WCU Hematologic and Cardiovascular Disorders Discussion Replies

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NURS 530 Week 4 Responses 

Adrienne Luna

One of the heart wall disorders I frequently encounter in nursing practice is Pericardial Effusion. This condition involves fluid accumulation in the pericardial sac, which surrounds the heart (Rogers, 2022, p. 1085).  My understanding of the pathophysiology of pericardial effusion has allowed me to develop targeted interventions in several ways. Regular assessments and monitoring are of utmost importance, as they help detect early signs and symptoms such as chest pain, shortness of breath, and elevated jugular venous pressure. Recognition of these symptoms enables me to focus my interventions on pain management, providing respiratory support, and collaborating closely with the medical team – emphasizing the importance of a prompt pericardiocentesis to prevent cardiac tamponade. Tamponade occurs when pericardial fluid pressure equals or surpasses diastolic heart chamber pressure, hindering atrial filling, resulting in right heart failure symptoms, including jugular vein distention, edema, and hepatomegaly, along with reduced ventricular filling, stroke volume, and cardiac output (Rogers, 2022, p. 1085). Interventions involve monitoring chest X-rays and echocardiogram findings to ensure timely intervention. Understanding that pericardial effusion can compress the heart and impair its function, I ensure that patients undergo echocardiography to assess the size and impact of the effusion (Hoit, 2022). This diagnostic information guides treatment decisions and helps determine the urgency of interventions like pericardiocentesis.

One more important aspect is that knowledge of pericardial effusion’s pathophysiology enables me to educate patients about the condition, its potential causes, and the importance of adherence to treatment plans. I try to empower my patients to recognize worsening symptoms and seek timely medical attention when needed. Understanding that patients often experience anxiety when faced with this diagnosis makes me want to provide more comprehensive support and guidance.

Maria Sanchez

One of the most common hematologic disorders that occurs in children is anemia. “Anemia results from inadequate erythropoiesis or early destruction of erythrocytes. Iron deficiency is the most common cause of inadequate erythropoiesis. Iron deficiency can result from insufficient dietary intake or chronic loss, or iron caused by bleeding” (Rogers, 2022, p. 990).  Iron deficiency anemia is considered a nutritional disorder. Being able to diagnose this condition is crucial because iron is needed for brain development for children. The symptoms of anemia would include extreme fatigue, low energy, pale skin, brittle nails, tachycardia, and can include craving of non-food items such as clay, dirt, or ice.

Nurse practitioners need to be aware of the signs and symptoms of hematologic disorders to be able to detect them early on. Detecting them early allows for early treatment and the best possible outcome for the child. In the case of iron deficiency anemia knowing the signs and symptoms would be important for nurse practitioner to be aware of in order to diagnose and provide proper treatment. Nurse practitioners can educate parents about iron rich foods and or iron supplements. Nurse practitioners can use various strategies to employ to promote the early detection and management of hematologic disorders in children that include listening to parents’ concerns, providing written information, answering questions, educating parent/child about nutrition, refer the family to a nutritionist, and continuous monitoring of labs.

NURS 676 Week 4 Responses 

Roxanne Noriega

Iron deficiency anemia is characterized by imbalance between iron uptake and iron demand. The amount of iron in the body is regulated by intestinal absorption (Rosenthal & Burchum, 2021). And therefore, most iron is excreted through the bowel. However, in some cases iron is depleted through blood loss via hemorrhage, blood donation or heavy periods. Absence of iron in the blood causes a reduction in oxygen-carrying blood cells and therefore the patient experiencing iron deficient anemia will present with pale skin, fatigue, dyspnea, arrythmias, tachycardia, or chest pain. Identifying the underlying causes is the priority, while moving forward with treatment of choice (Rosenthal & Burchum, 2021).

While ferrous sulfate is the treatment of choice for this type of anemia due to its availability, cost, and tolerability. It still comes with its share of unpleasant side effects such as nausea, heartburn, constipation, or diarrhea. Patients with a history of ulcers should be observed closely and avoid taking this drug by mouth. This drug is offered both orally and intravenous, intravenous being the safer and preferred route.  Patients should be warned that this medication may change their stool to a dark green or black in color. The course of ferrous treatment should be expected to last over a couple of months depending on the source of the depletion and the GI adverse effects should be expected to decrease over the course of medication use (Rosenthal & Burchum, 2021). And therefore, educating the patients of the necessity of the drug on a physiologic level and how it will improve how they feel and function with ferrous treatment and while the adverse effects might be unwelcome and uncomfortable the patient can expect them to be temporary. Therefore, the benefit in this case will outweigh the negative aspects of the temporary side effects. 

During treatment patients should be encouraged to increase their dietary intake of high iron food such as eggs, tofu, beef, beans, and green leafy vegetables like spinach. The patient should be closely monitored for compliance, bleeding, inflammatory disease, and absorption issues of iron.

Vicente Gutierrez

In the treatment of hypertension two of the most successful modes of management are lifestyle modifications and pharmacological therapy (Burchum & Rosenthal, 2021). When it comes to considering an antihypertensive medication or an establishment of treatment for a patient the nurse practitioner should consider the classification of BP based on systolic and diastolic pressure, types of hypertension, and the damaging effects of chronic hypertension (Burchum & Rosenthal, 2021). In hypertension there is primary and secondary hypertension. In primary hypertension the identifiable cause is unknown while in secondary hypertension the cause is from an identifiable primary cause (Burchum & Rosenthal, 2021). An example is management of chronic hypertension is to choose the best possible treatment for the patient to have the best effect while avoiding side effects. Lifestyle changes can control BP but most often medication is also needed. When considering medications for a specific patient it is important to take into consideration their comorbid conditions for instance a patient with diabetes cannot take thiazides, furosemide, and beta blockers due to these medications promoting hyperglycemia, or making signs of hypoglycemia (Burchum & Rosenthal, 2021). In African Americans hypertension is a major health problem, as a result they are at greater risk for heart disease, end stage renal disease and stroke (Burchum & Rosenthal, 2021). Diuretics are the drug of first choice when treating African Americans with hypertension. In older individuals is almost isolated to systolic hypertension and DBP is usually normal, treatment in these individuals can reduce incidents of heart failure and fatal stroke (Burchum & Rosenthal, 2021). In children the incident of secondary hypertension is much higher than adults, therefore it is important to find the cause of the hypertension and treat it to get rid of the hypertension in the child (Burchum & Rosenthal, 2021).