Posted: July 22nd, 2021

NURS23921 The Realities of Nursing Practice


In nursing career, professionals are accountable for a holistic nicely being of the care consumer. Whereas making certain the holistic nicely being of the affected person, nurse ought to perceive the affected person’s present wants and will prioritize these wants primarily based on the urgency. On this context, diagnosing affected person’s every symptom and very important indicators are essential for bettering the general well being problems with the affected person (Carpenito, 2012). The nurse is liable to behave as a communication bridge between the affected person and the physician, she wants to speak completely with the affected person for figuring out affected person’s well being wants and convey it to the multidisciplinary care crew for the affected person, for growing appropriate care plan for the affected person, which maximizes the constructive well being outcomes of the affected person (Hamm et al., 2011). On this task, a selected affected person’s case could be demonstrated and analyzed for figuring out his care wants and offering suggestion for his nicely being by a scientific method.

Interpretation of preliminary case info

On this case situation, the important thing focus is a 54 years previous male, named Mr. Frank Jura, who've been admitted to the cardiac unit, upon experiencing an exacerbation of an unstable angina. As well as, by reviewing his earlier well being historical past, it has been revealed that he's additionally experiencing with uncontrolled kind II diabetes, hypertension and weight problems. As well as, by his admission within the well being care centre, it has been revealed that his blood stress was barely excessive from the conventional vary, i.e. 145/90 mmHg. Thus, he wants steady monitoring for his situation (Hamm et al., 2011). Though the observe nurse has advised that the hypertension could be because of anxiousness and stress within the hospital setting.

Due to this fact, analyzing Mr. Jura’s case, it has been revealed that the affected person has a number of points, that are wanted to be prioritized in an pressing foundation. However, it has additionally been revealed that every of his signs and former well being historical past has a robust affiliation. For example, Mr. Jura’s historical past of Sort II diabetes, hypertension and weight problems are the important thing threat components for elevating the danger of cardiovascular issues, together with brief or long run angina, stroke and myocardial infarction (Lilley et al., 2011). Furthermore, in response to his fixed hypertension, the observe nurse depicted that he could also be anxious and stress within the hospital setting; nevertheless stress and despair are additionally penalties of kind II diabetes, hypertension and weight problems. Due to this fact, to make sure Mr. Jura’s holistic nicely being, it is very important mitigate his well being points from the foundation, prioritizing his earlier well being historical past, i.e. kind II diabetes, weight problems and hypertension.

Mr. Jura’s medicine chart consists of Ramipril, metropolol and Hydrochlorothiazide that are used for treating his hypertension; Transderm nitropatch and Nitrospray, that are administered for controlling angina or chest ache. Due to this fact, it has been revealed that Mr. Jure has been administered with drugs for treating his steady hypertension, nevertheless it has been additionally revealed that no medicine or therapies are supplied to Mr. Jura for controlling his excessive blood sugar, kind II diabetes in addition to weight problems (Potter & Perry, 2014). Due to this fact, these could be the important thing focus in Mr. Jura’s holistic care plan, together with the present signs. Along with that, his alleviated blood stress can be indicating stress and anxiousness, which additionally will increase the danger of persistent depressive signs to be developed quickly. On this context, psychological and emotional interventions must also be included within the holistic care plan for Mr. Jura (Barr et al., 2011).

Improvement of therapeutic targets

Based on the case situation, the next targets have been developed to satisfy Mr. Jura’s present well being care wants:

  • To determine a constructive therapeutic relationship
  • To advertise his wholesome life-style to manage weight problems
  • To observe and management hypertension
  • To cut back the danger of cardiovascular concern
  • To cut back the danger of growing depressive signs

To attain these targets, co-operation of affected person, affected person’s household and the members of multidisciplinary crew is essential and it's the preliminary step within the process (Sattelmair et al., 2011). As well as, whereas implementing the targets within the therapeutic plan, every purpose must be assessed on the premise of SMART standards, i.e. whether or not the purpose is restricted, measurable, attainable, life like and time-specific or not. Improvement of potential targets helps to satisfy the anticipated therapeutic outcomes by a scientific approach (Hamm et al., 2011).

Sources to handle therapeutic targets

Based on the pre-existing literatures and proof primarily based processes, the next assets could be really useful for Mr. Jura’s nicely being:

  • To determine a constructive therapeutic relationship-It's most vital step in making certain affected person’s nicely being. For this the nurse want to indicate respect, dignity, constructive regards, genuineness and constructive communication abilities, to advertise his understanding that his opinion is being valued within the well being care context (Lunney, 2013). It might additionally develop a belief of the affected person in direction of the affected person and the well being care system. The observe nurse depicted that Mr. Jura’s blood stress is continually excessive, as a result of discomfort within the hospital setting, which might be decreased by a constructive therapeutic relationship constructing with the nurse.
  • To advertise his wholesome life-style to manage obesity-Weight problems is a persistent dysfunction that additionally improve the danger of different illnesses, as in Mr. Jura’s case, it's considerably associated along with his excessive BP and angina. For this, a well being promotion could be organized for Mr. Jura and his members of the family, the place they might be supplied with info relating to the significance of main a wholesome life-style (Wilkinson, 2011). As well as, the dietician would make a weight-reduction plan chart for him. For example, the dietician would recommend him to keep away from junk meals, embody extra greens in weight-reduction plan. However, bodily therapist would put together an train schedule for him together with cardio train for decreasing his weight. Weight administration is essential additionally for controlling progress of kind II diabetes.
  • To observe and management excessive blood pressure-The nurse would constantly monitor his blood stress degree after a scheduled interval and would administer PRN Ativan for controlling BP. Because it has been revealed that it could be resulted from stress, steady emotional and psychological help could be supplied for making him conversant in the setting (Blais, 2015). As well as, nurse would give him enjoyable therapeutic massage; embody a number of enjoyable methods just like the acupuncture, meditation, yoga and music therapies for decreasing his stress.
  • To cut back the danger of cardiovascular concern- Steady monitoring of Mr. Jure’s very important indicators, indicators of chest ache, hypertension are wanted. For serving to him with this, reviewing his earlier well being historical past, acceptable bodily actions could be really useful, which might assist him to maintain his coronary heart wholesome, together with the nutritious diet (, 2017). Excessive blood sugar degree considerably enhances the danger of thrombosis in blood vessel, enhancing the cardiovascular threat, thus, Mr. Jura must be administered with acceptable medicine or controlling blood sugar degree; as an illustration, extracellular intravenous insulin, if required.
  • To cut back the danger of growing depressive signs- To cut back the danger of psychological concern growth, counseling is without doubt one of the key therapies. Based on the precept of person-centered strategy, his members of the family would additionally concerned, which might assist Mr. Jura to have a homely setting, thereby motivating him to realize the therapeutic targets (Tabloski, 2013).

Based on the “School of Nurses of Ontario Observe Normal or Guideline” establishing nurse-patient relationship is essential for making certain affected person’s nicely being and a nurse ought to exhibit the usual by establishing a constructive nurse-patient relationship, which is said to Mr. Jura’s case situation (School of Nurses of Ontario, 2015).

Conclusion and Reflection

In conclusion, demonstrating and analyzing Mr. Jura’s case, it has been revealed that nurses’ accountability is to keep up requirements in observe, whereas selling the utmost nicely being of the affected person. As well as, the case examine task helped to grasp the significance of holistic analysis and evaluation for figuring out the important thing causes of sickness (Hamm et al., 2011). I might use the acquired data in additional sensible instances, for bettering the connection with the affected person, by figuring out the affected person’s wants in logical and empathic approach. From Mr. Jura’s case, it has additionally been revealed that coping with CVD sufferers, it is very important monitor affected person’s very important indicators completely, as these can fluctuate considerably, thus, nurse ought to concentrate on any sorts of affected person’s altered signs. As well as, CVD sufferers additionally want psychological and emotional help to deal with the persistent dysfunction, which must be promoted by the nurse (Barr et al., 2013).  

Reference Record

Barr, J., Fraser, G. L., Puntillo, Okay., Ely, E. W., Gélinas, C., Dasta, J. F., ... & Coursin, D. B. (2013). Medical observe tips for the administration of ache, agitation, and delirium in grownup sufferers within the intensive care unit. Important care drugs, 41(1), 263-306.

Blais, Okay. (2015). Skilled nursing observe: Ideas and views. Pearson., U. (2017). Unstable angina: MedlinePlus Medical Encyclopedia. Retrieved four June 2017, from

Carpenito, L. J. (2012). Handbook of Nursing Analysis (14 ed.). New York: Wolters Kluwer Well being. 

School of Nurses of Ontario. (2015). Observe Requirements: Medicine. Retrieved from

Hamm, C. W., Bassand, J. P., Agewall, S., Bax, J., Boersma, E., Bueno, H., ... & Ohman, M. (2011). ESC Pointers for the administration of acute coronary syndromes in sufferers presenting with out persistent ST-segment elevation. European coronary heart journal, 32(23), 2999-3054.

Lilley, L., Harrington, S., Snyder, J., Swart, B., & Savoca, D. (2011). Pharmacology for Canadian Well being Care Observe. Toronto: Mosby Elsevier. 

Lunney, M. (Ed.). (2013). Important considering to realize constructive well being outcomes: Nursing case research and analyses. John Wiley & Sons.

Potter, P., & Perry, A. (2014). Canadian Fundamentals of Nursing (5 ed.). Toronto: Elsevier Canada.

Sattelmair, J., Pertman, J., Ding, E. L., Kohl, H. W., Haskell, W., & Lee, I. M. (2011). Dose response between bodily exercise and threat of coronary coronary heart illness. Circulation, CIRCULATIONAHA-110.

Tabloski, P. A. (2013). Gerontological nursing. Pearson Greater Ed.

Wilkinson, J. M. (2011). Nursing course of and important considering. Pearson Greater Ed.

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