Nursing considerations for CVD

Question 1

Prevention

Answer 1

PRIMARY: regular checkups for PREVENTING the onset of a disease, especially among those at high risk

SECONDARY: strengthens the abilities to avoid complications and prevent the disease from getting worse

TERTIARY: maximize capabilities via REHABILITATIVE & RESTORATIVE efforts so that the disease won’t create additional problems

Question 2

Keep the pt informed

Answer 2

due to sensory deficits, anxiety, poor memory or illness, an older pt may not fully comprehend or remember the explanations given for diagnostics & treatment measures

full explanations with reinforcement such as pictures would be helpful

keep in mind that even simple procedures such as taking vitals can be alarming to the pt & family`

Question 3

Prevent complications

Answer 3

edema associated with any type of CVD can promote skin breakdown

frequent position changes

avoid dangling the arms & legs off to the side

protection, padding, & massage of pressure points are beneficial

for edema, excessive activity should be avoided as it increases circulation of the fluid, with the toxic wastes it contains

weight & circumferences of the extremities & abdomen should be monitored to help detect changes with the edematous state

encourage fluid intake to prevent dehydration & facilitate diuresis

monitor I&O: assess urine using COCA

IV fluids should be monitored as an excessive fluid infusion can cause hypervolemia, which can increase the risk of CHF

IV glucose can stimulate an increase in insulin production, resulting in hypoglycemia if it’s abruptly discontinued without an adequate substitute

Monitor vitals: IT’S IMPORTANT TO KNOW THE BASELINE VITALS

Anorexia can accompany CVD. Several smaller meals throughout the day can compensate for poor appetite & reduce the work of the heart

The presentation of the food can make a big difference

Low-sodium, low-cholesterol & low-calorie diets

try to incorporate ethnic food as well. Negotiate with the pt as to how to moderate the sodium, cholesterol and calories in the ethnic foods

classify foods as “never be eaten”, “eaten occasionally” , or “eaten as desired”

Constipation, enemas & removal of fecal impaction can cause vagal stimulation, which can be dangerous for pts with CVD

If pt is on bed rest, ROM exercises should be done because the contractions compress the peripheral arteries, which would facilitate venous return

Footboards help prevent footdrop contractures

hepatic congestion can slow drug metabolism and along with the age-related change of slower rate of detoxification, adverse reactions to drugs such as digitalis can occur, which can present with
-change in mental stats
-nausea
-vomiting
-arrhythmias
-bradycardia
these can be prevented through proper diet & possible use of potassium supplements

Question 4

Promoting circulation

Answer 4

• ensure tht the BP is maintained within normal range
• prevent & eliminate sources of pressure on the body
• assist pts to change positions frequently
• prevent pooling of blood in the extremities
• encourage physical activity
• prevent hypothermia & maintain body warmth
• massage the body unless contraindicated (eg: DVT & pressure ulcer)
• monitor drugs for side effects of hypotension
• educate
• regularly assess physical & mental health for S&S of altered tissue perfusion
• ask the pt not to cross their legs
• weight control as obesity can interfere with venous return
• discourage smoking as it can cause arterial spasms

Question 5

Providing foot care (PVD/DVT)

Answer 5

any foot lesion