Cardiovascular Health and Disease

This assignment delves into the crucial aspects of cardiovascular health. It examines various risk factors associated with cardiovascular disease, including lifestyle choices, genetics, and age. The document also explores common manifestations of cardiovascular disease, such as heart attacks, strokes, and heart failure, shedding light on their impact on individuals' lives. Furthermore, it emphasizes preventative measures and strategies for managing cardiovascular health effectively.

Running head: NURSING CARE PLAN FOR ANTHONY KHOURY
NURSING CARE PLAN FOR ANTHONY KHOURY
Name of the Student
Name of the University
Author Notes

1NURSING CARE PLAN FOR ANTHONY KHOURY
Cardiovascular diseases involve disorders that are related to the heart as well as the blood
vessels and include the coronary heart diseases, peripheral arterial diseases, cerebrovascular
diseases, rheumatic heart diseases, pulmonary embolism, deep vein thrombosis, congenital heart
diseases, among others. These usually results in heart attacks or strokes (Berry et al. 2012).
These results due to the deposition of fat along the inner linings of the blood vessels that supply
blood to the heart or to the brain. Tobacco use apart from obesity, hypertension, hyperlipidaemia,
diabetes and physical inactivity generally gives rise to such problems (Rigotti and Clair 2013).
Some of the symptoms of cardiovascular diseases include chest pain, lightheadedness,
confusion, dizziness unconsciousness, among others (Www.nhs.uk 2018). This essay describes
the case study of Mr. Anthony Khoury. He was admitted to the hospital following symptoms of
chest pain and discomfort.
This essay will at first describe the actual or potential problems along with a nursing care
plan. The second part of the essay is an assessment report that provides the rationale for the
identified patient problems and the associated nursing interventions.
Part I
This is the case of Mr. Anthony Khoury, who is a 67-year-old male, who had been
admitted to the emergency department of the hospital following chest pain and inability to carry
out proper breathing. Upon arriving at the hospital he was monitored to determine his vital signs.
His heart rate was found to be 125BPM. Monitoring of the blood pressure revealed that on sitting
his blood pressure is 146/88 and on standing, his blood pressure was found to be 132/68. His
respiratory rate was found to be 28 BPM and the cough was identified to be non-productive that
is without the presence of sputum. It was identified to be dry cough. His oxygen saturation levels

2NURSING CARE PLAN FOR ANTHONY KHOURY
was found to be 91%, which then increased to 95% following administration of oxygen. His
temperature was however, normal but showed signs of confusion and felt light headed. His
pupils were however perceptive to light and was suffering from pain on his upper chest area,
which on the pain scale was found to be 4/10.
According to Mr. Khoury, he suffered from chest pain or angina and breathlessness after
subjecting to an argument with his sons. He has a medical history of diabetes, which is however
kept under control by the use of oral medications. However, he suffers from peripheral arterial
disease and symptomatic neuropathy, both of which are co-morbidities of diabetes (Thiruvoipati,
Kielhorn and Armstrong 2015). He also reported that in the past he has suffered from chest pain,
dyslipidaemia and hypertension. He controls these medical conditions by using hypolipidaemic
and anti-hypertensive medications. However, he has complained of uncontrolled blood pressure.
He has admitted to being a smoker and suffered from acute myocardial infarction after the death
of his wife. He had undergone coronary angioplasty and stents were used in order to manage his
medical condition. According to his daughter, he always remains stressed and anxious with
regards to his family business and she also has noticed a decline in his health as a result of this.
Assessment of his medical data reveals that his blood pressure falls in the standing
position, which may be caused due to postural hypotension (Pasma et al. 2014). Lack of oxygen
could be associated with him suffering from chest pain or angina and is showing signs of mild
dysfunction, incomplete speech and confusion (Ripley et al. 2012). Impaired speech and
confusion could be associated with hypoxia (Leto and Feola 2014). Moreover, impaired speech
and chest pain could be associated with heart attack. The pain scale indicated that he is suffering
from distressing pain. He is suffering from mild dysfunction, which could increase his risks of
falling. His heart rate is above normal, which could be due to tachycardia and low oxygen

3NURSING CARE PLAN FOR ANTHONY KHOURY
saturation. Low oxygen saturation could be associated with hypoxia and may be associated with
increased heart rates (Raut and Maheshwari 2015; Cowburn et al. 2017). He also suffers from
increased respiratory rate, which could be associated with Tachypnea.
ASSESSMENT/NURSING DIAGNOSIS/OUTCOME
PATIENT or
NURSING
ORIENTED
PATIENT
PROBLEM /
PATIENT NEED
PATIENT
ASSESSMENT
DATA
OPTIMAL PATIENT OUTCOME OR GOAL
Actual problem: The
patient is suffering
from low oxygen
levels in his body.
Tachypnea, high
respiratory rate.
His oxygen levels will return to normal, normal
respiratory rate.
Actual problem: The
patient is suffering
from low blood
pressure, while
standing up as
compared to when
sitting down.
Postural Hypotension,
light headedness,
confusion.
His blood pressure will return to normal.
Actual problem: The Fast heart rate, His heart rate will return to normal, his breathing rate

4NURSING CARE PLAN FOR ANTHONY KHOURY
patient suffers from
hypoxia.
confusion, rapid
breathing and
breathlessness.
will also be in the normal range, no reported to
shortness of breath and no signs of confusion.
Actual problem: The
patient is suffering
from high heart rate.
Tachycardia, low
oxygen saturation in the
body
His heart rate will be monitored and steps will be taken
to bring it to normal levels. Oxygen levels in the body
will be at normal levels.
Actual problem: The
patient has
underwent a heart
attack.
Chest pain, impaired
speech, confusion.
Lack of any reported event of chest pain, no report of
impaired speech and confusion.
Potential problem:
The patient may
have the risk of
suffering from falls.
He is showing mild
dysfunction, confusion,
slurred speech, low
blood pressure while
standing.
No signs of dysfunction and no reports of falls.
Part II
The patient described in this case study is Mr. Anthony Khoury. He has been admitted to
the emergency department of the hospital following chest pain and shortness of breath. He
complained of such a condition, following arguments with his sons over his family business. He

5NURSING CARE PLAN FOR ANTHONY KHOURY
has previous history of heart disease, hypertension and dyslipidaemia. On admission to the
hospital, his vital signs like heart rate, respiration rates were high, while his oxygen saturation
levels were low.
The patient suffers from low oxygen levels in his body as well as low blood pressure. His
heart rate was also high, which indicates that he is suffering from tachycardia. He is showing
high rates of breathing, which can be due to tachypnea (Abdullah et al. 2012). As he is suffering
from hypoxia, or low oxygen levels in the tissues it resulted in him showing signs of confusion,
faster heart rate, shortness of breath, among others. He is also showing signs of postural
hypotension, which may be caused due to his hypertension medications. Treatment of
hypertension with anti-hypertensives can lead to sudden fall in blood pressure on standing (Zia,
Kamaruzzaman and Tan 2015).
The 2 problems, which the patient is suffering from is an actual problem and the other is
a potential problem. The actual problem is low oxygen saturation levels or hypoxia. Hypoxia
results in increased heart rate or tachycardia, increased respiratory rate. Due to the lack of
oxygen in his body, his heart muscles cannot get enough oxygen, which in turn results in
myocardial ischemia and ultimately angina pectoris or chest pain (Leach and Fisher 2013). The
other potential problem is that he can succumb to falls. Low blood pressure also results in low
oxygen levels. The use of anti-hypertensives has resulted in his sudden drop of his blood
pressure, which may result in him falling. Moreover, his low blood pressure along with low
supply of oxygen have caused in him showing signs of confusion, impaired speech, anxious,
dizzy, among others. All these factors could increase the chances of him falling and succumbing
to serious injuries.

6NURSING CARE PLAN FOR ANTHONY KHOURY
The nursing interventions for low oxygen saturation levels include maintenance of
oxygen levels by using an oxygen administration device and increasing the oxygen saturation
levels to greater than 90%. The patient should be placed in a proper alignment to maximize
breathing, demonstration of controlled breathing methods to slow the respiration in patients
suffering from tachypnea, diaphragmatic breathing relaxes the muscles and increases the oxygen
levels of the patient. Other interventions include educating the patients about the use of nebulizer
treatments and metered dose inhaler, which promotes safe and highly effective administration of
medication, teaching patients about pursed lip breathing, abdominal breathing, among others.
This will help to improve ventilation. The nursing evaluation will include utilization of pulse
oximetry to monitor the pulse rate and oxygen saturation levels, noting PaO2 to determine the
presence of hypoxia (Www.health.wa.gov.au 2018). The nursing interventions to prevent the risk
of falls include assessments of medications that enhances the risks of falling, since side effects of
hypertension medications can give rise to postural hypotension that may result in falls. Other
interventions include participation in programs involving gait training and regular exercise, since
exercises can strengthen the muscles and improve balance, reality orientations for patients
suffering from confusion as it can reduce the confusion, which in turn decreases the chances of
falling, bringing about changes in diet containing high amounts of sodium. The nursing
evaluation will include monitoring of the blood pressure levels and assessment of patient
physical activity (Doclibrary-rcht.cornwall.nhs.uk 2018).
Thus, the patient described here is an individual, who suffers from poor levels of oxygen
as well as is prone to falling. The patient was admitted after complaining of chest pain and
breathing difficulties. The lack of oxygen in his body must be responsible for his chest pain,
tachycardia, tachypnea, among others. Moreover, because of his postural hypotension and

7NURSING CARE PLAN FOR ANTHONY KHOURY
hypoxia, he is suffering from mild dysfunction like confusion, impaired speech, among others.
Thus, appropriate nursing interventions are needed to overcome or reduce the risk of his fall.

8NURSING CARE PLAN FOR ANTHONY KHOURY
Reference List
Abdullah, B.B., Zoheb, M., Ashraf, S.M., Ali, S. and Nausheen, N., 2012. A study of
community-acquired pneumonias in elderly individuals in Bijapur, India. ISRN
Pulmonology, 2012.
Berry, J.D., Dyer, A., Cai, X., Garside, D.B., Ning, H., Thomas, A., Greenland, P., Van Horn, L.,
Tracy, R.P. and Lloyd-Jones, D.M., 2012. Lifetime risks of cardiovascular disease. New England
Journal of Medicine, 366(4), pp.321-329.
Cowburn, A.S., Macias, D., Summers, C., Chilvers, E.R. and Johnson, R.S., 2017.
Cardiovascular adaptation to hypoxia and the role of peripheral resistance. eLife, 6.
Doclibrary-rcht.cornwall.nhs.uk (2018). Cite a Website - Cite This For Me. [online] Doclibrary-
rcht.cornwall.nhs.uk. Available at:
https://doclibrary-rcht.cornwall.nhs.uk/documentslibrary/royalcornwallhospitalstrust/clinical/
general/fallspolicy.pdf [Accessed 1 Jan. 2018].
Leach, A. and Fisher, M., 2013. Myocardial ischaemia and cardiac pain–a mysterious
relationship. British journal of pain, 7(1), pp.23-30.
Leto, L. and Feola, M., 2014. Cognitive impairment in heart failure patients. Journal of geriatric
cardiology: JGC, 11(4), p.316.
Pasma, J.H., Bijlsma, A.Y., Klip, J.M., Stijntjes, M., Blauw, G.J., Muller, M., Meskers, C.G. and
Maier, A.B., 2014. Blood pressure associates with standing balance in elderly outpatients. PloS
one, 9(9), p.e106808.