The lesson started well, by introducing the Topic for the session. We looked at the learning outcomes, the aims, and objectives of the lesson.

Some random questions were asked at the start of the lesson, to assess the base of our knowledge, questions like

• how does the blood get around the body?

To answer this first question, the arteries carry blood away from the heart and vein carry blood back to the heart.

• What are the functions of the primary organs of the cardiovascular system?

It brings oxygen, nutrients, and other good things to every cell in the body.

• How does the cardiovascular system work with other systems of the body?

The heart, blood, and blood vessels work together to secure the cells of the body.

It also supports the respiratory system by bringing blood to and from the lungs.

We looked the organs of the cardiovascular system, these are divided into three components, the heart, the systemic circulation, and the pulmonic circulation. Theses organs all work together to deliver oxygen and rich blood to the organs and tissues of the body.

The heart is approximately the size of the fist, it weighs about 230 – 280g in females, 280 – 280 – 240 g in males. It’s about 12 -14 cm long and 9 – 10 cm wide.

The mitral valve is 9cm in male, and 7.2 cm in females.

The tricuspid valve is 10.8 in female and 11.4 cm in males. Since the heart is essentially very strong, reliable muscular pump, this muscular pump is controlled by a sophisticated electrical impulse system. I learnt that the heart beats on an average of 115,000 times per day. The muscular pump action of the heart circulates on an average of 2000 gallons of the blood around the body per day.

The systemic circulation is comprised of the arteries, veins, and capillaries. These vessels form a transport network that delivers blood to and from the top of the heard and down to the toes, and everywhere.

The pulmonic circulation is the transportation that shunts deoxygenated blood from the heart to the lungs to be re-saturated with oxygen before it is dispersed. Pulmonic circulation comprised of specific set of arteries and veins whose purpose is to deliver blood to and from the lungs and heart. The Vana cava transport.

According to the video, we learnt about the doors that control the flow of blood between each chamber of the heart. These doors are known as valves, they are divided into four and are important to the normal functioning of the heart. The following are the four valves and their locations:

• Tricuspid valve, it is located between the right atrium and the left ventricle.
• Pulmonary, this is located between the right ventricle and the pulmonary
• Mitral valve, it is located between the left atrium and the left ventricle
• Aortic valve, this is located between the left ventricle and the left aorta.

The heart is endowed with three layers, the endocardium (the smooth inner layer), the myocardium (the thick muscle of the heart) and the epicardium (the outer layer or surface of the heart).

The coronary arteries are like all muscles in the body, the myocardium requires a steady stream of oxygenated blood to fuel its contractions. These contractions send blood throughout the body. The heart requires a continuous supply of oxygen to function and survive just like any other tissue or organ of the body.

The electrical system. As we all aware, that the heart functions with an important set of muscles that are responsible for moving blood around the body. The contraction of the muscles is controlled by a complex system of electrical impulses known as the heart peacemaker (SA NODE). These electrical impulses control how fast the muscles contract and how to the atria and ventricles contract in the best rhythm to maximize the efficiency of blood flow.

In assessing the cardiovascular system, the following tools are available to nurses to monitor the cardiovascular system:

– Pulse and blood pressure.

– Electrocardiogram (ECG)

– Circulation assessment (from A – E assessment)

– Coronary Angiogram

– Doppler Ultrasound

– Echocardiogram.

The following are the clinical presentation:

– Chest pain

– Nausea/vomiting

– Anxiety

– Dyspnoea

– Rapid irregular pulse

– Hypotension

– Peripheral cyanosis

– Sweating

The investigations are as follows:

– ECG

– Chest X-ray

– Bloods

– Echo

– PCI

– CT/MRI

For its management, the following should be used:

– MONA – (Morphine Oxygen Nitrite Aspirin) a treatment for stable and unstable angina.

– CABG – (Coronary Artery Bypass Graft)

– Heart transplant/ VADs (ventricle Assisted Device) to name but a few.

The complications are:

– Arrhythmias

– HF (Heart failure)

– MOF (Multiple Organ Failure)

– Cardiogenic shock

– Death.

 

KNOWLEDGE

 

K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and how to fulfil all registration requirements.

K4: Understand the principles of research and how research findings are used to inform evidence-based practice.

K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice.

K8: Understand how discriminatory behaviour is exhibited.

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes.

K11: Understand the factors that may lead to inequalities in health outcomes.

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical, and behavioural health, and well-being.

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours, and lifestyle choices to mental, physical, and behavioural health outcomes.

K14: Understand the importance of health screening.

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care.

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care.

K17: Understand commonly encountered mental, physical, behavioural, and cognitive health conditions as applied to delivery of care.

K18: Understand and apply the principles and processes for making reasonable adjustments.

K19: Know how and when to escalate to the appropriate professional for expert help and advice.

K20: Know how people’s needs for safety, dignity, privacy, comfort, and sleep can be met.

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care.

K22: Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health.

K23: Know how to meet people’s needs related to mobility, hygiene, oral care, wound care, and skin integrity.

K24: Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.

K25: Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life.

K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld.

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies.

K28: Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications, and adverse reactions.

K29: Understand the different ways by which medicines can be prescribed.

K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments.

K36: Understand the roles of the different providers of health and care.

K37: Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs.

K38: Understand the complexities of providing mental, cognitive, behavioural, and physical care needs across a wide range of integrated care settings.

K39: Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives.

K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings, or services.

K41: Know the roles, responsibilities, and scope of practice of different members of the nursing and interdisciplinary team, and own role within it.

K43: Understand the influence of policy and political drivers that impact health and care provision Skills.

 

 

SKILLS

S1: Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements.

S13: Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing.

S15: Identify people who are eligible for health screening.

S16: Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination, and herd immunity.

S17: Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance and antimicrobial stewardship and resistance.

S18: Apply knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions.

S19: Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent.

S20: Recognise people at risk of abuse, self-harm and/or suicidal ideation and the situations that may put them and others at risk.

S21: Monitor the effectiveness of care in partnership with people, families and carers, documenting progress, and reporting outcomes.

S22: Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated.

S23: Work in partnership with people, to encourage shared decision making, to support individuals, their families, and carers to manage their own care when appropriate.

S24: Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective, and person-centred care.

S25: Meet people’s needs for safety, dignity, privacy, comfort, and sleep.

S26: Meet people’s needs related to nutrition, hydration and bladder and bowel health.

S27: Meet people’s needs related to mobility, hygiene, oral care, wound care, and skin integrity.

S28: Support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.

S30: Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings, and escalating as needed.

S38: Prioritise and manage own workload and recognise where elements of care can safely be delegated to other colleagues, carers, and family members.

 

 

 

 

BEHAVIOURS

B1: Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy, and preferences.

B2: Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice.

B3: Be adaptable, reliable, and consistent, show discretion, resilience, and self-awareness.