Effectiveness of Motivational Interviewing on Lifestyle

Question: Discuss about the Effectiveness of Motivational Interviewing on Lifestyle. Answer: Introduction: The internal factors that are affecting the physical condition of William are stress due to post traumatic disorder, unconsciousness level, increased alcohol level in blood and his injury on his forehead that can result in severe pain. These internal factors have the contributory effects in making him aggressive and confused. The external factors that are contributory to the condition of William are drunken driving, rash driving, disobeying the traffic rules and ignorance of the measures of personal safety (McLean et al. 2014). A significant brain injury can result in a decline in the consciousness level after six hours of admission and the ratings of the Glasgow coma scale can be beneficial for recording the responsiveness of William. The stage of unconsciousness will end with the opening of the eyes of William. The duration, peak and onset of alcohol in the blood of William will determine the intensity of brain injury and weather he has entered the stage of coma (Cassidy, Boyle and Carroll 2014). The specific diagnostic tests for William will be computerized tomography scan that will provide a comprehensive picture of his brain with the application of a sequence of x-rays (Fernndez-Espejo and Owen 2013). CT scans can be beneficial for revealing the presence of contusions, tissue swelling, hematomas and hemorrhage. Two of the specific healthcare professionals who will be required in the process of care of William in the settings of a hospital are a neurologist and a neurosurgeon. Neurologists in consultation with the general physician will take care of the brain and nerves and the neurosurgeon will stop the bleeding in the brain by surgical intervention. The caring for an old Buddhist woman who refuses to accept pharmacological interventions would require the consideration of the ethical issues that are followed in the process of end life palliative care for providing her relief in a way that is morally suitable. The religious beliefs of the woman have to be considered during the decision making process and alternatives to the pharmacological interventions have to be selected according to the Buddhist norms (Morgan and White 2015). In no way, it should hurt the sentiments of the patient while providing nursing care. The on-duty medical officer present in the ward can be of help of the enrolled nurses for seeking advice to provide her with comfort and relieve the pain following the organizational procedures and policies. The regulatory guidelines have to be referred to such circumstances and the legal advisory committee can also be consulted to know the procedures of administration of pharmacological interventions if required. Medication free death has been the wish of the patient but pain relieving responsibilities also lies with the nurses which can result in an ethical conflict. Nonpharmacological treatment procedures for the Buddhist woman can include massage, biofield therapy, complementary therapy and art therapy. Acute pain can be relieved with biofield therapy that includes Reiki and healing touch (Whellan et al. 2014). Stimulation of the spinal cord also has pain relieving abilities that can be associated with massages. Stimulation of the spinal cord is done with the application of electrodes near to the spinal cord and discharging electrical signals for stimulating the release of endorphins. They are the natural painkillers in the body that reduce pain without any pharmacological intervention. The symptoms of Tom are caused by the problems that involve complications of the heart or cardiovascular pathology. The pathophysiology of the chest pain of Tom can be attributed to the condition of congestive heart failure. There is a correlation of pathophysiology between the swelling of his ankles and feet and his chest pain. The swelling is because of the accumulation of fluid in his body due to decreased blood flow from the heart resulting in the venous return of the blood (Roffi et al. 2015). This is causing fluid accumulation in the lower limbs of Tom and is related to the disorder of the heart. Electrocardiogram (ECG) is the procedure to record the electrical activities of the heart over duration by the application of electrodes that are placed over the skin. It is a common form of cardiology test that works by the detection of the minute electrical changes that are present on the skin due to the electrophysiologic pattern of the depolarization process rising with every heartbeat. Conduction abnormalities, heart rhythm, heart rate and abnormal disturbances of the cardiac rhythm can be detected with ECG. ST segment depression is an abnormal condition as it indicates myocardial infarction occurring due to the lack of coronary blood supply to the heart. The two health professionals required for the care process of Tom will involve a cardiologist and a registered nurse. The treatment recommendations will be provided by the cardiologist after examining the condition of the heart and the diagnosis report (Mahler et al. 2013). The registered nurse will monitor the heart condition and administer the medications required by Tom as prescribed by the cardiologist. 1a. Smoking can have severe implications on the coronary artery disease of Tom from which he is suffering as the chemicals present in the smoking tobacco harms the blood cells that eventually damages the functioning of the function and structure of the heart and the blood vessels. Plaques tend to build up in the coronary arteries that lead to arrhythmias, heart failure, heart attack and even death and smoking aggravates these conditions in the patients with coronary artery disease (Lee et al. 2016). Action Plan commenced 02.04.2015 Objective (What do you hope to achieve?) Activities (What activities could help in achieving the objective) Anticipated outcomes (What is the expected outcome of the activities?) Timeline (What is the expected timeline?) Resources (What resource(s) will you need to achieve your objective?) WHS (What workplace health and safety (WHS) are required?) Cessation of cigarette smoking of Tom Nicotine replacement patches Complete cessation of smoking by Tom 1 month Transdermal system patches of nicotine, user guide and safety information The treatment cost will be subsidized by the quit smoking assistance program to promote quitting activities during work time Action Plan review date: 20.04.2015 Objective (What do you hope to achieve?) Activities (What activities could help in achieving the objective) Anticipated outcomes (What is the expected outcome of the activities?) Timeline (What is the expected timeline?) Resources (What resource(s) will you need to achieve your objective?) WHS (What workplace health and safety (WHS) are required?) Stop the smoking habit of Tom Nicotine gum Complete cessation of smoking by Tom with improved condition of his coronary heart disease 1 month Nicotine gums of required strength and user guide Quit smoking is encouraged by providing nicotine gums to the employees for a happy and healthy workforce and a clean and safe workplace for all References Cassidy, J.D., Boyle, E. and Carroll, L.J., 2014. Population-based, inception cohort study of the incidence, course, and prognosis of mild traumatic brain injury after motor vehicle collisions.Archives of physical medicine and rehabilitation,95(3), pp.S278-S285. Fernndez-Espejo, D. and Owen, A.M., 2013. Detecting awareness after severe brain injury.Nature Reviews Neuroscience,14(11), pp.801-809. Lee, W.W., Choi, K.C., Yum, R.W., Doris, S.F. and Chair, S.Y., 2016. Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: A systematic review.International journal of nursing studies,53, pp.331-341. Mahler, S.A., Miller, C.D., Hollander, J.E., Nagurney, J.T., Birkhahn, R., Singer, A.J., Shapiro, N.I., Glynn, T., Nowak, R., Safdar, B. and Peberdy, M., 2013. Identifying patients for early discharge: performance of decision rules among patients with acute chest pain.International journal of cardiology,168(2), pp.795-802. McLean, S.A., Ulirsch, J.C., Slade, G.D., Soward, A.C., Swor, R.A., Peak, D.A., Jones, J.S., Rathlev, N.K., Lee, D.C., Domeier, R.M. and Hendry, P.L., 2014. Incidence and predictors of neck and widespread pain after motor vehicle collision among US litigants and nonlitigants.PAIN,155(2), pp.309-321. Morgan, D.D. and White, K.M., 2015. Enabling Participation in Meaningful and Essential Occupations in End-of-Life Care. InInternational Handbook of Occupational Therapy Interventions(pp. 787-796). Springer International Publishing. Roffi, M., Patrono, C., Collet, J.P., Mueller, C., Valgimigli, M., Andreotti, F., Bax, J.J., Borger, M.A., Brotons, C., Chew, D.P. and Gencer, B., 2015. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.European heart journal, p.ehv320. Whellan, D.J., Goodlin, S.J., Dickinson, M.G., Heidenreich, P.A., Jaenicke, C., Stough, W.G., Rich, M.W., Quality of Care Committee and Heart Failure Society of America, 2014. End-of-life care in patients with heart failure.Journal of cardiac failure,20(2), pp.121-134.