Cardiovascular and respiratory nursing
Heart and lung conditions are among the most common reasons for hospital admission. Nurses monitor, treat, and teach patients to manage them. For study only, not clinical guidance: always follow your programme, current local protocols, and supervising clinicians.
Coronary artery disease and angina
Coronary artery disease narrows the arteries supplying the heart. Angina is chest pain from reduced blood flow, often triggered by exertion and relieved by rest or nitroglycerin. Stable angina is predictable; unstable angina, occurring at rest or worsening, is an emergency that may precede a heart attack.
Myocardial infarction
A myocardial infarction (heart attack) occurs when a coronary artery is blocked and heart muscle dies. Symptoms include chest pain or pressure that may spread to the arm, jaw, or back, shortness of breath, sweating, and nausea; women, older adults, and people with diabetes may have less typical symptoms. Rapid treatment, such as opening the artery, saves heart muscle: 'time is muscle'.
Heart failure
In heart failure, the heart cannot pump enough to meet the body's needs. Left-sided failure causes fluid to back up into the lungs: breathlessness, crackles, and difficulty breathing lying flat. Right-sided failure causes fluid to back up into the body: leg oedema, raised neck veins, and abdominal swelling. Nursing care includes daily weights, fluid and salt guidance, medications, and teaching.
Hypertension
Hypertension is often symptomless but damages the heart, brain, kidneys, and eyes. Nurses teach lifestyle changes (less salt, more activity, weight management, limiting alcohol, quitting smoking) and medication adherence, and help patients monitor blood pressure at home.
Asthma
Asthma involves airway inflammation and narrowing, causing wheezing, coughing, and breathlessness. Short-acting bronchodilators (such as salbutamol/albuterol) give quick relief; inhaled corticosteroids control inflammation over time. Nurses teach correct inhaler technique, which many patients get wrong, and recognising warning signs of severe attacks.
COPD
Chronic obstructive pulmonary disease, mainly caused by smoking, includes emphysema and chronic bronchitis. Patients have persistent breathlessness and cough. Care includes bronchodilators, pulmonary rehabilitation, smoking cessation, vaccinations, and pursed-lip breathing. Oxygen is titrated to prescribed targets; some patients with chronic CO2 retention need lower saturation targets, often 88-92%, as set by their care team.
Pneumonia
Pneumonia is infection of the lung tissue, causing fever, cough, sputum, breathlessness, and crackles. Older adults may present mainly with confusion. Care includes antibiotics for bacterial pneumonia, oxygen as needed, fluids, positioning, coughing and deep breathing, and early mobilisation. Vaccination against pneumococcus and influenza reduces risk.
Worked example
A patient with heart failure gains 2 kg over two days and now needs three pillows to sleep. Crackles are heard at both lung bases. These signs suggest worsening fluid overload. The nurse reports promptly, positions the patient upright, monitors oxygen saturation, anticipates diuretic adjustment, and reinforces teaching about daily weights and when to call for help.
Key takeaways
Angina is reduced blood flow; unstable angina is an emergency. Heart attack symptoms vary, especially in women and older adults; time is muscle. Left-sided heart failure affects the lungs; right-sided causes systemic oedema; daily weights are key. Hypertension needs lifestyle and medication support. Asthma uses relievers and preventers with correct inhaler technique. COPD care includes rehabilitation and prescribed oxygen targets. Pneumonia may present as confusion in older adults.
Flashcard
Chest pain from reduced coronary blood flow
Check your understanding
A patient with left-sided heart failure would most likely show: