NRS 410 Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion

NRS 410 Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion

NRS 410 Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion

Heart failure (HF) is a condition in which the cardiac and respiratory systems are interrelated. With HF, the heart fails to adequately distribute blood throughout the pulmonary system and systemic vasculature (Cross et al., 2020). HF is a chronic, progressive condition, and the heart cannot pump blood efficiently to help meet the body’s needs. As the heart tries to keep up with demands, it becomes enlarged and pumps faster. As the heart weakens, the blood tends to back up in the body, and fluid passes into the tissues, which leads to swelling (Gilbert, 2018). It can affect the blood pressure in the lungs, also leading to the build-up of fluid in the air sacs causing shortness of breath and fatigue. To explain, a nurse would educate the patient and family on how the heart and lungs interact—using easy-to-understand terms to explain how the heart pumping action delivers oxygen and nutrient-rich blood throughout the body. The nurse can use a model or handouts illustrating the blood flow between the heart and lungs. They can also use videos or website sources to demonstrate how a weakened heart can cause respiratory symptoms. Assessing patients for their preferred learning styles is necessary to ensure they can learn and understand the information provided.

References

Cross, T., Kim, C.-H., Johnson, B. D., & Lalande, S. (2020). The interactions between respiratory and cardiovascular systems in systolic heart failure. Journal of Applied Physiology128(1), 214–224. https://doi.org/10.1152/japplphysiol.00113.2019

Gilbert, J. (2018, February 23). How heart disease affects the respiratory system. Hometouch. https://myhometouch.com/articles/how-heart-disease-affects-the-respiratory-system

I like to explain to my patient and families in a way that they can understand. I often draw pictures for them. I would say this:

“CHF, which is also known as congestive heart failure, affects both your heart and lungs. The heart pumps the blood

NRS 410 Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion
NRS 410 Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion

and pushes it out into the organs and this blood carries oxygen. If you have a heart that does not pump out the blood effectively then the organs can not get the needed oxygen it requires to function properly. This includes your lungs, so if you are moving around and doing any activity you can be short of breath because of the lack of oxygen. This also affects the lungs because the blood can back up from the weakened heart muscles into the lungs causing congestion and this can also cause breathing difficulties.”

 

I feel that if you educate the patient and families in a way they can understand they are more likely to be compliant with suggested treatments. Health literacy is crucial to health prevention measures and educating patients results will be “improved health outcomes and reduced morbidity, and mortality” (Paterick et al., 2017).

 

Reference

Paterick, T. E., Patel, N., Tajik, A. J., & Chandrasekaran, K. (2017). Improving health outcomes through patient education and partnerships with patients. Proceedings (Baylor University. Medical Center), 30(1), 112–113. https://doi.org/10.1080/08998280.2017.11929552

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Pulmonary hypertension (PH) or pulmonary arterial hypertension (PAH) is another condition related to the heart. Affecting the lungs’ blood vessels, the constriction or wall thickening prevents blood flow and causes pressure build-up (American Heart Association [AHA], 2022). Pre-existing diseases such as congenital heart defects (CHD) can trigger secondary PAH. Atrial or ventricular septal defects cause a left-to-right- shunting of blood, causing too much blood flow through the lungs, increasing stress on the heart, and the high-pressure scars lung blood vessels (AHA, 2022). It is vital to repair congenital heart problems early, if possible, to try to reverse or prevent further damage to the vessels. Educating patients and families on CHD and PAH is vital to ensure they understand its impact on their lives. They must understand the importance of regular follow-ups with providers and taking medications as prescribed. PAH patients should avoid some activities, such as smoking, certain types of exercise, traveling to high-altitude locations, and avoiding estrogen forms of contraception and pregnancy (AHA, 2022). Preventing infections is essential; therefore, patients must be educated on the importance of vaccinations and routine dental exams. Some may need antibiotic therapy before dental procedures to prevent endocarditis. CHD is not preventable, and some patients are diagnosed as adults. Ensuring patients understand the disease and its impact on their lives, including what lifestyle changes they can make to improve their symptoms and prevent complications, is needed. Teaching gives patients the information needed to make the best health and well-being decisions, and additional resources such as websites, support groups, and community resources support continued learning.

Reference

American Heart Association. (2022). Pulmonary hypertension and chd. www.heart.org. https://www.heart.org/en/health-topics/congenital-heart-defects/the-impact-of-congenital-heart-defects/pulmonary-hypertension

In the hospital where I work, atrial fibrillation is one of the most frequently encountered cardiac arrhythmias that we diagnose and treat. Having atrial fibrillation can put a person at an increased risk of having a stroke, particularly if the condition is not treated or diagnosed in a timely manner. Because of the irregular heart rate, atrial fibrillation can also lead to heart failure. More than 5 million people in the United States are currently living with atrial fibrillation, and it is anticipated that the number of people affected will rise to 12.1 million by the year 2030 (Streur, 2019). According to Streur (2019), the risk of developing atrial fibrillation is increased by a number of comorbid conditions and lifestyle factors. These factors include hypertension, coronary artery disease, heart failure, diabetes mellitus, obesity, hyperlipidemia, sleep apnea, hyperthyroidism, moderate to heavy alcohol consumption, smoking, and excessive exposure to ultraviolet light. There are things in this list that a person can change and things that one cannot change.

“The plan of care prioritizes the management of comorbid conditions in order to shorten the duration of atrial fibrillation and prevent its recurrence. It also emphasizes the control of heart rate in order to minimize symptoms and the prevention of thromboembolism and stroke” (Little, 2022). Age, gender, genetics, and ethnicity are examples of inborn predispositions that cannot be changed. People have the ability to reduce some of the risks by deciding to stop smoking, reduce their weight, and improve their diet. People who make the conscious decision not to change aspects of their lives that they have the ability to change have options, such as medication. To assist in maintaining a healthy heart rate, your doctor may recommend taking a medication known as a beta blocker. In addition, there are medications that can treat diabetes, high cholesterol, and hypertension. Education regarding each of these medications is of the utmost importance, as is the management of the diseases that put patients at risk for atrial fibrillation or for developing this disease.

References.

Little, K. (2022). Atrial fibrillation: Recognition and management to improve quality of life: Keep patients at the center of decision making. American Nurse Today17(4), 10–16.

Streur, M. (2019). Atrial Fibrillation Symptom Perception. The Journal for Nurse Practitioners15(1), 60–64.

Most of time atrial fibrillation is a chronic condition caused by damage to the heart through varying disease processes. What I learned years ago is that atrial fibrillation can be episodic and completely reverse itself. My grandma who in her 70’s developed aspiration pneumonia after 50+ years of smoking. I was sure this was the final time we would see her alive. She was ventilated and her suction canister was filled with black fluid from years of tar filled lungs. While she lay in the hospital ICU her heart converted into atrial fibrillation and plans were made for her to take long-term anticoagulants upon discharge. However, as the days past and her infection died her a-fib rhythm converted back into sinus rhythm. The irony of this is that she soon quit smoking just in time for a lung cancer diagnosis that finally took her life a few more years later. The point of my story is that pneumonia can trigger atrial fibrillation but is one of the few triggers that a-fib can be reversed from if treated, (Nichols, 2017). I saw this firsthand.

Nichols L. (2017). Pneumonia as a trigger for atrial fibrillation. Journal of rural medicine: JRM12(2), 146–148. https://doi.org/0.2185/jrm.2937