Cardiac Disorders and Specific Nursing Management
This document provides detailed descriptions of cardiac disorders, including their etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, treatment modalities, and specific nursing management.
1. Hypertension
Etiology: Primary (idiopathic) and secondary causes (renal, endocrine, vascular disorders).
Clinical Manifestations: Often asymptomatic; headaches, dizziness, and visual disturbances.
Diagnosis: BP measurement (≥140/90 mmHg), ECG, echocardiogram, renal function tests.
Prognosis: Controlled hypertension prevents complications like stroke, MI, and renal failure.
Pathophysiology: Increased systemic vascular resistance elevates arterial pressure.
Treatment Modalities: Lifestyle modifications, antihypertensive medications (ACE inhibitors, beta-blockers).
Nursing Management:
Monitor BP regularly.
Educate on lifestyle changes (low-sodium diet, regular exercise).
Ensure adherence to medications.
2. Coronary Artery Disease (CAD)
Etiology: Atherosclerosis, high cholesterol, smoking, hypertension, diabetes.
Clinical Manifestations: Chest pain (angina), fatigue, shortness of breath.
Diagnosis: ECG, stress tests, coronary angiography.
Prognosis: Depends on the extent of coronary obstruction.
Pathophysiology: Plaque formation narrows coronary arteries, reducing myocardial blood flow.
Treatment Modalities: Lifestyle changes, medications (statins, nitrates, antiplatelets), angioplasty, CABG.
Nursing Management:
Monitor cardiac function.
Educate on risk factor management.
Provide emotional support.
3. Angina
Etiology: Decreased oxygen supply to the myocardium.
Clinical Manifestations: Chest pain (stable, unstable, variant).
Diagnosis: ECG, cardiac enzymes, angiography.
Prognosis: Stable angina has a better prognosis than unstable angina.
Pathophysiology: Myocardial ischemia due to coronary artery blockage.
Treatment Modalities: Nitroglycerin, beta-blockers, calcium channel blockers.
Nursing Management:
Assess pain characteristics.
Administer prescribed medications promptly.
Encourage rest during episodes.
4. Cardiomegaly
Etiology: Hypertension, valvular disease, cardiomyopathy.
Clinical Manifestations: Dyspnea, fatigue, palpitations.
Diagnosis: Chest X-ray, echocardiogram, MRI.
Prognosis: Varies based on underlying cause.
Pathophysiology: Overworked heart muscles enlarge, reducing efficiency.
Treatment Modalities: Address underlying cause, diuretics, ACE inhibitors.
Nursing Management:
Monitor for signs of heart failure.
Educate on lifestyle modifications.
5. Myocardial Infarction (MI)
Etiology: Coronary artery occlusion due to a thrombus.
Clinical Manifestations: Severe chest pain, diaphoresis, nausea, dyspnea.
Diagnosis: Elevated cardiac enzymes (Troponin), ECG changes.
Prognosis: Depends on time to reperfusion.
Pathophysiology: Ischemia leads to myocardial necrosis.
Treatment Modalities: Thrombolytics, PCI, aspirin, morphine, oxygen.
Nursing Management:
Administer oxygen and medications.
Monitor for complications like arrhythmias.
Provide psychological support.
6. Heart Failure (HF)
Etiology: CAD, hypertension, cardiomyopathy.
Clinical Manifestations: Fatigue, edema, shortness of breath.
Diagnosis: Echocardiogram, BNP levels, chest X-ray.
Prognosis: Chronic, progressive condition.
Pathophysiology: Ineffective pumping reduces cardiac output.
Treatment Modalities: Diuretics, ACE inhibitors, beta-blockers.
Nursing Management:
Monitor fluid balance.
Educate on low-sodium diet and medication adherence.
7. Pulmonary Edema
Etiology: Acute left ventricular failure.
Clinical Manifestations: Severe dyspnea, pink frothy sputum.
Diagnosis: Chest X-ray, ABGs.
Prognosis: Potentially life-threatening.
Pathophysiology: Increased pulmonary capillary pressure causes fluid leakage.
Treatment Modalities: Oxygen therapy, diuretics, morphine.
Nursing Management:
Ensure airway patency.
Administer prescribed diuretics.
Monitor respiratory status.
8. Shock
Etiology: Hypovolemic, cardiogenic, distributive.
Clinical Manifestations: Hypotension, tachycardia, altered mental status.
Diagnosis: Hemodynamic monitoring, lactate levels.
Prognosis: Depends on cause and rapidity of treatment.
Pathophysiology: Reduced perfusion leads to organ failure.
Treatment Modalities: Fluid resuscitation, vasopressors.
Nursing Management:
Monitor vital signs.
Administer fluids and medications.
Educate on early recognition of symptoms.
9. Rheumatic Heart Disease (RHD)
Etiology: Group A streptococcal infection.
Clinical Manifestations: Fever, joint pain, murmur.
Diagnosis: Echocardiogram, ASO titers.
Prognosis: Preventable with early antibiotic treatment.
Pathophysiology: Immune response damages heart valves.
Treatment Modalities: Antibiotics, anti-inflammatory drugs.
Nursing Management:
Administer antibiotics.
Monitor for valve-related complications.
10. Infective Endocarditis
Etiology: Bacterial infection.
Clinical Manifestations: Fever, Osler nodes, Janeway lesions.
Diagnosis: Blood cultures, echocardiography.
Prognosis: Dependent on early intervention.
Pathophysiology: Infection leads to vegetations on valves.
Treatment Modalities: Prolonged antibiotics.
Nursing Management:
Monitor for embolic events.
Educate on oral hygiene and prophylaxis.
11. Cardiomyopathy
Types: Dilated, restrictive, hypertrophic.
Etiology: Genetic, ischemic, idiopathic.
Clinical Manifestations: Fatigue, arrhythmias, HF symptoms.
Diagnosis: Echocardiogram, MRI.
Prognosis: Varies with type.
Pathophysiology: Structural abnormalities impair cardiac function.
Treatment Modalities: Medications, ICDs, transplant.
Nursing Management:
Monitor for arrhythmias.
Educate on lifestyle changes and symptoms to report.
12. Arrhythmias
Etiology: Ischemia, electrolyte imbalance.
Clinical Manifestations: Palpitations, dizziness, syncope.
Diagnosis: ECG, Holter monitoring.
Prognosis: Depends on type and response to treatment.
Pathophysiology: Abnormal impulse generation or conduction.
Treatment Modalities: Antiarrhythmics, pacemakers.
Nursing Management:
Monitor ECG.
Educate on pacemaker care if applicable.
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