Nursing Skills in Cardiorespiratory Assessment and Monitoring

Tina Moore, Sheila Cunningham

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781351066044
• Edition: 1
• Topic: Medicina
• Subtopic: Tecniche infermieristiche

Organisms need to be able to maintain nearly constant internal environments in order to survive, grow and function effectively and efficiently. By maintaining homeostasis, humans remain healthy, strong and protected from the invasion of foreign organisms, such as viruses, bacteria and fungi. This practical pocket guide covers:

• the anatomy and physiology of cardiovascular system vital signs

• recognition of common arrhythmias and important skills for cardiovascular health cannulation and venepuncture

• the anatomy and physiology of the respiratory system

• skills related to addressing respiratory problems.

This competency-based text covers relevant key concepts, anatomy and physiology, lifespan matters, assessment and nursing skills. To support your learning, it also includes learning outcomes, concept map summaries, activities, questions and scenarios with sample answers and critical reflection thinking points.

Quick and easy to reference, this short, clinically-focused guide is ideal for use on placements or for revision. It is suitable for pre-registration nurses, students on the nursing associate programme and newly qualified nurses.

CHAPTER 1

Anatomy and physiology of cardiorespiratory system

Sheila Cunningham

Overview

Cardiorespiratory systems are key to human functioning. For a body, optimal functioning depends on the individual and collective functioning of all cells. For optimal functioning, each cell depends on a stable supply of nutrients and oxygen and on the removal of waste. Working in unison to ensure such supply of essential items and removal of wastes is core to homeostasis and growth and development.

Link to Future Nurse Proficiencies (NMC 2018)

Platform 3 Assessing needs and planning care Section 3.2: demonstrate and apply knowledge of body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology and social and behavioural sciences when undertaking full and accurate person-centred nursing assessments and developing appropriate care plans.

Annexe B: Nursing procedures Section 2: Procedures for assessing people’s needs for person-centred care. Specifically 2.7: undertake a whole body systems assessment including respiratory, circulatory, neurological, musculoskeletal, cardiovascular and skin status.

Expected knowledge

• The organs within the cardiovascular and respiratory systems
• Basic cellular needs and the concept of homeostasis
• The purpose of ‘vital signs’ and parameters within these for health.

Introduction

Considerable information about the condition and functioning of the cardiovascular system can be obtained by examining a person’s ‘vital signs’, which include pulse and blood pressure. The RCN (2017, 2) indicates that

the monitoring and measurement of vital signs and clinical assessment are core essential skills for all health care practitioners working with infants, children and young people. This guidance applies to professionals who work in acute care settings, as well as those who work in GP surgeries, walk-in clinics, telephone advice and triage services, schools and other community settings.

Whilst this guidance focusses on children and young people it also vitally important for all clients in whatever situation and need.

At a cellular level, humans and cells have similar needs: oxygen and nutrients to carry out metabolic functions, and removal and excretion of wastes such as carbon dioxide and other waste products. The role of the cardiovascular system is to transport oxygen and nutrients to cells and remove waste, thereby maintaining a stable internal environment known as ‘homeostasis’. In a complementary way, the role of the respiratory system is to take up oxygen and eliminate waste products from metabolism. As a unified team the cardiovascular and respiratory systems work dynamically together. Prior to performing associated skills, sound knowledge and understanding of these systems in terms of structure and function are essential.

Content

Cardiovascular functions	Control of blood pressure and heart rate	Regulation and homeostatic role of cardiovascular and respiratory systems
Respiratory functions	Control of breathing	Volumes and capacities

Learning outcomes

• Revisit the anatomical structures of the cardiorespiratory systems
• Differentiate lung volumes and capacities and why they are important in health monitoring
• Consolidate mechanisms and control of circulation and respiration
• Differentiate external and internal respiration and tissue needs including the role of microcirculation
• Reflect on knowledge of physiology and connections with nursing skills of monitoring vital signs.

Key background

All life forms are comprised of connected units called ‘cells’. This includes humans, animals and also some microorganisms such as bacteria. Like all living organisms, humans must maintain cell integrity and functioning to maintain life. Cells are not empty vessels but a complex blend of elements and components, namely chemicals, such as proteins, ions and other elements. This enables them to survive in very particular conditions and as such they are sensitive to changes in variables in the internal (as well as external) environment or ‘stressors’ such as changes in oxygen, heat or hydration. External and internal environments are constantly changing and impacting on cell and tissue functioning. Together with other stressors such as growth, ageing, diet and a wide variety of emotional and psychological triggers, environmental stressors can impact on physical functioning and disrupt performance. These can be translated into changes in processes or vital signs, or even to disordered functioning.

Normally, bodies are resilient in the maintenance of function (homeostasis) but when changes do occur they can manifest in a series of changes either physically (signs) or subjectively (symptoms) which can be observed or measured. As you may recall, stress is a key disruption to homeostasis and in the longer term can lead to problems such as behaviour changes (smoking, drinking, risky behaviours such as substance use) or ineffective coping mechanisms causing a ‘re-set’ of normal functioning physiologically or even psychologically. Considering physiology, this may manifest as alterations in respiratory or cardiovascular functioning (i.e. heart rate, blood pressure, respiratory volumes or hyperventilation). Nurses can determ...