Prophylaxis of coronary artery disease

Week 8

Patient’s need for education

This week, I am lucky enough to get a chance to go to the Cath lab to observe the procedure. I am so amazed by the procedure, amazed how quickly a narrowing coronary artery can be fixed during the procedure. I really appreciate the opportunity I got.

One patient went to see his doctor for other reasons other than coronary artery disease. Just before he left the doctor’s office, he asked: “What is about the chest pain I am having now?” made him to be referred to a cardiologist. After few noninvasive diagnostic tests, he was diagnosed as coronary artery disease and scheduled for coronary angiogram and possible intervention. Under X-ray during agiogram, we saw a significant narrowing of his mid LAD, and the cardiologist decided to put a stent in it to treat the lesion. The procedure was successful and the patient can go home the same day.

There are still 3 places of his coronary artery a narrowed but insignificant and there is no need to put a stent in. It can be managed with medication. But the patient really needs to be taught to manage his blood cholesterol and change lifestyle which can reduce the factor of myocardial infarct. He also needs to be on Aspirin for at least a year to Prophylaxis of transient ischemic attacks and MI.

I would basically use the hand out the cath lab have abut the procedure and the hand out in PCU about CAD to do my patient teaching. I would also give him the information about internet and community services for him to get information in the future. The important thing need to be stressed is the cholesterol management and the life style changing. It can enhance pt’s well being and protect future damage of the coronary arteries. Stent fixed the existing problem, the potential problem need the pt. To be motivated to act and prevent.

5 stressors in my life

Weekly Journal Assignment

Week 7

5 stressors in my life and the intervention that would enhance my ability to cope with these stressors

1) School ---
As a nursing school, middle aged and English as second language student, school is a stressor of my life now. Sometimes I felt like I am reaching the point I want to quit or never going to school again. Yes, the intensive training of nursing can really stress students well. But I think to be able to see the future is a positive reinforcement of the students’ life. And also, it is the student’s decision to go to school. We have to remember it and respect it. For me, I just see the intensive training period is temporary, it is time limit. Once you graduate, life will be different. So laundry can wait, house doesn’t need to be super clean and food can be simple. It is all temporary, it will be over soon. For study, I put my mind on reading, trying to understand all the objects. Of curse, my back ground knowledge helps me too. So even with the second language, I cannot complain much.I think a positive attitude; an active learning plan can enhance my ability to cope with the stress.

2) Work ---
Work is wonderful! It gives us opportunity to be socialized, it gives us a source to live, and it gives us a reason to live too. But when you are stressed for school, plus there is not every day’s work is wonderful and peaceful, work can be stressful. When there is a work scheduled, I think it is a better idea to make the entire study and work plan together in detail so that when there is a work day, concentrate on work and forget about school. When there is the time to study, do not let anything else to interrupt you. So straight schedule and study plan is helping me to cope with this. And if you feel like it is too much to deal with, cut off some work hours. Take some student loans, live a simpler life. These all can help.

3) Children ---
Children occupy my mind all the time, even sometimes I cannot do anything. It really bothers me when they are not listening; they are not doing what they suppose to do. I used to be bothered a lot, but my brother’s talking put my on ease. He said: “everyone has their own orbit. Children have their own fates; you don’t have to be a slave of your children.” Since then, I am just talking to them and let them know what I am thinking and what I want them to do. If they listen or not, it is their choice. They are old enough to make decisions not matter good or bad; sometimes they have to learn the hard way.

4) Parents ---
As middle aged person, parents are getting old and need us to care of. One phone call from my parents can make me worry all day long. And when I am worried I cannot concentrate on my study. This can be stressful. My way to cope this stress is to ask my friends and brother close to my parents to call them and help them. And then write a dairy to talk to myself that they are already being taken cared of by my friends and nothing I can do here, so just do not worry. Writing to myself if another way I cope with stress and it works well for me so far.

5) Grades ---
I am a perfectionist. I always want to be the best of my life. This really is a big stressor for me. It pushes me keep going and sounds like there is no stopping. As a student now, I always want to get good grades; I mean “A”s. But with the 15 credits courses I am taking, it is hard to get all “A”s. It bothered me when I got my first “B”, I felt so sorry that I was so close to an “A”. So grades are a stressor for me and I am trying to let myself notice that “B” is a respectful grade too. I think I need to compare with people “C”s and be happy. Do not put on oneself too high expectation is a way to cope this stressor I think. I am doing better with it now. I think it enhanced my ability to cope with the unexpected grades.