Tag: Clinical-Nursing

Coronary Artery Disease Interventions

Coronary artery disease –
 over time arteries build up with fatty deposits. This causes reduced blood flow to the heart. This can cause a heart attack if the arteries rupture. Then blood clots can formed and may block flow to the heart’s muscle, weakening the heart’s ability to pump.

Interventions:
 medications like ACE inhibitors, beta-blockers, NGT, calcium-channel blockers and aspirin can be used to treat CAD and prevent heart failure. Also cardiac catheters and surgery can be done to help remove the fatty deposit build up.

IV morphine sulphate (Morphine)

IV morphine sulphate (Morphine) is used to reduce preload, heart rate, and possibly afterload, the net effect of which is a reduction in myocardial oxygen demand.

Metoprolol (Lopressor)

Metoprolol (Lopressor) is a beta-blocker. Beta-blockers are used to help treat left ventricular systolic dysfunction. They are typically used with other medications to treat heart failure. They are also used to treat diastolic heart failure. They do this by slowing the heart rate and allowing more time for the heart to fill with blood to increase the ejection fraction.

Enalapril (Vasotec)

Enalapril (Vasotec) is an angiotensin-converting enzyme (ACE inhibitor). It is used to help block the angiotensin-converting enzyme, which is what is used by the body to cause the blood vessels to constrict. When you block this enzyme the blood vessels relax which cause a lower blood pressure, that increases the efficiency of the heart. This is used to help the body pump more blood out to the rest of the body.

IV furosemide (Lasix)

IV furosemide (Lasix) is a diuretic used in heart failure patients because heart failure leads to renal retention of sodium and water, which will increase the blood volume and venous pressure, and cause edema formation. Pulmonary edema (caused during left ventricular failure) can be life threatening due to pulmonary oxygen exchange being compromised. Diuretics are used to promote renal loss of sodium and water which reduces chances of vascular congestion and edema.

High cholesterol

High cholesterol
 – too much cholesterol in the blood causes build up on the walls of the arteries. Overtime blood flow gets compromised and might lead to negative consequences like heart disease, blood clots, high blood pressure etc.

Interventions: Nutrition consult (education about right food choices is crucial), follow up labs measuring LDL and LHL. Take medications as prescribed.

Obesity

Obesity puts stress on entire body including cardiac system. Heart has to work harder to pump blood. According to American College of Cardiology (AAC) left ventricular hypertrophy is very common in people who are obese (2015).

Interventions: Nutrition consult, patient needs encouragement and support to be able to implement changes of her habits. Working with patient, finding support programs for mental and physical support. In Mrs J.’s case weight loss could help with her sleep apnea as well.

High blood pressure

High blood pressure
 – according to American Heart Association (AHA) HTN is when force of the blood flowing through blood vessels is constantly too high (AHA, 2017).

Interventions
: part of a heart education would be ways to control blood pressure (measuring it every day, diet, follow up appointments with cardiologist). Smoking cessation program (support program will be needed since patient is not willing to quit)

Coronary artery disease

Coronary artery disease
 – with certain risk factors overtime blood flow in vessels becomes restricted because of plaque buildup. Compromised blood flow depletes heart of oxygen and nutrients leading to weakening of the heart muscle and congestive heart failure. Heart is not able to pump efficiently enough to meet body’s needs. Body starts to retain fluid and that is called “congestion” (Mayo Clinic, 2017).

Interventions
: getting heart educator to talk to the patient, nutrition consult. Making sure patient understands medications purpose, schedule and taking them as prescribed. Assessing patient’s home situation to make sure appropriate living conditions to be able to follow diet, medication plan and dr’s appointments.

IV morphine sulphate

IV morphine sulphate is an opiod. Usually indicator for its use is a pain. However it works for brain respiratory center, lowering breathing rate and anxiety.