macro-vascular complications (coronary artery diseases ( medical…
coronary artery diseases
Coronary artery disease: Impedance or blockage of one or more arteries that supply blood to the heart, usually due to atherosclerosis (hardening of the arteries).
pain, discomfort, pressure, tightness, numbness, or burning sensation in your chest, arms, shoulders, back, upper abdomen, or jaw.
weakness or fatigue.
nausea or vomiting.
indigestion or heartburn.
High blood pressure
Diabetes or insulin resistance
assessment and common findings
A blood pressure check.
An examination for fatty deposits (xanthomas) under the skin.
A general assessment of blood circulation
A funduscopic exam of the back of the eye (retina).
Listening to the heart with a stethoscope for heart murmurs.
A check for swelling in the feet and legs (a sign of heart failure)
Changes in how the blood sounds as it flows through a narrowed artery can be heard when listening to the arteries in the neck.
Coronary artery disease is usually caused by a build up cholesterol rich deposits or plaques on the lining inside the artery. These plaques are also called atheromatous plaques or simply atheromas and they cause a thickening of the arterial wall and a narrowing of the arterial space through which blood flows to reach the heart.
Body mass index goal of 18.5 to 24.9 kg per m2
Moderate-intensity activity for 30 to 60 minutes seven days a week
Alcohol consumption in moderation
Two to three servings a day each of fruit and vegetables
Saturated fat less than 10 percent of daily calories
asses the patient risk of CAD
monitor vital signs
obtain and asses ECG
management of blood glucose by daily sugar monitoring
optimum management of cholestrol
encourage regular excercises
calcium channel blockers
impromine for analgesia
nursing care plans
Monitor heart rate and rhythm
Elevate head of bed if patient is short of breath.
Assess and document patient response to medication.
Monitor vital signs every 5 min during initial anginal attack.
Instruct patient to notify nurse immediately when chest pain occurs.
Discuss pathophysiology of condition.
Review significance of cholesterol levels
Encourage avoidance of situations that may precipitate angina
Encourage patient to follow prescribed reconditioning program.
Damage to the brain caused by disease of the arteries supplying it with blood, especially athesclerosis
hypertension, or blood pressure of 140/90 mm Hg or above
poor diet, and lack of exercise
high blood cholesterol of 240 milligrams per deciliter (mg/dL) or over
a severe and sudden headache
paralysis of one side (hemiplegia)
weakness on one side (hemiparesis)
difficulty communicating, including slurred speech
loss of half of vision
loss of balance
loss of consciousness
Assessments and common functions
patient's medical history
A cerebral angiography, vertebral angiogram can be used.
A CAT scan can help diagnose and detect hemorrhagic strokes
An MRI scan can detect strokes, including in the early stages.
An electrocardiogram (EKG or ECG) can detect cardiac arrhythmia
results from sudden interruption of blood supply to the brain, which precipitates neurologic dysfunction lasting longer than 24 hours. Stroke are either ischemic, caused by partial or complete occlusions of a cerebral blood vessel by cerebral thrombosis or embolism or hemorrhage
Blood pressure control
Nursing care plan
Position to prevent contractures
Apply a splint at night to prevent ﬂexion of affected extremity.
Prevent adduction of the affected shoulder with a pillow placed in the axilla
Elevate affected arm to prevent edema and ﬁbrosis.
Change position every 2 hours
Avoidance of shoulder pain.
Never lift patient by the ﬂaccid shoulder or pull on the affected arm or shoulder.
Use proper patient movement and positioning
Range of motion exercises are beneﬁcial, but avoid over strenuous arm movements.
Elevate arm and hand to prevent dependent edema of the hand; administer analgesic agents as indicated.
Achievement of self-care.
Encourage personal hygiene activities as soon as the patient can sit up
Help patient to set realistic goals; add a new task daily.
As a ﬁrst step, encourage patient to carry out all self-care activities on the unaffected side.
Make sure patient does not neglect affected side; provide assistive devices as indicated.
Improve morale by making sure patient is fully dressed during ambulatory activities.
Assist with dressing activities
Relief of sensory and perceptual deprivation.
Approach patient with a decreased ﬁeld of vision on the side where visual perception is intact
Teach patient to turn and look in the direction of the defective visual ﬁeld to compensate for the loss
Increase natural or artiﬁcial lighting in the room
Remind patient with hemianopsia of the other side of the body
quitting tobacco use, or reducing the amount smoked, or not starting the habit;
making healthy food choices;
● being physically active
lowering blood cholesterol
patient is encouraged to limit alcohol intake
a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140 or a diastolic pressure above 90. Chronic hypertension is a "silent" condition.
Obstructive sleep apnea
Adrenal gland tumors
Certain defects you're born with (congenital) in blood vessels
Certain medications, such as birth control pills, cold remedie
Illegal drugs, such as cocaine and amphetamines
Assessment and common findinds
Assess the patient’s health history
Perform physical examination as appropriate.
The retinas are examined to assess possible organ damage.
Laboratory tests are also taken to check target organ damage.
Urinalysis is performed to check the concentration of sodium in the urine though the specific gravity.
Renin level. Renin level should be assessed to determine how RAAS is coping.
Hypertension is a multifactorial
When there is excess sodium intake, renal sodium retention occurs, which increases fluid volume resulting in increased preload and increase in contractility.
The medications used for treating hypertension decrease peripheral resistance, blood volume, or the strength and rate of myocardial contraction.
For uncomplicated hypertension, the initial medications recommended are diuretics and beta blockers.
Only low doses are given, but if blood pressure still exceeds 140/90 mmHg, the dose is increased gradually.
Thiazide diuretics decrease blood volume, renal blood flow, and cardiac output.
Encourage the patient to consult a dietitian to help develop a plan for improving nutrient intake or for weight loss.
Encourage restriction of sodium and fat
Emphasize increase intake of fruits and vegetables.
Implement regular physical activity.
Advise patient to limit alcohol consumption and avoidance of tobacco.
Assist the patient to develop and adhere to an appropriate exercise regimen.
Assist the patient in setting goal blood pressures.
Provide assistance with social support.
Encourage the involvement of family members in the education program to support the patient’s efforts to control hypertension.
Provide written information about expected effects and side effects.
Encourage and teach patients to measure their blood pressures at home.
Emphasize strict compliance of follow-up check up.