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CARDIOVASCULAR AND HEMATOLOGIC DISORDER
Diagnosis ; Atherosclerosis.
Pathophysiology
* Due to high blood pressure,high cholesterol level and smoking result in damages
occur in the endothelium lining of wall of artery.
* Accumulation of fat,cholesterol in this walls (plaque formation) of artery leads to
hardening of artery,clot formation and obstruct the blood flow.
* If the blood flow through the coronary arteries obstruct due to plaque formation which
result in myocardial infarction and other heart problems.
Heath promotion and disease prevention
* Avoid use of saturated fats and food containing high level of LDH cholesterol.
(eg; red meat,buter,ice cream,fried chicken,shell fish etc.)
* Quit smoking.
* Regular exercises and balanced diet.
* Take regular treatment if the patient is diabetic or hypertensive.
ASSESSMENT
Risk factors
* Obesity.
* Hypertension.
* Diabetic melitus.
* Old age.
* Chronic smoker.
* Sedentary life style.
Expected findings.
* Chest pain or angina.
* Confusion.
* Hypertension.
* High LDL level.
* Mini strokes if plaque rupture and clots enter into circulation in the brain.
* Pheripheral artery diseases.
* Aneurysms.
* Heart attack.
* Pulmoary embolism.
Lab tests
* Serum cholesterol level.
* Blood sugar level.
* Blood protein level.
Diagnostic procedures.
* Angiogram (Arteriogram)
* Chest x ray.
* Echocardiogram.
* CT scan.
* Exercise stress test.
* Electrocardiogram.
* Doppler ultrasound.
PATIENT CENTERED CARE
* Nursing care.
* Prepare a balanced diet plan for the patient to reduce bad cholesterol (LDL)level.
* Management of symptoms like pain,weakness through medicines and fluids as
per physicians order.
* Provide relaxation therapy to reduce stress level of patient.
* Educate patient about importance of avoiding smoking habit to control and prevent
the disease.
* Therapeutic procedures
* Pharmacological therapy.(Antiplatelets to prevent clot formation.)
* Angioplasty.(surgical repair of blood vessel)
* Stent placement.(placing stents in the artery to remove obstruction and avoid
plaque formation).
* Medications
* Antiplatelets.( To prevent clot formation).
* Statins.(To reduce high LDL level)
*Atovastatin,pravastatin,lovastatin etc.
* Beta blockers. ( Reduce heart rate and blood pressure.)
* Metaprolol,atenolol etc.
* ACE inhibitors. (control progression of atherosclerosis by lowering blood pressure.)
* Enalapril,captopril etc.
* Calcium channel blockers. (Reduce blood pressure)
* Amlodipine,diltiazem etc.
* Diuretics (Reduce boold pressure.)
* Furosemide
* Client education
* Educate about avoiding bad habits like smoking and overuse of alcohol.
* Teach to do regular exercises which increase HDL (Good cholesterol) level.
* Educate to follow a balanced diet and avoid use of spicy foods.
* Use medicines to control hypertension,diabetic melitus to reduce the risk
of progression of atherosclerosis.
* Interprofessional care
* Help the patient to maintain normal nutritional pattern.
* Assist in medication administration and surgical procedure.
* Report any complications like stroke,myocardial infarction occur during
the period of treatment to physician immediately.
* Promote patient to do physical activities.
* Educate to practice good life style and avoid bad habits.
* Safety considerations
* Restrict intake of foods which contain saturated fats.
* Check the patient for risk of bleeding after stent placement or surgical repair.
* Complications
* Coronary artery disease.
* Myocardial infarction.
* Stroke.
* Heart failure.
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