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International Journal of Cardiovascular Nursing

The International Journal of Cardiovascular Nursing is a Peer reviewed Journal providing users with recent Advancements in the field of Cardiovascular Nursing, Case studies and Clinical Practice related to cardiovascular Conditions. The Journal covers both theoretical and practical Aspects of Nursing and Cardiovascular care.

Focus and Scope of the Journal  Physiological factors in Heart disease  Women and cardiovascular Disease  Acute Coronary Syndrome  Physiologic, Psycologic and Social needs of Cardiovascular Patients  Clinical Reviews  Epidemiology and Physiology  Cardiac Rehabilitation  Drug Therapy and Clinical Trials

International Journal of Cardiovascular Nursing is published twice a year (bi-annual) by JournalsPub an imprint of Dhruv Infosystems Pvt. Ltd., India. The outlooks stated in the articles do not essentially reflect of the publisher. The publisher does not endorse the quality or value of the advertised/sponsored products described therein. Please consult full prescribing information before issuing a prescription for any products mentioned in this publication. No part of this publication may be reproduced, stored in retrieval or transmitted in any form without written permission to the publisher. To cite any of the material contained in this journal, in English or translation, please use the full English reference at the beginning of each article. To reuse any of the material, please contact JournalsPub (info@journalspub.com).

PUBLICATION MANAGEMENT TEAM

Chairman Mr. Puneet Mehrotra Managing Director, JournalsPub, New Delhi

INTERNAL MEMBERS

Associate Manager Hidam Renubala

Commissioning Editors Ankita Singh

Dr. Chhavi Goel

Deepika Bhadauria

Manisha Dhoble Rekha Rani

EDITORIAL BOARD MEMBERS Dr. Sukhpal Kaur Lecturer, National Institute of Nursing Education, PGIMER, Chandigarh, India.

Dr. Sutapa Agrawal Epidemiologist, South Asia Network for Chronic Disease, Public Health Foundation of India Gurgaon (Haryana), India.

Dr. Gowrishankar Potturi Lecturer in Allied sciences, Allianze College of Medical sciences, Malaysia.

Mr. Nitin Nayyar Public Health Services & District Hospitals, National Health Mission, Delhi State Health Mission, New Delhi, India.

Dharitri Swain Department of Nursing, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Sijua, Odisha, India.

Simranjeet Kaur Cardiovascular and Thoracic Nursing, Lecturer, Manipal University, Karnataka, India.

Mr. N.J. Vasudevan Associate Professor, Chitra College of Nursing, Kerala, India.

Mr. Anil Sharma Joint Secretary, NRSI (Nursing Research Society of India), Associate Professor cum I/C Principal, Manikaka Topawala Institute of Nursing, CHARUSAT Changa & Charotar University of Science and technology, Changa.

Dr. Harmeet Kaur Principal, Chitkara School of Health Sciences, Chitkara University, Punjab, India.

Dr. C. Kanniammal Principal, Meenakshi College of Nursing, Mangadu, Chennai, 600069, MAHER, (Meenakshi University), India.

Dr. Bimla Rani Vice Principal, Mai Bhago College of Nursing, Punjab, India.

Ms. Kripa Angeline A. Associate Professor, Kasturba Gandhi Nursing College, Puducherry, India.

Mr. Vijay V R Demonstrator, Government College of Nursing, UP RIMS&R, UP, India.

Mr. Sembian. N. Associate Professor, Government Nursing College, U.P. Rural Institute of Medical Sciences & Research, Saifai, Etawah.

Dr. B. Tamilarasi Principal, Madha College of Nursing, Chennai, India

Dr. Renuka Gugan Professor of Nursing Sciences, Sri Balaji Vidyapeeth Puducherry, India

Dr. Rajee Reghunath Professor, Amala College of Nursing, Kerala, India

From the Editor's Desk Dear Readers, We would like to present, with great pleasure, the Second Volume of a new scholarly journal, International Journal of Cardiovascular Nursing. This journal is part of the Applied Sciences, and is devoted to the scope of present nursing issues, from theoretical aspects to application-dependent studies and the validation of emerging technologies. This new journal was planned and established to represent the growing needs of Cardiovascular Nursing as an emerging and increasingly vital field, now widely recognized as an integral part of scientific and technical investigations. Its mission is to become a voice of the Nursing Science community, addressing researchers and practitioners in this area. The core vision of International journal of Cardiovascular Nursing in JournalsPub is to propagate novel awareness and know-how for the profit of mankind ranging from the academic and professional research societies to industry practitioners in a range of topics in Plant Nursing in general. JournalsPub acts as a pathfinder for the scientific community to published their papers at excellently, well-time & successfully. International Journal of Cardiovascular Nursing focuses on original high-quality research in the realm of Physiological factors in Heart disease, Women and cardiovascular Disease, Acute Coronary Syndrome; Physiologic, Psychological and Social needs of Cardiovascular Patients, Clinical Reviews, Epidemiology and Physiology, Cardiac Rehabilitation, Drug Therapy and Clinical Trials. The Journal is intended as a forum for practitioners and researchers to share the techniques of Nursing and solutions in the area. Many scientists and researchers have contributed to the creation and the success of the Nursing community. We are very thankful to everybody within that community who supported the idea of creating an innovative platform. We are certain that this issue will be followed by many others, reporting new developments in the field of Nursing. This issue would not have been possible without the great support of the Editorial Board members, and we would like to express our sincere thanks to all of them. We would also like to express our gratitude to the editorial staff of JournalsPub, who supported us at every stage of the project. It is our hope that this fine collection of articles will be a valuable resource for Nursing readers and will stimulate further research into the vibrant area of Nursing. Puneet Mehrotra Managing Director

Contents 1. Drugs Used for the Treatment of Heart Diseases Avtar Singh

2. Heart Diseases: A Review Ranju Kondal

3. Effectiveness of Deep Breathing Exercise to Reduce Stress among Intradialytic Patients Admitted in Tertiary Care Hospital, Belagavi, Karnataka Ramakant R. Patil, Preeti R. Bhupali

4. Effectiveness of Self-Instructional Module on Knowledge of Digitalis Therapy Among the Nurses Working in Coronary Care Unit of Selected Tertiary Care Hospital, Belagavi, Karnataka, India Laxmi Shah, Deepak Bagi

5. Competency in Measuring Blood Pressure among Staff Nurses L. Premeshwori, N. Sembian, K. Jyoti

6. Lifestyle Diseases Swallows India Usha Sanjeev

International Journal of Cardiovascular Nursing

Vol. 2: Issue 2

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Drugs Used for the Treatment of Heart Diseases Avtar Singh

Army College of Nursing, Jalandhar, India

The heart is the body's primary pump for the development of blood. It circulates essential blood, oxygen, and supplements all through your body. Coronary illness happens when the veins of the heart are harmed or unhealthy. Coronary illness can have numerous genuine outcomes. It can prompt to a heart attack (myocardial dead tissue), congestive heart Failure, or arrhythmias, all of which can bring about death. Notwithstanding suggesting that a man roll out imperative way of life improvements, a specialist may recommend meds. These solutions have a few distinct objectives relying on how coronary illness particularly influences a patient's heart. A considerable lot of the medications endorsed for individuals with coronary illness have been authoritatively demonstrated to expand individuals' lives. Along these lines, while a few drugs may just control an indication or diminishing uneasiness, different ones will bring down the probability that a man with coronary corridor illness (CAD) will pass on from their infection. It's essential that individuals with CAD take the greater part of their pharmaceutical precisely as their specialists have endorsed it for them.

Albeit coronary course illness dependably influences the patient's heart, not all CAD is the same and in this way it's not all treated similarly.[1] For instance, a few patients experience difficulty with intemperate blood thickening while others have to bring down their pulse. Patients may need to use different medicines to deal with their coronary illness. Every

prescription ought to specialist's suggestions.

taken

Angiotensin-Converting Enzyme (ACE) Inhibitors Angiotensin is a hormone that makes the veins contract or get littler. This raises a man's circulatory strain. By lessening angiotensin levels, veins extend. Blood streams less demanding through the amplified veins, and pulse is diminished. A specialist would recommend an ACE inhibitor for individuals with hypertension or heart Failure in which the heart does not pump enough blood to meet the body's requests. These prescriptions are additionally essential post-heart attack. This is on the grounds that they can keep a future occasion and they likewise help the heart muscle recoup from the absence of oxygen amid the heart assault. Cases of these meds incorporate benazepril (Lotensin), ramipril (Altacte), and captopril (Capoten). Angiotensin II Receptor Blockers/Inhibitors (ARBs) Not at all like ACE inhibitors, have ARBs totally hindered the impacts of angiotensin II on the heart. This impact brings down circulatory strain. Specialists endorse this prescription to congestive heart disappointment patients and patients with hypertension. ARBs and ACE inhibitors have comparable capacities and purposes. Thinks about have indicated ACE inhibitors may moderate kidney sickness movement in patients with sort 1 diabetes and kidney malady. ARBs may moderate kidney illness movement in licenses with sort 2 diabetes and kidney ailment. Cases

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International Journal of Cardiovascular Nursing

Vol. 2: Issue 2

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Heart Diseases: A Review Ranju Kondal*

Department of Microbiology, Khalsa College, Amritsar, Punjab, India

ABSTRACT Our heart is the extent of your clench hand and the most grounded muscle in your body. Your heart began pulsating around three weeks after you were imagined. On the off chance that you live to be 70 your heart will have beat more than two billion times. Every pulse pumps blood around the body, pushing it from the left heart loads, through conduits of perpetually diminishing size, at last achieving the vessels in all parts of the body. Once your body has taken oxygen and supplements from the blood, it is come back to the heart by means of the veins to the right councils of the heart. On its way back, the blood goes through the liver and waste items are expelled. As magnificent as this framework seems to be, it is extremely defenseless against harm from the things we do to it, such as smoking, eating an undesirable eating routine or putting it under anxiety. Then again you might be conceived with a heart condition. At the point when your heart's capacities get to be bargained, this is known as cardiovascular illness, an expansive term that covers any confusion to the framework that has the heart at its middle. Keywords: cardiomyopathy, cardiovascular ailment, coronary, peripheral

INTRODUCTION Heart diseases are a class of illnesses that include the heart or veins. Cardiovascular ailment incorporates coronary corridor ailments (CAD, for example, angina and myocardial dead tissue (generally known as a heart attack).[1] Other CVDs are stroke, heart disappointment, hypertensive coronary illness, rheumatic coronary illness, cardiomyopathy, heart arrhythmia, intrinsic coronary illness, valvular coronary illness, carditis, aortic aneurysms, fringe conduit infection, and venous thrombosis. Cardiovascular illnesses are the main source of death all around. Types of Heart Diseases There are numerous cardiovascular infections including the veins. They are known as vascular infections.

    

Coronary course infection (otherwise called coronary illness and ischemic coronary illness) Peripheral blood vessel infection – sickness of veins that supply blood to the arms and legs Cerebrovascular malady – ailment of veins that supply blood to the cerebrum (incorporates stroke) Renal supply route stenosis Aortic aneurysm

There are additionally numerous cardiovascular ailments that include the heart.  Cardiomyopathy – maladies of cardiovascular muscle  Hypertensive coronary illness – maladies of the heart optional to hypertension or hypertension Heart failure – a clinical syndrome caused by

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Vol. 2: Issue 2

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Effectiveness of Deep Breathing Exercise to Reduce Stress among Intradialytic Patients Admitted in Tertiary Care Hospital, Belagavi, Karnataka Ramakant R. Patil*, Preeti R. Bhupali

Department of Medical Surgical Nursing, K.L.E.U’s Institute of Nursing Sciences, Nehru-Nagar, Belagavi, Karnataka, India

ABSTRACT Background: Chronic renal failure is one of the never-ending medical condition and a progressive loss in kidney function over a period of months of years. Hemodialysis is one of the medical management usually do for CRF patients. Stress is one of the common psychological symptoms experienced by the patients during dialysis. This study focuses on aim to evaluate the effectiveness of deep breathing exercise on reducing stress among intradialytic patients. Objectives: To find out the level of stress among intradialytic patients by using modified stress scale. To administer deep breathing exercise to the experimental group. To find out the effectiveness of intradialytic deep breathing exercise on stress reduction level. To find out association between intradialytic deep breathing exercise with selected demographic variables. Materials and methods: A randomized control trial conducted in intradialytic patients in dialysis unit. The study was conducted on a sample of 60 (30 experimental, 30 control). Data was collected by using modified stress scale prior to the procedure then intervention deep breathing exercise was given to experimental group. Results: The results revealed that paired ‘t’ test between pre-test stress scores and posttest stress scores in experimental group showed that there was significant reduction of stress (p<0.05). Paired ‘t’ test between pre stress scores and post stress scores in control group showed that there was no significant reduction of stress(p>0.05).Unpaired ‘t’ test between posttest stress scores in experimental group and posttest stress scores in control group revealed that there was significant reduction of stress in experimental group compared to control group(p<0.001). Conclusion: The results showed that deep breathing exercise is an effective, noninvasive and cost effective, nonpharmacological method of treatment among intradialytic patients to reduce stress, to increase coping ability and as a relaxation technique. Keywords: deep breathing exercise, intradialytic patients, stress

INTRODUCTION Presence of stress is one of the common psychological symptoms experienced by the patients during hemodialysis. Hemodialysis is one of the medical management usually do for CRF patients.[1] Hemodialysis patients are often contend with severe anxiety and stress

associated with their health, dialysis treatment, financial difficulties, insurance issues, juggling the uncertainty of dialysis with schedules etc.[2,3] So, the stress has to be controlled. The most effective stress reliever is deep breathing exercise.[4] Hence, the aim of the

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International Journal of Cardiovascular Nursing

Vol. 2: Issue 2

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Effectiveness of Self-Instructional Module on Knowledge of Digitalis Therapy Among the Nurses Working in Coronary Care Unit of Selected Tertiary Care Hospital, Belagavi, Karnataka, India Laxmi Shah*, Deepak Bagi

Department of Medical Surgical Nursing, KLE University’s Institute of Nursing Science, Belagavi, Karnataka, India

ABSTRACT A pre-experimental, evaluative research approach was used with one group pre-test post-test design was undertaken in KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi. The aim of the study to assess the knowledge on digitals therapy among coronary care nurses before and after introduction of self-instructional module and to find association between the pre-test posttest knowledge scores with selected demographic variables. The sample composed of 70 nurses working in coronary care unit (CCU) through non-probability Purposive sampling technique using structured knowledge questionnaire. Data was analyzed by using descriptive and inferential statistics. The study revealed that highest number 35 (50%) of the nurses were 20-25 years of age group where higher percentage 42 (60%) were female. Majority 43 (61.4%) of them were having diploma holder. Maximum number 53 (75.7%) nurses were from ITU. Maximum number 36 (51.4%) nurses had total years of clinical experience of 0-2 years where as majority 31 (58.6%) of nurses were having 0-2 years of experience in coronary care unit and did not attended training program (100%). The pretest posttest finding showed that, nurses had average level of knowledge regarding digitalis therapy whereas post test score was significantly higher than the pre-test score. Therefore, the self-instructional module was found to be effective teaching strategy in increasing the knowledge of the nurses on digitalis therapy. Keywords: digitalis, digoxin, heart failure, nurse, toxicity

INTRODUCTION Digitalis has been used as a therapy for a congestive heart failure for century.[1] Over the past decade, digoxin has received renewed attention because of recognition of its neuro hormonal effective and the successful used as lower dosages. In recent trials, digoxin has shown reduce morbidity associated with congestive heart failure. The goal of digitalis therapy to improve quality of life of congestive heart failure Patients by reducing symptoms and preventing hospitalizations.[2] Digitalis

toxicity is a complication of digitalis therapy due to more consumption of the drug at one time. The incidence of digitalis toxicity has been estimated from 5% to 23%. The digitalis intoxication is not only depends on dose but also interaction by other medications.[3] Recognition of cardiac glycosides toxicity is one of the main steps in management of toxicity.[4] In addition, adverse events occur because nurses are well trained towards the patients’ care, but less trained towards the potential error. Similarly, study has

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International Journal of Cardiovascular Nursing

Vol. 2: Issue 2

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Competency in Measuring Blood Pressure among Staff Nurses 1

L. Premeshwori1, N. Sembian2*, K. Jyoti3

Aditya College of Nursing, Yelahanka, Benguluru, India 2 U.P.U.M.S. Nursing College, Saifai, UP, India 3 GMCH, College of Nursing, Chandigarh, India

ABSTRACT Objective: To assess and describe the overall and area wise competency of measuring Blood pressure among Staff Nurses and find out the association of level of competency of Staff Nurses in measuring Blood pressure with selected demographic variables. Methods: Non experimental approach, descriptive study was conducted to measure the competency in measuring Blood pressure with 40 staff nurses. Convenient sampling technique was used and the data was collected by Check list on competency of Blood pressure measurement with nonparticipant observation technique. Result: Only six Staff Nurses had competent in measuring Blood pressure and 85 % had moderate competency level. The overall mean competency score of the Staff Nurses was 29.93. There was no association of level of competency of Staff Nurses in measuring Blood pressure with selected demographic variables except area of working. Conclusion: The study findings conclude that overall the Staff Nurses had moderate competency in measuring Blood pressure. Keywords: competency, blood pressure BACKGROUND Vital sign measurements are a basic series of physiological assessment that reflects the client’s health status. The Nurse uses these data when making clinical decisions. The Nurse is often the one who determines the need for and frequency of vital sign assessment.[1] Assessment of vital sign is not simply a routine task but rather an integral part of the nursing process. Blood pressure (BP) measurement is an important clinical nursing skill.[2] The clinical nursing skills for the Nurses are paramount important not only to provide comprehensive care but also enhance clinical competence.[3] Measurement of a patient’s BP is one of the most common and basic medical assessments. However, errors in measuring Blood pressure often occur. Most errors result because overestimates of Blood

pressure, which could result almost twice as many patients’ receiving the diagnosis of hypertension as actually have high Blood pressure. Many errors result in variability of readings and cause confusion regarding Blood pressure status.[4] The AHA recommends that at least two readings be taken, with a one-minute interval between them, and the average of the measurements recorded. The first reading of the series is usually the highest. Additional readings should be taken if the difference between the first two is greater than 5 mm Hg.[5] Small inaccuracies in Blood pressure measurement can have considerable consequence. Overestimating true Blood pressure by 5mm Hg would lead to inappropriate treatment with antihypertensive medications with exposure to adverse drug effects, the

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Lifestyle Diseases Swallows India Usha Sanjeev

Professor, Govt. College of Nursing, Kottayam, Kerala, India

Communicable diseases like malaria, cholera and polio have become manageable due to recent advancements in medicines. Now a new breed of diseases called’ lifestyle diseases’ has developed. Globally 14.2 million people between the 30-69 years of ages die prematurely every year from these diseases. These diseases have emerged as bigger killers than infectious or hereditary ones. Tobacco use, unhealthy diets and physical inactivity are the risk factors for these diseases. Life style diseases include obesity, type II diabetes, arteriosclerosis, heart disease, high blood pressure, swimmer’s ear, cancer, stroke, COPD, cirrhosis and nephritis. The National Family Health Survey figures suggest that currently India ranks second with 155 million obese citizens and are increasing at 33-51% every year. The International Diabetes Federation suggests that India has the largest number of people who suffer with type 2 diabetes at around 40.9 million people. Around 30% to 40% of cardiovascular deaths happen in India among the age group of 34–64 years of age. India ranks No.1 in cardiac patients,

around 50 million people in India suffer from heart problems. In India, more than 100 million people have high blood pressure. An estimated of 12.5% have suffered permanent damage to their hearing in India from excessive exposure to noise, and the number is growing each year. Cancer killed almost 556,400 people across the country in 2011. Indian studies have shown that about 10% to 15% of strokes occur in people below the age of 40 years. In India, approximately 36,149 people die each year due to cirrhosis. Around 39,480 deaths are estimated due to nephritis each year in India. Lifestyle diseases are preventable for the children if parents set them on the correct path, as our early life decisions and influences can impact us later on in life. All causes of lifestyle disease can be prevented through giving up smoking and alcohol, processed meats (sausages), red meats (pork, beef and lamb), fatty foods and by engaging in daily exercise. Hence, we have to take a step back and relearn how to lead physically active disease-free lives.

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