Nursing Scope and Standards

Question: Discuss about the Nursing for Scope and Standards. Answer: Introduction: The care plan will be developed upon assessment of the patient Michelle Bell, who presented symptoms like frequent bouts of breathlessness and nausea. Her diagnosis revealed high BP, 165/90 mmHg along with mild tachycardia. During the presentation of second round of breathlessness, she was extremely pale and her pulse was irregular, 160 bpm. Reviewing her heath history, it has been revealed that she lives a harsh lifestyle, including long hours in office, frequent interstate travel with no exercise or healthy diet plan. She also consumes alcohol on regular basis. Diagnosis Based on the above symptoms presented by the patient, the registered nurse would recommend for a thorough physical exam, chest X-ray, ECG, a CT scan, cardiac imaging, and MRI for identifying the actual health complications Michele is experiencing (Healey et al. 2012). The condition is diagnosed to be atrial fibrillation, in which the abnormal firing of electrical impulses causes fibrilation of atria. High systolic blood pressure is the most common cause of AF, thus it can be a common cause of Mrs. Bells symptoms, as her blood pressure is 160/90 mmHg. In addition, she consumes alcohol on regular basis, which is also a risk factor for AF. She was extremely pale at the time of second breathlessness. Goal statement After bringing the patient to the emergency department, the short term goal for the patient is to stabilize the patient. It can be done by rate control or rhythm control treatment. The long term goal will include secondary prevention of further complications like stroke, heart failure, angina and hypertension. The long term goal will also aim to educate the patient about healthy lifestyle for her well being (Camm et al. 2012). Intervention Mrs. Bell has been diagnosed with high risk of stroke or health failure, which has been presented by frequent breathlessness, nausea and irregular pulse. Initially, for stabilizing the patient, according to the short term goal, the initial requirement is to control the rapid and irregular pulse. For this, several medicines like beta-blockers, calcium channel blockers and digoxin are recommended for slowing the heart rate. In beta-blocker, atenolol, propranolol and in calcium chain blocker medicine, dilitiazem and verapamil are administered initially (Healey et al. 2012). These medicines would interfere with the irregular electrical impulses of heart, thereby bringing heart rate back to normal range (i.e. 90 bpm). In case of long term care plan, an anticoagulant treatment would be recommended for reducing the chance of blood clot, thereby reducing the risk of stroke. The commonly used anticoagulant is warfarin, which can prevent stroke by two thirds (Camm et al. 2012). However, there are some common adverse effects, for which regular blood test is recommended, while recommending warfarin. Evidences suggest that proper exercise and healthy diet can reduce the risk of stroke, by improving blood circulation (Camm et al. 2012). Thus, a physical therapist would be appointed to make a physical exercise program for Mrs. Bell. The exercise plan will focus more on cardiovascular or aerobic exercise, to improve her blood circulation. She would be recommended to meet a dietician for a proper diet plan. A health promotion session would be arranged for her, where she would be educated about the importance of healthy diet and exercise for her health and well being. Moreover, she would be educated to reduce her alcohol consumption and maintain a healthy diet, while travelling. Reflection Being a registered nurse, I have demonstrated my risk handling and problem solving skills, while dealing with Mrs. Bells complications. Visualizing Mrs. Bells physical status, I have used my critical thinking skills and decided to take her to the emergency department and consulted with the physician. While assessing her medical and personal history, I have initially established a good rapport with the patient, for enhancing her trust towards the therapeutic relationship, thereby meeting my professional nursing standard. I have potentially involved in the multidisciplinary team and assisted the other professionals like physical therapist or dietician. It enhanced my professional competence and promoted the success of care intervention (American Nurses Association 2010). Moreover, I have fulfilled the duty of care in the professional practice area. I have kept all the personal and health care related information confidential, meeting the ethical codes of nursing. However, I have one we akness that initially, which was my nervousness prior handling an issue. Thus, I need to improve in this area in future practice. Reference List American Nurses Association, 2010. Nursing: Scope and standards of practice. Nursesbooks. org.. Camm, A.J., Lip, G.Y., De Caterina, R., Savelieva, I., Atar, D., Hohnloser, S.H., Hindricks, G., Kirchhof, P., Bax, J.J., Baumgartner, H. and Ceconi, C., 2012. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. European heart journal, 33(21), pp.2719-2747. Healey, J.S., Connolly, S.J., Gold, M.R., Israel, C.W., Van Gelder, I.C., Capucci, A., Lau, C.P., Fain, E., Yang, S., Bailleul, C. and Morillo, C.A., 2012. Subclinical atrial fibrillation and the risk of stroke. New England Journal of Medicine, 366(2),