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Gero Exam 1 > Ch 17: Cardiovascular > Flashcards

Ch 17: Cardiovascular Flashcards

1
Q

abnormal heart rate or rhythm

A

Arrhythmia

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2
Q

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

A

Atherosclerosis

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3
Q

consistent blood pressure reading >120 systolic and >80 diastolic

A

Hypertension

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4
Q

decline in cardiovascular function due to physical inactivity

A

Physical Deconditioning

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5
Q

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

A

Postural (Orthostatic) Hypotension

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6
Q

Effects of Aging on Cardiovascular Health

A

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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7
Q

Conditions altering tissue perfusion

A

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

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8
Q

age-related changes in cardiovascular disease

A

-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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9
Q

cardiovascular health promotion

A

proper diet
exercise
avoid cigarette smoke
manage stress

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10
Q

proper nutrition for cardiac function

A

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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11
Q

adequate exercise for cardiovascular health

A

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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12
Q

evaluation of blood pressure

A

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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13
Q

symptoms of hypertension in older adults

A

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

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14
Q

wide range of treatment

A

DASH diet
non-pharmacological measures
pharmacological

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15
Q

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

A

hypotension

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16
Q

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

A

postural or orthostatic hypotension

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17
Q

consequences of hypotension

A

falls
stroke
syncope
other coronary complications

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18
Q

what is responsible for most CHF cases

A

coronary artery disease

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19
Q

leading cause of hospitalization of older adults

A

CHF

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20
Q

CHF is a complication of:

A

arteriosclerotic heart disease

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21
Q

what happens in CHF

A

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

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22
Q

symptoms of CHF

A

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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23
Q

New York Heart Association Classification (NYHA)

A

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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24
Q

nursing care considerations for older adults with cardiovascular disease

A

-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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25
Q

what number do we want of total cholesterol number

A

under 200

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26
Q

what number for HDL

A

greater than 60

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27
Q

what number for LDL

A

less than 100

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28
Q

what number for VLDL

A

between 2 and 30

29
Q

what number for triglycerides

A

less than 150

30
Q

cardiac diet

A

decreased alcohol
decrease saturated fat
decrease

31
Q

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

A

pulmonary emboli

32
Q

how often for moderate vs high intensity exercise

A

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

33
Q

risk factors for pulmonary emboli

A

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

34
Q

s/s of pulmonary emboli

A

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

35
Q

how to confirm diagnosis of PE

A

lung scan or angiography

36
Q

important lab value for PE

A

D-Dimer usually elevated

37
Q

ischemic heart disease

A

coronary artery disease

38
Q

Vague discomfort under the sternum after exertion or a large meal

A

angina

39
Q

atypical presentation of angina

A

coughing
syncope
sweating
confusion

40
Q

treatment of angina

A

nitro - can lead to orthostatic hypotension
education

41
Q

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

A

MI

42
Q

atypical presentation of an MI

A

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

43
Q

number 1 symptom of CHF

A

dyspnea on exertion

44
Q

what are you at risk for with elevated cholesterol

A

cardiovascular disease

45
Q

what to evaluate with hyperlipidemia

A

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

46
Q

treatment for hyperlipidemia

A

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

47
Q

causes of arrythmias

A

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

48
Q

symptoms of arrythmias

A

weakness
fatigue
SOB
palpitations
confusion
dizziness
hypotension
bradycardia
syncope

49
Q

treatment of arrythmias

A

antiarrhythmic drugs
digitalis
potassium supplements
cardioversion
surgical ablations

50
Q

education for arrythmias

A

modify diet
smoking cessation
decrease alcohol and activity
take pulse

51
Q

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

A

arteriosclerosis

52
Q

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.

A

arteriosclerosis

53
Q

diagnosis of arteriosclerosis

A

arteriography
radiography
oscillometric testing

54
Q

treatment of arteriosclerosis

A

warmth
exercises
vasodilators

55
Q

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

A

beurger-allen exercises

56
Q

special cardiac problems associated with diabetes

A

-high risk for peripheral vascular problems
-arterial insufficiency
-

57
Q

characteristics of arterial insufficiency

A

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***

58
Q

diagnostic measures of associated diabetic problems

A

arteriography

59
Q

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

A

aneurysms

60
Q

locations of aneurysms

A

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

61
Q

what aids in the development of aneurysms

A

advanced arteriosclerosis

62
Q

treatments of aneurysms

A

stents
endovascular surgery

63
Q

characteristics of varicose veins**

A

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

64
Q

high risk patients for venous thromboembolism

A

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

**orthopedic sx

65
Q

s/s of venous thromboembolism

A

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

66
Q

treatment for venous thromboembolism

A

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

67
Q

General Nursing Considerations for Cardiovascular Condition

A

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

68
Q

foot care for PVD***

A

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

Gero Exam 1 (9 decks)

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