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Cardiac Focused Interview
The article I chose was How I Do It: The Patient Who Asks About Lifestyle Choices to Prevent Heart Disease. This article hits home talking about how motivated patients are. YOU must take the steps to reduce the risk of cardiovascular problems, no one can do it for you. The person I chose to interview has had many trials in life. He has been married twice, both wives have passed away. He says that he has a hard time remembering his medications because his previous wife took care of him. We started our interview by talking about prior hospitalizations. He doesnt remember having any kind of patient teaching. He says with a laugh, they threaten that I will end up back in the hospital if I dont take care of myself. He says that more information about what his issues were, would have been important early on. The article mentions the importance of how to correctly feed your heart. Lifestyle or medications are important for reducing your risk of heart disease (Roizen, 2013). He wasnt taught early on the importance of a healthy diet early on in life. He believes that the influence he had in childhood carried throughout his life. His father was a chronic alcoholic and a smoker as well. He is interested in a lifestyle change, he mentioned that having Chronic Obstructive Pulmonary Disease and Coronary Artery Disease is hard and tiring. We talked about the new apps that are available on his new iPhone, he downloaded Cardiio. I do have to say it is pretty neat.
The man I interviewed had been nervous that his past tobacco and alcohol use would cause problems further down the line. The first diagnosis was tonsil cancer in 2014. This was treated with radiation, surgery, and chemotherapy. He has recovered since then, however, he suffers from many side effects of radiation. The second diagnosis was COPD, which was diagnosed in 2015. He had periods of shortness of breath and an ongoing cough, but he was able to get a referral to pulmonology for a diagnosis. The diagnoses last year were CAD and hypertension.
Can you tell me about your previous eating habits and your current daily diet?
He grew up on a farm and his mom died when he was five. His dad didnt cook for them. They ate whatever they could find, fruit and vegetables were too expensive. He blames a lot of his eating habits on not having a mother to teach him differently. He believes that his family has a long history of heart problems, attributed to genetics and poor eating habits. He says it’s hard to cook healthy for one person. He isnt as hungry as he used to be, he thinks it is probably because he isnt as active. He eats sandwiches and snacks with chips and chocolate. I explained to him the importance of eating less sugar and more omega-6 fatty acids. Some food ideas are whole grains and some nuts. Omega-3 is also important, oily fish (salmon) is a great example. He says that hearing the information from someone he knows is different than at the hospital. So, he will try and make better choices as he wants to be around for his grandchildren.
What is your current activity level and was the importance of exercise explained to you? If so, how often? He explains that exercise was mentioned at some point, although the older she gets, it is talked about less. He wanted to know if I think exercise is important, even with taking his medications. He commented that taking his pills should be good enough and that he doesnt think exercise is as important as he ages. I explained that exercise makes his heart muscles stronger and even though he is older, it is still needed. Walking is a great way to start exercising, this is also a great way to reduce stress and obesity. Stress can cause as many heart attacks as tobacco (Roizen, 2011).
What medications are you prescribed for your diagnoses, do you understand the importance of compliance with your medications? He is prescribed aspirin, Atenolol, Amlodipine, an Omega-3 supplement, a multivitamin, and Nitroglycerin PRN. He was taking lisinopril, but it was discontinued. He takes these medications daily, most of the time. Poor compliance with antihypertensive drug treatment has often been associated with treatment failure or uncontrolled hypertension and disease progression (Ren, Kazis, Lee, Zhang, & Miller, 2002). He did discuss a few previous hospitalizations that may have been prevented with medication compliance.
We chatted about how his compliance has changed, he now uses weekly pill containers for his medicine. He is prescribed Advair and Albuterol for COPD. He explained to me that he wasnt taught how to take his inhalers, and this broke my heart. I explained to him how to breathe out all of the way, before breathing in slowly and depressing inhaler. He was going through his inhalers in 15 days getting no relief, because he didnt know how to use them. He was spraying them in his mouth, trying to take a deep breath. There ks]
I think that I am a great patient advocate. I am standing up more for my patients at work, since starting this course. I feel that our physicians forget how important it is to go over instructions with patients and clearly explain their diagnoses. Written If this opportunity is missed, client safety is at risk. I will be able to apply this information as a Registered Nurse because with this interview, I was able to hear and feel the complexities of a patient with chronic illnesses. This will make me a better nurse, I will spend more time with my patients and make sure that they have the tools to be successful. I was able to teach my interview subject and explain things more thoroughly that he may have missed in the healthcare setting. He is also hard of hearing, knowing this, I sat next to him and discussed the interview. Listening and teaching from afar doesnt help the client. He thanked me for my patience after the interview. This is a life-changing experience.
References
- Ren, X. S., Kazis, L. E., Lee, A., Zhang, H., & Miller, D. R. (2002). Identifying patient and physician characteristics that affect compliance with antihypertensive medications. Journal of Clinical Pharmacy and Therapeutics, 27(1), 47-56. doi:10.1046/j.1365-2710.2002.00387.x
- Roizen, M., MD. (2011). How I Do It: The Patient Who Asks About Lifestyle Choices to Prevent Heart Disease. Retrieved 2019, from http://plminstitute.org/
- (anonymous informant, personal communication, Dec 05, 2019) A question may ask you to make a connection between a person’s diet and their specific health symptoms or issues. You might also be asked to determine what you would do in a certain medical situation or emergency or what approach would work best for communicating with a patient about specific concerns.Â
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