Guideline on the Assessment of Cardiovascular Risk

Question: Discuss about the Guideline on the Assessment of Cardiovascular Risk. Answer: A thorough cardiovascular assessment for Daisy would help in the identification of significant factors that may influence cardiovascular health, such as hypertension, high blood cholesterol. A focused assessment would be beneficial after a comprehensive assessment of the patient in order to highlight any potential complication (Goff et al., 2014). The first assessment to be considered for Daisy would be an assessment of chest pain using the PQRST Mnemonic (Proactive Quality Radiation Severity Timing). This is a methodology that is very useful in the assessment of chest pain and fosters communication with other healthcare providers in an informative and efficient manner. The patient needs to be checked for symmetry and posture of the thorax, the point of maximum intensity (PMI), gross deformities of skin, the colour of the skin and abnormal contours. The patient has an irregular pulse rate at 130-150 wheres the normal 60-100 bpm. The respiratory rate of the patient is abnormal at 24 a s the normal rate is 12-18 bpm. The pulse rate and respiratory rate would be regularly checked for. The patient is to be checked for central cyanosis that leads to the blue colouration of the mouth, conjunctiva and lips. The next step would be to examine palpation. The assessment of edema will be done through venous blood gas test, creatinine and liver function test. Physical examination of edema can be done through identifying tenderness, warmth and erythema in the area of edema. Presenec and degree of pitting edema also gives information about cardiovascular status of patients. This would include examining the ankles, feet, face and trunk (Goff et al., 2013). Atrial fibrillation is an irregular heart beat that can cause blood clots, heart failure or strokes nd other complications of the heart (Mehra et al., 2016). The patient needs to be checked for her heart rate and heart rhythm. The blood pressure and pulse would be measured. The patient would be asked about feelings of fatigue and respiratory distress. In the case of atrial fibrillation, it is expected that the patient is easily fatigued, is anxious about the condition and does not tolerate activity very well. The nursing goals would be to identify proper coping strategies for managing anxiety and decreasing feelings of fatigues. A number of nursing interventions would be appropriate in this regard. The patient would be advised to take frequent rest and encouraged to express her concerns and feelings about the condition. Vital signs would be recorded on a regular basis. Input and output would be measured, and signs of embolism would be monitored. Abnormal bleeding would be checked for (Potter et al., 2016). A comprehensive respiratory assessment would be conducted for Daisy. The first examination would be of conscious state and general appearance. In patients with respiratory distress, a conscious state is altered, and patients feel anxious, distressed, exhausted and have difficulties in breathing. The rationale is that patients with respiratory distress have difficulty in speech, speak in short sentences and are unable to verbalise. Peripheral capillary oxygen saturation is found to be less at 92%. An oximeter would be used for measuring the oxygen saturation level. The respiratory rate has been found to increase at 28 bpm. Respiratory rate would therefore be assesed at a regular interval. A rapid and thorough airway breathing assessment of respiratory distress will help to determine the patients work of breathing (WOB), respiratory rate and oxygen saturation level. If the respiratory rate is higher, Daisys WOB will be higher too. Monitoring oxgygen saturation is also a vital sign to a ssess the progress of patient with respiratory distress (Tulaimat et al., 2016). The patient would also be examined for sweaty and pale skin, pulse rate and breath sounds. (Coombs et al., 2013). Pulmonary edema is the medical condition of the excess fluid in the lungs of the patient, either in the alveoli or the interstitial spaces. A robust management and treatment plan for pulmonary edema would bring better patient outcomes. The immediate objective for Daisy would be to improve the oxygenation status and bring a reduction in the pulmonary congestion. The precipitating factors would be identified. The other goals would be to increase oxygen tension, reduce fluid volume, improve the ability of the heart to pump in an effective manner and decrease anxiety level of the patient. Since pulmonary edema is a medical emergency and life-threatening condition, prompt actions would be required. Oxygen would be given in high concentrations for relieving dyspnea and hypoxia. Morphine would be administred in small intermittent doses. Intravenous injections would be given for diuretics. Vitals signs are to e checked for increased heart rate, falling blood pressure, decreased urinary outpu t. Electrolyte levels are to be checked as potassium loss is significant. If the patient fails to have the adequate response to therapy, administration of vasodilator would be required (Powell et al., 2016). References Coombs, M., Dyos, J., Waters, D., Nesbitt, I. (2013). Assessment, monitoring and interventions for the respiratory system.Critical Care Manual of Clinical Procedures and Competencies. Wiley-Blackwell, Chichester, 63-171. Goff Jr, D. C., Lloyd-Jones, D. M., Bennett, G., Coady, S., D'Agostino Sr, R. B., Gibbons, R., ... Robinson, J. G. 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