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Running head: “ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

Authors’ Name

Institution

1

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

2

Introduction
There are significant and advanced levels of interventions that could be adopted in
preventing cardiovascular diseases (CVD) in women
...
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
...
al
...
This could conversely be approximated as 1 death in every 2
minutes
...
The CVD is disproportionately
afflicting both racial and ethnic minorities hence it could be regarded as a prime target for
prevention (Ross et
...
, 2009; Pochciol & Warren, 2009)
...
, 2000)
...
Other considerations like atherosclerotic/ thrombotic CVD, for
example; peripheral arterial disease and cerebrovascular disease are critical, hence should be
taken seriously in women
...
al
...


“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

3

In accomplishing the assignment, the key words used would be explained; research years
which data was obtained, databases used would also be explained
...

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
...

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
...
,
2004)
...
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

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

4

adopted to enhance disease free life among women who are the most vulnerable to CVD (Boaz,
Smetana & Weinstein, et al
...

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
...
, 2004)
...
al
...
al
...
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)
...
al
...
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)
...
al
...
This creates better opportunities for
them to identify strategies that improves and also prevents the spread of devastating cases of
cardiovascular disease
...
, 2000)
...
al
...
There is growing or appreciating
continuum of CVD risks globally
...
Such schemes are effective in enhancing intensity
in the way in which health workers handle baseline preventive strategies against increased cases
of CVD risks (http://www
...
org/awareness-women
...
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)
...
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
...
al
...

The distinct countries strive to adopt strategies that could enhance effective practices to
prevent cardiovascular ailments in women
...


“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

6

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)
...
But either symptom or asymptotic Carotid artery disease with >50% stenosis, would
confer high risk (http://www
...
org/awareness-women
...

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
...
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)
...
al
...

However, in ensuring that health practitioners deliver tasks well regarding preventive
mechanisms of CVD in women
...
,

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

7

2000)
...
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
...

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
(http://www
...
org/awareness-women
...

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)
...
al
...
However,
in the contemporary world, nurses encounter myriad problems especially when dealing with
agencies that provide health care services and the local community members
...
al
...
al
...
Research outcomes within the
global health sectors indicate that cardiovascular diseases are critically global issues (Beaglehole
et
...
, 2007)
...
al
...
In the quest to reduce the rate and also prevent CVD, cardiovascular nurses are
of great importance
...

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)
...
This would
enhance ability to derive better understanding of the practices that promotes and increased
chances of being diagnosed with cardiovascular diseases
...
al
...
This is the reason as to why mentoring the
nurse practitioners on the best strategies to adopt would be of great importance
...
al
...
This influences the common human practice that predisposes the global
populace to the chronic ailments globally (Polit & Beck, 2008; Melnyk, 2010)
...
al
...
al
...
This jeopardizes the work or role of nurse
practitioners in preventing cardiovascular diseases in women
...
Nursing personnel have to
ensure that they are well equipped with literal information that would support their statements in
relation to CVD (Beaglehole et
...
, 2007; Hammick et
...
, 2007; McCloughen et
...
, 2009)
...
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)
...
This should
involve the use of local and national languages so that vulnerable groups would realize

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

10

respective risk factors
...

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
...
, 2009; Pochciol & Warren, 2009)
...
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)
...
Most of the
best nurse professional often seeks greener pasture abroad
...
al
...
al
...
However, dealing with native populations is
a challenge to the nurse practitioners
...
al
...
There are cultural beliefs that continue to exist with increase in population
...
This has
jeopardized efforts to realize the signs and symptoms of heart diseases in women (Ross et
...
,
2009; Pochciol & Warren, 2009)
...
al
...
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)
...
al
...

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)
...
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)
...
al
...

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)
...
al
...
al
...
al
...

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)
...
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
...
al
...

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)
...
Women, are the persons involved in food
handling and preparation, are characterized by duties that do not require a lot of energy hence

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

13

they are prone to cases like diabetes and obesity (Rust & Cooper, 2007; Melnyk, 2010)
...

However, despite efficacy of recommendations: what has been proven through clinical
research (Hammick et
...
, 2007; McCloughen et
...
, 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)
...
al
...

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)
...

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
...
,
2007; McCloughen et
...
, 2009)
...
Nurse

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

14

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)
...

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
...
, 2007; McCloughen et
...
, 2009)
...
According to research done by American Health
Association (AHA), recommendation associated with women often change (American College of
Cardiology Foundation & American Nurses Association, 2008)
...
This also affirms why research indicate that
women are at higher risk comparatively to men (Rust & Cooper, 2007; Melnyk, 2010)
...
Nurse practitioners showcase the dire need to enhance safe
practices, according to emphasis from expert panel (Melnyk, 2010; Hammick et
...
, 2007;
McCloughen et
...
, 2009)
...
al
...
Nurse practitioners and

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

15

other clinical medics should be aggressive so that interventions would be initiated early to
prevent higher risks factors (Beaglehole et
...
, 2007)
...
al
...
This calls for
realization and identification of thresholds for what could be considered as high risks associated
with cardiovascular diseases (Rust & Cooper, 2007)
...
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)
...
al
...
al
...

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)
...
al
...
In addition,
more emphasis indicates that between men and women, gender factor creates differences in
cardiovascular outcomes
...
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)
...

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)
...
In order to address these factors nurse practitioner and
other clinical medics should recommend debigatran as new alternative to warfarin (Polit & Beck,
2008)
...
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
...
, 2007; McCloughen et
...
, 2009)
...
This implies that
such people should undergo thorough scan to affirm their conditions as far as cardiovascular
diseases are concerned (Hammick et
...
, 2007; McCloughen et
...
, 2009)
...

Physicians and nurse practitioners should endeavor to direct depressed persons for
screening (Beaglehole et
...
, 2007)
...
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)
...
Most of the patients do not intend to take preventive
medication so that they could avert the malady (Polit & Beck, 2008)
...
worldheart
...
php
...

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
...
, 2007)
...
Conversely, such encounters often jeopardize efforts by nurse practitioners to continue

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

18

advocating for healthy practices that acts as preventive measures against cardiovascular heard
diseases (Rust & Cooper, 2007; Hammick et
...
, 2007; McCloughen et
...
, 2009)
...

Hence there would be hope of deriving more appropriate recommendations on net balance of
benefits and corresponding risks (Hammick et
...
, 2007; McCloughen et
...
, 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)
...
There are a series of marked disparities between men and women, and among group of
women in particular (Polit & Beck, 2008)
...
al
...

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,

“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

19

2008)
...
al
...
al
...

Research literature indicates that nurse practitioners have to deal with three major
explanations: provider bias, sex-based physiology and psychological influences (Ross et
...
,
2009; Pochciol & Warren, 2009)
...
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)
...

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
...
, 2007; McCloughen et
...
, 2009)
...
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)
...
al
...
For example, they are able to monitor hemodynamic functions in disease management
...
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)
...
It is explicit that nurse practitioners perform commendable work in prevention
and implementation of patient compliance in cardiovascular care (Hammick et
...
, 2007;
McCloughen et
...
, 2009)
...

Nurse's Skills in Cardiovascular Challenges
In science, there are areas within the cardiovascular Care where nurse practitioner’s skills
greatly make a difference
...
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)
...
al
...

According to scientific research, among the main causes of death experienced in Critical
Nurse Care is inadequate oxygenation (Hammick et
...
, 2007; McCloughen et
...
, 2009)
...
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)
...
al
...
This would conversely promote
physiological adaptations that prevent further complications associated with hypoxia for
example; cardiac arrest, cardiac dysrhythmias, and hypotension (McCloughen et
...
, 2009)
...

There is need for medical scientists to derive accurate regarding cardiac rhythm
monitoring from competence nurse practitioners (Hammick et
...
, 2007; McCloughen et
...
,
2009)
...
This affirms the
reason as to why nurse practitioners are the best teams to enhance preventive management of
cardiovascular diseases in women (Ross et
...
, 2009; Pochciol & Warren, 2009)
...
They warrant adoption of
appropriate assessment of cardiovascular and neurological signs
...
Mitral Stenosis is another one that poses significant risk of maternal mortality and
morbidity in pregnant women http://www
...
org/awareness-women
...
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
...
, 2007)
...
al
...
It entails cardiac
catheterization and also precutaneous coronary intervention
...

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
...
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
...
, 2007)
...

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
...


“ROLE OF THE NURSE PRACTITIONIER IN THE PREVENTION OF
CARDIOVASCULAR DISEASE IN WOMEN”

24

References

American College of Cardiology Foundation, American Nurses Association
...

Cardiovascular Nursing: Scope and Standards of Practice
...
Org
...
(2007)
...
Lancet
...

Hammick M, Freeth D, Koppel I, Reeves S, Barr H
...
A best evidence systematic review
of interprofessional education: BEME guide no
...
Med Teach
...

McCloughen A, O'Brien L, Jackson D
...
Esteemed connection: creating a mentoring
relationship for nurse leadership
...
16(4):326-336
...
(2010)
...
Am J Nurs
...

Pochciol JM, Warren JI
...
An information technology infrastructure to enable evidencebased nursing practice
...
33(4):317-324
...
(2008)
...
8th ed
...

Ross AM, Noone J, Luce LL, Sideras SA
...
Spiraling evidence-based practice and
outcomes management concepts in an undergraduate curriculum: a systematic approach
...
48(6):319-326
...
(2007)
...
20(2):105-114
...
World Heart Federation Web site
...
worldheart
...
php
...




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