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24.1 Cardiovascular System

The cardiovascular system is essential for maintaining continuous blood circulation and oxygen and nutrient delivery throughout the body. This intricate network of the heart, blood vessels, and blood works interdependently with other organ systems, such as the respiratory and immune systems, to sustain homeostasis. Nurses, pivotal in identifying and addressing cardiovascular issues such as hypertension and arrhythmias, must comprehend the dynamics of heart structures, assess cardiac function accurately, and intervene effectively. The myocardium’s intricate muscle pattern, particularly in the left ventricle, plays a critical role in efficient pumping of blood to ensure all tissues and cells receive adequate supplies of oxygen and nutrients. Understanding the cardiac cycle and how blood flows through various vessels is integral to understanding cardiac physiology and therefore promoting optimal cardiovascular health. Nurses must be prepared to identify and understand the ECG abnormalities that may herald a variety of cardiovascular abnormalities.

24.2 Peripheral Vascular System

The peripheral vascular system consists of arteries, veins, and capillaries. This system is responsible for the transportation of oxygen, nutrients, and waste products throughout the body, which is integral to maintaining homeostasis and overall health. Nursing professionals need a comprehensive understanding of this complex network of structures for effective assessment, diagnosis, and management of various health conditions, ranging from peripheral artery disease to venous insufficiency.

Nurses must understand the functions performed by the peripheral vascular system. This allows the nurse to effectively identify early signs of vascular dysfunction and implement interventions to resolve problems. Arteries, responsible for transporting oxygenated blood away from the heart, exhibit elasticity and respond to signals for dilation or constriction, affecting blood pressure regulation. Arterioles branch from arteries and respond to the sympathetic nervous system and hormones. Veins have thinner walls and rely on muscle contraction to return deoxygenated blood to the heart.

Abnormalities in the PVS can be occlusive or functional in nature. Characteristics of arterial and venous insufficiency result in insufficient blood supply, leading to symptoms such as intermittent claudication and critical limb ischemia. Other symptoms of PVD include edema, pain and cramping, temperature changes, and skin changes. Understanding these aspects is crucial for accurate diagnosis and effective nursing care in individuals with peripheral vascular disorders.

24.3 Nursing Assessment

Assessing the cardiovascular and peripheral vascular systems for potential CVD, heart disease, and stroke is a critical component of the nursing evaluation. Nurses should collect both subjective data (from the patient) and objective findings (from the examination) to create a thorough, well-planned nursing care plan. Subjective data include the patient’s medical and surgical history, social history, cardiac risk factors, symptoms, medications and other therapies, and family history to determine the potential causes and effects of CVD. Objective findings include the results of the physical examination, laboratory tests, and imaging studies. Nurses should ask clear and inquiry-based questions to clarify the patient’s condition and identify any signs of dysfunction. Nurses should also follow the PQRSTU model to assess chest pain.

The various modifiable and nonmodifiable risk factors for CVD (e.g., smoking, blood pressure, cholesterol, obesity, diabetes, age, gender, genetics) should be identified and modifiable risks addressed. Validated risk assessment tools (e.g., BE-FAST, RACE, CPSS, LAMS, MEND) help nurses estimate the likelihood of stroke or heart attack and guide the treatment options. One or more of these risk assessment tools should be performed in patients who are exhibiting signs and symptoms of heart disease, stroke, and peripheral vascular disease and who have a family history of cardiovascular or peripheral vascular dysfunction.

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