Care: Issler Is A Patient Who Recently Essay

Excerpt from Essay :


Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of medications like metoprolol, lasic, synthroid, and Coumadin. Mr. Issler's condition requires an effective plan of care from a primary care provider to help in managing the illness.

Mr. Issler's Plan of Care:

In developing an effective plan of care for Mr. Issler's condition, the first major step in the process is to identify the vital signs and carry out a lab test of his illness. The vital signs of the patient are pulse (58), b/p (176/84), respirations (22), and pulse oximetry (88). The lab test results are BUN (29), hemoglobin (10.4), hematocrit (29.6%), IND (2.5), and creatinine (2.0). Despite of the history of severe medical conditions, Mr. Issler weighs 147 pounds and he is 72 inches tall.

The main aim of this article is to utilize the AACN Synergy Model and the Chronic Care Model to develop a care plan to deal with the nursing problems of Mr. Issler. According to Hardin & Hussey (2003), the AACN Synergy Model focuses on describing a framework for nursing practice and is based on the linkage of patient characteristics with nurse competencies to realize optimal patient outcomes (p.73). As a result, this model is easily adaptable to the acute care setting, critical care setting for...
...Moreover, the AACN Synergy Model enables nurses to manage complex patients experiencing acute vexation of their conditions and work toward lessening the trajectory of the disease.

In contrast, the Chronic Care Model (CCM) is regarded as the best known concept of disease management since it incorporates care coordination, integrated care, and case-management (Drewes et. al., 2012, p.1927). Consequently, the model has been widely embraced as an evidence-based mechanism for improving chronic care. Generally, the Chronic Care Model is usually used in care management to significantly lessen mortality through positive impacts on hospitalization and the patient's quality of life. These effects in care management are always achieved through CCM because the model contains substantial heterogeneity in effectiveness.

Notably, the core concept of the American Association of Critical-Care Nurses (AACN) model is that the patient's needs or characteristics and the influence of his/her family drive nurses' competencies and characteristics (Kaplow, 2008). Synergy in this model is achieved when the patient's characteristics and needs, medical unit, and system are aligned with the nurse's competencies. There are four major components of the AACN model such as the patients' characteristics are of significant concern to nurses and the competencies of the nurses being important to patients. The other components are patients' characteristics guide the competencies of the nurse and the fact that optimal patient outcomes are realized when the characteristics of patients and competencies of nurses are aligned and synergized.

The AACN Synergy Model is guided by various assumptions for patient care including the consideration of patients as biological, social, spiritual, and psychological entities through an examination of body, mind, and spirit. Secondly, the patient, family, and the society play a crucial role in providing the basis for…

Sources Used in Documents:


Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from

Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.

Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from

Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing

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