Changes in the Cardiovascular System Related to Age

Question 1

Cardiac Valves

Answer 1

Change:
> Calcification and mucoid degeneration occur, especially in mitral and aortic valves

Nursing Interventions:
> Assess heart rate and rhythm and heart sounds for murmurs
> Question patient about dyspnea

Question 2

Conduction System

Answer 2

Change:
> Pacemaker cells decrease in number. Fibrous tissue and fat in the sinoatrial node increase.
> Few muscle fibers remain in the atrial myocardium and bundle of His
> Conduction time increases

Nursing Intervention: Assess the ECG and heart rhythm for dysrhythmias or a heart rate less than 60 beats/min

Question 3

Left Ventricle

Answer 3

Change:
> The size of the left ventricle increases
> The left ventricle becomes stiff and less distensible
> Fibrotic changes in the left ventricle decrease the speed of early diastolic filing by about 50%

Nursing Interventions:
> Assess the ECG for a widening QRS complex and a longer QT interval
> Assess heart rate at rest and with activity
> Assess for activity intolerance

Question 4

Aorta and Other Large Arteries

Answer 4

Change:
>The aorta and other large arteries thicken and become stiffer and less distensible. Systolic blood pressure increases to compensate for the stiff arteries
> Systemic vascular resistance increases as a result of less distensible arteries; therefore the left ventricle pumps against greater resistance, contributing to left ventricular hypertrophy

Nursing Interventions:
> Assess blood pressure
> Note increase in systolic, diastolic, and pulse pressures
> Assess for activity intolerance and shortness of breath
> Assess the peripheral pulses

Question 5

Baroreceptors

Answer 5

Change:
> Become less sensitive

Nursing Interventions:
> Assess the patient’s BP with the patient lying and then sitting or standing
> Assess for dizziness when the patient changes from a lying position to a sitting or standing position
> Teach the patient to change position slowly