This document discusses the integrated role of nurses in preventing cardiovascular disease (CVD) during the COVID-19 pandemic. It outlines modifiable and non-modifiable risk factors for CVD. It also describes the three levels of CVD prevention: primary, secondary, and tertiary. An example nursing diagnosis of activity intolerance related to imbalance between oxygen supply and demand is provided, along with defining characteristics, desired outcomes, and nursing interventions. The document concludes by emphasizing the importance of educating patients, families, and caregivers on seven simple lifestyle changes to reduce CVD risk.

2. Integrated Role Of Nurses in
Prevention Of CVD During COVID-19
Pandemic
Dr. Amr Abdrabou, CIA
Former Clinical Instructive Administrator, Nursing Administration
Dep. Faculty of Nursing, Cairo University, Egypt
Kasr-Alainy Hospital
amreid@cu.edu.eg

3. CVD
• is a very serious health condition
that keeps the heart or blood
vessels from working properly.
• If there is a clog in our blood
vessels or if our heart is not
pumping blood properly, this
prevents blood from being delivered
to many important parts of our
body.

4. Risk Factors
Modifiable risk factors :
• Tobacco smoke
• High blood cholesterol
• High blood pressure
• Obesity
• Psychosocial wellbeing
• Diabetes mellitus
• Physical inactivity
• Alcohol
Fixed factors :
• Increasing age
• Male sex
• Familial
(including race,
genetics)

5. Three levels of prevention
Primary
Prevention
Entire
Population
•- Reduction
of RF
•-Health
Promotion.
Secondary
Prevention
Those at risk
of CVD
-Early
detection of
the potential.
-Prevention of
asymptomatic
CVD.
Tertiary
Prevention
Already Have
CVD
-Treatment of
symptomatic CVD.
-Reduce CVD Progress
& Mortality (MI)
-Rehabilitation and
health edu.

6. Nursing Diagnoses
(NANDA)
• Decreased Cardiac Output related to Altered
myocardial contractility/inotropic changes.
• Activity Intolerance related to Imbalance
between oxygen supply/demand.
• Risk for Impaired Skin Integrity related to
the Presence of edema.
• Deficient Knowledge related to Lack of
understanding about cardiac
function/disease/failure .
• Ineffective Tissue Perfusion related to
Decreased cardiac output.

7. •Ex.
Activity Intolerance related to Imbalance between
oxygen supply/demand
DefiningCharacteristics :
• Weakness, fatigue.
• Changes in vital signs .
• Dyspnea.
• Pallor, diaphoresis.
DesiredOutcomes
• Participate in desired activities; meet own self-care needs.
• Achieve measurable increase in activity tolerance, evidenced by
reduced fatigue and weakness and by vital signs within acceptable
limits during activity.

8. Nursing Interventions
• Check vital signs before and immediately after activity, especially if patient is
receiving vasodilators, diuretics, or beta-blockers.
• Document cardiopulmonary response to activity. Note tachycardia, dysrhythmias,
dyspnea, diaphoresis, pallor.
• Assess for other causes of fatigue (treatments, pain, medications).
• Evaluate accelerating activity intolerance.
• Provide assistance with self-care activities as indicated.
• Assist patient with ROM exercises.Check regularly for calf pain and tenderness.
• Encourage patient to have adequate bed rest and sleep.
• Provide the patient with a calm and quiet environment.
• Assist the client in a semi-fowlers position.
• Assist the client in learning and demonstrating appropriate safety measures.

9. Take Home Message
Educate..
Patient/Family/Caregivers
7 Simple ways to live Better !
1. Avoid smoking and using tobacco products
2. Be physically active every day
3. Eat a heart-healthy diet and Nutritional
counseling.
4. Keep a healthy weight.
5. Keep your BP and total cholesterol +
blood sugar healthy.
6. Stress management and Psychological
support.
7. medication adherence.

10. References
• Murray CJ, Lopez AD.The global burden of disease, 1990–
2020. Nat Med 1998;4:1241
• Neaton JD, Wentworth D. Serum cholesterol, blood pressure,
cigarette smoking, and death from coronary heart disease. Arch
Intern Med 1992;152:56–64.
• Doll R , Peto R,Wheatley K, et al. Mortality in relation to
smoking: 40 years’ observations on male British
doctors. BMJ 1994;309:901–11.
• MacMahon S , Peto R, Cutler J, et al. Blood pressure, stroke,
and coronary heart disease. Part 1, prolonged differences in
blood pressure: prospective observational studies corrected for
the regression dilution bias. Lancet 1990;335:765–74.
•
Pocock SJ, Shaper AG, Phillips AN. Concentrations of high-
density lipoprotein cholesterol, triglycerides, and total
cholesterol in ischaemic heart disease. BMJ 1989;298:998–
1002.