Assessment of the Clients with Cardiovascular Disorders Nursing History (Non-Modifiable Risk & Modifiable Risk) Physical Examination

on Common Clinical Manifestations Diagnostic Tests Non-Modifiable Risk Factors Age (above 40 years) Gender - Males more prone before age 65 - Females have higher propensity after age 65. This is due to decreased estrogen levels in menopause. HDL (high density lipoprotein/ good cholesterol) decreases, LDL (low density lipoprotein/ bad cholesterol) increases. Race among the 10 leading causes of death worldwide. US = rank 1 causes of morbidity Heredity Modifiable Risk Factors Stress sympathetic response stimulation causes increased secretion of norepinephrine. This results to vasoconstriction and tachycardia increased BP and increased cardiac workload occur. Diet increased dietary intake of foods high in sodium, fats and cholesterol predisposes a person to cardiovascular disorders. Sodium retains water and increases blood volume. High fats and high cholesterol diet predisposes a person to atherosclerosis. Exercise Regular pattern of exercise improves circulation to different body parts including the heart and blood vessels; maintains vascular tone; and enhances releases of chemical activators which prevents platelet aggregation and prevent blood clotting. Sedentary lifestyle increases the risk. Cigarette Smoking Nicotine causes vasoconstriction and spasm of the arteries; increases myocardial oxygen demands; and adhesion of platelets. In addition, it has been associated with decreased levels of HDLs. In smoking, more carbon dioxide is inhaled than oxygen. Alcohol causes vasoconstriction. Thirty ml of alcohol is stimulant and causes vasodilatation. More than 30 ml causes vasoconstriction and elevation of BP. Hypertension Increased systemic vascular resistance, endothelial damage, increased platelet adherence, and increased permeability of endothelial lining, results from elevated BP. Hyperlipidemia Hypercholesterolemia, increased LDL, cholesterol damages endothelium and causes accumulation of fatty plaques on endothelial lining and proliferation of smooth muscle cells.

 Diabetes Mellitus due to lipolysis (mobilizes fats) not all of the fats mobilized are converted into glucose, most remains as lipids. Hyperlipidemia results which enhances the risk of atherosclerosis. Obesity increase cardiac workload Personality type or behavioral factors The type A behavior pattern, characterized by competitiveness, impatience, aggressiveness and time urgency has been correlated to coronary artery disease (CAD), although the mechanism is unknown. Contraceptive Pills May precipitate thromboembolism and hypertension. The estrogen component of oral contraceptive pills increases blood viscosity, thereby increasing the risk to thromboembolism. It also stimulates the liver to synthesize angiotensinogen triggers production of pulmonary converting enzymes. This in turn causes conversion of angiotensinogen to Angiotensin I, a vasoconstrictor.