Ch 17: Cardiovascular Flashcards by Tyece Henry

abnormal heart rate or rhythm

Arrhythmia

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hardening and narrowing of arteries due to plaque buildup in vessel walls

Atherosclerosis

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consistent blood pressure reading >120 systolic and >80 diastolic

Hypertension

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decline in cardiovascular function due to physical inactivity

Physical Deconditioning

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decline in systolic blood pressure of 20 mm Hg or more after rising and standing for 1 minute

Postural (Orthostatic) Hypotension

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Effects of Aging on Cardiovascular Health

Heart valves become thicker and rigid
Aorta becomes dilated
–Slight ventricular hypertrophy
–Thickening of left ventricular wall
Myocardial muscle less efficient
–Decreased contractile strength
–Decreased cardiac output when demands increased
Calcification, reduced elasticity of vessels
Less sensitive to baroreceptor regulation of blood pressure

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Conditions altering tissue perfusion

Cardiovascular diseases
Diabetes, cancer, and renal failure
Blood dyscrasias
Hypotension
Medication side effects
Other issues of concern

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age-related changes in cardiovascular disease

-more prominent arteries in head, neck, and extremities
-valves become thicker and more rigid
-stroke volume decreases by 1% per year
-heart pigmented with lipfuscin granules
-less efficient O2 utilization
-aorta becomes dilated and elongated
-cardiac output decreases
-resistance to peripheral blood flow increases by 1% per year
-blood pressure increase to compensate for increased peripheral resistance and decreased cardiac output
-less elasticity of vessels

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cardiovascular health promotion

proper diet
exercise
avoid cigarette smoke
manage stress

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proper nutrition for cardiac function

Control of cholesterol – HDL, LDL, VLDL, Triglycerides
Reduced intake of fried and fatty foods, red meat, sugar, and highly processed foods
Reduced cardiovascular and cerebrovascular incidents
Nutritional supplements
Fish Oil, Omega-3 Fatty Acids, Vitamin B6, Garlic
Various diets – low saturated fat, Mediterranean Diet. Diet low in saturated fat and high in fiber, fruits, and vegetables
Dr. Ornish’s Dietary Program for reversing Heart Disease

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adequate exercise for cardiovascular health

Regular exercise versus spurts of activity
Physical deconditioning related to functional decline – decreased efficiency utilizing available oxygen.
Enhance circulation with aerobic exercise, yoga, strengthening exercises, balance exercises, and tai chi

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evaluation of blood pressure

Systolic blood pressure greater than 120 mm Hg
Diastolic blood pressure greater than 80 mm Hg

Factors to consider when monitoring blood pressure: anxiety, stress, and activity before assessment

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symptoms of hypertension in older adults

from no symptoms, dull headache, impaired memory, disorientation, confusion, epistaxis, and slow tremor

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wide range of treatment

DASH diet
non-pharmacological measures
pharmacological

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Decline in systolic blood pressure of 20 mm Hg or more after changing positions

hypotension

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occurs due to increased intake of vasoactive medications, baroreceptor sensitivity, and diseases of the heart

postural or orthostatic hypotension

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consequences of hypotension

falls
stroke
syncope
other coronary complications

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what is responsible for most CHF cases

coronary artery disease

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leading cause of hospitalization of older adults

CHF

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CHF is a complication of:

arteriosclerotic heart disease

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what happens in CHF

reduced elasticity and lumen size of the vessels, and increase in BP that interferes with blood supply to the heart

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symptoms of CHF

shortness of breath, dyspnea on exertion, confusion, insomnia, wandering at night, agitation, depression, orthopnea, wheezing, weight gain, and bilateral ankle edema

crackles are also heard on auscultation

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New York Heart Association Classification (NYHA)

Class 1 - no physical
limitations
Class 2 - light limitations with ordinary physical activity
Class 3 - symptoms limit ordinary physical activities
Class 4 - symptoms with any activity and rest

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nursing care considerations for older adults with cardiovascular disease

-cluster activities allowing for rest period
-monitor for edema and subsequent skin breakdown
-daily weight - report gain of greater than 3 pounds in less than several days or 10 in a month
-low salt diet
-watch cough, fatigue, DOE, and changes in skin color and pulse

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what number do we want of total cholesterol number

under 200

what number for HDL

greater than 60

what number for LDL

less than 100

what number for VLDL

between 2 and 30

what number for triglycerides

less than 150

cardiac diet

decreased alcohol decrease saturated fat decrease

occurs when a clump of material, most often a blood clot, gets stuck in an artery in the lungs, blocking the flow of blood.

pulmonary emboli

how often for moderate vs high intensity exercise

moderate = 5x a week high = 3x a week

risk factors for pulmonary emboli

fractures, congestive heart failure, arrhythmias, history of thrombosis, and immobilization

s/s of pulmonary emboli

confusion, apprehension, shortness of breath, temperature elevation, pneumonitis, and elevated sedimentation rate

how to confirm diagnosis of PE

lung scan or angiography

important lab value for PE

D-Dimer usually elevated

ischemic heart disease

coronary artery disease

Vague discomfort under the sternum after exertion or a large meal

angina

atypical presentation of angina

coughing syncope sweating confusion

treatment of angina

nitro - can lead to orthostatic hypotension education

midsternal chest heaviness, radiation, associated with nausea/vomiting, diaphoresis

atypical presentation of an MI

confusion, decreased blood pressure, shortness of breath, elevated temperature, fatigue, and sedimentation rat

number 1 symptom of CHF

dyspnea on exertion

what are you at risk for with elevated cholesterol

cardiovascular disease

what to evaluate with hyperlipidemia

full lipid profile, triglycerides, high-density lipoprotein, and low-density lipoprotein

treatment for hyperlipidemia

dietary changes, niacin, medications, and alternative and complementary therapies

causes of arrythmias

digitalis toxicity hypokalemia acute infections hemorrhage anginal syndrome CHF coronary insufficiency Afib

symptoms of arrythmias

weakness fatigue SOB palpitations confusion dizziness hypotension bradycardia syncope

treatment of arrythmias

antiarrhythmic drugs digitalis potassium supplements cardioversion surgical ablations

education for arrythmias

modify diet smoking cessation decrease alcohol and activity take pulse

common especially among those with diabetes Affects smaller vessels furthest from heart

arteriosclerosis

blood vessels that carry oxygen and nutrients from the heart to the rest of the body (arteries) become thick and stiff — sometimes restricting blood flow to the organs and tissues.

arteriosclerosis

diagnosis of arteriosclerosis

arteriography radiography oscillometric testing

treatment of arteriosclerosis

warmth exercises vasodilators

are active postural exercises in which gravity alternately deflates and fills blood vessels to increase blood flow to the lower limbs

beurger-allen exercises

special cardiac problems associated with diabetes

-high risk for peripheral vascular problems -arterial insufficiency -

characteristics of arterial insufficiency

Resting pain: intermittent claudication Arterial pulses: absent or difficult to palpate Skin discoloration, ulcerations, and gangrene Loss of hair and/or shiny skin on the extremities***

diagnostic measures of associated diabetic problems

arteriography

outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall

aneurysms

locations of aneurysms

aorta, brain, mesenteric, renal arteries, but mostly seen in the abdominal aorta in older adults

what aids in the development of aneurysms

advanced arteriosclerosis

treatments of aneurysms

stents endovascular surgery

characteristics of varicose veins**

dilated, tortuous nature of vein dull pain, cramping, can interfere with sleep dizziness may occur makes the skin more susceptible to trauma and infection - rupture and bleeding treatment aimed at reducing venous stasis = pooling

high risk patients for venous thromboembolism

restricted to bed rest, recent surgery, and fractures of lower extremities **orthopedic sx

s/s of venous thromboembolism

Edema, warmth over affected area, pain in foot, cyanosis, aching, and engorgement of superficial veins

treatment for venous thromboembolism

Anticoagulants, surgery, elastic stockings, bandages, and elevation of extremities

General Nursing Considerations for Cardiovascular Condition

Prevention Keep the patient informed Prevent complications Promote circulation Provide foot care Manage problems associated with peripheral vascular disease Promote normality Integrate complementary therapies

foot care for PVD***

Bathe and inspect daily Avoid injury - can lead to amputations Prompt attention for any lesions Potential for fungal infections - take off socks and shoes throughout the days Wear socks with shoes

Ch 17: Cardiovascular Flashcards

(68 cards)