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DEVELOPING INTEGRATED HEALTH SCIENCES: NUR5023/24/25
Table of Contents
1. Myocardial Infarction (MI)    7
1. Describing the Condition    7
Introduction    7
Prevalence Rates    7
Incidence Rates    7
Impact on Global, National and Local Levels    7
Defining Features    7
Risk Factors    7
Types and Subtypes    8
Causes    8
2. Explaining Physiological or Anatomical Changes Taking Place    8
Anatomical Changes    8
Physiological Changes    8
Signs and Symptoms    8
Complications    9
3. Required Medication or Therapeutic Interventions    9
Assessment Data    9
Nursing Diagnosis    9
Desired Outcomes    9
Intervention    9
Medical-Surgical Interventions    9
Pharmacologic Therapy    9
Non-Pharmacologic Therapy    9
Evaluation    10
2. Diabetes    11
1. Describing the Condition    11
Introduction    11
Prevalence Rates    11
Incidence Rates    11
Impact on Global, National and Local Levels    11
Defining Features    11
Risk Factors    11
Types and Subtypes    11
Causes    12
2. Explaining Physiological or Anatomical Changes Taking Place    12
Anatomical Changes    12
Physiological Changes    12
Signs and Symptoms    12
Complications    12
3. Required Medication or Therapeutic Interventions    12
Assessment Data    12
Nursing Diagnosis    13
Desired Outcomes    13
Intervention    13
Medical-Surgical Interventions    13
Pharmacologic Therapy    13
Non-Pharmacologic Therapy    13
Evaluation    13
3. Pneumonia    15
1. Describing the Condition    15
Introduction    15
Prevalence Rates    15
Incidence Rates    15
Impact on Global, National and Local Levels    15
Defining Features    15
Risk Factors    15
Types and Subtypes    15
Causes    15
2. Explaining Physiological or Anatomical Changes Taking Place    16
Anatomical Changes    16
Physiological Changes    16
Signs and Symptoms    16
Complications    17
3. Required Medication or Therapeutic Interventions    17
Assessment Data    17
Nursing Diagnosis    17
Desired Outcomes    17
Intervention    17
Medical-Surgical Interventions    17
Pharmacologic Therapy    17
Non-Pharmacologic Therapy    18
Evaluation    18
4. Ulcerative Colitis    19
1. Describing the Condition    19
Introduction    19
Prevalence Rates    19
Incidence Rates    19
Impact on Global, National and Local Levels    19
Defining Features    19
Risk Factors    19
Types and Subtypes    19
Causes    19
2. Explaining Physiological or Anatomical Changes Taking Place    20
Anatomical Changes    20
Physiological Changes    20
Signs and Symptoms    20
Complications    20
3. Required Medication or Therapeutic Interventions    20
Assessment Data    20
Nursing Diagnosis    21
Desired Outcomes    21
Intervention    21
Medical-Surgical Interventions    21
Pharmacologic Therapy    21
Non-Pharmacologic Therapy    21
Evaluation    21
5. Cerebrovascular Accident (Stroke)    23
1. Describing the Condition    23
Introduction    23
Prevalence Rates    23
Incidence Rates    23
Impact on Global, National and Local Levels    23
Defining Features    23
Risk Factors    23
Types and Subtypes    24
Causes    24
2. Explaining Physiological or Anatomical Changes Taking Place    24
Anatomical Changes    24
Physiological Changes    24
Signs and Symptoms    25
Complications    25
3. Required Medication or Therapeutic Interventions    25
Assessment Data    25
Nursing Diagnosis    25
Desired Outcomes    25
Intervention    25
Medical-Surgical Interventions    25
Pharmacologic Therapy    26
Non-Pharmacologic Therapy    26
Evaluation    26
6. Chronic Kidney Disease    27
1. Describing the Condition    27
Introduction    27
Prevalence Rates    27
Incidence Rates    27
Impact on Global, National and Local Levels    27
Defining Features    27
Risk Factors    27
Types and Subtypes    28
Causes    28
2. Explaining Physiological or Anatomical Changes Taking Place    28
Anatomical Changes    28
Physiological Changes    28
Signs and Symptoms    29
Complications    29
3. Required Medication or Therapeutic Interventions    29
Assessment Data    29
Nursing Diagnosis    29
Desired Outcomes    29
Intervention    29
Medical-Surgical Interventions    29
Pharmacologic Therapy    30
Non-Pharmacologic Therapy    30
Evaluation    30
References    32
1. Myocardial Infarction (MI)
1. Describing the Condition
Introduction
Myocardial Infarction is also known in common everyday terms as a heart attack. The condition is caused by the decrease of blood flow or the blood does not reach the heart and causes damage to the heart muscle.
Prevalence Rates
According to the studies, the myocardial infarction lays impacts on the black men more than the other population in between the age of 75 to 84 years. Every black man 12.9/100,000 males are known to suffer from myocardial infarction (Zeng, Huang and Pan, 2020). While among the white 9.1 male in every 100,000 and 7.8 women in every 100,000 were observed to suffer from myocardial infarction.
Incidence Rates
There are 1.5 million cases of myocardial infarction that is reported annually with a yearly incidence rate of 600 case per 100,000 people (Zeng, Huang and Pan, 2020).
Impact on Global, National and Local Levels
Myocardial infarction is one such cardiovascular condition that causes the highest number of deaths globally compared to the other condition, for which the people has died (Tedeschi et al. 2021). As estimated people of 17.9 million has died from myocardial infarction in 2016 representing 31% of death while others died of heart attack 85% and stroke.
Defining Features
In Myocardial Infarction, the symptoms include chest, there is also discomfort in the shoulder, arm, back, neck and jaw as well. The blockage is usually caused by atherosclerosis (Victora et al. 2018). Atherosclerosis is defined as the blockage is caused by a build-up of plaque in the arteries.
Risk Factors
People with inherited high blood pressure, who have low levels of HDL cholesterol, high levels of LDL cholesterol, high levels of triglycerides, with family history of heart disease, older men and women, with type 1 diabetes. Women going through menopause and regular smokers are also more at risk. People, who are under a lot of stress, drink too much alcohol, people who have a sedentary lifestyle, people who are overweight by thirty percent, people who eat a diet high in saturated fat and people with type 2 diabetes (Tedeschi et al. 2021).
Types and Subtypes
There are three types of myocardial infarction leading to heart attacks. ST segment elevation myocardial infarction (STEMI), non-ST segment elevation myocardial infarction (NSTEMI) and coronary spasm as well as unstable angina (Zeng, Huang and Pan, 2020).
Causes
Plaque is caused due to a deposit caused by other substances and cholesterol. The plaque then ruptures, which causes a blood clot to form quickly, which causes the heart attack. The blood and oxygen supply is cut off leading to muscle cells to be damaged. The muscle cells then start to die. The damage starts after about thirty minutes and the damage is usually irreversible. The heart muscle is affected due to the lack of oxygen and this reduces the ability or completely diminishes the ability to function (Thygesen et al. 2018).
2. Explaining Physiological or Anatomical Changes Taking Place
Anatomical Changes
The flow of oxygen rich blood is blocked to the heart and it reduces the oxygen levels of cells in the heart. The heart muscle’s oxygen supply is blocked. The heart cannot get oxygen and this causes a heart attack. Heart attacks can be caused by ischemic heart disease. This is a condition, in which a waxy substance called plaque builds up in the coronary arteries. The arteries are tasked with bringing oxygen to the heart. The build-up of the plaque occurs due to atherosclerosis (Cui et al. 2020).
Physiological Changes
The atherosclerosis is the plaque that is built up over many years and this causes a rupture within the arteries. This leads to the formation of a blood clot on the surface of a plaque. Once the clot is large enough, it can block the blood flow through a coronary artery. This blockage should be treated immediately or it causes the artery to die. The healthy issue is slowly replaced by scar tissue. The damage of the heart leads to severe problems that may occur for prolonged durations of time (Gkontra et al. 2019).
Signs and Symptoms
A coronary artery spasm can also cause a heart attack. It is less common and can be described as a severe spasm of the coronary artery. Severe Spasm is the tightening of the artery cuts off the blood flow through the artery. The spasms may occur due to drug abuse of drugs such as cocaine, due to smoking, exposure to extreme climates and due to extreme stress or emotional distress.
Complications
Some of the complications associated with myocardial infarction includes disturbance in the rhythm, rate and conduction. It also results in cardiac rupture, pericarditis, ruptured papillary muscles and ventricular septal defect. Ventricular aneurysm, Dressler’s syndrome and heart failure.
3. Required Medication or Therapeutic Interventions
Assessment Data
According to the case study, the patient John already had two myocardial infarctions and he had been resuscitated in both the situations. Further, he had four blocked coronary arteries, of which two of them were occluded. The condition shows that there is subsequent building up of fatty deposits and cholesterol forming plaques and narrowing of the arteries leading to atherosclerosis.
Nursing Diagnosis
The nursing diagnosis, based on which the care plan is developed include activity intolerance and imbalance in the concentration of myocardial oxygen (Zeng, Huang and Pan, 2020). Further, the patient shows a perceived loss in his general well-being and needs to change his lifestyle.
Desired Outcomes
The desired outcome for MI is relieving chest pain with the stabilisation of the heart rhythm. The intervention will help in reducing the cardiac workload with the revascularisation of the coronary artery and preserving of the myocardial tissue.
Intervention
Medical-Surgical Interventions
The immediate treatment for a heart attack is aspirin to prevent the blood-clotting, nitro-glycerine to reduce the heart’s workload, improve blood flow through coronary arteries and oxygen therapy. The blood flow is treated by either clot busting medication or an intervention known as coronary angioplasty (Zeng, Huang and Pan, 2020).
Pharmacologic Therapy
Clot buster medications are also known as thrombolytic medicines. The medications are given after hours of the heart attack symptoms. Percutaneous coronary intervention is another mode of treatment.
Non-Pharmacologic Therapy
It is a non-surgical procedure, which is used to clear the coronary arteries. A catheter, which is a thin flexible tube with a balloon or another device at the other end, is threaded through the blood vessel and the catheter inflated to compress the plague and the clot against the wall of the artery. This unblocks the blood flow and a stent is placed. The stent ensures the blockage does not occur again. The heart attack can be treated by medicines, medical procedures, healthy lifestyle changes and cardiac rehabilitation (Niccoli et al. 2019). Ace inhibitors may be prescribed to help to lower blood pressure and reduce the strain the heart feels.
Evaluation
Anti-clotting medications stop platelets from clumping together and forming unwanted blood clots. Anti-coagulated also known as blood thinner prevents the clots from forming. Beta Blockers decrease the heart’s workload. Statin medications lower blood cholesterol and decrease the chance of stroke. In extreme cases, coronary artery bypass grafts may occur, where a health artery is removed and it is bypassed or grafted to the section that is experiencing the blockage. This way it provides a new way for the blood to flow to the heart muscle (Vos et al. 2019). The person may also be encouraged to change their lifestyle and live a more heart healthy lifestyle.
Overall Impression of the Condition
The chest pain gives a substernal pressure, which is perceived as aching, burning and squeezing of the heart. There is some patient have a symptom of epigastric with the feeling of indigestion or feeling of gas or fullness (Zeng, Huang and Pan, 2020).
Relevance of the Condition to Future Practice
Early diagnosis helps in reducing the extent of the myocardial damage and prevent diminished flow of oxygen in the heart.
2. Diabetes
1. Describing the Condition
Introduction
Diabetes is a disease where the glucose of the blood is high. The high blood glucose levels lead to heart diseases, strokes, kidney diseases, eye problems, dental issues and nerve damage.
Prevalence Rates
Diabetes has a high prevalence in all-age groups worldwide. It was reported to affect 2.8% of the population globally in 2000, which is expected to increase to 4.4% by 2030. There are 171 million people with diabetes in 2000, which will increase to 366 million by the year 2030 (American Diabetes Association, 2018).
Incidence Rates
In 2018, it was observed that there were 34.2 million Americans, which is 10.5% of the population suffered from diabetes (American Diabetes Association, 2018). There are still 7.3 million people, who are undiagnosed and they have diabetes.
Impact on Global, National and Local Levels
Diabetes have become a global crisis in public health. It threatens economy of all the nations especially for the developing countries (American Diabetes Association, 2018). Due to the high transition in nutrition, rapid urbanisation and sedentary lifestyle the obesity and leading to diabetes have increased.
Defining Features
In diabetes, the blood sugar is high, as the insulin produced cannot break enough of the sugar that is being consumed. The glucose stays in the blood due to insulin levels being low and it does not reach the cells.
Risk Factors
The patients with this type of diabetes are at a higher risk of developing type 2 diabetes later in their lives. Diabetes can be passed on in families. This type of diabetes is known as monogenic diabetes (Ode et al. 2019). Cystic Fibrosis can also cause diabetes. In major cases, there are instances of major foot damage and in some cases; they may have to amputate the foot.
Types and Subtypes
The types of diabetes are type 1, type 2, gestational diabetes and other types of diabetes. Type 1 diabetes occurs when the body does not make enough insulin (Van Der Lee et al. 2017). The immune system attacks the cells in the pancreas that creates the insulin. This is commonly found in children and young adults.
Causes
Type 2 diabetes occurs when the body cannot make insulin and does not use the insulin well. This disease can occur at an age but it is concentrated in middle aged and older people. This is the most common type of diabetes. The third type is gestational diabetes. This occurs in pregnant women and often subsides or goes away after the birth of the child.
2. Explaining Physiological or Anatomical Changes Taking Place
Anatomical Changes
Diabetes is a disease that affects various parts of the body. Diabetes affects the body in a way that increases thirst, it increases the need to urinate and it increases fatigue, blurred vision, pain in the hands as well as feet. The disease is known to cause long-term damage to the various types of the body (Moser, Yardley and Bracken, 2018). The disease is known to affect the blood vessels and nerves. The complications occur when the disease is not controlled properly. Diabetes is often related to heart diseases as it increases blood pressure and contributes to high cholesterol that may cause blocking of arteries and cause heart attacks.
Physiological Changes
It also increased the risk of strokes. It affects the eyes and it causes a condition called diabetic retinopathy. This is caused by the blood vessels in the back of the eye that swells and leaks. The high blood pressure is also a major contributor to this condition. The disease also affects the kidneys. The kidneys may be damaged over the years, if the condition goes on without prolonged treatment.
Signs and Symptoms
The diabetes also affects the nerves that cause the tingles in the feet, lack of sexual arousal, excessive sweating and diagnosis of delayed stomach emptying. It also causes nausea, constipation or diarrhoea (Ivanova, Kovacs-Oller and Sagdullaev, 2017). It also causes dry skin, slow healing of the wounds, it causes fungal and bacterial infection, even discolouring of the skin can be caused and the loss of feeling in the foot.
Complications
Some of the complications of diabetes includes cardiovascular disease, foot damage, hearing impairment, Alzheimer’s disease, skin condition, eye damage, nerve damage, nephropathy, neuropathy and various cardiovascular diseases.
3. Required Medication or Therapeutic Interventions
Assessment Data
The patient Lauren, who was 65 years’ old, has been suffering from diabetes since last five years. Due to diabetes, even though she liked walking in the park, she finds it challenging to do so now. The skin in Lauren’s feet is dry and discoloured with the toenails showing different coloured as well as are gnarled.
Nursing Diagnosis
The patient shows evidences of diabetic dermopathy, which results in the change in the blood vessels of the patient. Dermopathy due to diabetes results in forming scally patches with red and brown patches on the front part of the legs.
Desired Outcomes
The main aim of the intervention will help the patient in avoiding acute decompensation with the prevention and delay in the appearance in the disease complications (American Diabetes Association, 2018). Further, it will decrease mortality and help the patient in maintaining a good quality of life.
Intervention
Medical-Surgical Interventions
Diabetes does not bear any surgical interventions.
Pharmacologic Therapy
The diet and exercise are the main parts of the treatment plan and in some cases; patients may have to take medication. The medication will lower the blood sugar. The medication that is used for each type of diabetes is different. Some are taken through oral means and others need to be injected into the body. Type 1 diabetes is treated by insulin. It helps to replace the hormone that the patient is able to produce. There are four types of insulin, which are used, they are differentiated based on how much their effect last and how quickly the action of the hormone occurs: Rapid acting insulin, Short Acting Insulin, Intermediate acting insulin and long acting insulin (American Diabetes Association, 2018).
Non-Pharmacologic Therapy
Lifestyle intervention is the most common type of non-pharmacologic therapy for diabetes management, because usually, administering medicines to a diabetic patient is a matter of lifetime, as diabetes cannot be cured. Hence, prolonged medication usage can cause renal dysfunction. Therefore, diet control, physical activities, meditations and exercises are suggested to them.
Evaluation
The rapid acting insulin starts to work fifteen minutes after it has been given and it affects the body last for three to four hours. The short acting insulin starts to work thirty minutes and lasts six to eight hours. The intermediate acting insulin starts to work after one to two hours after it is given and it lasts for twelve to eighteen hours (American Diabetes Association, 2018).. Finally, long acting insulin starts to work after a few hours and lasts for over twenty hours and more. Type 2 diabetes, on the other hand, is managed and it can be fixed through lifestyle...