Cardiovascular Case Study

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Cardiovascular disorders: A case study
xxxxxxxxxxxxxxxxx, Pathopharmacology
October 27, 2013
Cardiovascular disorders: A case study
Cardiovascular disease (CVD), the leading cause of death in both men and women in the United States and worldwide, includes coronary artery disease, cerebrovascular disease, peripheral artery disease, rheumatic heart disease, deep vein thrombosis, congenital heart disease, and pulmonary embolism (Caboral, 2013). In the United States, heart disease affects 26.8 million Americans (Sherrod, McIntire-Sherrod, Spitzer, & Cheek, 2013), and nearly 500,000 women died, in 2008, from CVD (Wells & Kalman, 2011). Research shows that risk factors for CVD are not evaluated as frequently in women as in men (Karch, 2013), pharmacological treatment for CVD in women is less aggressive, and surgical procedures, such as cardiac catherization, are not performed as frequently in women as in men (Caboral, 2013; Sherrod et al., 2013). Healthcare providers may fail to diagnose CVD in women because signs and symptoms in women are different from those experienced by men, such as jaw and neck pain, fatigue, and insomnia (Karch, 2013). Other symptoms typical in women include shortness of breath, nausea, diaphoresis, and epigastric pain (Caboral, 2013). Furthermore, “electrocardiograms and exercise electrocardiograms are less sensitive to changes in women, making it more difficult for providers to diagnose coronary artery disease” (Caboral, 2013, p. 28). The purpose of this paper is to outline the nurse’s responsibility to understand the contributing factors to CVD, its pharmacological treatment, side effects and contraindications of treatment, and patient education for a post-menopause female patient. Case study: Mrs. K

Three days ago, Mrs. K, a 63 years old white female, was brought to the ER with complaints of left shoulder pain radiating up to her neck for 2 hours. EKG and cardiac enzymes confirmed diagnosis of acute myocardial infarction (AMI), cardiac catherization and angioplasty were performed without complications; she was later admitted to the telemetry unit. Mrs. K reported taking Hydrochlorothiazide (HCTZ) 25 mg. once a day for 10 years for diagnosis of hypertension. Assessment revealed she is slightly overweight, her job as a secretary is sedentary. Mrs. K also indicated she commutes to and from work one hour each way. Meals are mostly of convenience foods and meal times are irregular. Mrs. K’s physician informed her that laboratory results showed she has Diabetes Mellitus Type II (DM II) in addition to coronary artery disease (CAD). The physician informed her of the addition of three medications: metformin 250 mg. twice a day, atorvastatin (Lipitor) 10 mg. once a day, and enalapril (Vasotec) 10 mg. once a day. Contributing factors

Contributing risk factors to CAD include increasing age, gender, ethnicity, diet, obesity, genetic predisposition, sedentary lifestyle, smoking, stress, bacterial infections, hypertension, diabetes, and menopause (Karch, 2013). In the case study, Mrs. K is positive for the following risk factors: age, gender, menopause, diet, obesity, sedentary lifestyle, stress, hypertension, and diabetes. DM II was newly diagnosed during this admission. Mrs. K is not able to control or modify her age, gender, or post-menopause status (Karch, 2013). However, other risk factors like diet, obesity, stress, and sedentary lifestyle can be managed by modifying her diet, stress management, and promoting exercise (Karch, 2013). Along with pharmacological agents, interventions to modify Mrs. K’s diet, weight, and physical activity will be effective in the management of diabetes and hypertension (Karch, 2013; Caboral, 2013). Treatment: current and new medications, rationale, and contraindications In this case study, while inpatient, Mrs. K was diagnosed with CAD and DM II, and her physician added three new medications to her current regimen...