Discuss about the Warfarin Therapy for Atrial Fibrillation.
Atrial Fibrillation that is a medical condition occurring due to irregular heartbeats in patient enhancing the chances of blood clots ultimately leading to a stroke. Warfarin therapy is an effective treatment for the atrial fibrillation and discontinuation of the green vegetables is essential as these works in against of the regulatory and remedial procedure undertaken by the Warfarin therapy (Moss et al., 2014).
The essay is a case study of Mrs. Lillian Gamble who is suffering from atrial fibrillation and is under Warfarin therapy for treatment.
This essay outlines the learning needs of Mrs. Lillian gamble, aids and barriers to effective treatment with the help of Warfarin therapy. Furthermore, formulation of smart objective for effective imparting of awareness and effective teaching aid that can be undertaken.
According to the case study, Mrs Lillian Gamble is a 78 years old aged woman who carries a long history of medical conditions. Recently she has been suffering from atrial fibrillation with the symptoms that started to show up three months back in term of chest pain, palpitations and dyspnoea (Raine et al., 2016). The learning requirement of Mrs. Gamble is on Warfarin therapy and prohibition from eating green leafy vegetables. Warfarin is an anticoagulant tablets that increases the time of blood coagulation by making it thin. The blood clot inside the body can causes cardiac arrest, heart failure or the failure of any other essential organ leading to ultimately death. Besides this, the consumption of green leafy vegetables has been prohibited for her as these vegetables contain high levels of vitamin K that helps in coagulation process. Continual consumption of these along with Warfarin tablets will breach the thinning of the blood.
Aid and barriers are most common and prevalent issues faced by the healthcare professionals when dealing with the patients for any malady or illness. The level of understanding for a disease is not common and updated by the patients that lead to a lag and huge gap in undertaking the optimal treatment imparted by healthcare professionals (Loewen et al., 2017). Same issue prevails in the case of Mrs. Gamble who does not know much about her condition that is atrial fibrillation, its symptoms and why she is prevented from eating green leafy vegetables. Furthermore, due to long history of severe health conditions she has severe pain in the body and further impairment of the physical movement and activities. Besides this, she is lagging in optimal cognitive skills that have affected her ability to remember provided information and effectual decision-making. Furthermore, her short stay in the hospital has also breached the detailed understanding on her medical condition, symptoms and implemented preventions (Lee et al., 2016).
Increment in self advocacy can be done with optimal awareness allowing them to make independent decisions based on the knowledge. The SMART approach has been undertaken along with the Blooms Taxonomy of Learning Objective for the formulation of procedures and aims (Kirchhof et al., 2016). The goals are:
Specific: To enhance the existing knowledge with the help of optimal communication of Mrs. Lillian Gamble on her medical condition that is Atrial Fibrillation and its prevailing symptoms in her. Further enhancing knowledge on what dietary intake she is required to consume during the remedial treatment. Besides this, awareness is to be provided on the Warfarin therapy in accordance with the prevailing issues such as overall lack in education, cognitive skills, decision-making, learning and understanding. Undertaking of certain exercises such as flash cards or mcqs based on the guidelines of the hospital will help in achieving the target (Culebras et al., 2014).
Measurable: To conduct this awareness program with her for a week in order to instil complete information required by Mrs Gamble on the prevailing conditions in her understandable terminologies and interpretation. The growth and development must be determined daily with the help of questionnaire and asking for feedback. This also undertakes qualitative analysis on the approach of Mrs. Gamble towards the imparted knowledge and further critical evaluation is to be conducted to mould the further training (Culebras et al., 2014).
Achievable: Within a week, the awareness program must instil optimal knowledge on the atrial fibrillation and related must be provided with the help of certain guidelines and exercises. To achieve this goal within time, effective trained and professional approach by the healthcare professionals is required that undertakes the training with efficacious compassion and dedication. For this, such professionals must be trained enough of handling patients with conditions as Mrs. Gamble (Kirchhof, 2017).
Result-Oriented: Each and every aspect of the atrial fibrillation, warfarin therapy and other important information related to it must be meet leading to the completion of the program. Such measures will help in providing person centred training required by Mrs. Gamble.
Time-bound: Within a week, the newly implemented awareness program for Mrs Gamble must provide optimal information required. Optimal efficacy is determined by critically analysing the effectiveness of the imparted information with the help of questionnaire (Kirchhof, 2017).
Effective teaching aids and optimal environment for learning are two prime factors required for the learning and understanding of the patient to be imparted by the healthcare professionals regarding their prevailing condition. As Mrs. Gamble is suffering from different conditions such as cognitive impairment, lack in understand, learning and formulating the decision-making on the basis of the information given, different teaching aids that can be used for her are displaying information with the help of flash cards, using motion picture, providing her written information on the prevalent condition, existing symptoms, and knowledge on remedial treatment undertaken such as Warfarin therapy (Gladstone et al., 2015). The remedial environment required for optimal imparting of the information requires good knowledge on the condition of the patient case history and current condition. Furthermore, any kind of pressure must not adhere in mrs. gamble while implementation of the exercise. Besides this, optimal regulation of the teaching aids such as flash cards, motion picture or written information in the form of brochures, flyers or a written booklet must be provided to mrs. gamble along with a small diary in which she can write and preserve the allotted prescription for the optimal intake of the medication provided. Effective communication is one of the essential criteria to be followed on which all other factors for the optimal regulation of the exercise depends. Effective communication must be patient oriented and implemented cautiously by the healthcare professional making the patient comfortable, congenial and interested enough towards the communication (Tamura, 2013).
The series of induction includes the study of the old age and the case history of mrs. Gamble. This analysis needs to be studied by the healthcare professional as well as mrs gamble as well in order to understand the reason behind the prevailing health condition. She is a 78 years old woman with a long history of medical conditions such as hypothyroidism, hip replacement and the rehabilitation, abdominal pain, distension, septicaemia, MRSA infection, pseudoarthrosis, dyspnoea, chest pain, artial fibrillation and pneumonia. This long history has triggered symptoms of artrial fibrillation such as palpitations, chest pain, reduced exercising capability, dyspnoea, confusion and short of breath. After acknowledging and imparting the case history, information must be provided on arterial fibrillation and its effect on the coagulation process conducted by blood. Information must be imparted on the Warfarin therapy that conducts thinning of the blood and information on Coumadin medication that is provided to mrs. gamble for treatment. Besides this, regulation of optimal diet is essential and green leafy vegetables must be prohibited till the time Warfarin therapy is been undertaken. Green leafy vegetables are rich in vitamin K that undertakes the coagulation process of the blood. The Warfarin therapy or medication is undertaken for the thinning of the blood. The function of the Warfarin therapy and green leafy vegetables are just opposite and this will prevent optimal regulation and treatment of the arterial fibrillation in mrs gamble. Furthermore, importance of prescribing Coumadin which is a colour coded tablets of Warfarin especially made for the patients suffering from confusion and impaired cognitive skills (Graudins, Chen & Hopper, 2015). At the end, approach of mrs gamble needs to be generalised towards this in order to generate self advocacy in her. Self advocacy will provide optimal decision-making which is extremely essential for the regulation of the treatment provided by the healthcare professional as per the extent of own understanding and learning. Conclusively, the induction procedure includes background study of mrs. gamble, study on atrial fibrillation its symptoms and remedial Warfarin therapy that leads to prohibition of intake of green leafy vegetables (Jun et al., 2015).
According to a study conducted by Gomes et al. (2013), warfarin therapy is essential for the treatment of various maladies such as Atrial Fibrillation, Pulmonary Embolism (PE), artificial heart valves, Deep Vein Thrombosis (DVT) and others. Warfarin is a medicine that prevents the clotting of blood by thinning it. Furthermore, this medicine is essential after big surgeries such as bypass surgery, cardiac arrest or any other surgery of organs. Coumadin and Marevan are two different brands of the warfarin tablet are available for commercial purpose. They come in different colours for different strengths to prevent any sort of confusion during consumption. Mrs Gamble is suffering from atrial fibrillation that promotes blood clotting. Optimal undertaking of this tablet by her will prevent clotting by thinning the blood. Besides this malady, old age and severe medical case history one of the prevailing factors of the symptoms shown by her. Confusion, unable to take correct doses, palpitation, short breath, body pain, weakness and unable to walk are some of the essential symptoms leading to decrement in her condition (Gomes et al., 2013).
Another study conducted by Bjorck et al. (2013), though there are many advantages of using Warfarin tablet, certain limitations are also there if doses are not maintained optimally. This may lead to haemorrhage that is release of blood from ruptured and broken blood vessels. Older patients suffering from atrial fibrillation tend to get exposed from haemorrhage mostly within the thirty days of starting of Warfarin therapy. Furthermore, atrial fibrillation is also responsible for ischemic stroke. Occurrence of this stroke increases with age mostly in the aged people above eighty years of age. Alteration in the required doses of Warfarin therapy increases the chances of ischemic stroke in the patients suffering from atrial fibrillation to a greater extent (Bjorck et al., 2013).
A study conducted by Dennis et al. (2017) determines that warfarin therapy is one of the most prevailing anticoagulant medication that is accepted by different healthcare professionals yet its context and usefulness is not fully informed and accepted in remote areas. Scope for improvement for determined when an analysis for the warfarin tablet users in the remote areas of Northern Australia was undertaken. A very less number of patients were aware with the concept of anticoagulation property of warfarin tablets (Dennis et al., 2017).
The necessary information for Mrs. Gamble undertakes sufficient knowledge towards her symptoms, her prevailing malady that is atrial fibrillation, prohibition on certain dietary intake such as green leafy vegetables and remedial treatment provided to her through Warfarin therapy. Furthermore, Mrs Gamble must be provided information on the doses of the Warfarin to be consumed in a day. Besides this, resourceful information must be provided on the treatment plan covering different questions such as the importance of the consumption of the Warfarin tablet and the time of next blood test to determine the amount of the time the blood takes to coagulate. Furthermore, information must be provided on how to undertake the optimal usage of Warfarin at home on own for the continual intake of the medication (Wang et al., 2014). This can be done by regular consumption of the medication as prescribed by the doctor with the help of the colour coding of the tablet. Additionally, Warfarin tablets must be consume along with the evening meal but other schedule is to be prescribed by the doctor and consumption must be undertaken accordingly.
Information of missing the doses in accordance with the prescription must be directly consulted with the doctor to prevent any dangerous implications. Conclusively, warfarin therapy is a good method of providing relief to the patients but must be undertaken in accordance to the prescription. Furthermore, regular blood test must be conducted that determines how much time blood is taking to coagulate with the help of International Normalised Ratio. Lower value will lead to more coagulation and high value will lead to bleeding. Besides this, Mrs. Gamble requires to follow all rules and regulation for the consumption regulation and maintaining equilibrium in the warfarin therapy (Coyle et al., 2015).
Conclusively, warfarin therapy is the best possible solution for the treatment of atrial fibrillation among aged people. Besides this, different barriers such as ageing and maladies have affected Mrs. Lillian Gamble cognitive skills and ability of understanding, learning and decision-making. The major goal of teaching the patients regarding their prevailing severe healthcare condition is to improve their existing knowledge on the disease and why different remedial measures has been undertaken. Furthermore, effective communication along with the usage of teaching aids will create awareness in the patient leading to self advocacy. This measure is extremely important for the optimal conduction and regulation of the treatment provided by the healthcare professional to the patient.
References:
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Culebras, A., Messé, S. R., Chaturvedi, S., Kase, C. S., & Gronseth, G. (2014). Summary of evidence-based guideline update: Prevention of stroke in nonvalvular atrial fibrillation Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 82(8), 716-724.
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