Caring for Patients with Cardiac Problems
Cardiac problems are conditions involving the narrowing or blockage of blood vessels thus resulting in heart attack, chest pain, or in worst cases stroke. Cardiac problems also entail conditions that affect the heart’s muscle, rhythm, or valves.
The pathophysiology of cardiac problems is majorly linked to atherosclerosis. Atherosclerosis is a condition that usually develops due to the build-up of plaque substance on the artery walls. The build-up primarily narrows the arteries thus making the flow of blood hard. This disorder in physiological processes in the arteries may lead to cardiac problems such as coronary artery disease, congestive heart failure, and heart arrhythmias.
Signs and Symptoms
Signs and symptoms of cardiac problems might be similar although they require different treatments. The most common symptom of coronary artery disease (CAD) is angina (Wild, Grubb, Hartz, Van Nort, Bachman, & Bartholomew, 1990). Angina is associated with discomfort, aching, pressure, chest painful feeling, burning, and heaviness. Other symptoms of CAD include shortness of breath, faster heartbeat, palpitations, sweating, nausea, and weakness or dizziness in an individual. Congestive heart failure is the failure of the heart to pump blood and in sufficient quantities required to meet an individual’s body’s needs. It is caused by CAD, thyroid disease, high blood pressure, and heart muscle disease (cardiomyopathy). Its signs and symptoms include discomfort, pain in the chest, pressure, rapid heartbeats, extreme weakness, sweating, vomiting, nausea and shortness in breath. It also includes discomfort radiating to the back jaw, and throat. Heart arrhythmias is associated with irregular heart beating patterns. It often develops from other heart failures and it may develop on its own. Its signs and symptoms are palpitations, shortness of breath, an individual experiencing weakness or fatigue, faintness, dizziness, pounding in the chest, and chest discomfort.
Treatment of cardiac problems or CAD involves lifestyle changes, use of drugs, and the application of certain medical procedures. To promote the health arteries through healthy lifestyle changes, an individual with CAD must quit smoking, reduce stress, exercise regularly, and lose excess weight. Drugs such as cholesterol-modifying medications, and aspirin are also used to treat CAD. Cholesterol-modifying medications help to decrease the amount of plaque that builds on coronary arteries (Hiatt, 2001). Aspirin helps to reduce the tendency of the blood clot, as such, preventing obstruction in the coronary arteries. Medical procedures such as angioplasty and stent placement and coronary artery bypass surgery also play a major role in restoring and improving blood flow in the coronary arteries.
Treatment of congestive heart failure involves medications and certain medical procedures. (Swedberg, Kjekshus, & Consensus Trial Study Group, 1988). Heart failure is treated with various drugs such as angiotensin-converting enzyme (ACE) inhibitors, and aldosterone antagonists depending on an individual’s symptoms. ACE inhibitors primarily widen blood vessels, as such, it lowers blood pressure and increases blood flow. Aldosterone antagonist drugs help majorly helps people with severe heart failure to live longer. Medical procedures such as coronary bypass surgery and heart valve repair and replacement are significant in the treatment of heart failure. The treatment of heart arrhythmias involves medication and medical procedures. The condition is treated with various drugs such as anticoagulants that prevent blood clotting or coagulation. Beta-blockers are also used to decrease heart rate and cardiac output. As such, the effects of adrenalin are blocked, and thus, blood pressure is lowered (Keefe, Kates, & Harrison, 1981).
Cardiac problems or heart diseases contribute to the high mortality rate in the U.S. and around the world. Patients with cardiac problems are often at a high risk of hospitalization. Thus, nurses play a crucial in managing their situation. Nurses often undertake a physical examination, history taking, and detect early sign and symptoms of an individual’s suspected or known heart disease (Franklin & Mathew, 1994). Nurses often initiate care plans for effective intervention to prevent the need for an emergency of worsening symptoms of certain heart disease.
Nursing Diagnosis and Care Plans
To diagnose cardiac problems, a nurse can acquire a patient’s clinical history, undertake a physical examination, and perform diagnostic tests. Acquiring a patient’s clinical history and interviewing the patient provides important information for determining a diagnosis for the patient’s condition. It also strengthens the nurse-patient relationship. A patient’s clinical history often include current medications, past medical history, social and family history, and current condition. Effective communication and active listening skills should be integrated into the process of acquiring a patient’s clinical history, majorly based on his or her needs, preferences, and values. Clinicians are required to only ask detailed questions at an appropriate time and create a safe environment for the patients to share sensitive information about their condition. Undertaking physical observation involves a clinician observing a patient’s level of distress, and signs and symptoms. With careful physical examination, the clinician can refine the next steps in the diagnosis process, as well, build up trust with the patient by preventing unnecessary diagnostic testing. Diagnostic testing revolves around information gathering, integration, and interpretation (Kelley, Docherty, & Brandon, 2013). With the information, diagnostic testing can identify a condition even in the absence of symptoms to enable the early management of the condition before it worsens.
Cardiac problems contribute to the high mortality rate in the U.S. and around the world. People should be effectively educated about cardiac problems, including their signs and symptoms to enable for their effective treatment and management. Clinicians should be well educated on how to manage the cardiac or heart problems. Also, health facilities should be well equipped to aid in the treatment and management of the heart problems.
Franklin, C., & Mathew, J. (1994). Developing Strategies to Prevent In-Hospital Cardiac Arrest: Analyzing Responses of Physicians and Nurses in The Hours Before the Event. Critical care medicine, 22(2), 244-247. Retrieved from https://europepmc.org/abstract/med/8306682
Hiatt, W. R. (2001). Medical treatment of peripheral arterial disease and claudication. New England Journal of Medicine, 344(21), 1608-1621. Retrieved from http://w3.csmu.edu.tw/~chr/PDF/2001%20PAOD%20NEJM.pdf
Keefe, D. L., Kates, R. E., & Harrison, D. C. (1981). New antiarrhythmic drugs: their place in therapy. Drugs, 22(5), 363-400. Retrieved from https://link.springer.com/article/10.2165/00003495-198122050-00002
Kelley, T., Docherty, S., & Brandon, D. (2013). Information needed to support knowing the patient. ANS. Advances in nursing science, 36(4), 351. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000752/
Swedberg, K., Kjekshus, J., & Consensus Trial Study Group. (1988). Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). The American journal of cardiology, 62(2), 60A-66A. Retrieved from https://www.sciencedirect.com/science/article/pii/S0002914988800870
Wild, R. A., Grubb, B., Hartz, A., Van Nort, J. J., Bachman, W., & Bartholomew, M. (1990). Clinical signs of androgen excess as risk factors for coronary artery disease. Fertility and sterility, 54(2), 255-259. Retrieved from https://www.fertstert.org/article/S0015-0282(16)53699-1/pdf