TYPES

ASSESSMENT S/Sx
Subj: -Chest Pain -SOB -Dyspnea Obj: -Increased RR -Tachycardia -Palpitations -Diaphoresis

CARDIOVASCULAR DISEASE HEALTH HISTORY RISK FACTOR CONTRIBUTORY ASSOCIATED MODIF NON MODIF
-Smoking -Hypertension -DM -Obesity -Lack of exercise -Stress -High fat diet -Elevated serum cholesterol level -Alcohol consumption Age Sex (Male) Race (Black) Family history -MI -Atherosclerosis -Angina

PRESENTING PROBLEM SPECIFIC NON SPECIFIC -Hypercholesterolemia

(specifically,serum LDL concentrations) -Smoking -Hypertension (high systolic pressure seems to be most significant in this regard) -Hyperglycemia (due to DM) -Type A Behavioral Patterns, twice as likely to exhibit CAD as any other personality type. -Hemostatic factors: High levels of fibrinogen and coagulation factor VII are associated with an increased risk of CAD. Factor VII levels are higher in individuals with a high intake of dietary fat. Decreased fibrinolytic activity has been reported in patients with coronary atherosclerosis. -Genetics -High levels of Lipoprotein a compound formed when LDL cholesterol combines with a substance known as Apoliprotein -Lack of exercise -Alcohol -Stress -Diet low in -Antioxidants -Obesity -Men over 60 -Women over 65 -Low Hemoglobin

NURSING DX.

Coronary Artery Disease (aka Coronary heart disease, Ischemic heart disease, Atherosclerotic heart disease)

- Pain -Activity Intolerance -Anxiety -Risk for Dec. Card. Output -Ineffective Tissue Perfusion -Risk for Excess Fluid Volume -Knowledge Deficit

Cardiomyopathy

Subj: -Fatigue -Weakness -Dyspnea -Orthopnea Obj: -Jugular Vein Distention -Edema -Rales -Hepatomegaly

-Lifestyle

-Age -Gender -Race/ Culture -Family Hx

-CHF -Arrhythmias

-Decreased cardiac output -Activity intolerance -Ineffective role performance -Pain

Hypertensive Heart Disease

Subj: Fatigue Nausea Shortness of breath Difficulty sleeping flat in bed (orthopnea) Bloating and abdominal pain Obj: Irregular pulse or palpitations Swelling of feet and ankles Weight gain Greater need to urinate at night Altered mentation (in severe cases) An enlarged heart (cardiomegaly)

-Lifestyle (Alcohol, Smoking, Obesity) -Stress -Socio Economic Status

-Age -Gender -Race/ Culture -Family Hx

-Hormonal Changes

-Contraceptive -Menopause

-Acute Pain, headache -Risk for Dec. Card. Output -Activity Intolerance -Nutrition More than Body Req., Imbalanced -Ineffective Coping -Knowledge Deficit

Heart Failure

Easy fatigability, weakness, restlessness (earliest sign of tissue hypoxia), mental confusion, renal retention of Na and H20. Left Sided: -Pulmonary Congestion Dyspnea (exertional, orthopnea, paroxysmal nocturnal dyspnea) -Cardiac murmurs, -Cough -Pulmonary crackles. Right Sided: -Edema (peripheral dependent) -Jugular vein distension -Ascites -Hepatomegaly -Weight gain -Increase CVP -Jaundice Biventricular: -Pleura

-Smoking -Hypertension -DM -Obesity -Lack of exercise -Stress -High fat diet -Alcohol consumption

Age Sex Race Family history

-Decreased cardiac output -Excess fluid volume -Impaired gas exchange -Activity intolerance -Risk for impaired skin integrity -Deficient knowledge

Cor pulmonale

Subj: -Shortness of breath which occurs on exertion but when severe can occur at rest. Obj: -Wheezing -Chronic wet cough -Swelling of the abdomen

-Lifestyle -Diet

-Age -Sex(Male) -Heredity

with fluid (ascites) -Swelling of the ankles and feet (pedal edema) -Enlargement or prominent neck and facial veins -Raised Jugular Venous Pressure (JVP) -Enlargement of the liver -Bluish discoloration of the skin (cyanosis) -Presence of abnormal heart sounds possible bi-phasic atrial response shown on an EKG due to hypertrophy Cardiac Dysrhythmias Subj: - Anxiety - Weakness, dizziness, and light-headedness - Shortness of breath -Chest pain Obj: -Palpitations -Irregular heartbeat -Feeling pauses between heartbeats -Fainting or nearly fainting -Sweating Inflammatory Heart Disease -Endocarditis - CAD, other heart problems & previous heart surgery - High blood pressure. - Congenital heart disease. - Thyroid problems. - Drugs and supplements. - Diabetes. - Electrolyte imb. -Alcohol -Caffeine -Age -Gender -Heredity -Race -HPN -Atherosclerosis -MI -Sinus Node Dysrhythmias -Atrial Dysrhythmias -Junctional Dysrhythmias -Ventricular Dysrhythmias -AV Blocks -Risk for decreased cardiac output -Deficient knowledge -Risk for poisoning(digitalis toxicity)

-Flu-like symptoms, such as fever, chills, fatigue -aching muscles and joints, night sweats, and headaches. -Shortness of breath or a cough -Heart murmur. -Overall paleness. -Small, painful, red or purplish bumps under the skin on the fingers or toes. -Small, dark, painless flat spots on the palms of the hands or the soles of the feet. -Tiny spots under the fingernails, on the whites of the eyes, on the roof of the mouth and inside of the cheeks, or on the chest. These spots are from broken blood vessels. -Nausea (feeling sick to your stomach), vomiting

-Infection

-Age -Gender -Heredity -Race

-Viral Infection -Bacterial Infection

-Risk for decreased cardiac output -Anxiety -Acute pain -Activity intolerance -Ineffective tissue perfusion

-Blood in the urine. -Swelling in the feet, legs, or abdomen. -Myocarditis -Shortness of breath at night while lying down -Light-headedness -Chest pain or pressure, which may spread to neck and shoulders -Fatigue -Fever, muscle aches, sore throat, headache, or diarrhea -Painful joints, Swollen joints, legs, or neck veins -Small amounts of urine Palpitations SOB Chest Pain -Infection -Age -Gender -Heredity -Race -Viral Infection -Bacterial Infection -Activity intolerance -Decreased cardiac output -Deficient knowledge

-Cardiomegaly

-Lifestyle

-Age -Gender -Heredity -Race

-Diseases of the heart muscle or heart valves -High blood pressure -Arrhythmias -Pulmonary hpn -Rheumatic fever -HF -Aortic-Mitral Valve disorders -Pulmonary & tricuspid valve disorders -Tetralogy of Fallot

Valvular Heart Disease

Subj: -Fatigue -SOB -Chest Pain Obj: -Heart Murmur -Swelling of ankles, feet legs, abdomen, & veins of the neck. Subj: -Headache -Dizziness -Tinnitus -Visual and speech disturbances -Paresis to plegia -anorexia -N/V -dysphagia Obj: -increased ICP -cheyne-stokes resp. -neurological deficits -+kernigs & brudzinki

-Lifestyle -Infections and untreated strep throat, which can lead to rheumatic fever.

-Age -Gender -Heredity -Race

Cerebrovascular Disease (Stroke)

-HPN -DM -Atherosclerosis -Valvular heart disease -Lifestyle( Type A personality, smoking, hyperlipidemia, oral contraceptives)

-Age -Gender -Heredity -Race

-Transient ischemic attack -Stroke evolution -Complete stroke

Peripheral Arterial Disease

Subj: -Intermittent claudication-leg pain upon walking.

-Lifestyle

-Male -Age (30) -Female -Age (40)

-Atherosclerosis

-Thromboangitis obliterans -Raynauds disease -TIA

-Ineffective cerebral tissue perfusion -Impaired physical mobility -Impaired verbal and or written communication -Self-care deficit -Impaired swallowing -Risk for unilateral neglect -Impaired home maintenance -Complicated grieving -Situational lowesteem/ disturbed body image/ ineffective role performance -Ineffective tissue perfusion -Impaired walking or activity intolerance

Obj: -Cold sensitivity and skin color changes (pallor, bluish cyanosis) -Decrease peripheral pulse -Ulceration -Gangrene formation Congenital Heart Disease Subj: -High pitch voice Obj: -SOB -Cyanosis -Syncope -Heart Murmur -Under-developed limbs and muscles -Poor feeding & Growth -Resp. Infection -Lifestyle (Alcohol, Smoking, Drugs especially when youre pregnant) -DM -Rubella vaccine -Age -Gender -Heredity -Race

-Heart Attack -Stroke -Buergers disease

-Impaired skin/ tissue integrity

A cyanotic Diseases: -Patent Ductus Arteriosus -Atrial Septal Defect -Ventricular Septal Defect Coarctation of the Aorta -Pulmonic Valve Stenosis -Aortic Valve Stenosis Cyanotic Diseases: -Tetralogy of Fallot -Tricuspid Atresia -Total Anomalous Venous Return -Truncus arteriosus -Cardiovascular Defects -Cardiac surgery -CHF -Rheumatic Fever -Kawasaki Disease

-Ineffective tissue perfusion -Activity intolerance -Decreased cardiac output

Rheumatic Heart Disease

Subj: -Chest pain -Fatigue Obj: -Rapid breathing

-Smoking -Lifestyle -Sore throat (cause by untreated Group A streptococcus bacterial infection) -Uncompliance to medication

-Age(5-15) -Genetic(father w/ RHD) -Sex (Male)

-Ineffective tissue perfusion -Activity intolerance -Decreased cardiac output -Ineffective airway clearance

Objectives: To identify the Cardiovascular Diseases, Assessment, Health History and Presenting Problem. To identify the possible Nursing Diagnosis.