Nursing Essay: Case Analysis of a Patient Suffering from Cardiovascular disease

Question

Task: Edward is a 64-year-old man, who has a history that includes diabetes, alcoholic cardiomyopathy, and peripheral vascular disease. Edward and his wife divorced several years ago. He has two adult children a son and a daughter who live nearby. Edward has recently been discharged from an acute care facility following an admission for acute pulmonary oedema and uncontrolled blood glucose levels secondary to excessive alcohol consumption. This is Edward’s third admission in the past 12 months for the same health issue.

Part A- Consider the above case scenario and prepare a nursing essay answering the below points:
• Identify both the chronic disease and the presenting condition.
• Succinctly describe the pathophysiology and symptoms, associated with the chronic disease and the presenting condition.
• Provide a brief outline of the relevant diagnostic and ongoing tests (e.g. blood tests, vital signs, x-rays, physiotherapy), associated with the patient’s chronic and presenting conditions.

• Outline two (2) potential problems (complications) associated with the chronic disease.
• Briefly outline the psychosocial developmental, cultural and health literacy considerations for the person in your case study. Developmental theorists have been identified in the modules on the StudyDesk, you are encouraged to use your recommended texts and library resources.
• Describe three (3) priorities of nursing management for the patient’s chronic and presenting condition. These may include nursing management/ nursing assessment, and/ or pharmacological /nonpharmacological management and/ or self-management.

Part B-
Describe the condition, pathophysiology, and symptoms, associated with the chronic condition.
• Outline the potential diagnostic tests, treatments, and medications that the patient may experience while managing their condition
• Briefly describe three (3) management strategies e.g. options for relief of symptoms, lifestyle changes, prevention of relapse/escalation/complications.
• Include a link to an additional resource on the condition that patients and their families can read or watch (i.e.: a website, YouTube video). Note these must be from reputable sources with the patient in mind, not medical practitioner focus.

Answer

Introduction
Cardiovascular disease is a health condition that affects the heart and blood vessels. The different types of CVD include high blood pressure, heart failure, cardiomyopathy, peripheral vascular / artery disease and congenital cardiac abnormalities among others. Every condition is distinguished epidemiologically; frequency and occurrence rates differ broadly by nation and ethnic group since these types of CVD are accountable for most of the vascular complications and fatality in advanced nations.

Pathophysiology of Cardiovascular Disease
Cardiovascular disease (CVD) is a comprehensive phrase that represents all kinds of diseases that affect the circulatory system comprising of the heart and the capillaries, whichtransposes and transmits blood. This multifaceted disease incorporates many inherent and acquired ailments. CVD is connected with congestion of fatty residues in the atherosclerosis and a rise in coagulum. It may as well be linked with impairment in organs like the brain, eyes, kidneys, and the heart. CVD is amongst the principalreason for mortality and disabilities in the UK;however,it can be avoided through practicing a healthy living (Bhatnagar et al, .2015). In this essay, we review the various types of CVD, their signs, elements and how eliminate and manage them. CVD has several types of conditions. Some can emerge concurrently or bring on other disorders in the group.

The maladies linked with the heart are;coronary thrombosis, a chest pain which happens because of reduced blood flow to the heart; congenital heart disease where the heart structure is present since birth; heart attack, this is a condition where there is gradual clogging of blood flow and oxygen supply; and cardiomyopathy,in that the heart enlarges and is cannotspout blood effectively (Li et al, .2020). The other disorders include vascular conditions, which affect the arteries, veins, and capillaries around the heart and the whole body. These are; peripheral artery disease, that makes the arteries to be thin thus reducing the blood floor to the limbs; atherosclerosis, is a condition where the deposits form on the walls of the capillaries, making them narrow and thus reducing the floor of blood rich with oxygen; and peripheral venous disease, where veins which transfer blood from other parts of the body to the heart are damaged, thus causing varicose veins (Krittanawong et al, .2020). It is possible to control other health disorders linked with CVD through lifestyle modifications, though other diseases may be dangerous and need urgent operation.

Symptoms
Signs and symptoms are different according to a particular disorder. Some diseases such as type 2 diabetes or hypertension can at first display zero signs. Though, usual signs for an underlying vascular condition are; dizziness, cold sweats, pain or discomfort in the chest thus indicating cardiac infarction, fatigue, shortness of breath and nausea.

Diagnosis of Cardiovascular Disease
Diagnosis of cardiovascular heart disease is done according to your signs and symptoms and depending on the disorder; your physician thinks you might have. Tests can be carried out depending on family history. These tests include chest x-ray, electrocardiogram, and blood tests.

Blood Tests
Blood tests help clinicians and healthcare practitioners to examine a person’s health. If an individual has been diagnosed with a circulatory disorder, blood tests help in observing their conditions and the impact of the medication the person is prescribed to. The different types of blood tests in CVD include; cardiac enzyme tests, which help assess and prevent heart attack; clotting screen, measures how fast an individual’s blood clots. This is significant if one is prescribed to medications like warfarin; liver tests, this gives report on how the liver is working and when the liver is not function well it can have effects on the entire body; full blood count, measures various kinds of blood vessels and also indicate if one has an infection.

Chest X-ray
A chest x-ray gives the image of an individual’s lungs, heart, and ribs allowing the doctor to assess the organs. This mostly applies to patient’s who experience shortness of breath, whichhelps the doctor to discover the cause of the problem from either the heart or lungs (Budoff, &Shinbane, 2016). The chest x-ray is also done as part of normal work up for heart surgery. If your health practitioner feels that you have a heart disorder, they will schedule other tests to be conducted too.

Electrocardiogram
An ECG is a valuable and simple test that notes the pulse, electrical activity, and rate of the heart. It helps detect complications of the pulse rate and help the clinicians to tell if have a heart attack or has experienced one before. It is usually the first heart test an individual will have. There are limitations, usually you will undergo one or ore tests. Having unusual readings from the ECG does not indicate that you may have a problem with your heart. Types of ECG include, exercise ECG and 24hr ECG recording.

Complications Associated with CVD
Heart Failure
Heart disease can contribute to sudden weakening of the heart, which is referred to as heart failure. As the heart deteriorates, it finds it difficult to stream blood out to other organs. Hence,blood backs up in the lungs. The fluid will also start forming in the various parts of the body. Heart failure is among the main reasons for people being admitted in hospitals. It is also known to be chief cause of mortality to individuals above 60 years. The symptoms include, swelling ankles, extreme fatigue, and shortness of breath.

Pulmonary Edema
Pulmonary edema causes the fluid to accumulate in the lungs. The main cause for this disorder is the heart failure since it cannot pump blood as needed. Hence, blood backs up in the veins in the lungs thus causing leakage of fluid in the lungs. Symptoms include, chest pain, coughing with bloodstains and shortness of breath.

Social and cultural impact on health literacy
Social and cultural divergence among cultures set up issues in comprehending health care. Studies carried out show that women between the ages of 50-70 years who were acquiring medication for primary hypertension defined their ailment as “pressure.” Most of them believed they were suffering from two disorders; “high blood” and “high pretension.” These notions affected their outlook of and cohesion to treatment.Most of the patients do not know the best way they can take care of themselves and avoid illnesses. Some do not know that cardiovascular conditions are avoidable. In a recent study, most of the patients with heart failure believed their signs were because of being elderly. They had no idea of how they developed the condition (Thilaka, & Nikita, 2017). The effect of enough health education skills is important. According to Healthy People 2010, health knowledgeability is important for advanced communication, high ability to participate in selfcare, improved health conditions and cost effective to the general health system. The health literacy issue has to be addressed, especially in a particular disease state like CVD. The issue needs to be addressed to make the next great improvement in preventing cardiovascular disease.

Nursing Management
Providing clinical nursing care to a person with cardiovascular disease needs, the employment of the knowledge of the condition that tells instructs the nursing conciliation (Dunn et al, .2015). The essay illustrates the priority factors of clinical care for Edward who has CVD from a nursing care/ management perspective.

Lifestyle interventions
It is important for the patient to change their way of living pertaining to behavior, emotions and activities that may maximize workload on the heart. The healthcare provider must therefore enforce the nursing interventions for lifestyle modification and encourage Edward adjust his lifestyle favorable health results. The nurse should constitute an angelic environment that enhances rest for Edward to avoid the demand for oxygen incase he becomes agitated.

Diet modification
Diet has an important role in maintaining proper health to an individual with CVD. Edward should transition his diet to conform to low salt and foods free from cholesterol. Salt free foods reduce fluid build up while fat free foods decrease the dangers for chlorosis heart disease. Replace large meals with small servings and provide the patient with enough vitamins to improve their immunity.

Administration of medication
In a clinical environment, medications are administered by the doctor. The nurse should therefore give the medication as prescribed by the physician. However, the nurse must have facts of the pharmaceutical namely, the benefits and limitations to ensure improvement of the patient.

Conclusion
In conclusion, cardiovascular disease is developing as a single chief cause of death in several countries. The immense affliction caused, about suffering and healthcare costs, is growing. It is advised that techniques and mechanisms must be implemented to inspire action by nations to address this main issue.

References
Bhatnagar, P., Wickramasinghe, K., Williams, J., Rayner, M., & Townsend, N. (2015).The epidemiology of cardiovascular disease in the UK 2014. Heart, 101(15), 1182-1189.

Budoff, M. J., &Shinbane, J. S. (Eds.). (2016). Cardiac CT imaging: diagnosis of cardiovascular disease. Springer.

Dunn, S. P., Birtcher, K. K., Beavers, C. J., Baker, W. L., Brouse, S. D., Page, R. L., ... & Walsh, M. N. (2015). The role of the clinical pharmacist in the care of patients with cardiovascular disease. Journal of the American College of Cardiology, 66(19), 2129-2139.

Krittanawong, C., Kumar, A., Hahn, J., Wang, Z., Zhang, H. J., Sun, T., ...&Jneid, H. (2020). Cardiovascular risk and complications associated with COVID-19. American journal of cardiovascular disease, 10(4), 479.

Leon, B. M., & Maddox, T. M. (2015). Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World journal of diabetes, 6(13), 1246.

Li, S., Nemeth, I., Donnelly, L., Hapca, S., Zhou, K., & Pearson, E. R. (2020). Visit-to-visit HbA1c variability is associated with cardiovascular disease and microvascular complications in patients with newly diagnosed type 2 diabetes. Diabetes care, 43(2), 426-432.

Thilaka, N., & Nikita, G. (2017).Evaluation of Effectiveness of the Printed Educational Material (Brochure and Pamphlets) for Cardiovascular Diseases for Use among Patients. Indian Journal of Public Health Research & Development, 8(4).

Part B
Cardiovascular Disease
A resource for patients and families

A resource for patients and families What is cardiovascular disease (CDV)?
Cardiovascular disease is a health condition that affect the heart and blood vessels. The different types of CVD include high blood pressure, heart failure, cardiomyopathy, peripheral vascular / artery disease and congenital cardiac abnormalities among others. What causes cardiovascular disease?

• Hypertension
• Smoking
• High cholesterol
• Diabetes
• Dormancy
• Obesity
• Heredity

What are the signs and symptoms of CVD?
• dizziness
• cold sweats
• chest discomfort
• fatigue
• shortness of breath
• nausea

Potential diagnostic tests for CVD
• Chest x-ray - A chest x-ray gives the image of an individual’s lungs, heart, and ribs allowing the doctor to assess the organs. This mostly applies to patient’s who experience shortness of breath which helps the doctor to discover the cause of the problem either from the heart or lungs

• Electrocardiogram - An ECG is a valuable and easytest, which notes the pulse, electrical activity, and rate of the heart. It helps detect complications of the pulse rate and help the clinicians to tell if have a heart attack or has experienced one before.

• Blood tests - Blood tests help clinicians and healthcare practitioners to examine a person’s health. If an individual has been diagnosed with a circulatory disorder, blood tests help in observing their conditions and the impact of the medication the person is prescribed to

Treatmentsfor CVD
Treatment will depend with type of CVD,
• Prescriptions,such as minimizing less dense lipids, enhance circulation of blood, or monitor the pulse rate
• Surgeries like arteriosclerosis skip graft, valve reformation or substitute operation
• Cardiovascular therapy such as physical training and lifestyle modification

Medications for CVD
• Diuretics –these medications maximize the evacuation of water in the urine; hence reduce the general quantity of blood. This therefore minimizes the blood pressure.

• Antiplatelet agents –thrombocytes have a significant duty in blood clotting and creation of hemostatic plugs, which prohibit bleeding.

• Thrombolytic agents – They are used to disintegrate coagulum which is accumulated and examples are reteplase and altepase.

Management strategies
• Lifestyle interventions - It is important for the patient to change their way of living pertaining to behavior, emotions and activities that may maximize workload on the heart.

• Diet modification - Diet has an important role in maintaining proper health to an individual with CVD. Patients should transition his diet to conform to low salt and foods free from cholesterol.

• Administration of medication - In a clinical environment, medications is administered by the doctor. The nurse should therefore give the medication as prescribed by the physician.

Additional online resource
https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118