Nursing Management Gibbs Model of Reflection

by Lucy Coyle June 19, 2016
Sample assignment 255*368

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Question

Why does Myocardial infarction occurs and what are its impacts on the body?

Solution

Myocardial infarction occurs due to inadequate blood supply to the heart muscles, leading to sudden premature death. The condition leads to permanent damage to the heart muscles (Kushner FG, 2009). The total number of deaths attributed by cardiovascular disease numbers to 30.5% worldwide showcasing the graveness of the condition. In Australia, measure portions of the myocardial infarction patients suffers from ventricular fibrillation prior to getting any medical aid or intervention. According to 2011 statistics, the total number of deaths due to cardiovascular disease accounts for 45,600 which shares 31% of the total number of deaths occurred in the same year. Despite huge advances in medical intervention and care delivery strategies, it still haunts the health care system as well as public health with huge cost burden and increased risk of life (Statistics, 2012).

In such situation, the role of a cardiac nurse becomes very crucial, studies, says in most of the deaths caused by cardiovascular disease, it was lack of proper knowledge of condition from patient side. Due to lack of patient education, the patient fails to recognize the signs and symptoms of the initial stage of cardiovascular disease which in later stage leads to death of the patients (Khraim & Carey, 2009). Thus, as a cardiac nurse, having subject knowledge and evidence based intervention knowledge of cardiac diseases is must. While interventions and management are meticulously met by nurses in such crucial situations, guided by a professional code of conduct, there must be some evaluator tool to ensure the efficacy and efficiency of the interventions, assessment, goals setting in such cases.

While reflective practice can be employed in any professional field, its importance in nursing has its own designated place as nurses when deals with such death causing factors, they are expected to perform at their best integrating knowledge, skills and best practice.

In this assignment, I am going to reflect on my experience during the clinical placement where I have used my interpersonal skills to maintain therapeutic relation with the patient. I will be using GIBBS model of reflection that is composed of six stages, which is useful in completing my reflection analysis and improve my nursing abilities. The six stages through which I will do reflection is as follows –
Elaboration of the situation, feeling analysis, experiences evaluation, analysis to make application of those experiences in my professional career, next is betterment of the action plan or how better the action can be done, at last how to prepare myself during the situation in future and what will be the action plan.
This assignment not only aims to prepare a reflective account for nursing management of myocardial infarction, but also guides the reader to carry out similar reflective practice in their domain in order to professionally and ethically more competent. The essay aims to facilitate adequate knowledge on having reflective practice in nursing field which can help in the development of quality health care delivery strategies.

PART B
AEITIOLOGY OF MYOCARDIAL INFARCTION

Myocardial infarction in a very lucid way is defined in two words- heart attack. When any damage occurs to heart vessels leading to inadequate blood supply and low oxygen supply to the heart, it leads to heart attack. The coronary artery blockage is considered to be the major cause behind this condition which gets blocked by cholesterol, white blood cells or fats (Costa e Silva R, 2008). The situation in the above case can be termed as acute myocardial infarction as it was sudden in onset. The signs and symptoms may confuse the physician as it overwrites upon many other conditions but the main sign and symptoms observed for this condition are – pain in chest beneath the breast bone, shortness of breath, abnormal heart rate, sweating, nausea and vomiting etc. Like all other conditions this condition is also associated with certain risk factors such as old age, previous incidence of cardio vascular disease, high level of lipids in the blood (low density or high density) , high blood pressure or diabetes etc (Valensi P, 2011). The two common testing’s carried out for diagnosis of myocardial infarction are – ECG and blood tests to diagnose certain components which are released into the blood due to injury to heart. They are creatinine kinase and troponin (Rutten, 2013).

IMMEDIATE MANAGEMENT

The immediate management in case of myocardial patients will be lifesaving interventions. The main aim should be preventing ventricular fibrillation through appropriate medication and pharmacologic therapies. The first target should be use of any anti thrombolytic agent, oxygen optimization, decrease in cardiac workload and control of the pain (Varon & Acosta, 2010). To carry out anti thrombolytic activity anti pletlets agents like aspirin serves the best, as research suggests early administration of aspirin leads to reduction in the death rate by 23% in myocardial infarction cases (Hennekens & Dalen, 2013). Since the patient chest pain was occurring from last 20 minutes as an immediate measure vasodilators should be administered. The action of these drugs is to increase myocardial blood supply in turn leading to dilation of epicardial and collateral vessels. This increase blood supply to the myocardial muscles (Wiggins, Rodgers, DiDomenico, Cook, & Page, 2013). The nitro glycerin which has been administered helps in relaxation of vascular smooth muscles. The drug acts by stimulation of intra cyclic guanosine mono phosphate production which leads to decrease in the blood pressure (Kodama, 2013). The patient was already upon ACE inhibitors for reduction in the blood pressure. Similarly, analgesics must be administered in order to comfort the patient from pain. This will help in promotion of pulmonary toilet as well sedative properties will reduce pain experience in the patient. Morphine has been administered in the above case study, as it has predictable effects, reliability, safe to use and the actions can be reversed through use of naloxone (Roxas & Weekes, 2011). T hus these three medication forms the immediate management schedule for myocardial infarction patients.

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