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Nursing Diagnosis

Strengths Noted from Milestone # 1

Given the fact that the patient sought help to address her chest pains, the thorough examination on the health history is a foundation for linking the chest pains with other ailments, as well as health precautions observed. The strength of the health history is rooted on the ability of detailing the patient’s health without breech of privacy with regard to ethics of care. 


The patient sought medical help after she discovered her pain was getting intense and prolonged as compare to previous episodes; however, the patients’ general health is faced with other factors that demand intervention. Such factors include severe migraines that have prevailed since age 18, and blurred vision without the help of spectacles.

Strengths Related to Patient’s Overall health

Having had a difficult time fighting various ailments, the patient is doing better at 56 years old than she was at 40. On assessment of general health, some of the physical routines that the patient has been engaging in are some of the positive installments that have caused her to develop a rather tolerable health. The fact that the patient has abstained from alcohol, illicit drugs, and tobacco predicts treatable chest pains and the lack of other conditions: like cancer and chronic ulcers. In terms of diet, the routine on calibrated amount of food is a reason the patient was never treated of cardiovascular conditions or obesity related cancer. The daily, or rather the routine on exercise is a strength that has aided in keeping a healthy life and prevention of obesity (D'Amico & Barbarito, 2012). On the other hand, exercises that include daily working out in gym and recommended night sleep are some of the health measures that can be associated with her lack of joint-pains (D'Amico & Barbarito, 2012). Finally, the observation of Japanese culture and traditions have limited number of ingested medication to Aspirin, therefore limiting the likelihood of chemical inflammation, poisoning, and associated hazards like allergies (injections are different).

Areas of Concern

Besides the chest pain, recurring sharp migraines and eye problems are other areas of concern that need to be treated as well. The amount of mental activities that the patient is subjected to and the type of exercise she engages could be linked to the migraine episodes. This is because physiological aspects of exercises and activities have led to constrictions of blood in the brain. It is likely that patient’s migraines are of the classic type because this is the only type associated with visual complications. The association of aura with classic migraines characteristics causes visual, motor, and sensory symptoms.

Health Education Needs

Given the cultural and the traditional beliefs of patient, health education is needed for this patient to enlighten her on the benefits of creating space for non-traditional intervention. Ailments differ in effects and interventions are different; therefore, acupuncture and herbals are limited in variety and health benefits are biased to a particular type of illnesses.

Nursing Diagnosis

One of the nursing diagnoses that demand a high priority in this patient is the migraines and associated visual impairments.

Nursing Interventions

  1. Regulation and assessment of the patients’ chest pain will be monitored on a 6-hour basis with the patient reporting on the levels of pain and the degree of pain (Hadjistavropoulos & Craig, 2002). This will be done through Abbey Tool of Pain Assessment. This would register the pain and take count of associated emotional deviation (Marquie, 2004).
  2. In regards to the migraines and vision problems, Doloplus-2 Tool of Pain Assessment would be used to register the degree of pain and frequency of recurrence (Note: this tool is mostly used for non-verbal patients, but its level of accuracy is applicable to various care settings) (Herr, Decker & Bjoro, 2005). Assuming that the migraines are causing visual issues, focus on the migraines would determine connection with visual issues. If none, the vision problem would be addressed to an ophthalmological setting.
  3. The patient has two options to remain admitted until the treatment is completed: dropping by the health facility for checkups, or have a family member monitor the progress. Whichever method would be used, it aims at addressing the primary problem (Chest Pains) and the secondary ones (Migraines and Associated Visual problems) that have been diagnosed.

Working towards Effectiveness

By providing intervention for this patient, I would use healthcare ethics to regulate the course of action I choose as well as create a trust relationship with the client. This would create accountability and reliability of relationship between nurse and patient.


In regards to the patient's migraines, one goal related to this diagnosis would be to regulate and quantify the activities that lead to this condition. It also involves recommending a change in routine and intervene with means that do not differ with the patient's traditional beliefs and cultural ties. Through this, the patient's preference to acupuncture treatment would be considered and she will be appropriately informed concerning the effectiveness of her preferred treatments. Although acupuncture may not be a recommended form of intervention, one measurable expectation of this goal would be to entirely cure the migraines within the accepted means of treatment to the patient. If modifications have to be resulted to, consent would be sought from the patient to apply much modern means.

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