CV Flashcards

1
Q

primary function

A

bringing O2 and nutrients to organs and transporting CO2 and other waste products for removal

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2
Q

myocardium + age-related changes

A
  • scaffolding of the heart chambers
  • decreasing cardiac contractility
  • more time for diastolic filling and systolic emptying
  • less responsive to SNS
    > > fight, flight, freeze
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3
Q

myocardium + age-related changes
–electrophysiology decline

A
  • less pacemaker cells
  • irregularity in shape of pacemaker cells
  • increased deposits of fats, collagen, and elastic fibers around SA node
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4
Q

vasculature: age-related changes

A
  • changed in tunica intima and media
    > > endothelial cells become - irregular in size/shape
  • diameter of lumen of aorta increases to compensate for arterial stiffening
  • veins become thicker, more dilated, less elastic
  • increased vascular resistance > > increase in systolic BP
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5
Q

vasculature: age-related changes

A
  • increased peripheral resistance diminishes ability to increase blood flow to vital organs
  • due to peripheral resistance the LV is
    forced to work harder and becomes larger and
    thicker
  • valves of large leg veins become less efficient in
    returning blood to heart
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6
Q

Baroreflex Mechanism

A

receptors in aortic arch and carotid artery
physiologic process that regulates BP
- BP high, baroreceptor send signal to brain
- brain sends cardiac inhibitory signal to heart or blood vessel to decrease
sympathetic response (ie. lower the HR, lower the CO and decrease resistance) and lower the BP

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7
Q

Baroreflex Mechanism-Age
Related Changes

A
  • decreased compensatory responses in both hyper/hypo stimuli
  • Baroreceptors in large arteries less effective in controlling BP
    > > postural changes
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8
Q

Consequences of Age-Related Changes

A
  • decreased adaptive response to exercise
  • slightly lower HR
    ^ susceptibility to hyper AND hypo
    ^ susceptibility to arrythmias (i.e., atrial fib)
  • decreased cerebral blood flow
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9
Q

Pathological Risk Factors Affecting CV Function

A
  • Arrhythmias
  • Heart Failure
  • Myocardial Infarction (MI)
  • Peripheral Vascular Disease (PVD)
  • Venous Thromboembolism (DVT or PE)
  • Stroke (aka CVA)
  • Transient Ischemic Attack (TIA)
  • Atherosclerosis
    NOTE: Most CV disease is preventable through
    interventions to reduce risk factor
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10
Q

atherosclerosis

A

def: disorder of the medium and small arteries in which deposits of lipids and atherosclerotic plaques reduce or obstruct blood flow
- atherosclerotic changes begin in childhood and can progress to plaque formation
- plaque lesions can rupture (causing acute
events) OR remain stable and continue to grow (causing chronic disease

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11
Q

modifiable risk factors
– physical inactivity

A

def: <30 mins of moderate physical activity 5x/ wk or <20 mins of vigorous physical activity 3x/ wk
- older adults often have compounding conditions making reaching these goals difficult
- any physical activity reduces the CV disease risk

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12
Q

modifiable risk factors
– smoking + 2nd-hand smoke

A
  • all exposure to smoking increases risk of CV disease
    and mortality
  • on avg. both M and F smokers reduce their life expectancy by 13-15 years
  • non-smokers exposed to second-hand smoke ^ their risk for developing Coronary Artery Disease (CAD) by 25-30%
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13
Q

modifiable risk factors
– dietary habits

A
  • high intake of saturated fats increases risk of CV
    disease
  • intake of 2.5 servings of whole grains/ day associated with 21% reduction in CV disease
  • intake of 1-2 servings of oily fish/ week lowered risk of CV disease by 36%
  • each daily serving of fruit/ veg associated with 4%
    reduction in CAD and 5% reduction in stroke
  • low sodium intake associated with at 25% reduction in CV disease after 10-15 yrs follow-up
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14
Q

obesity

A

BMI 30 kg/m2 <

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15
Q

hypertension (HTN)

A

risk factors:
- age
- ethnicity
- heredity
- weight
- physical inactivity
- psychosocial stressors
- sleep apnea
- low education
- low socioeconomic factors

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16
Q

dyslipidemia

A

broad term of lipoprotein metabolism
- statin and other cholesterol-lowering meds can be prescribes

17
Q

HDL cholesterol

A

good cholesterol
- high number = good

18
Q

LDL cholesterol

A

bad cholesterol
- low number = good

19
Q

non-HDL cholesterol

A

total cholesterol - HDL cholesterol
- low number = good

20
Q

triglycerides

A

high reading = bad

21
Q

metabolic syndrome

A
  • a group of clinically identifiable conditions that double the risk of CV disease and ^ the risk of NIDDM by five times.
    ** chronic, unmanaged

the existence of 3 of 5 constitutes a dx of “Metabolic Syndrome”:
1 ) abdominal obesity
2 ) BP = / > 130/85
3 ) HDL cholesterol levels <1.03 OR on treatment for a lipid disorder
4 )Triglyceride levels higher than 1.7 mmol/L or on treatment for hypertriglyceridemia
5 ) Fasting blood glucose levels (FBG) level > 5.6 OR on pharmacologic treatment for ^ glucose level

22
Q

NIDDM

A

non-insulin dependent diabetes mellitus

23
Q

Psychosocial Factors

A
  • anxiety
  • depression
  • social isolation
  • poor social supports
  • specific personality traits
    > > high anger and hostility
    major life events (stressors)
24
Q

Heredity, Gender, Race

A

Heredity: inherited conditions cannot be changed, but people who are aware of genetic risks can be more motivated to address modifiable risk factors.
Socioeconomic status: low income and lack of education can influence the use of preventive and interventional health care, leading to poorer CV outcomes.
Gender: symptoms of heart disease differ in women and men, and are often not recognized (atypical) in women and older adults

25
Q

orthostatic hypotension

A
  • reduction in systolic/diastolic BP of at least 20 or 10 mmHg within 1-3 min of standing
    symptoms:
  • fatigue
  • blurred vision
  • lightheadedness
  • syncope upon standing
26
Q

postprandial hypotension

A

reduction in systolic BP of 20 mmHg < within 2 hrs of eating a meal
causes: impaired autonomic function
contributing factors:
- GI vasoactive peptides
- impaired glucose metabolism/diabetes

27
Q

S&S of CV disease

A

atypical symptoms
- fatigue
- nausea
- anxiety
- headache
- cough
- visual change
- SOB
- pain in arm, jaw, neck or throat

28
Q

nursing assessment of CV function

A
  • H2T
  • determining baseline ‘normal’ = important
  • self-measurement of BP by capable older adults or caregivers
  • assess modifiable risks
  • determine if they know when to initiate immediate help-seeking actions
  • assess OAs knowledge of what they would do
29
Q

health promotion

A

detection of risks for CV diseases
reduction of risks

30
Q

summary

A

CV system
- structure and age-related changes
- risk factors
> disease
> modifiable risk factors
> non-modifiable risk factor
- pathological conditions
- nursing assessment/ intervention