ch 22 - cardiovascular and cerebrovascular health and wellness Flashcards
which is serious: systolic heart murmur or diastolic heart murmur
diastolic is serious
systolic murmur is considered normal finding for older adult
first sign of cardiovascular disease
acute MI
unmodifiable risk factors for CVD (5)
- age
- gender
- family history
- race
- genetics
modifiable risk factors for CVD (6)
- smoking
- obesity
- poor diet
- physical inactivity
- excess alcohol use
- poverty (?)
treatable risk factors for CVD (5)
- DM
- HTN
- hyperlipidemia
- insulin resistance
- metabolic syndrome
recommended bp
no higher than 120/80
hypertensive emergency = target organ damage + bp of ?
> 180/>120
risk factors HTN
- smoking
- DM
- dyslipidemia
- overweight
- physical inactivity
- unhealthy diet
- psychosocial stress
- sleep apnea
causes secondary HTN
- CKD
- OSA
- meds (NSAIDs, decongestants, caffeine)
complications of HTN
- strokes
- acute Mi
- CAD
- dementia
S+S potential exacerbation of coronary heart disease in older adult
- dizziness
- gait/balance disturbances
- loss of appetite
- changes in mood
- unusual patterns urination/defecation
- excessive fatigue and pain
atypical signs chest pain in older adults
- dyspnea
- fatigue
major S+S CAD
- exertional sob
- less severe and shorter angina
- epigastric pain after eating in back/shoulders
S+S associated with afib in older adults
- recurrent falls
- fainting
- dizziness
- worsening HF
Tx afib
- antithrombotics
- b blockers
- aspirin, clopidogrel
- warfarin, anticoagulants
causes afib
- DM
- OSA
- thyroid disorders
- CHD
- HTN
atypical S+S HF older adults
- chronic cough
- insomnia
- weight loss
- nausea
- falls
is left sided HF associated with impaired diastolic or systolic function
diastolic
heart is unable to relax
is right sided HF associated with impaired diastolic or systolic function
systolic
always symptomatic
S+S left sided HF
-sob
S+S right sided HF
- sob
- fatigue
- edema
- sleep problems
warnings of sudden death with HF
- fainting
- uncontrolled afib
interventions to promote health for older adults with HF
- activity as tolerated
- meds
- diet (low cholesterol, sodium, and fat)
- fluid restriction
what is considered elevated bp
120/129/80
what is considered stage 1 HTN
130-139/80-89
what is considered stage 2 HTN
140+/90+
what bp is considered a hypertensive crisis
180/120
S+S peripheral vascular disease
- pain
- changes to skin
- wounds that won’t heal
S+S chronic venous insufficiency
- numbness
- tingling
- mild edema when standing
differences between arterial v venous insufficiency
ARTERIAL:
- pain relieved with exercise
- absent/weak pulses
- pallor with elevation, rubor with dependency
- coolness
- thin shiny dry skin
VENOUS:
- pain relieved with elevation
- normal pulses
- hyperpigmentation
- edema
- acute DVT
Dx PVD
- ankle brachial index
- doppler/duplex ultrasound
- CT angiogram
Tx PVD
- exercise
- protection of skin
- intermittent diuretics for severe edema
- compression stockings
should you put the legs up or down for arterial disease
legs down - promote circulation to extremities
should you put the legs up or down for venous insufficiency
legs up - promote movement of blood back to heart
cause of ischemic strok
blockage of blood to brain
cause of hemorrhagic stroke
artery in brain bleeds/ruptures
S+S ischemic stroke
- sudden weakness
- tingling
- neurological deficits
FAST assessment of person who might be having stroke
Face - smile, does one side droop
Arms - raise both arms, does one drift down
Speech - is speech slurred or strange
Time - call 911
Tx ischemic stroke
tPA
why can an ACE and ARB not be combined
risk hyperkalemia
serious complications PVD
- DVT
- PE
- amputation from wound that won’t heal
