Role of The Nurse Practitionier in The Prevention of Cardiovascular Disease in Women

Introduction

There are significant and advanced levels of interventions that could be adopted in preventing cardiovascular diseases (CVD) in women. In history, there have been numerous publications and corresponding recommendations since the year 1999. However, despite myriad research on treatment of CVD, it has constantly remained to be a global threat against women especially in the United States and other parts of the developed world. In women, CVD related deaths exceeds number of deaths exhibited in men, and also the next 7 causes of deaths in women globally (Gu et. al., 2005). This could conversely be approximated as 1 death in every 2 minutes. Research indicates that, among the cardiovascular diseases in women, Coronary heart disease (CHD) accounts for majority of deaths exhibited. The CVD is disproportionately afflicting both racial and ethnic minorities hence it could be regarded as a prime target for prevention (Ross et. al., 2009; Pochciol & Warren, 2009).

Nurse practitioners plays key role in the prevention of CVD due to increasing level of fatalities among women (Boaz, Smetana & Weinstein, et al., 2000). Research indicates that about two thirds of women die suddenly without exhibiting any signs and symptoms of CVD, this implies that nurse practitioners have to strive to ensure that the malady is prevented (Mosca, Collins & Herrington, 2001). Other considerations like atherosclerotic/ thrombotic CVD, for example; peripheral arterial disease and cerebrovascular disease are critical, hence should be taken seriously in women. Nursing practitioners struggles to put into practice known strategies that reduces burdens associated with Coronary heart disease as substantial practices which are beneficial  in preventing non-coronary atherosclerosis (Ross et. al., 2009; Pochciol & Warren, 2009).

In accomplishing the assignment, the key words used would be explained; research years which data was obtained, databases used would also be explained. In addition the main source of information for the assignment would be derived from secondary data obtained from relevant journals that would finally be indicated in the reference list.

Abbreviations

CVD- Cardiovascular disease

CHD- Coronary heart disease

HERS- Heart and Estrogen/ Progestin Replacement Study

WHI- Women’s Health Initiative

Literature Review

Research on Heart and Estrogen/ Progestin Replacement Study (HERS), and other searches on Women’s Health Initiative (WHI) indicate cases of unexpected integration of hormone therapy to be associated with adverse CHD effects. This implies that there is need for nursing practitioners to explicitly view strategies that would enhance prevention of CVD in women (Mosca, Collins & Herrington, 2001).

In nursing profusion, specialist in the field of cardiovascular diseases underscore the importance of enhancing evidence- based practices that aim at preventing the CVD (Smith et. al., 2004). This process involves translation and implementation of science in provision of nursing care. Nurses require the best processes and products that could enhance their ability to rigorously process and evaluate patents conditions and recommend preventive practices that could be adopted to enhance disease free life among women who are the most vulnerable to CVD (Boaz, Smetana & Weinstein, et al., 2000).

However, research indicates that nurse practitioners have quantifiable evidences that could be effectively studies to derive strategies for supporting clinical recommendations as preventive measures against CVD (Smith et. al., 2004). Clinical trials documented in the past indicate that despite luck of full participation of women in trials, data collected on men would still be appropriate for developing recommendations that could cover diverse population of women (Hammick et. al., 2007; McCloughen et. al., 2009). Furthermore, irrespective of dissimilar characteristics detected on patients with CVD comparatively to the results of the trials, nurse practitioners are capable of drawing inference that research data would generalize both from clinical setting to research study outcome (Mosca, Collins & Herrington, 2001).

It is objective that nurse practitioners’ efforts are effective in deriving first set of evidence- based CVD preventive strategies since the group often interacts with patients at all levels (Gu et. al., 2005). In addition, it could be realistic to reiterate that adult women are at higher risk with broad range of predisposing factors that increases their chances of having cardiovascular diseases (American Heart Association, 2002). However, regarding technology, nurse practitioners are perceived to be better in handling equipments that facilitate exploration of the extent to which CVD patients suffer (Smith et. al., 2004). This creates better opportunities for them to identify strategies that improves and also prevents the spread of devastating cases of cardiovascular disease. Conditions characterized by blurring of distinctions between primary and secondary preventive measures respectively (Boaz, Smetana & Weinstein, et al., 2000).

Historical Evolution

Globally, documented research outcomes indicate that concept of CVD is categorical, both the “have-or-have not” are not spared (Smith et. al., 2004). There is growing or appreciating continuum of CVD risks globally. Research indicates that according to Framingham’s Risk Score for Women (FRSW), areas with less intervention from nurse practitioners are recording high rate of scenarios and diagnosis of CVD. Such schemes are effective in enhancing intensity in the way in which health workers handle baseline preventive strategies against increased cases of CVD risks. Respective score cards are recommended herein and designed in order to assist nurse practitioners and other health providers in optimizing preventive measures against CVD in women (American Heart Association, 2002).

However, in spite of the efforts showcased by nurse practitioners in the quest to prevent cardiovascular diseases, it is pragmatic to state that there are numerous impediments in the implementation process (Mosca, Collins & Herrington, 2001). The distinct populations are characterized by levels of economic development, literacy and cultural beliefs; these are among other factors that nurse practitioners have affirmed to jeopardize the process of enhancing healthy leaving through fight against cardiovascular diseases in women (Boaz, Smetana & Weinstein, et al., 2000; Ross et. al., 2009; Pochciol & Warren, 2009).

The distinct countries strive to adopt strategies that could enhance effective practices to prevent cardiovascular ailments in women. These strategies also include life expectancy and frailty.

Data related to spectrum of CVD Risk in Women

It is realistic that among other diagnostic ways of ensuring that risk of CVD in women are reduced include consideration of proper management of related ailments that could increase the risk of CVD (American Heart Association, 2002). For example, nurse practitioners among other health care providers assert that women with cerebrovascular disease may not have high risk for coronary heart disease (CHD) especially when the affected vasculature is detected above carotids. But either symptom or asymptotic Carotid artery disease with >50% stenosis, would confer high risk.

However, for women with chronic kidney disease that deteriorates wit progression towards end- stage kidney ailment, there are considerable increase in the risk of CVD. Nurse practitioners affirm that, during their work encounters, patients with subclinical CVD will possibly have 20% after 10 years of Coronary heart disease; hence such patients should be moved to high-risk category (American Heart Association, 2002). On the other hand, according to Framingham’s Score Card; female patients with multiple risk factors are able to fall within any category among the three (low-risk, medium-risk or high-risk categories). This implies that women with single or several risk- factors could possibly have a 10 year risk<10% CHD (Coronary Heart Disease); CVD (Cardiovascular Disease) (Gu et. al., 2005).

However, in ensuring that health practitioners deliver tasks well regarding preventive mechanisms of CVD in women. Scientific research indicates that there should be both inclusion and exclusion study criterions on evidence based preventive measures would be implemented to salvage the lives of innocent women against the pandemic (Boaz, Smetana & Weinstein, et al., 2000). In order to enhance reduction, there should be interventional studies rather than studies that are etiological in nature. For example, this should be based on studies impacts weight loss on major cases of clinical CVD outcomes; this does not mean that CVD should be associated with obesity. Other forms of inclusion criteria include large prospective studies or randomized clinical trials (>100 subjects), interventions on reducing CVD risk through evaluation (Mosca, Collins & Herrington, 2001). However, in this case all studies should have at least 10 cases that major on clinical CVD; this would greatly enhance nurse practitioners’ ability to derive effective strategies that would enhance high rate of prevention of the risk- factors against women, the most vulnerable group to CVD, although it is not a must that female participants have to be included (https://www.worldheart.org/awareness-women.php).

Methodological (Research Problems That Have Arisen In Evolution of “Role of the Problems Faced By Nurse Practitioner in the Prevention of Cardiovascular Disease in Women”

Nurse practitioners are believed to encounter series of issues in their quest to derive strategies that prevent cardiovascular disease in women (Polit & Beck, 2008). This implies that nursing roles in this area extends beyond patient care; it encompasses community organization, advocacy, health education, and social and political reform (Beaglehole et. al., 2007). However, in the contemporary world, nurses encounter myriad problems especially when dealing with agencies that provide health care services and the local community members. There are evolving multi-casual, community based and complex problems (Rust & Cooper, 2007; Hammick et. al., 2007; McCloughen et. al., 2009).

Research outcomes within the global health sectors indicate that cardiovascular diseases are critically global issues (Beaglehole et. al., 2007). Nurse practitioners just like their counterparts in the health sector are faced with myriad challenges in ensuring the malady is prevented in women (Ross et. al., 2009; Pochciol & Warren, 2009). In the quest to reduce the rate and also prevent CVD, cardiovascular nurses are of great importance. Their participation effectively contributes to and enhances decrease in the global burden (American College of Cardiology Foundation & American Nurses Association, 2008).

The common response from the nurse practitioners indicate that there is need for World Health Organization and other global funders to indulge in strategies that would enhance and strengthen cultural development, change leadership competencies and also available healthcare management system (Polit & Beck, 2008). Unlike the increased perception that patients should seek medical care, it is pragmatic to note that most of the people require mentorship. This would enhance ability to derive better understanding of the practices that promotes and increased chances of being diagnosed with cardiovascular diseases. (Rust & Cooper, 2007)

Mentorship

In spite of the need to effectively perform their duties, nurse practitioners find it difficult to deal with ignorant members of the community in reduction of CVD risks (Ross et. al., 2009; Pochciol & Warren, 2009); this is the most effective strategy that would enhance reduction in the number of people diagnosed with cardiovascular related ailments which are not limited to coronary heart disease as indicated earlier in the assignment (American College of Cardiology Foundation & American Nurses Association, 2008). This is the reason as to why mentoring the nurse practitioners on the best strategies to adopt would be of great importance. The nurses would be equipped with skills and expertise that cut across socio-cultural and political grounds (Ross et. al., 2009). This influences the common human practice that predisposes the global populace to the chronic ailments globally (Polit & Beck, 2008; Melnyk, 2010).

The global populace suffers from cardiovascular ailments due to lack of information (Hammick et. al., 2007; McCloughen et. al., 2009). This jeopardizes the work or role of nurse practitioners in preventing cardiovascular diseases in women. There is need to ensure that all nursing levels are able to tackle issues related to preventive strategies (American College of Cardiology Foundation & American Nurses Association, 2008). Nursing personnel have to ensure that they are well equipped with literal information that would support their statements in relation to CVD (Beaglehole et. al., 2007; Hammick et. al., 2007; McCloughen et. al., 2009). Research information learnt on the preventative measures against the malady should be put into practice. This implies that nurse practitioners have to develop cultural competencies so that they could effectively derive strategies to handle women as the highly vulnerable population globally (American College of Cardiology Foundation & American Nurses Association, 2008).

Since cardiovascular diseases are global issues, the media should be adopted in the quest to disseminate information across diverse cultural grounds (Polit & Beck, 2008). This should involve the use of local and national languages so that vulnerable groups would realize respective risk factors. When nurse practitioners approach the enlightened population they would work with ease to achieve a common goal (Rust & Cooper, 2007).

In this respect, global networks like medical sites and social media and should be designed to disseminate information that is effective in creating awareness across diverse cultures (Ross et. al., 2009; Pochciol & Warren, 2009). The developed and developing world has common factors that should be dealt with as far as prevention of cardiovascular diseases is concerned (Rust & Cooper, 2007). For example; the aging populations which deprive the global medical sector of skilled nurse practitioners with diverse technical knowhow on the best strategies that could be adopted to enhance healthy world (American College of Cardiology Foundation & American Nurses Association, 2008); other factors in the global economic crisis that warrants transfer of severe cases in women to be handled in different countries due to shortage of nurses (American College of Cardiology Foundation & American Nurses Association, 2008). In reality, the issue of nurse shortage should not be the issue, but it is upon the government to strategize in a manner that enhances nurse retention and satisfaction. Most of the best nurse professional often seeks greener pasture abroad. This reduces the number of nurse professional who could effectively handle cases of CVD in women (Rust & Cooper, 2007; Hammick et. al., 2007; McCloughen et. al., 2009).

However, dealing with native populations is a challenge to the nurse practitioners. Most of the indigenous population do not understand the need to adhere to instructions from the practitioners (Beaglehole et. al., 2007), this create conflict of interest, which henceforth jeopardize efforts to salvage the people from risk associated with cardiovascular diseases (American College of Cardiology Foundation & American Nurses Association, 2008). There are cultural beliefs that continue to exist with increase in population. However, many efforts should be made to ensure that the global populace embraces information technology which has since brought information closer to the consumers than ever. This has jeopardized efforts to realize the signs and symptoms of heart diseases in women (Ross et. al., 2009; Pochciol & Warren, 2009).

Despite the need to continue with sensitization as nurse practitioners, it is therefore important that health care providers (Beaglehole et. al., 2007). They should understand and respect culturally sensitive teachings so that they would be able to create good rapport which is effective in facilitating their core mandates within the health sector (Polit & Beck, 2008). Research indicate that patients are more willing to provide accurate data about their health  and general practices that they engage in, only when the nurse practitioners consider their conditions and act psychologically towards the patients’ perceived strategies (Beaglehole et. al., 2007). 

In spite of the need to enhance rapport within the occupational areas, nurse practitioners are challenged in deriving better approaches that would enhance their participation within diverse cultural consideration (American College of Cardiology Foundation & American Nurses Association, 2008). It is not routinely planned that nurse practitioners would work within their renowned cultural areas. Language factor itself is diverse to an extent that some of the nurse practitioners may not be able to grasp aspects and characters of the patients and the participants (Polit & Beck, 2008). This is a challenge that jeopardizes efforts in the fight for enhancing preventive control against cardiovascular diseases among women population (Ross et. al., 2009; Pochciol & Warren, 2009).

Women are considered as part of the global population, but the nurse practitioners find it hectic to deal with feminine issues due to the fact that cardiovascular disease does not spare pregnant women (American College of Cardiology Foundation & American Nurses Association, 2008). Under such situations nurse practitioners should as well consider risks and complications associated with pregnancy before deriving strategies to monitor and perform thorough check-up (Ross et. al., 2009; Pochciol & Warren, 2009; Hammick et. al., 2007; McCloughen et. al., 2009). It is evidenced that improper management and diagnosis of pregnant women could endanger the lives of both the mother and the fetus (Polit & Beck, 2008). 

Such challenges necessitate further research to derive better and safe strategies that could be adopted to deal with women (Rust & Cooper, 2007). CVD is still a bone of contention within the global scope, researchers and scientists are yet to derive effective remedies; nurse practitioners would not have different strategies other than the available and recognized ones. This implies that nurse practitioners have to starve to be at par with latest information regarding prevention and management of cardiovascular diseases in women (Beaglehole et. al., 2007).

Research indicate that among the global population, men often work hard comparatively to the feminine counterparts (American College of Cardiology Foundation & American Nurses Association, 2008). This has been found to reduce chances of being diagnosed with cardiovascular diseases among the global populace. Women, are the persons involved in food handling and preparation, are characterized by duties that do not require a lot of energy hence they are prone to cases like diabetes and obesity (Rust & Cooper, 2007; Melnyk, 2010). Obese population are at higher risk of suffering from CVD, research indicate that nurse practitioners strive to enhance safe dietary so that the global population would be safe from complications that are brought about by poor cultural practices and eating habits (Polit & Beck, 2008).

However, despite efficacy of recommendations: what has been proven through clinical research (Hammick et. al., 2007; McCloughen et. al., 2009), and effectiveness: what is experienced through practice, many people do not heed to calls by nurse practitioners to put into practice, strategies that would be beneficial to them health wise (Rust & Cooper, 2007). Such observation defiance of strategies that has been proved as preventive measures to devastating epidemics jeopardize efforts by nurse practitioners to continue advocating for healthy practices within the diverse global scope (Beaglehole et. al., 2007).

Through experience, nurse practitioners and clinical medics are concerned on the rate at which the women treated from cardiovascular diseases get sicker, older and exhibit high comorbidities comparatively to their counterparts who take part in clinical trials (Polit & Beck, 2008). This implies that cost implications, side effects and corresponding absolute net benefits of therapies differ within research setting comparatively to real life practice setting (American College of Cardiology Foundation & American Nurses Association, 2008).

  Benefits- to-Risk Ratio

As the nurse practitioners perform their duties, it is challenging that not all situations they face are conducive for balancing benefits-to-risk ratio (Rust & Cooper, 2007; Hammick et. al., 2007; McCloughen et. al., 2009). This is in addition to adherence to real-world situations. Nurse practitioners among other stakeholders in the health sector strive to take into consideration these factors in decision making with targets on preventive therapy (Polit & Beck, 2008). Other researches indicate that women are prone to myocardial infarction which results into stroke. Although there are other risks associated with cardiovascular diseases, this creates demand for further sensitization of the global community so that preventable risks could be avoided (Rust & Cooper, 2007; Hammick et. al., 2007; McCloughen et. al., 2009).

CVD Risk Assessment

It is improper to discuss about risks associated with cardiovascular diseases without stating the classification schemes in women. According to research done by American Health Association (AHA), recommendation associated with women often change (American College of Cardiology Foundation & American Nurses Association, 2008). In pregnant women, cardiovascular ailments could be traced from history of gestational diabetes, preterm birth, preeclampsia bleeding within third trimester or small for gestational age; these stages are associated with high risks of cardiovascular diseases. This also affirms why research indicate that women are at higher risk comparatively to men (Rust & Cooper, 2007; Melnyk, 2010).

According to research, women with preeclampsia have double the risk of heart attack or stroke, within the next 10 to 15 years. Nurse practitioners showcase the dire need to enhance safe practices, according to emphasis from expert panel (Melnyk, 2010; Hammick et. al., 2007; McCloughen et. al., 2009). This implies that there should be more concern in identifying pregnant women with complications which depict early signs of increased cardiovascular disease risks so that the patients would be attended to in time (Ross et. al., 2009). Nurse practitioners and other clinical medics should be aggressive so that interventions would be initiated early to prevent higher risks factors (Beaglehole et. al., 2007).

However, in enhancing nurse practitioner’s work, research indicate that if the conditions are severe in women (Polit & Beck, 2008), it is recommended that physicians should follow-ups after pregnancy so that risks associated with cardiovascular diseases could be addressed effectively in timely manner (Ross et. al., 2009; Pochciol & Warren, 2009). This calls for realization and identification of thresholds for what could be considered as high risks associated with cardiovascular diseases (Rust & Cooper, 2007). According to Framingham’s risk score, more adjustments are necessary to increase emphasis based on stroke. By the year 2007, it was stated in Framingham’s score card that high risk starts from 10% or higher 10 years coronary heart disease (CHD) risk (American College of Cardiology Foundation & American Nurses Association, 2008). But, this has been altered by the myriad researches done so far; it is currently indicated that high risk relates to 10% or higher 10 years risk associated with cardiovascular heart disease (CVD) in general, not just coronary heart disease (CHD) (Melnyk, 2010; Hammick et. al., 2007; McCloughen et. al., 2009).

Conversely, it is evident that there are constant challenges that nurse practitioners face in enhancing preventive measures against cardiovascular diseases in women (Rust & Cooper, 2007). This would be evidenced according to research on global risk derived from Framingham score that underestimates cardiac risk rates in women (Beaglehole et. al., 2007). In addition, more emphasis indicates that between men and women, gender factor creates differences in cardiovascular outcomes. As stated before, women are more prone to myocardial infarction which is related to stroke (Polit & Beck, 2008; Melnyk, 2010). In addition, it is syndicated that despite the changes in preventive guidelines for cardiovascular diseases, guidelines for managing lipids are still intact and should be adhered to accordingly (Pochciol & Warren, 2009). This implies that they are still based on 10% or higher 10 years risk for coronary heart disease (CHD), with respect to Framingham risk score (American College of Cardiology Foundation & American Nurses Association, 2008).

Major Guideline Changes

Nurse practitioners should be aware, as is often stated by research that there are unique factors that affirm the fact that women are at higher risk of experiencing stroke (Melnyk, 2010). Other than pregnancy, there are other factors like hormone therapy, atrial fibrillation (AF), and hypertension (Rust & Cooper, 2007). In order to address these factors nurse practitioner and other clinical medics should recommend debigatran as new alternative to warfarin (Polit & Beck, 2008). It is affirmed by researchers that it acts as an effective remedy for women with paroxysmal or chronic atrial fibrillation (AF). Therefore nurse practitioners should recommend same to within work jurisdictions in order to improve compliance, in preventing stoke within atrial fibrillation setting (Melnyk, 2010; Hammick et. al., 2007; McCloughen et. al., 2009).

In nursing practice, persons diagnosed with rheumatoid arthritis and lupus; have been found to depict indicators of potential heart problems (Rust & Cooper, 2007). This implies that such people should undergo thorough scan to affirm their conditions as far as cardiovascular diseases are concerned (Hammick et. al., 2007; McCloughen et. al., 2009). In some instances, people with depression also have high prevalence of cardiovascular diseases; however, this is in accordance with cardiovascular prevention guidelines (American College of Cardiology Foundation & American Nurses Association, 2008).

Physicians and nurse practitioners should endeavor to direct depressed persons for screening (Beaglehole et. al., 2007). More research in needed to assert if depression could alter cardiovascular outcomes directly. In case it could be affirmed, it would impact on adherence to corresponding preventive guidelines that have showcased improvement in clinical outcomes (Rust & Cooper, 2007).

More Research Warranted

As the nurse practitioners strive to deliver to their utmost best, researches indicate that physicians and patients experience distinct barriers in bid to adhere to medical recommendations and healthy lifestyles (Melnyk, 2010). Most of the patients do not intend to take preventive medication so that they could avert the malady (Polit & Beck, 2008). On the other hand, there is exhibited poor time management, which interferes with the effectiveness of preventive medication. These at times lead to drug resistance which consequently causes more unwarranted complications in patients (American College of Cardiology Foundation & American Nurses Association, 2008). However, in the reminiscence of the information illustrated earlier, many people derive pleasure to engage in unhealthy eating habits that derail their health a great deal (Beaglehole et. al., 2007). Such practices deviate from recommended dietary guidelines that enhance healthy living. Conversely, such encounters often jeopardize efforts by nurse practitioners to continue advocating for healthy practices that acts as preventive measures against cardiovascular heart diseases (Rust & Cooper, 2007; Hammick et. al., 2007; McCloughen et. al., 2009).

 These necessitates further research and action that would enhance scientific and medical practitioners’ ability to counter gender based data associated with adverse effects and related efficacy plans that could be effectively adopted as preventive strategies (Polit & Beck, 2008). Hence there would be hope of deriving more appropriate recommendations on net balance of benefits and corresponding risks (Hammick et. al., 2007; McCloughen et. al., 2009); it is appropriate to state that such interventions would differ based on gender; this is an important facet in enhancing informed practices in the future (Melnyk, 2010).

State of the Science on Cardiovascular Diseases in Women

According to the global health reports, it is impeccable to state that cardiovascular diseases are ranked among the top killers of women globally (Rust & Cooper, 2007; Melnyk, 2010). There are a series of marked disparities between men and women, and among group of women in particular (Polit & Beck, 2008). Despite efforts by the nurse practitioners to enhance safe strategies to prevent increasing cares of CVD among women population, research indicate that coronary heart disease among other cardiovascular diseases is under-diagnosed, under-researched, and as well undertreated among women (Ross et. al., 2009; Pochciol & Warren, 2009).

It is unrealistic and unacceptable that most of the women with suspected cases of heart disease are less likely than men to be accorded specific and indicated medical tests and procedures (American College of Cardiology Foundation & American Nurses Association, 2008).. There are continued sex-based biases in administering medical treatment and care of myocardial infarction persists; research studies on cardiovascular diseases exhibit underrepresentation of women (Hammick et. al., 2007; McCloughen et. al., 2009). 

Research literature indicates that nurse practitioners have to deal with three major explanations: provider bias, sex-based physiology and psychological influences (Ross et. al., 2009; Pochciol & Warren, 2009). Women exhibit prodromal and acute symptoms, and myocardial infarction, yet they experience difficulties in recognizing and acting with respect to the indications. However, there are imperative research data on primary and secondary prevention of heart diseases in women (American College of Cardiology Foundation & American Nurses Association, 2008). In spite of inadequate scientific implications in several areas, there are existing evidence on aspirin, diet, physical activity and obesity, hormone therapy and also diabetes, which could be referred to as basis for interventions (Rust & Cooper, 2007).

Conversely, it is perceived that there could be potentially large impacts based on women’s mortality and morbidity in case the current scientific knowledge could be effectively implemented (Hammick et. al., 2007; McCloughen et. al., 2009). The state of science on preventive strategies of heart diseases in women should be reviewed frequently; much focus should be based on areas with great potential in order to effectively address women’s plight with respect to cardiovascular status. This implies that the key gaps in research and corresponding research questions be presented for further research debates in the coming decade (Rust & Cooper, 2007; Melnyk, 2010).

Nurse practitioner’s Role

Cardiovascular Nurses are essential in the quest to derive preventive strategies in the evaluation of cardiovascular disease Status in women (Ross et. al., 2009; Pochciol & Warren, 2009). For example, they are able to monitor hemodynamic functions in disease management. However, according to research, nursing interventions have been illustrated as best approaches to reduce patient stress (Melnyk, 2010). In addition, it is suggested in research findings that mortality and morbidity in patients with cardiac patients could be effectively improved through adoption of comprehensive treatment plan; this would merge other procedure like nurse management stress reduction plans (American College of Cardiology Foundation & American Nurses Association, 2008)..

However, in enhancing progress in preventive interventions on cardiac patients, randomized control research trials have been confirmed to depict and demonstrate beneficial evidences of nurse-managed clinics as the best ways for secondary prevention of coronary heart disease (CHD). It is explicit that nurse practitioners perform commendable work in prevention and implementation of patient compliance in cardiovascular care (Hammick et. al., 2007; McCloughen et. al., 2009). Nurse practitioner programs should integrate or use multifactor approach as highly effective strategy in reducing mortality and morbidity on women (Rust & Cooper, 2007; Melnyk, 2010).

Nurse’s Skills in Cardiovascular Challenges

In science, there are areas within the cardiovascular Care where nurse practitioner’s skills greatly make a difference. This implies that functions of nurse care providers should not be undermined despite high rate of scientific innovations experienced of late (Rust & Cooper, 2007; Melnyk, 2010). For example; in monitoring Hemodynamic functions and Oxygen, nurse practitioners effectively use pulse oximetry tool for motoring oxygen saturation to enhance patient safety (Polit & Beck, 2008). This is carried on in variety of clinical settings whereby there is need for deriving thorough understanding of principles of oxygen transportation and delivery; this clarifies the need for enhancing nurse practitioners’ efficiency in delivering cardiovascular care on patients (Ross et. al., 2009; Pochciol & Warren, 2009).

According to scientific research, among the main causes of death experienced in Critical Nurse Care is inadequate oxygenation (Hammick et. al., 2007; McCloughen et. al., 2009). This is supposed to promote functions of vital organs especially in patients with impaired cardiac functions; hence high rate of vulnerability to tissue oxygen deprivation as a result of limited ability to enhance adequate oxygen delivery when there is demand for oxygen (Rust & Cooper, 2007; Melnyk, 2010). This implies that there is need for further scientific research to ensure that routine nursing procedures to counter adverse effects on tissue oxygenation (American College of Cardiology Foundation & American Nurses Association, 2008).

There is need for integrating preventive strategies and guidelines to include and enhance tolerance (Ross et. al., 2009; Pochciol & Warren, 2009); hence supporting effective strategies between supply and demand of oxygen for patients with cardiovascular complications. This would conversely promote physiological adaptations that prevent further complications associated with hypoxia for example; cardiac arrest, cardiac dysrhythmias, and hypotension (McCloughen et. al., 2009). According to scientific research, hemodynamic monitoring is vital in enhancing clinical nurse assessment of critically ill patients; but the unique challenge is the complex congenital cardiac defects that are hemodynamic especially in monitoring and postoperative care for patients with cardiovascular complications (American College of Cardiology Foundation & American Nurses Association, 2008).

There is need for medical scientists to derive accurate regarding cardiac rhythm monitoring from competence nurse practitioners (Hammick et. al., 2007; McCloughen et. al., 2009). This is due to the fact that they have proven and beneficial information that explicitly identify necessary challenges in cardiac status, diagnosis and post- surgical monitoring, and assessment of response to treatment (Rust & Cooper, 2007; Melnyk, 2010). This affirms the reason as to why nurse practitioners are the best teams to enhance preventive management of cardiovascular diseases in women (Ross et. al., 2009; Pochciol & Warren, 2009).

Carotid Artery Aneurysms are confirmed to be rare but serious complications. They warrant adoption of appropriate assessment of cardiovascular and neurological signs. However, appropriate nurse interventions could be provide for preoperative and postoperative strategic interventions (Polit & Beck, 2008). Mitral Stenosis is another one that poses significant risk especially for maternal mortality and morbidity in pregnant women (https://www.worldheart.org/awareness-women.php). According to research on nursing assessment and intervention, there are positive outcomes in pregnancies complicated by Mitral Stenosis when physiological principles of obstetric and cardiac care are adopted during the intrapartum period (Beaglehole et. al., 2007). 

Neo Trends

Science indicate that the currently transradial approach has gained recognition within the United States; it is an advanced nursing practice that should be embraced in enhancing prevention of cardiovascular diseases in women (Beaglehole et. al., 2007). It entails cardiac catheterization and also precutaneous coronary intervention. On the same note, it is pragmatic to state that scientific intervention on the use of a less aggressive anticoagulation regimen and Radial Access during Transfemoral Interventions could be effective in preventing Vascular Access Complications (American College of Cardiology Foundation & American Nurses Association, 2008).

A more recent innovation is the use of guided compression repairs and ultrasonographic diagnosis of Femoral Artery Pseudoaneurysm is effective in enhancing Vascular Nurse Practice. Other research recommends radiographic technology as safe and cost- effective approach in handling numerous cases of Femoral Artery Pseudoaneurysm (Polit & Beck, 2008). This is due to the fact that it has not adverse effects on any possible surgical intervention in case the guided compression repairs fail to materialize (Beaglehole et. al., 2007). More clinical and scientific research outcomes indicate that Esophageal Doppler monitor (EDM) could be adopted as a less invasive approach to obtain hemodynamic information faster and safer at the bedside with positive impacts on nurse practitioner’s decision at the bedside (Polit & Beck, 2008).

In conclusion, it could be reiterated that cardiovascular nurse practitioner plays a great role in evaluation of cardiovascular diseases’ status, monitoring disease management and hemodynamic functions respectively.  In carrying out nurse-led cardiovascular procedures like Subclavian CVC placement and also precutaneous Coronary interventions are affirmed to be safe among other ways of enhancing preventive strategies of cardiovascular diseases in women.

References

American College of Cardiology Foundation, American Nurses Association. (2008). Cardiovascular Nursing: Scope and Standards of Practice. Silver Spring, MD: Nursebooks.Org.

Beaglehole R, Ebrahim S, Reddy S, Voute J, Leeder S. (2007). Prevention of chronic diseases: a call to action. Lancet. 370 (9605):2152-2157.

Hammick M, Freeth D, Koppel I, Reeves S, Barr H. (2007). A best evidence systematic review of interprofessional education: BEME guide no. 9. Med Teach. 29(8):735-751.

McCloughen A, O’Brien L, Jackson D. (2009). Esteemed connection: creating a mentoring relationship for nurse leadership. Nurs Inq. 16(4):326-336.

Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. (2010). Evidence-based practice: step by step: the seven steps of evidence-based practice. Am J Nurs. 110(1):51-53.

Pochciol JM, Warren JI. (2009). An information technology infrastructure to enable evidence-based nursing practice. Nurs Adm Q. 33(4):317-324.

Polit DF, Beck CT, eds. (2008). Nursing Research: Generating and Asessing Evidence for Nursing Practice. 8th ed. Philadelphia, PA: Wolters Kluewer Lippincott Williams & Wilkins.

Ross AM, Noone J, Luce LL, Sideras SA. (2009). Spiraling evidence-based practice and outcomes management concepts in an undergraduate curriculum: a systematic approach. J Nurs Educ. 48(6):319-326.

Rust G, Cooper LA. (2007). How can practice-based research contribute to the elimination of health disparities? J Am Board Fam Med. 20(2):105-114.

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