Management of Long-Term Cardiorespiratory Symptoms - Essay Example

Her daughter is concerned as Mary is breathless at rest, has a persistent cough and appears to have some ankle oedema. This first case study will deal with the nursing issues related to the management of this elderly, obese hypertensive patient with history of smoking. He is undergoing treatment for hypertension, and on this presentation, he is complaining of shortness of breath on minimal exertion. Like any other nursing management, an evaluation is necessary which would initiate the nursing process.

The assessment would involve first taking a detailed history of this patient. Nursing assessment of the cardiovascular system includes a patient health history and physical examination. If the patient had been experiencing an acute problem, the focus should be on the most serious sign and symptom. In this case, the symptom is difficulty breathing on minimal exertion. It appears that this is new development over the baseline hypertension and obesity, and this has been continuing for quite some time.

Since rest produces amelioration of this patient's symptoms of dyspnoea on exertion, it is highly probable that this new development in chronic in nature and is stable (Ahmed et al., 2004, 297-307). Therefore, a complete nursing assessment may be undertaken on presentation. In the second scenario, the patient has complicated lung disease, which has characteristic exacerbations and remissions. This patient is dependent on home care, and her condition has deteriorated due to development of congestive right heart failure secondary to her lung disease.

The presence of heart failure is indicated by the history of persistent cough and ankle edema. Therefore, there is fluid retention, and the pump failure in the heart has led to accumulation of fluid in the lung leading to breathlessness and persistent cough. HistoryThe history is that of a person who is currently having a sedentary lifestyle and is perhaps not able to control body weight. He had symptoms of weakness, fatigue, shortness of breath on exertion. Although he had dyspnoea on exertion, he did not have dyspnoea at rest.

However, fatigue and exhaustion continued throughout the day, and he had activity intolerance. There was a sense of chest pressure with activity, and he did not complain about insomnia. His personal history revealed little to no exercise, and he spent most of the day at home watching television. He is obese and is a heavy smoker. Obesity is associated with breathlessness on the simple level of reducing the capacity of the lungs to expand and increasing the workload of the organs. Specifically, obesity may decondition the heart, result in fatty infiltration of the myocardium and lead to altered filling pressures (Gustafsson et al.

, 2005, 58-64). A long history of hypertension is more closely associated with heart failure than a shorter history.In the second case, when assessing the patient with heart failure and breathlessness, especially if the pattern or severity of the breathlessness is changing, it is worth looking for factors that may be contributing to the problem. The most likely would be common problems such as chest infections and anaemia (Anand et al., 2005, 12-15). A chest infection can provoke heart failure due to increased haemodynamic demands or by the formation of pleural effusions. Anaemia