intensive care unit. Also medication for decrease the anxiety of my father. They also told that he would be given blood thining agents like aspirin. They stopes all medication of Diabetes Mellitus and planned to given insulin shots after measure blood sugar level. They also planned for percutaneous coronary angiography in next day and angioplasty if needed. They gave strict instruction that not to move from the bed even for passing stool and urination.

4. Implementation:

They gave tablet isosorbid dinitrate sublingual, tablet aspirin and an injection of morphin. Then they shifted the patient in cardiac intensive care unit. During shifting my father felt comfort in epigastric region and in arm. In intensive care unit they started the ECG, BP, Pulse monitoring. After 5 min they gave the tablet clonazepam chewable. And start infusion of the streptokinase injection by infusion set. They started insuline shot befor breakfast, lunch and dinner after assessing blood glucose level. After 24 hrs they performed angiography. They continued the aspirin 75 mg twice a day with clopidogrel and nitroglycerine. Out of total 5 days hospital stay he was not allowed to moved from the bed for first 4 days. 5th day he allowed to walk to urinal , washroom and toilet for passing stool.

5. Evalution:

After angiography they found 2 blockage of 60% and one of 90%. They did not suggested angioplasty as the 90% block was not in eng artery . There were alternate artery was available to perfuse the affected cardiac tissue. Fortunatly there was not damage in the heart but only ischemia. Discomfort and pain were reliefed within 2 hrs of admission and remained same in further 5 day stay in hospital. They discharged my father on 5th day with some medication viz. Tab aspirin, clopidogrel, nitroglycerin, atorvastatin and all previous medication of Diabetes mellitus 2.