Cardiovascular Assessment Essay
This concept was taken from module 5 "assessing problems related to cardiovascular assessment", sub topic 1" assessment of the heart".
According to statistics from world health organization, 20 million people died from heart related problems in 2015. This population records that half of this people fall under the age of 50 and 25% under the age of 40.
The heart is a hollow muscular organ which is situated in the thoracic cavity. It is located between the lungs in the middle of the chest. The heart is responsible for pumping blood into the system. The heart has four chambers namely; the right atrium, the left atrium, the right ventricle and left ventricle. The wall of the heart is made up of three layers namely; endocardium, myocardium and pericardium. The size …show more content…
of the heart is about the size of the fist of any individual.
Cardiovascular disease are diseases of the heart and it accounts for leading causes of death worldwide. Cardiovascular diseases are non-communicable and majority results from lifestyle and ageing process.
Some of the diagnostic procedures of cardiovascular diseases are medical history, cardiac examination which includes inspection, palpation and auscultation. Blood test can also be carried out, echocardiograms, electrocardiograms, cardiac catherization and imaging like CT scans, MRI or PET.
Some common signs and symptoms of cardiovascular diseases include;
ANGINA: this is a common symptom of cardiovascular disease. It is a chest pain or discomfort which results from shortage of oxygen rich blood to the heart muscles. The patient often complain of pressure or squeezing in the chest. This pain usually reflects to the neck, jaw, throat, abdomen or back. It usually results from physical and emotional stress. It is usually of sudden onset and last for 2-5minutes and most times it is relieved by rest.
CYANOSIS OR PALLOR: cyanosis is defined as blueish discoloration especially of the skin and mucous membranes due to excessive concentration of deoxyhemoglobin in the blood caused by deoxygenation. It could be central affecting the core, lips, and tongue or it could be peripheral affecting the extremities or fingers. This is common in myocardia infarction, het failure, congenital heart disease, valve heart disease and reduced cardiac output.
Pallor is the paleness of the skin and mucous membrane which results from a reduction in the amount of the blood flow and oxygen or by reduced number of red blood cells. A patient with cardiovascular disease will most times present with pallor as can be seen on examination of the conjunctiva, mouth, skin, palm, etc.
DYSPNOEA: this is also a very common symptom of cardiovascular disease and it accounts for the main reason why most patients with cardiovascular disease are rushed to the hospital in an emergency state.
Dyspnea is a sudden shortness of breath or difficulty with breathing. It can also be defined as an uncomfortable sensation of breathing, or air hunger. In cardiovascular disease, the heart is unable to pump enough blood to the vital organs in the body including the lungs and as a result there is buildup of water in the lungs which causes difficulty in breathing.
COUGH: this is one of the symptoms of the cardiovascular disease that is mostly neglected. The truth is that in some cases cough may be associated with failure in cardiac treatment like some patients on captopril usually lay complain of discomforting cough.
Cardiac coughs can be seen in cases of cardiac failure, which can be a sign that the condition is getting worse and this cough is most times accompanied by a general flare up of the heart failure symptoms. This coughs could be more chronic and drier and cough produce only a very little amount of white or pink frothy mucus. Though some people always overlook this symptom, it should be noted that anyone with cardiac disease should never overlook any symptom of coughing.
PALPITATIONS: palpitations are irregular heartbeats, fluttering or flip flops in the chest. Some cardiac conditions that comes with palpitations include heart attacks, coronary artery disease, heart failure, heart valve problems and heart muscle problems. Here the heart is compensating for the loss in pumping capacity.
Most cardiovascular disease are evident by tachycardia or bradycardia. Once a patient complain of increased or decreased heart rate, it is enough reason to do a proper investigation to rule out any cardiovascular disease. Patients with palpitations usually complain of racing heartbeat.
FATIQUE/WEAKNESS: this is a common symptom of cardiovascular disease. This results from a decrease in cardiac output. Patients complain of extreme weakness after any activity. A patient who would have normally carried out his activities for the day will suddenly start complaining of extreme tiredness after each activity and in worse cases patients will not be able to carry out those activities again.
In cardiovascular disease the heart is unable to pump enough blood to vital organs and tissues hence the different parts of the body are not getting enough blood leading to extreme fatigue and tiredness and this is evidenced by inability to carryout normal activities.
OEDEMA: this is another common symptom of cardiovascular disease. This is the excess accumulation of fluid in the body tissue. This can be seen in the feet, ankles, legs or abdomen or patient might suddenly gain excess weight.
The heart here is unable to pump out enough blood to the kidneys and this will hinder the kidney from functioning well to secret sodium and water leading to fluid retention.
Also the blood that is returning to the heart is reduced causing buildup of fluids in the tissues leading to edema.
GASTRO INTESTINAL SYMPTOMS: patients with cardiovascular disease also presents with gastro intestinal symptoms like nausea, vomiting, anorexia and indigestion. This results from reduced blood supply to the digestive system.
CONFUSION: this is also one of the complaint or symptoms presented by some patients with cardiovascular disease. You will find out that the patient will be confused, disoriented and sometimes even their thinking will be altered. This results from reduced blood supply to the brain.
SYNCOPE/PRESYNCOPE: this is temporary loss of consciousness, light headedness and dizziness. This is as a result of reduced cardiac output which causes reduced oxygen to the brain. The onset is usually fast and lasting for a short duration. Recovery is also spontaneous.
5.2 PERSNAL CONTEXT
Personally I have come to understand that no cardiovascular symptom should be neglected. The effect of neglecting any of this symptom is
fatal.
During my nursing days, a guy who was doing his youth service was rushed to the hospital unconscious. On examination, he was noticed to be lifeless and no longer breathing. He was finally certified dead on arrival. From our assessment we knew that he must have had a cardiovascular disease without knowing and must have been having some of this symptoms without taking it serious.
In my practice as a nurse I have witnessed most patients complain of this symptoms on arrival to the hospital. Palpitations is a very common symptom. Some patients present with bradycardia while others present with tachycardia. Some of them are brought in a confused, unconscious state and cyanosed. Majority will need immediate oxygen therapy ad will feel better after about 30mins on oxygen. Proper laboratory investigations are needed to know the actual cause of the problem and treat immediately.
5.3 SOCIA CONTEXT
Majority of sudden deaths which occur in the society is as a result of cardiovascular disease. There are so many people in the society who are yet to be diagnosed with cardiovascular disease due to the fact that they are yet to present to the hospital. They are going about with their normal activities in the society and though from time to time experience some of this symptoms, but because they still feel that they are not yet down, they do not see the need to seek medical care. Some others because of financial constraints, they are not able to seek medical care.
Many people collapse in the market place, church, school and in social gatherings. Some become unconscious and are rushed to the hospital. Some experience severe cardiac attack and have angina like pain where you see them holding their chest and panting for air. Some suddenly develop cough over a period of time with edema. All this symptoms necessitate medical assistance for proper diagnosis and treatment.
5.4 APPLICATION TO CURRENT JOB
The hospital is the place where people with medical problems present to seek solutions to their health needs.
In the hospital where I work, we have patients who are rushed into the ward with symptoms of cardiovascular disease. Patients are rushed in an unconscious state, with visible difficulty in respiration. Oxygen saturation will show that the patient will be needing oxygen therapy. When the heartbeat of the patient is checked it is usually either bradycardia or tachycardia. It is never normal at this state. Treatment given at this stage depends on the vital signs of the patient. Example, if the blood pressure is high, a start dose of injection furosemide can be given, care is always taken to avoid crashing the blood pressure. Mannitol 10% or 20% is also given for three doses to reduce intracranial edema. If the temperature is high, injection paracetamol can be given to help reduce the temperature. Intra venous fluid is also set up immediately with injection vitamin B complex for the brain.
On the other hand, if the blood pressure is too low, we usually set up dopamine injection using infusion pump and the blood pressure is monitored closely. After stabilizing the patient, all necessary investigations are done to ascertain the right diagnosis of the patient. ECG is done to know the status of the heart, 2D ECHO is done, chest x-ray, full blood count, liver function test, serum urea and electrolyte test, blood glucose levels, lipid test, and test for cholesterol.
Following the results of the investigations, the patients is placed on due drugs to help maintain the patient’s condition. The patient will be placed on cardiac drugs like diuretics, anti-hypertensive, aldosterone inhibitors, ACE drugs etc.
This patient is also placed on low salt, low cholesterol diet to help with the blood pressure and cholesterol level and to help maintain the cardiac condition. The patient is also educated on minimal exercise like walking, educated on regular checkups and adherence to medications.
5.5 SIGNIFICANCE TO THE NURSING ROFESSION
This concept is important as it is necessary for nurses to know the symptoms of cardiovascular disease. They are usually the first people that patients meet on arrival to the hospital. The knowledge of it will help the nurse to ascertain that it is an emergency situation.
This concept will also help the nurse to correctly diagnose a cardiovascular disease. When nurses are faced with cardiovascular disease emergency outside the hospital, they will be able to adequately administer first aid treatment before rushing them to the hospital.
5.6 IMPORTANCE TO THE WORLD
The general public needs to be aware of the signs and symptoms of cardiovascular disease. They need to be educated on early detection and treatment. The people should know how fatal cardiovascular disease is and heed to preventive measures. This will help to reduce the incidence of death that results from cardiovascular disease.
5.7 RECENT RRSEARCH
In a recent research in the United States in 2015 researchers were measuring the progress on heart disease and other leading causes of death. Statistics showed that there was a decline in mortality rate from 1969-2013.
The research showed that from1969-2013 death rate due to stroke have reduced by 77% and heart disease mortality rate reduced by 68%. The statistics showed that there have been a lot of improvement in the treatment and prevention of heart disease but more efforts nerds to be made in eradicating the problem, as the burden of stroke and heart problem is too much.
According to statistics from world health organization, 20 million people died from heart related problems in 2015. This population records that half of this people fall under the age of 50 and 25% under the age of 40.
The heart is a hollow muscular organ which is situated in the thoracic cavity. It is located between the lungs in the middle of the chest. The heart is responsible for pumping blood into the system. The heart has four chambers namely; the right atrium, the left atrium, the right ventricle and left ventricle. The wall of the heart is made up of three layers namely; endocardium, myocardium and pericardium. The size …show more content…
of the heart is about the size of the fist of any individual.
Cardiovascular disease are diseases of the heart and it accounts for leading causes of death worldwide. Cardiovascular diseases are non-communicable and majority results from lifestyle and ageing process.
Some of the diagnostic procedures of cardiovascular diseases are medical history, cardiac examination which includes inspection, palpation and auscultation. Blood test can also be carried out, echocardiograms, electrocardiograms, cardiac catherization and imaging like CT scans, MRI or PET.
Some common signs and symptoms of cardiovascular diseases include;
ANGINA: this is a common symptom of cardiovascular disease. It is a chest pain or discomfort which results from shortage of oxygen rich blood to the heart muscles. The patient often complain of pressure or squeezing in the chest. This pain usually reflects to the neck, jaw, throat, abdomen or back. It usually results from physical and emotional stress. It is usually of sudden onset and last for 2-5minutes and most times it is relieved by rest.
CYANOSIS OR PALLOR: cyanosis is defined as blueish discoloration especially of the skin and mucous membranes due to excessive concentration of deoxyhemoglobin in the blood caused by deoxygenation. It could be central affecting the core, lips, and tongue or it could be peripheral affecting the extremities or fingers. This is common in myocardia infarction, het failure, congenital heart disease, valve heart disease and reduced cardiac output.
Pallor is the paleness of the skin and mucous membrane which results from a reduction in the amount of the blood flow and oxygen or by reduced number of red blood cells. A patient with cardiovascular disease will most times present with pallor as can be seen on examination of the conjunctiva, mouth, skin, palm, etc.
DYSPNOEA: this is also a very common symptom of cardiovascular disease and it accounts for the main reason why most patients with cardiovascular disease are rushed to the hospital in an emergency state.
Dyspnea is a sudden shortness of breath or difficulty with breathing. It can also be defined as an uncomfortable sensation of breathing, or air hunger. In cardiovascular disease, the heart is unable to pump enough blood to the vital organs in the body including the lungs and as a result there is buildup of water in the lungs which causes difficulty in breathing.
COUGH: this is one of the symptoms of the cardiovascular disease that is mostly neglected. The truth is that in some cases cough may be associated with failure in cardiac treatment like some patients on captopril usually lay complain of discomforting cough.
Cardiac coughs can be seen in cases of cardiac failure, which can be a sign that the condition is getting worse and this cough is most times accompanied by a general flare up of the heart failure symptoms. This coughs could be more chronic and drier and cough produce only a very little amount of white or pink frothy mucus. Though some people always overlook this symptom, it should be noted that anyone with cardiac disease should never overlook any symptom of coughing.
PALPITATIONS: palpitations are irregular heartbeats, fluttering or flip flops in the chest. Some cardiac conditions that comes with palpitations include heart attacks, coronary artery disease, heart failure, heart valve problems and heart muscle problems. Here the heart is compensating for the loss in pumping capacity.
Most cardiovascular disease are evident by tachycardia or bradycardia. Once a patient complain of increased or decreased heart rate, it is enough reason to do a proper investigation to rule out any cardiovascular disease. Patients with palpitations usually complain of racing heartbeat.
FATIQUE/WEAKNESS: this is a common symptom of cardiovascular disease. This results from a decrease in cardiac output. Patients complain of extreme weakness after any activity. A patient who would have normally carried out his activities for the day will suddenly start complaining of extreme tiredness after each activity and in worse cases patients will not be able to carry out those activities again.
In cardiovascular disease the heart is unable to pump enough blood to vital organs and tissues hence the different parts of the body are not getting enough blood leading to extreme fatigue and tiredness and this is evidenced by inability to carryout normal activities.
OEDEMA: this is another common symptom of cardiovascular disease. This is the excess accumulation of fluid in the body tissue. This can be seen in the feet, ankles, legs or abdomen or patient might suddenly gain excess weight.
The heart here is unable to pump out enough blood to the kidneys and this will hinder the kidney from functioning well to secret sodium and water leading to fluid retention.
Also the blood that is returning to the heart is reduced causing buildup of fluids in the tissues leading to edema.
GASTRO INTESTINAL SYMPTOMS: patients with cardiovascular disease also presents with gastro intestinal symptoms like nausea, vomiting, anorexia and indigestion. This results from reduced blood supply to the digestive system.
CONFUSION: this is also one of the complaint or symptoms presented by some patients with cardiovascular disease. You will find out that the patient will be confused, disoriented and sometimes even their thinking will be altered. This results from reduced blood supply to the brain.
SYNCOPE/PRESYNCOPE: this is temporary loss of consciousness, light headedness and dizziness. This is as a result of reduced cardiac output which causes reduced oxygen to the brain. The onset is usually fast and lasting for a short duration. Recovery is also spontaneous.
5.2 PERSNAL CONTEXT
Personally I have come to understand that no cardiovascular symptom should be neglected. The effect of neglecting any of this symptom is
fatal.
During my nursing days, a guy who was doing his youth service was rushed to the hospital unconscious. On examination, he was noticed to be lifeless and no longer breathing. He was finally certified dead on arrival. From our assessment we knew that he must have had a cardiovascular disease without knowing and must have been having some of this symptoms without taking it serious.
In my practice as a nurse I have witnessed most patients complain of this symptoms on arrival to the hospital. Palpitations is a very common symptom. Some patients present with bradycardia while others present with tachycardia. Some of them are brought in a confused, unconscious state and cyanosed. Majority will need immediate oxygen therapy ad will feel better after about 30mins on oxygen. Proper laboratory investigations are needed to know the actual cause of the problem and treat immediately.
5.3 SOCIA CONTEXT
Majority of sudden deaths which occur in the society is as a result of cardiovascular disease. There are so many people in the society who are yet to be diagnosed with cardiovascular disease due to the fact that they are yet to present to the hospital. They are going about with their normal activities in the society and though from time to time experience some of this symptoms, but because they still feel that they are not yet down, they do not see the need to seek medical care. Some others because of financial constraints, they are not able to seek medical care.
Many people collapse in the market place, church, school and in social gatherings. Some become unconscious and are rushed to the hospital. Some experience severe cardiac attack and have angina like pain where you see them holding their chest and panting for air. Some suddenly develop cough over a period of time with edema. All this symptoms necessitate medical assistance for proper diagnosis and treatment.
5.4 APPLICATION TO CURRENT JOB
The hospital is the place where people with medical problems present to seek solutions to their health needs.
In the hospital where I work, we have patients who are rushed into the ward with symptoms of cardiovascular disease. Patients are rushed in an unconscious state, with visible difficulty in respiration. Oxygen saturation will show that the patient will be needing oxygen therapy. When the heartbeat of the patient is checked it is usually either bradycardia or tachycardia. It is never normal at this state. Treatment given at this stage depends on the vital signs of the patient. Example, if the blood pressure is high, a start dose of injection furosemide can be given, care is always taken to avoid crashing the blood pressure. Mannitol 10% or 20% is also given for three doses to reduce intracranial edema. If the temperature is high, injection paracetamol can be given to help reduce the temperature. Intra venous fluid is also set up immediately with injection vitamin B complex for the brain.
On the other hand, if the blood pressure is too low, we usually set up dopamine injection using infusion pump and the blood pressure is monitored closely. After stabilizing the patient, all necessary investigations are done to ascertain the right diagnosis of the patient. ECG is done to know the status of the heart, 2D ECHO is done, chest x-ray, full blood count, liver function test, serum urea and electrolyte test, blood glucose levels, lipid test, and test for cholesterol.
Following the results of the investigations, the patients is placed on due drugs to help maintain the patient’s condition. The patient will be placed on cardiac drugs like diuretics, anti-hypertensive, aldosterone inhibitors, ACE drugs etc.
This patient is also placed on low salt, low cholesterol diet to help with the blood pressure and cholesterol level and to help maintain the cardiac condition. The patient is also educated on minimal exercise like walking, educated on regular checkups and adherence to medications.
5.5 SIGNIFICANCE TO THE NURSING ROFESSION
This concept is important as it is necessary for nurses to know the symptoms of cardiovascular disease. They are usually the first people that patients meet on arrival to the hospital. The knowledge of it will help the nurse to ascertain that it is an emergency situation.
This concept will also help the nurse to correctly diagnose a cardiovascular disease. When nurses are faced with cardiovascular disease emergency outside the hospital, they will be able to adequately administer first aid treatment before rushing them to the hospital.
5.6 IMPORTANCE TO THE WORLD
The general public needs to be aware of the signs and symptoms of cardiovascular disease. They need to be educated on early detection and treatment. The people should know how fatal cardiovascular disease is and heed to preventive measures. This will help to reduce the incidence of death that results from cardiovascular disease.
5.7 RECENT RRSEARCH
In a recent research in the United States in 2015 researchers were measuring the progress on heart disease and other leading causes of death. Statistics showed that there was a decline in mortality rate from 1969-2013.
The research showed that from1969-2013 death rate due to stroke have reduced by 77% and heart disease mortality rate reduced by 68%. The statistics showed that there have been a lot of improvement in the treatment and prevention of heart disease but more efforts nerds to be made in eradicating the problem, as the burden of stroke and heart problem is too much.