Common Cardiovascular and Neurologic Conditions
Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions
Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions
NURS 6551:Week 10: Common Health Conditions with Implications for Women, Part 1
Sixty-one percent of the people who die from stroke are women, and it is really perceived as an old man’s disease. And it isn’t.
—Lynn Goddess, Founder of the Hazel K. Goddess Fund for Stroke Research in Women
Stroke is among the leading causes of death for women in the United States (CDC, 2008b). This common health condition has severe implications for women, yet it is frequently misdiagnosed because the female presentation of stroke often differs from the typical recognized male presentation. Like stroke, many other common cardiovascular and neurologic health conditions also present differently and progress differently in women. As an advanced practice nurse providing care for women, you must be able to quickly identify the unique signs and symptoms of these common health conditions in women.
This week you examine common cardiovascular and neurologic conditions that impact women. You consider differential diagnoses, treatment and management plans, and patient education strategies for women with these conditions. You also examine the Women’s Health Initiative study and research current best practices for assessing and managing common health conditions in women.
Learning Objectives – Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions
By the end of this week, students will:
- Assess patients with common cardiovascular and neurologic conditions
- Evaluate differential diagnoses for common cardiovascular and neurologic conditions
- Analyze treatment and management plans for patients with common cardiovascular and neurologic conditions
- Analyze strategies for educating patients on the treatment and management of common cardiovascular and neurologic conditions
- Compare the diagnosis and management of female and male patients with the same conditions
- Evaluate best practices for assessing and managing conditions related to women’s health
- Evaluate the impact of differences in best practices on women’s health
- Understand and apply key terms, principles, and concepts related to common health conditions with implications for women
- Evaluate body system conditions
Learning Resources
Required Readings
Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.). Burlington, MA: Jones & Bartlett Publishers.
- Chapter 8, “Primary Care in Women’s Health” (pp. 457-616)
This chapter explores health promotion and disease prevention in women’s health. It also describes the presentation, assessment, diagnosis, and management of various systemic conditions, including cardiovascular and neurologic conditions.
McSweeney, J. C., Pettey, C. M., Souder, E., & Rhoads, S. (2011). Disparities in Women’s cardiovascular health. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(3), 362–371.
This article explores health disparities in cardiovascular disease, including gender and racial disparities related to the diagnosis, treatment, and outcomes of patients with this disease.
Department of Health and Human Services, National Institutes of Health, & National Heart, Lung, and Blood Institute. (n.d.). Women’s Health Initiative: WHI background and overview. Retrieved March 20, 2013, from http://www.nhlbi.nih.gov/whi/background.htm
This website outlines details of the Women’s Health Initiative (WHI) and introduces the various health issues addressed by the WHI.
Optional Resources – Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions
Centers for Disease Control and Prevention. (2012b). Women’s health. Retrieved from http://www.cdc.gov/women/
National Institutes of Health. (2012). Office of Research on Women’s Health (ORWH). Retrieved from http://orwh.od.nih.gov/
U.S. Department of Health and Human Services. (2012a). Womenshealth.gov. Retrieved from http://www.womenshealth.gov/
Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions
Cardiovascular and neurologic conditions are among the leading causes of death and hospitalization of women in the United States (Centers for Disease Control and Prevention, 2008a). As an advanced practice nurse, you must routinely monitor patients at risk of these conditions and recommend the appropriate health screenings and preventive services. When assessing patients for these conditions, it is important to keep in mind that while some female patients might present with typical signs and symptoms, others might present with atypical signs and symptoms that are unique to women. For this Discussion, consider signs and symptoms presented by the women in the following case studies and develop differential diagnoses:
Case Study 1
A 48-year-old overweight African American female is in the clinic for a wellness visit. A routine fasting lipid panel returned with the following results:
- Total cholesterol: 305 mmol/L
- Low-density lipoprotein (LDL): 180 mg/dl
- High-density lipoprotein (HDL): 30 mg/dl
- Triglycerides: 165 mg/dl
Case Study 2
You are seeing a 63-year-old African American female for a two-week history of intermittent chest pain. The pain varies in intensity and resolves with rest. She does not believe it has increased over time. She is a nonsmoker with a history of hypertension treated with Lisinopril 10 mg once daily. She had an exercise stress test one year ago that was within normal limits. Her physical exam findings are as follows: HR–90, BP–150/92, R–22, O2Sat 98% RA; lungs: clear to auscultation bilaterally; cardiovascular: apical pulse of 90 RRR, no rubs, murmurs, or gallops. Chest wall mildly tender to palpation that reproduces her complaint of pain. Extremities include no clubbing, cyanosis, or edema. The remainder of the exam is within normal limits.
Case Study 3
A 32-year-old Asian American female is in the clinic for a history of recurrent headaches for the past year, occurring monthly, lasting up to 12–18 hours. The headaches are sometimes associated with photophobia, nausea, and vomiting. She takes either acetaminophen or ibuprofen for relief that is not always successful. She uses Ortho Tricyclin for birth control. Her physical exam is within normal limits.
To prepare:
- Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.
- Review and select one of the three provided case studies. Analyze the patient information.
- Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
- Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
- Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.
By Day 3
Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who selected different case studies than you did. Keep in mind the conditions your colleagues identified as their primary diagnoses. Explain signs and symptoms of these conditions that are unique to women or are more commonly seen in women. Then, explain how the assessment, diagnosis, treatment, and management of female patients might differ from male patients with the same conditions.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions.
Common Cardiovascular and Neurologic Conditions
Introduction
Parkinson’s disease, multiple sclerosis (MS), and other neurological disorders are a major cause of disability and mortality. They affect millions of Americans, but they can be difficult to diagnose because they share similar symptoms. A combination of clinical features, imaging findings, and laboratory tests may help to distinguish these conditions from each other and other diseases.
Neurologic Disorders
Neurologic disorders are disorders that affect the nerves and other parts of the brain. They include:
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Multiple sclerosis (MS) is a disease that affects the central nervous system, causing symptoms such as numbness and tingling in parts of your body. MS can cause paralysis or muscle weakness in different areas of your body, including the limbs and trunk. In addition to having physical problems with movement, people who have MS may experience emotional symptoms such as depression or anxiety that come on suddenly without any warning signs beforehand.
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Parkinson’s disease is another condition where symptoms begin in one part of your body but spread over time to affect other systems as well (such as certain muscles). These symptoms can range from mild stiffness to tremor; they often worsen over time but do not always get worse until after 20 years (or longer). Unlike most forms of dementia where memory loss occurs first then other cognitive functions follow suit later on down road,” said Dr Amol Gala MD PhD MBA FAAFP Clinical Associate Professor at University Hospital Columbia Medical Center.”
Neuromuscular disorders
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Myopathies
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Myositis
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Polymyositis
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Amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease) is a disease that affects the nervous system and skeletal muscles. This includes the brain and spinal cord, as well as the muscles themselves. ALS causes gradual muscle deterioration that can lead to paralysis and death within 10 years of diagnosis if left untreated. The cause of ALS is unknown but it has been linked to genetics, environment (including exposure to certain chemicals), or some combination thereof.[6]
Paraneoplastic syndromes
Paraneoplastic syndromes are autoimmune disorders that occur in the context of cancer. Paraneoplastic syndromes can be either monophasic or polyphasic, and may be caused by various types of cancer or non-cancerous conditions.
In some cases, these syndromes can be treated with immunotherapy (drugs targeted at specific types of cells). Other times, it’s not possible to treat the disease at all; for example, myasthenia gravis (a condition characterized by weakness) is associated with antibodies called antinuclear antibodies (ANA), which target nerve cells. Treatment options include steroids or other drugs designed to block ANA activity while also reducing inflammation caused by its presence.
In other cases like systemic lupus erythematosus (SLE) there isn’t any treatment available beyond symptomatic relief via medication prescriptions.
Demyelinating conditions
Demyelinating diseases are a group of conditions in which the myelin sheath surrounding nerves is damaged, causing demyelination. This can lead to problems with movement, pain, and other symptoms.
The most common demyelinating diseases include:
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Multiple sclerosis (MS) is an autoimmune disease that attacks the central nervous system. It has three major phases: acute disseminated encephalomyelitis (ADEM), secondary progressive MS and relapsing remitting MS. In ADEM phase there may be short periods of remission followed by relapse; the second phase involves slower progression than in early stages where people have more disability and disability progression occurs laterally instead of medially as well as ataxia or cerebellar ataxia which occurs only in late stages when lesions have spread beyond one hemisphere on MRI scan but this does not mean that all patients will develop these symptoms later on – some do not develop any neurological impairments at all!
Inflammatory brain diseases
Inflammatory brain diseases are a group of conditions that can cause seizures, headaches, memory loss and confusion. These disorders also may cause depression or delirium (a change in consciousness).
In some cases, inflammatory brain diseases may result in behavioral changes such as aggression or agitation; these behaviors tend to improve with treatment. In others it may lead to fatigue and sleep problems if left untreated for a long period of time.
Systemic conditions
Systemic conditions are diseases that affect the whole body. They can be caused by:
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Cardiovascular disease (CVD) – atherosclerosis, heart failure and stroke.
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Neurologic disorders – such as Parkinson’s disease or multiple sclerosis.
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Rheumatologic disorders like rheumatoid arthritis or psoriatic arthritis.
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Hematologic disorders such as leukemia or lymphoma
Conclusion
There are many neurologic disorders that can be diagnosed by a cardiologists, neurologist or neurosurgeon. Cardiovascular diseases may be diagnosed by a cardiologist and is sometimes referred to as an “acute heart failure”. However, there are also other conditions that are not related to the heart but can still lead to death such as cancer of the brain or blood vessels themselves. The cause of these conditions is complex and often multifactorial but it is important for your doctor to know what’s going on so they can best treat you with care.
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