** Chapter 19: Cardiovascular Flashcards
Abnormal heart rate or rhythm
Arrhythmia
Hardening & narrowing of arteries due to plaque buildup in vessel walls
Atherosclerosis
Pain (usually in calf) when the affected leg is dorsiflexed, usually associated with deep vein thrombosis (can be deep phlebitis as well) of the leg
Homan’s sign
Consistent blood pressure reading >140 systolic & >90 diastolic
Hypertension
Decline in cardiovascular function due to physical inactivity
Physical deconditioning
Decline in systolic blood pressure for 20 mm Hg or more after rising & standing for 1 minute
Postural hypotension
Improved technology & increased public awareness resulted in decline in __ __.
heart disease
___ ___ has become the major cause of disability & death in older population.
Cardiovascular disease
Nursing interventions for prevention address potential problems related to ___
circulation
Heart valves become ___ and ___
thicker & rigid
The aorta becomes ____
dilated
There is slight ventricular ____
hypertrophy
There is thickening of the ___ ventricular wall
left
Myocardial muscles are less ___
efficient
There is decreased ___ strength in the heart.
contractile
There is also decreased ___ ___ when demands are increased by the heart.
cardiac output
___ and reduced ____ of the vessel also occur in the heart.
Calcification
elasticity
Also, the heart is less sensitive to baroreceptor regulation of ___ ___
blood pressure
Conditions altering tissue perfusion (most common ones):
- Cardiovascular diseases
- Diabetes, cancer, & renal failure
- Blood dyscrasias
- Hypotension
- Medication side effects
2 things to promote cardiovascular health:
- modify lifestyle and diet
- identify and lower risks through education
What are some important practices for cardiovascular health promotion?
proper diet, exercise, no cigarette smoking, manage stress, & proactive interventions
For proper diet & weight, you want to control your levels of ___
cholesterol
A proper diet to control nutrition is a diet low in __ __ and __.
fat cholesterol and salt
____ is important for optimal health.
Exercise
Physical deconditioning is related to ___ ___.
functional decline
You can enhance circulation with:
aerobic exercise, yoga, strengthening exercises, balance exercises, & tai chi
T/F: Smokers are usually aware of the risks?
True
___ is a normal part of life.
Stress
Educate regarding identification of stressors, ___ to stress, & effective ___.
reactions
management
Interventions for handling stress can include:
relaxation exercises, yoga, meditation, & other stress-reducing activities
Low-dose aspirin daily can reduce ____ events
cardiovascular
If your patient is on ____, that could be why they are having cardiovascular events.
aspirin
T/F: Light drinking may be beneficial
true
Comprehensive assessment of the cardiovascular system includes ___ ___ screening.
C-reactive protein
What test? Blood work. Looks at inflammatory markers for your patient.
C-reactive protein screening
Prevalence of Cardiovascular disease and women ___ with age.
increases
T/F: signs of cardiovascular disease differ with women.
true
What gender is this an example of when it comes to cardiovascular disease: Could be more vague. Like they have an MI but think they are just having acid reflex.
women
When discussing cardiovascular diseases, guide women about
NOT ignoring symptoms!!
Hypertension is defined as a:
Systolic blood pressure greater than ___ mm Hg
Diastolic blood pressure greater than ___ mm Hg
140
90
Factors to consider when monitoring blood pressure:
anxiety, stress, & activity, if their legs are crossed, etc before assessment will raise their BP
Symptoms: dull headache, impaired memory, disorientation, confusion, epistaxis, & slow tremor
Hypertension
Defined as: orthostatic/postural hypotension=decline in systolic blood pressure of 20 mm Hg or more after changing positions (lying sitting standing)
Hypotension
___ & ____ hypotension are due to increased intake of vasoactive medications & baroreceptor sensitivity can result in hypotension.
Postural & postprandial
Consequences of hypotension include:
falls, stroke, syncope, & other coronary complications
Leading cause of hospitalization?
Congestive Heart Failure
__ ___ ___ is a complication of arteriosclerotic heart disease.
congestive heart failure
__ __ __ is responsible for most cases when it comes to congestive heart failure.
Coronary artery disease
What disease? Symptoms: shortness of breath, dyspnea on exertion, confusion, insomnia, wandering at night, agitation, depression, orthopnea (might need to sleep with more pillows so their pulmonary edema doesn’t affect her breathing), wheezing, weight gain, & edema
congestive heart failure
What disease? Signs/symptoms: confusion, apprehension, shortness of breath, temperature elevation, pneumonitis, & elevated sedimentation rate
pulmonary edema
Some risk factors for pulmonary edema include:
fractures, congestive heart failure, arrhythmias, history of thrombosis, & immobilization, lung cancer
A condition where the major blood vessels supplying the heart are narrowed.
Ischemic heart disease
Nitroglycerin is effective to use for __.
angina
Atypical presentation of ___ ___: confusion, decreased blood pressure, shortness of breath, elevated temperature, & sedimentation rate increases
myocardial infarction
Atypical presentation of ___: coughing, syncope, sweating, & confusion
Angina
Defined as: Elevated full lipid profile, triglycerides, high-density lipoprotein, & low-density lipoprotein
hyperlipidemia
What are 3 treatments for hyperlipidemia?
- dietary changes
- medications
- alternative & complimentary therapies
What can digitalis toxicity, hypokalemia, acute infections, hemorrhage, anginal syndrome, & coronary insufficiency cause?
arrhythmias
Symptoms: weakness, fatigue, palpitations, confusion, dizziness, hypotension, bradycardia, & syncope
arrhythmias
Education on preventing arrhythmias:
modify diet, smoking cessation, decrease alcohol, & activity
__ is common especially among those with diabetes.
Arteriosclerosis
PVD affects the ___ vessels ___ from the heart.
smaller
furthest
Treatment of PVD?
warmth, exercises, & vasodilators
How do you diagnose PVD?
arteriography, radiography, & oscillometric testing (blood pressure cuff)
Diabetics have a high risk for __ __ __
peripheral vascular problems
Arterial insufficiency includes what 3 things?
- Resting pain: aka intermittent claudication
- Arterial pulses are absent or difficult to palpate
- Skin discoloration, ulcerations, & gangrene
Advanced arteriosclerosis aids in the development of __.
aneurysms
Some see, some palpable, & others detected by radiography.
aneurysms
___ can develop from aneurysms.
Thrombosis
Dilated, tortuous nature of vein.
varicose vein
What are symptoms of varicose veins?
Dull pain, cramping, can interfere with sleep
Patients with varicose veins are susceptible to __ & ___.
trauma & infection
Treatment for varicose veins is aimed at reducing __ __.
venous stasis
Edema, warmth over affected area, pain in foot, cyanosis, aching, & engorgement of superficial veins are all signs of ___ ___
venous thromboembolism
You treat venous thromboembolism or varicose veins with what medication?
anticoagulants
General Nursing Considerations for Cardiovascular Conditions can include:
- Prevention
- Keep the patient informed
- Prevent complications
- Promote circulation
- Provide foot care
- Manage problems associated with peripheral vascular disease
- Promote normality
- Integrate complementary therapies
3 levels of prevention:
Primary: prevention of illness, screening
Secondary: prevention progression of illness
Tertiary: improve quality of life, reduce disability, delay complications
___ can promote skin breakdown.
Edema
List ways you can prevent skin breakdown:
Change position frequently Proper alignment for body Monitor conditions that increase chances of edema Protect from skin breakdown Monitor, observe, & document
To prevent cardiovascular complications you should assess vital signs and ___ ____, and use careful administration of ___.
fluid balance
oxygen
Patients may have the potential for what 2 complications to develops?
- anorexia
- vagal stimulation (stimulation in the vagus nerve)
Patients with cardiovascular diseases have an increased risk of altered __ __ .
tissue perfusion
People with peripheral vascular disease must pay special attention to their __.
feet
When integrating complementary therapies, some conventional measures include:
Meditation Biofeedback Guided imagery Tai chi Yoga
What is the full benefit of complementary therapies?
less intrusive, less expensive, & minimal risk
Symptoms: dull headache, impaired memory, disorientation, confusion, epistaxis, & slow tremor
Hypertension
Consequences=falls, stroke, syncope, & other coronary complications
Hypotension
Dizziness, light-headedness Fainting Unsteadiness Blurred vision Heartbeats become more noticeable Confusion Tiredness Nausea
hypotension
Symptoms: shortness of breath, dyspnea on exertion, confusion, insomnia, wandering at night, agitation, depression, orthopnea, wheezing, weight gain, & edema
CHF
Signs/symptoms: confusion, apprehension, shortness of breath, temperature elevation, pneumonitis, & elevated sedimentation rate
PE
Atypical presentation: confusion, decreased blood pressure, shortness of breath, elevated temperature, & sedimentation rate
MI
Atypical presentation: coughing, syncope, sweating, & confusion
Angina
Fatigue, weakness, and lethargy Depression and disinterest in activities Anorexia Weight gain and puffy face Impaired hearing Periorbital or peripheral edema Constipation Cold intolerance Myalgia, paresthesia, and ataxia Dry skin and coarse hair
hypothyroisism
Classic symptoms of ___ include diaphoresis, tachycardia, palpitations, hypertension, tremor, diarrhea, stare, lid lag, insomnia, nervousness, confusion, heat intolerance, increased hunger, proximal muscle weakness, and hyperreflexia.
hyperthyroidism
