Question

. Mr. Smith, a 52-year old patient, is admitted to the coronary care unit with the diagnosis of acute inferior myocardial infarction. The patient has a history of smoking two packs per day of cigarettes for 35 years, and he drinks a six-pack of beer on weekend nights, but does not drink the rest of the week. He is the sole financial support for his family. He is a consultant for a company and is out of town during week days. Over the past year, Mr. Smith has gained 20 pounds. He is 5 foot 6 inches, weighing 200 pounds. His diet consists mostly of fast food. He rarely exercises. His wife cares for their three teenage children. The eldest son, 17 years of age, totaled the family car when drinking and driving 2 days ago and he is in the local children’s hospital in the intensive care unit in critical condition. Mr. Smith developed chest pain and slumped over in his chair during an argument with his wife about their teenage daughter, who is 15 years of age and wanted to get birth control pills. The wife is in the waiting room while the nurses settle Mr. Smith into his room. The youngest son, 13 years of age, is at a friend’s house. The teenage daughter is staying at the bedside of the critically ill eldest son. The wife blames her eldest son for her husband’s heart attack and told the emergency department nurse that she does not care to see her son at all. (Learning Objectives 6, 10, and 11) What maladaptive responses to stress may have contributed to Mr. Smith’s development of an illness? Based on the case study, what family assessment data may be used to determine coping strategies being currently used by the family in crisis? What nursing interventions should be used to promote effective coping for the patient and his family?

Answer 1

Due to stress ------> Large amounts of adrenaline and nor adrenaline secreted ----------> Poured into blood stream----->cells of heart muscles to burn oxygen in higher rate------>Depletion of oxygen to heart---->deficient oxygen leading in Acute MI-----> Even death in some persons.

Maladaptive stress generally increases anxiety and stress resulting in binge eating, substance abuse and self harm.The current situation of this patient shows he needs to get proper rest and sleep as sleeping repairs the body by itself and refreshen him.

Eating healthy foods not only help the body to get energy but also paly an essential role in mental health.

Minimal physical activity helps the body to release endorphins and help him to get rid of stress.

Spirituality- believe in higher divine power helps him to overcome stress and have balance in mental health

Meditation and relaxation techniques help him to overcome stress.

Nurses role:

To reassure the patient

To provide minimal physical activity

To provide emotional support

To counsel the patient