Understanding Heart Arrhythmia In Older Populations: A Case Study Of Alan Smith

1. describe the impact that specific stereotypes of older people may have on the person, and
2. identify a specific, and recent environmental change impacting this older person. 

Main Issues of Patient

The older population are prone to be ill as there are various causes regarding their health condition along with external environment lead to illness of these older people. Hence, the older peoples need proper healthcare services in order to keep them healthy. There are several health-related issues hinder the health outcomes of the older population across the globe. Moreover, the heart arrhythmia is one of the most critical diseases that increase the concern of the healthcare authorities and people across the globe (Burnett, 2005). In Australia also the prevalence of heart arrhythmia among the older population is considerably growing and that increases the concern of the health authorities of the country.  To understand the impacts of this disease a case of a 64-year patient Alan has been represented here.  The purpose of the case study is to understand the issues of, related to the heart arrhythmia and the effective intervention programs for managing the impact of this specific disease on Alan. The stereotype for the aging of older people possesses the potential for reinforcing ageism as they position unwell health as undesirable. It is not been acknowledge the huge diversity of older adults. The usage of terms such as older people, old age, seniors and the elderly were in practice interchangeably within the academic policy, literature, and press for referring to the individuals aging between 55years and above (DeSilva, 2013).   

The case study is on a 64 years patient in Australia. The name of the patient is Alan Smith, who is residing in Melbourne. Mr Alan Smith was admitted to the healthcare setting with the problem of heart arrhythmia. He had a complete heart block and he required a pacemaker to live. In the Echocardiography test of Allan provide the evidence of a mild thickened interventricular septum with sound left the ventricular function. The patient had been suffering from the issues like an irregular heartbeat (Buttigieg, Rathert & Eiff, 2015). The disease also referred to the dysrhythmia and in this disease, the heartbeat of the patient is usually irregular, often the heartbeat is too fast and sometimes it is too slow. Hence, Alan is also facing the same problem of irregular heartbeat. The disease shows extra beats, as well as it can be supraventricular tachycardia, ventricular arrhythmias, and Bradyarrhythmias. Sometimes, there is not any symptom observed in the patient of heart arrhythmia. However, in the case of Alan, the symptoms are present as there are palpitations in the patient as well as a sometimes evident pause between the heartbeats (Canfield, Hansen & Rackner, 2012). Besides this, Alan showed light-headedness, shortness of the breath, passing out, chest pain. Apart from this, Alan also suffering from hypertension as well as his blood sugar level was also high. Hence, the two co-morbidities in the case of Alan are hypertension and high blood sugar level along with heart arrhythmia.  

In this framework, the experimental studies comprising stereotype activation has represented that explicit as well as implicit negative aging stereotype possess related detrimental effects upon the performance of elderly people in mental as well as physical tasks. The implicit stereotypes have represented that underlining positive stereotypes along with images of getting older could deteriorate the negative effect of particular circumstances on older people's behaviour (Michael, Scharf, Letzkus & Vergales, 2016). By comparing the explicit and implicit priming for aging stereotypes upon the mental performance of older individuals, have shown that the primed implicitly represent vital differences in their memory.  The positive primes illustrate better ability to recall that the primes, which are negative. It is also found that while the stereotypes of aging matched the domain outcomes, there was a greater influence upon their performance. This is suggested that while the stereotype match has been taking place, it is possible to generate expectations, which turn out to be self-fulfilling prophecies. Mr Alan was very much anxious about his life and his illness. Moreover, he even did not talk or convey his messages properly. Hence, the healthcare staff faces significant communication problem in order to prepare an effective treatment plan for Alan. The recent environmental changes have significant impacts on the patient of heart arrhythmia.  The healthcare setting and nursing intervention help in improving the condition of Alan. The medication and nursing care reinforce his health and cause for his improvement. The patient has provided oxygen as in the critical condition he could not inhale required oxygen it supports him immensely (Naff, 2008).  

Impact of Specific Stereotypes of Older People

The care of heart arrhythmia patient should be planned carefully in order to manage the symptoms and the condition of the patient. In this matter, the evidence-based nursing care plan is useful as it helps to provide effective treatment to the patient according to their condition. Hence, for the particular patient Alan, the evidence-based nursing care plan had been adopted that support in understanding the issues of Alan and according to the issues the treatment plan had been prescribed (Hart & Davis, 2011).  

Evidence-based nursing is a decision-making process that that is developed to consider the appropriateness, effectiveness, and feasibility of the healthcare setting.  The evidence-based nursing is developed with the effective utilization of the available evidence. The available evidence includes previous care delivery, the situation of the patient in this case Alan and the advice of the healthcare professionals. Moreover, the evidence-based planning requires the active cooperation of the embedding evidence and all the health care professionals attached to the healthcare settings (Parks, 2009).    

The Main foundation of nursing is based on the five objectives. The five objectives of nursing are as below:

Assessment 

The first step that should be initiated by the nurse is an assessment. A thorough assessment of Mr Alan is required to get a clear picture .Assessment of Alan includes a holistic test of the vital statistics of the patient. In the case of the old aged patient, the complication is more so assessment should be made according to the medical guidelines. Patient with cardiac arrhythmia and pulmonary heart disease are likely to develop a tendency of stroke. In the assessment, the nurse should not only asses the pathological and the physiological condition of the patient but also asses the psychological, socio-cultural and economic background of the patient to have a clear idea about the background of the patient (Hunnicutt, 2010).

In the case of cardiac arrhythmia the blood pressure, heart rate pulse rate and breathing rate all need to be assessed properly by the nurse. Electrocardiogram and electroencephalogram should be done for the proper assessment. Evidence-based nursing practices are helpful in achieving the five general objectives for nursing. Evidence-based nursing generally strives for providing effective healthcare practices to their patients. It includes regular checkup, noting down the symptoms and the pace of improvement which satisfies the excellent care services for the old ages suffering from heart arrhythmia in this case Mr Alan. The healthcare plans can be evaluated through three states- pre-implementation of the healthcare plan, concurrent implementation of the healthcare plans and post-implementation criteria for the healthcare plans.  The pre-implementation stage includes policy making, setting objectives, identification of the technical feasibility, financial capability, political aspect and administrative operability. During the pre-implementation stage, the healthcare staffs first check Alan’s heart beat, blood pressure, pulse rate and various test reports. These reports are analyzed and the policies are developed according to the type of the patient (Taniguchi, 2008).

After the proper assessment is performed, the next objective is the diagnosis. During the assessment, the pathos physiological condition of Mr Alan should be documented for analysis. The analysis should be done of the assessment report and with the help of clinical judgment; the nurse should start the diagnosis phase according to the health needs of Mr Alan. It is essential to perform a proper diagnosis of the patient to reduce his stress. Before performing the diagnosis proper symptoms should be analyzed by the nurse. If Alan has a rapid heartbeat, chest pain dizziness, and light head then steps should be taken (Keller & Raines, 2005).

Care Plan - Introduction

Special care should be taken for the old aged people who develop chances for the cardiac arrest. If the proper diagnosis is not done then short-term and long-term planning will be hampered. If the planning is not done then recovery of the patient is impossible. It is essential to perform the diagnosis properly. If Mr Alan is diagnosed with cardiac arrhythmia then only proper action and long-term planning can be done. The evidence-based practices have three core components; evidence synthesis, effective utilization of the evidence and transferring the evidence. A systematic review is required to indulge and continue the practices for the heart arrhythmias patients.  The systematic review requires identifying, storing, maintaining and applying the collected evidence to provide health care for Mr Alan. In order to have this, the healthcare staffs must need to know the effective utilization of technology knowledge.  They must store the evidence in the computerized database according to the type of disease, symptoms, test results, treatment procedure, and cure. As per the case study, Mr Alan is suffering from heart arrhythmia. Thus, his heartbeat, pulse beat, and blood pressure would be checked up and policies would be developed according to the report (SATTINGER, 2006).

Based on the assessment and diagnosis the nurse will be able to make a short and long-term action plan for Mr Alan. It is absolutely necessary to make two action plans. In cardiac arrhythmia, it is necessary to give proper medication to make the condition of the patient a little stable. Long-term planning like proper monitoring of the blood pressure, control diet, use of medication performing the ECG and EEG on a regular basis should be done (Kimata, 2009).

The healthcare staffs usually take decision according to the care situation. It is required fundamental knowledge to identify other types, sizes and amount of evidence are required to answer the healthcare series. Moreover, the healthcare staff must be aware of the availability of the evidence. A continual nursing education process would be helpful for the healthcare staffs to recognize the needs of the evidence, types of the required evidence and answer the healthcare queries. Moreover, the availability of the evidence can be traced with the effective implementation of nursing knowledge. The nursing knowledge can be beneficial to opine on every specific type of health-related questions. In the concurrent implementation stage, the present situation of Mr Alan is measured. It includes the situation of  Alan after starting the treatment and the types of progress. This stage is for evidence collection (Thompson, 2007).

Implementation in practical life is the most important part. The action plan which is made by the nurse should be implemented accordingly without fail. If the proper implementation is not done then it will be fatal for Mr Alan.  In case of cardiac arrhythmia of Alan the short term medication and stress release treatment should be implemented properly or else it causes cardiac arrest and heart failure for the old aged people. In the long term basis implementation of the diet plan should be there so that the problem does not revert. Sometimes during the implementation part medication is necessary according to some emergency situation (Liu, 2013).

Identification and Justification of Top Five Objectives for Nursing Care

Modification in the action plan should be done during the implementation phase. For example, some of the medication might not work properly or can cause some side effects to Mr Alan so the medication might be changed according to the physiological condition of Alan. The evidence of the nursing care synthesized and analyzed properly to implement productive healthcare practice. The transfer and synthesization of an evidence-sharing process that enables felicitate and implement an effective healthcare system. The synthesization requires sufficient interpersonal skills from the nurses to transfer and share the care evidence so that the treatment procedure can be enforced immediately (Tourigny, 2016).

Moreover, dissemination of the healthcare evidence is required which can be conducted through interpersonal communication skills.  In addition, communication with the patients is a most essential aspect for healthcare staffs that requires profound communication to spread information to the patient. The progress report, the symptoms, the food habits and the type and amount of medicine are recorded. The post-implementation stage, include the observation of the patient after the end of the treatment procedure (Sillman & Parsh, 2010).

Evaluation: The evaluation part is another essential part which should be followed by the nurse. The condition of Mr Alan and the effectiveness of the action plan should be monitored in a fixed time interval. The plan should be modified according to the needs of Mr Alan. If Mr Alan is diagnosed with cardiac arrhythmia it is necessary to test of the heart should be performed from time to time. Moreover, the nursing care and medication should be modified according to the needs.  The nursing plan should be evaluated according to the updated condition of Mr Alan. Documentation of the updated condition of the patient is absolutely necessary. For example, if a diet plan for Alan with a heart problem, it may not provide him with proper nutrient which can cause an imbalance in important parameters (Miller, 2011).

The Diet plan should be analyzed and related to the condition of the patient and modified accordingly. The same theory is applicable for medication, ECG or EEG test is to be performed for determining the condition of the heart. Medication will be prescribed according to the needs of Mr Alan. Acute knowledge in evidence embedding and creating evidence in the health care systems, policies and procedures are necessary for the improvising the decision-making ability of the healthcare organization. Thus, having potential knowledge of healthcare evidence and healthcare systems and policies are relatable to expertise the ability of the nurses in the healthcare settings and treating the heart arrhythmia patient successfully.  The nurses observe the after treatment situation and advise the medicines and food habits (Tavera, Foresti & Cappato, 2007).   

Conclusion  

Older individuals are major users of the health services because of their medical complexities related to heart and requirements for proper care. Since the amount of individual in Australia is constantly rising, thus it is necessary for the health service provider to look after the old age groups as their chief users. This leads to build culture, which enhances the implementation procedures for meeting the specific necessities of the old age group in this case Alan. It has been found out that in spite of the kind of preliminary awareness, participant groups, the discipline of the case study or method, that negative age primary brings out a great effect on the elderly people's performance (Haugen & Musser, 2012).

References

Hart, P., & Davis, N. (2011). Effects of Nursing Care and Staff Skill Mix on Patient Outcomes Within Acute Care Nursing Units. Journal Of Nursing Care Quality, 26(2), 161-168.

Haugen, D., & Musser, S. (2012). Healthcare. Farmington Hills, MI: Greenhaven Press.

Hunnicutt, S. (2010). Universal health care. Detroit: Greenhaven Press.

Keller, K., & Raines, D. (2005). Arrhythmia knowledge: A qualitative study. Heart & Lung: The Journal Of Acute And Critical Care, 34(5), 309-316.

Kimata, S. (2009). Treatment of Patients with Both Arrhythmias and Heart Failure. Journal Of Arrhythmia, 25(1), 3-3.

Liu, L. (2013). Analysis of Clinical Effect of Treating Arrhythmia with Stable Heart Granules. Advanced Emergency Medicine, 2, 7.

Miller, D. (2011). Healthcare. Detroit, Mich.: Lucent Books.

Parks, P. (2009). Healthcare. San Diego, CA: ReferencePoint Press.

SATTINGER, A. (2006). Heart Failure: Integrating Disease Management and Palliative Care. Caring For The Ages, 7(6), 12-13.

Sillman, C., & Parsh, B. (2010). Caring for adults with congenital heart disease. Nursing, 40(10), 63.

Taniguchi, K. (2008). Phylogenesis of the Conduction System of the Heart. Journal Of Arrhythmia, 24(1), 3-3.

Tavera, M., Foresti, S., & Cappato, R. (2007). Arrhythmia in Congenital Heart Disease. European Cardiology Review, 3(1), 110.

Thompson, L. (2007). Care of the Patient With Adult Congenital Heart Disease. Critical Care Nursing Quarterly, 30(1), 3-11.

Tourigny, L. (2016). Nursing and Patient Care. Journal Of Nursing & Patient Care, 01(01).