Managing Cardiovascular Disease: A Holistic Approach

The assignment content discusses the nursing care plan for a patient with hypertension, chronic renal failure, and cardiovascular disease. The patient's condition is characterized by low blood pressure, which increases the risk of vascular stasis. The nurse's role is to monitor vital signs, cardiac monitoring, and management of heart rate to reduce the risk of stroke and attack. Additionally, the patient must adhere to medication regimens, including salt restriction, and engage in physical exercises for overall fitness. The nursing goal for chronic renal failure is to prevent further complications through supportive care and client education. The nurse must monitor vital signs, manage fluid intake, and develop a plan to maintain ideal body weight without excess fluid.

CASE BASED WRITTEN
ASSIGNMENT

TABLE OF CONTENTS
Introduction......................................................................................................................................3
1.......................................................................................................................................................3
Pathophysiology, health assessment and clinical findings for M.G's conditions........................3
2.......................................................................................................................................................4
Risk factors for cardiovascular disease........................................................................................4
3.......................................................................................................................................................5
What other complication does MG present with and why these have occurred..........................5
4.......................................................................................................................................................6
Using clinical Reasoning Cycle, identify three priorities nursing diagnoses..............................6
5.......................................................................................................................................................6
State the goal of care, specific nursing intervention and usefulness of such intervention..........6
Conclusion.......................................................................................................................................8
References........................................................................................................................................9

INTRODUCTION
Nursing helps in providing proper care and medical attention to a patient or person who is
suffering from certain kind of unhealthiest. In this report, the critical condition of M.G a 76 year
old female has been discussed. Various complications related with her health and three types of
nursing intervention to be provided by the nurses have been described in the report.
1
Pathophysiology, health assessment and clinical findings for M.G's conditions
Pathophysiology of M.G's conditions:
The pathophysiology helps in determining the pathology and physiology of a patient's
condition. M.G has suffered from congestive heart failure recently. This kind of disease leads to
heart failure because the victim faces heart blockage. It is important to understand the basic
conditions which are contributing to such critical situations. Pathophysiology depicts the
conditions which have occurred during the traumatic phase of patient (Dovancescu and et. al.,
2017). For M.G the major symptoms were swollen feet and legs. She also faced breathlessness
and severe coughing. The current observations which were recorded by the hospital staff when
M.G recently got admitted to the hospital include irregular pulse rate, high blood pressure and lot
of sweat. On performing the ECG, it was diagnosed that the patient suffered from atrial
fibrillation.
Despite of being admitted in the hospital, M.G's condition worsened just in a few days of
discharge. This implies that she did not follow the instructions which were provided by medical
practitioner for retaining the state of health. Moreover, it was determined that she did not follow
restrictions of salt and fluids. Salt is one of the triggering agents which can lead to severe
conditions of heart and increase hypertension (Sagar and et. al., 2015). It is advised for patients
suffering from heart diseases to look up for healthy eating habits and maintain the fluid intakes.
Health Assessment:
M.G's current conditions reflect that she has been suffering from congestive heart failure
because she has following major symptoms:
 Atrial fibrillation
 Inability to breather or breathlessness
 Coughing

 High Blood pressure
 High pulse rate
 Severe sweating
 Swollen legs
The nursing staff of the hospital found that despite of taking a critical treatment, M.G was
suffering from breathlessness. It has been reported that she gained 2 kgs after her discharge. This
implies that there were no precautionary measures followed. Moreover, her symptoms of
congestive heart failure are again dominating the health conditions. The past history of patient
depicts that she has been subjected to hypertension and Type 2 Diabetes. Both these diseases are
themselves very critical and can worsen the situation if medications and health restrictions are
not followed (Kitzman and et. al., 2014).
Clinical findings:
There were various tests conducted on M.G to scan and verify the symptoms so that a
conclusion can be reached. The radiology results depicted that after performing the Chest X-ray
(CXR), there was cardiomegaly and pulmonary congestion. This determines that M.G had a
blockage in her heart which was restricting her to breathe normally. Moreover, it was found that
she was careless in controlling her salt and fluid intakes. Excessive salts in the blood causes the
blood pressure to rise and sweating takes place.
2
Risk factors for cardiovascular disease
Cardiovascular disease is a disease which is caused to the heart and the blood vessels.
There are variety of symptoms and risk factors which together contribute to this fatal problem.
Some of these risk factors have been described as follows: Genetics: Children carry many traits from their parents as part of their genes. If parents
have been subjected to any sort of heart problem then the risk increases for children or
the next generation. Multiple single nucleotide polymorphisms are associated with the
cardiovascular diseases that are acquired genetically (Cardiovascular disease risk
factors, 2017). Age: Considered as the most important element for determining the health status, age
plays a vital role in undermining the symptoms of cardiovascular diseases. Right from

adolescence the coronary fatty streaks are formed. The risk of death is more in coronary
heart disease patients who are above 65 years of age. In M.G's condition, she is also
subjected to a cardiovascular disease according to her age. Sex: It has been evaluated from various reports and researches that risk of heart disease is
more in men as compared to women. Gender differences depict more than half risks in
men as compared to women when considering cardiovascular disease (Cardiovascular
disease risk factors, 2017).
 Physical inactivity: Unhealthy lifestyle is the prime factor which leads to diseases and
chronic problems. The inability to perform exercises or no physical exercises leads to
congestion of heart walls which accumulates cholestrol and fatty cells around the
sensitive heart area. This blocks the blood flow and as a result congestive heart failure or
cardiovascular disease takes place.
3
What other complication does MG present with and why these have occurred
According to the case analysis, it has been observed that MG is having severe issue due
to cardiovascular disease and at the same time, other health issues are also increasing
accordingly. It is also observed that her Pulse rate is not normal and along with that, respiratory
rate is also getting higher. Hypertension, chronic renal failure, type 2 diabetes mellitus and
hyperlipidaemia are some of the issues which she is having and because of that her health
condition is changing continuously. When she was admitted in the hospital, she was asked to
have control on her fluid and salt consumption rate; however she failed to do so. Reportedly she
has also gained 2 kg weight after getting discharged from the hospital.
It can be said that the issues of cardiovascular disease is getting more because MG has
type 2 diabetes which is changing the blood sugar level. At the same time, she is also not
adopting suitable dietary as asked and in terms of consequences, problems of obesity and fatigue
has been developed. Further the chances of heart failure is also increasing because MG has
hypertension along with type 2 diabetes. Besides the same, MG is also experiencing chronic
renal failure which has also changed the functioning of kidney. It can also be said that due to
family history, the risk factors for MG could also enhance. Hence, on the basis of present

situation of MG, it is clear that she had not followed any of the prescribed things properly; thus
this has increased other risks as well.
4
Using clinical Reasoning Cycle, identify three priorities nursing diagnoses
In the present case, MG is having several health problems; therefore nurses must carry
out the diagnosis procedure in effective manner. It is also useful for the purpose of improving the
health conditions of MG.
 Respiratory system
 Cardiovascular disease (Ignatavicius & Workman, 2015)
 Chronic renal system
Henceforth, these are the major priorities that are identified and nurses must focus on
these priorities so that proper care can be delivered to MG. Thus, with the use of Clinical
Reasoning Cycle, it is essential for the nurse to render appropriate care services to MG according
to the health priorities.
5
State the goal of care, specific nursing intervention and usefulness of such intervention
According to the above discussion, it is evident that MG is experiencing several health
problems; thus on such basis, nurses must focus on adopting specific nursing intervention (Lehne
& Rosenthal, 2014). While dealing with every single health issue, it is vital for the nurse to
develop a goal of care so that accordingly medication and treatment can be provided.
Nursing diagnosis for Respiratory system
Respiratory failure is one of the most common reasons for which patients are admitted to
ICU and this is also one of the factors that led MG to admit in hospital. Nursing care have a
tremendous impact in improving efficiency of patient’s respiration and ventilation and at the
same time it also increases the chance of recovery (Sidani & Braden, 2011). To detect the
changes in respiratory status, it is essential for the nurse to access the patient’s tissue
oxygenation status on regular basis. Nurses are also required to evaluate ABG results which
indices end- organ perfusion. Nurse should also keep this in mind that brain is extremely

sensitive to O2 supply and decreased O2 can lead to an altered mental status. Further, nurses
should also stay alert for condition that can impair O2 delivery such as elevated temperature,
anemia, impaired cardiac output, sepsis and acidosis.
Thus, these aspects needs to exist in the nursing intervention because that can assist MG
to improve the functioning of respiratory system. Thus, in the process of diagnoses, nurses
should include possible ineffective airway clearance and breathing pattern. In the present case,
nurses will have to include determination of baseline respiratory status which assess patient’s
ability to cough and deep breathe effectually. At the same time, nurse should monitor chest x-
ray, blood gas levels, CBC, sputum cultures and pulmonary function tests as through that
functioning of heart and kidney can be managed suitably (Lehne & Rosenthal, 2014).
Another nursing intervention includes intubation and ventilator support which also
supplements oxygen and consultation with pulmonologist. Nurses must also make use of chest
physical therapy so as to manage deep breathing. At the same time, it is also vital to use
inventive spirometer in every four hour so as to manage the process of breathing (Butcher & et.
al., 2013). Thus, concluding it can be said that such intervention are required to be followed so
that health condition of MG can be improved. This is also essential for the purpose of changing
the degree of breathe.
Nursing diagnosis for Cardiovascular disease
According to the present case, it is being analysed that MG is having cardiac arrest, deep
venous thrombosis and hypertension. The level of blood pressure is also low which leads to
blood pooling; hence this has increased the risk of vascular stasis. Thus, according to the nursing
intervention, it is vital for the nurse to include impaired gas exchange, decreased output, and
altered tissue perfusion hypovolemia (Nordén, Hult & Engström, 2014). Nurses are required to
monitor vital signs, cardiac monitoring so that to ascertain the flow of blood in the heart. The
process of nursing should also include management of heart rate which is essential in terms of
reducing problems associated with heart stroke and attack.
Thus, along with medication, MG must get assistance from physical exercises so that
along with physical fitness, she can help herself to manage her life and work both. According to
the prescribed medication, nurses must monitor that MG is continuously following it

(Hockenberry & Wilson, 2014). Since, there is salt restriction on her, hence she must consider
this fact that this can even worse health aspects. Moreover, nurse should also focus on proper
dosage of medication as MG has several health issues. Type 2 diabetes is also one of the major
causes that increases the problems related to cardiovascular diseases; hence it is essential for
nurses to consider all such aspects.
Nursing diagnosis for Chronic renal failure
The nursing goal for clients with chronic renal failure is to prevent further complication
and that is possible through supportive care. In this respect, client education is also essential as
treatment takes long time to get recovered (Ignatavicius & Workman, 2015). Thus, in this
situation, nurse is required to monitor the presence of tachycardia and heart beat so that
accordingly medicines can be provided. Thus, nurse must investigate complaints of chest pain,
radiation and other severity. Along with this, nurse should also develop a goal to maintain the
ideal body weight without excess fluid as this is useful in balancing input and output. Therefore,
MG is required to limit the intake of fluid and she should also respond positively to therapy.
CONCLUSION
Summing up the entire research study, it can be said that all such defined nursing
intervention would be helpful for MG to get recovered as early as possible. In the present case, I
have learned various things about the medication process for chronic renal failure and
cardiovascular disease which lies among major health problems of MG. Thus, I can suggest that
proper diet and medication should be followed from all domains.

REFERENCES
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