There are a number of different special considerations that need to be made when assessing the heart and vascular system of a patient. The first one is the age of the patient. In this case, the patient is 85 years old, which puts him at a higher rate of heart and vascular problems (Davis, 2004). The second is whether there are any lifestyle factors that present themselves in the patient, including whether the patient is a smoker, or are over- or underweight (Topol & Califf, 2007).
The patient has orthostatic hypotension, as highlighted by the fact that his blood pressure changes dramatically between lying, sitting, and standing. He becomes dizzy and light-headed when moving from a sitting to a standing positon. As such, it is likely that he has some form of heart valve issue, although it is not clear whether it is triscuspid, pulmonary, mitral, or aeortic from the brief case study.
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Overall, taking histories and providing a full physical assessment of the heart and vascular system is fairly simple. There are a number of steps to follow, such as taking the pulse, blood pressure, and measuring the rate of breathing, and each of these can be easily noted on the history and compared with past results to get an overview of patient health (Topol & Califf, 2007). Despite this, it can be challenging to understand which heart or valve disease might be affecting the patient, as there are a number of different iterations of each disease and each requires blood work or further tests to ascertain the true result (Topol & Califf, 2007).
I overcame this challenge by becoming more familiar with the physiology of the heart and its valves and understanding the various sounds that can be heard through the stethoscope, as well as understanding how further tests can help nurses to reach a conclusion
- Davis, L. (2004). Cardiovascular Nursing Secrets. New ork: Elsevier Mosby.
- Topol, E. J., & Califf, R. M. (2007). Textbook of Cardiovascular Medicine. Boston: Lippincott Williams & Wilkins.
