learning Objectives - Describe cardiovascular circulatory and Hematological disorders and diseases. Demonstrates skill in carrying nursing interventions for clients with circulatory and hematological disorders and diseases.
Hours - 28
Teaching and Learning Activities - Lecture cum discussion Demonstration Clinical teaching Videos, Simulation
Assessment Methods - Short answer Objective type Essay type Return demonstration
Content of the chapter
Cardio Vascular
a) Review of anatomy and physiology of heart
and circulatory system
b) Assessment of functions of heart and
vascular system
– History
– Physical exam
– Diagnostic tests
c) Diseases and disorders of cardio vascular
system
– Coronary Artery disease
– Arrhythmia
– Coronary Artery disease
• Angina pectoris
• Coronary atherosclerosis
• Myocardial infarction
– Valvular heart disease
• Mitral stenosis
• Aortic stenosis,
• Incompetence, regurgitation
• Tricuspid stenosis
• Pulmonary stenosis
– Inflammation and infections
• Pericarditis, Myocarditis, Endocarditis
• Rheumatic fever
– Heart block
– Complication of heart disease
• Acute Heart failure (Pulmonary Edema)
• Chronic (Congestive Cardiac failure)
• Cardiogenic shock
• Pericardial effusion, cardiac tamponade
– Cardiac emergencies
• Cardiac arrest
• Shock
– Vascular disorders
• Arterial disorders
• Berger’s disease (TAO),
• Arterial ulcers,
• Arteriosclerosis,
• Aneurysm,
• Thrombosis and emboli,
• Raynaud’s disease
• Hypertension
– Venous disorder
• Deep Vein Thrombosis (DVT)
• Venous insufficiency
• Venous ulcer
• Varicose vein
• Cellulitis
• Lymphatic disorders
• Lymphangitis & Lymphadenitis
• Lymphedema & elephantiasis
Hematological disorders
a) Review of function and structure of blood
components
– Assessment
– History
– Physical examination
– Diagnostic tests
b) Diseases and disorders of blood and its
components
– Anemia
– Thalassemia
– Polycythemia
– Leukopenia and neutropenia
– Leukocytosis & leukemia
– Lymphomas Hodgkin & Non Hodgkin
diseases, Multiple myeloma
– Bleeding disorders
– Thrombocytopenia,
– Purpura, hemophilia
– Acquired coagulation
– Disorders – Liver disease, Vitamin K
deficiency, DIC
c) Alternate therapies
d) Drugs used in treatment of cardiovascular
circulatory and hematology disorders
Nursing Management of Patients with Cardiovascular, Circulatory, and Hematological Disorders
Nursing care in these disorders involves assessment, monitoring, prevention of complications, patient education, rehabilitation, and pharmacological management.
CARDIOVASCULAR SYSTEM
a) Review of Anatomy and Physiology
- Heart: four chambers (atria, ventricles), valves (mitral, tricuspid, aortic, pulmonary)
- Circulatory system: arteries (oxygenated blood), veins (deoxygenated), capillaries (exchange of nutrients and waste)
- Physiology: heart acts as a pump, generating cardiac output; coronary circulation supplies heart muscles; blood pressure maintained by cardiac output and vascular resistance
b) Assessment of Cardiac Function
History:
- Chest pain, palpitations, dyspnea, fatigue, syncope, edema
- Past cardiac history, hypertension, diabetes, smoking, family history
Physical Examination:
- Vital signs, pulse, heart sounds, murmurs
- Peripheral pulses, edema, jugular vein distension
- Skin color and temperature
Diagnostic Tests:
- ECG, Echocardiography, Chest X-ray, Stress tests
- Cardiac enzymes (Troponin, CK-MB)
- Lipid profile, BNP for heart failure
c) Cardiovascular Diseases and Nursing Management
1. Coronary Artery Disease (CAD)
- Angina pectoris: chest pain due to myocardial ischemia
- Care: rest, oxygen, nitrates, monitor vitals, patient education
- Coronary atherosclerosis: plaque buildup; care: lifestyle modification, medication adherence
- Myocardial infarction: necrosis of heart muscle; care: ECG monitoring, pain management, reperfusion therapy
2. Arrhythmias
- Abnormal heart rhythms; care: ECG monitoring, antiarrhythmic medications, patient safety
3. Valvular Heart Disease
- Mitral stenosis, aortic stenosis, regurgitation, tricuspid stenosis, pulmonary stenosis
- Care: monitor for heart failure, administer diuretics, post-valve surgery care
4. Inflammatory and Infective Disorders
- Pericarditis, myocarditis, endocarditis, rheumatic fever
- Care: antibiotics, anti-inflammatories, monitor cardiac function
5. Heart Block and Complications
- Acute heart failure: pulmonary edema; care: oxygen therapy, diuretics, monitor vitals
- Chronic heart failure (CCF): fluid restriction, low-sodium diet, daily weight monitoring
- Cardiogenic shock: monitor hemodynamics, fluid resuscitation, inotropes
- Cardiac tamponade: monitor vitals, pericardiocentesis assistance
6. Cardiac Emergencies
- Cardiac arrest: CPR, defibrillation, advanced life support
- Shock: monitor perfusion, fluids, medications
7. Vascular Disorders
- Arterial disorders: arteriosclerosis, aneurysm, thrombosis, Raynaud’s disease; care: monitor circulation, prevent ulcers, medication management
- Venous disorders: DVT, varicose veins, venous ulcers; care: compression therapy, anticoagulants, mobility exercises
- Lymphatic disorders: lymphedema, lymphangitis; care: limb elevation, compression, infection prevention
HEMATOLOGICAL DISORDERS
a) Review of Blood Function and Structure
- Components: RBC (oxygen transport), WBC (immunity), platelets (clotting), plasma (nutrients, hormones)
Assessment:
- History: fatigue, bleeding tendencies, infections, pallor
- Physical exam: pallor, jaundice, petechiae, splenomegaly
- Diagnostic tests: CBC, peripheral smear, coagulation profile, bone marrow biopsy
b) Diseases and Disorders of Blood
1. Anemia
- Causes: iron deficiency, vitamin B12 deficiency, chronic disease
- Care: monitor Hb, administer supplements, diet education
2. Thalassemia
- Genetic hemoglobin disorder; care: transfusions, chelation therapy, infection prevention
3. Polycythemia
- Increased RBC count; care: phlebotomy, monitor blood viscosity, prevent thrombosis
4. WBC Disorders
- Leukopenia/neutropenia: infection prevention, monitor temperature, strict hygiene
- Leukocytosis, leukemia: chemotherapy care, monitor for infection, bleeding, nutrition
5. Lymphomas and Multiple Myeloma
- Hodgkin & Non-Hodgkin lymphoma; care: chemotherapy, infection prevention, psychosocial support
6. Bleeding Disorders
- Thrombocytopenia, purpura, hemophilia: monitor for bleeding, transfusions, patient education
- Acquired coagulation disorders: due to liver disease, vitamin K deficiency, DIC; care: monitor coagulation profile, administer vitamin K or plasma
c) Alternate Therapies
- Nutritional supplementation: iron, folic acid, vitamin B12
- Lifestyle modifications for cardiovascular risk reduction
- Exercise and rehabilitation programs
- Complementary therapies under supervision
d) Drugs Used in Treatment
- Cardiovascular drugs: ACE inhibitors, beta-blockers, nitrates, antiarrhythmics, anticoagulants, diuretics
- Hematological drugs: iron, folic acid, vitamin B12, erythropoietin, platelet transfusions, chemotherapeutic agents, anticoagulants
- Supportive therapy: analgesics, anti-inflammatories, antibiotics for infections
Conclusion
Nursing management of cardiovascular, circulatory, and hematological disorders involves:
- Comprehensive assessment (history, physical, diagnostic tests)
- Monitoring and early detection of complications
- Medication administration and education
- Lifestyle modification counseling
- Rehabilitation and psychosocial support
Proper nursing care prevents complications, improves quality of life, and promotes recovery.