Exam 3 Study guide Flashcards
Define the categories of abnormal blood pressure
Normal systolic > 120 and diastolic > 80
Pre HTN/Elevated 120-129 and > 80
HTN stage 1 130-139 and 80-89
HTN stage 2 140 > greater or equal to 90 or higher
Hypertension crisis higher than 180 and higher than 120
Discuss risk factors for hypertension
Stress High salt diet Obesity Physical inactivity Poor diet habits Low K diet Age Men vs women African american Family HX Smoking Too much alcohol Sleep apnea
Correlate clinical manifestations of hypertension to pathophysiological processes
Damaged blood vessels
Inflammation in the endothelium causes atherosclertoic disease which contributes to MO, CVA and chronic kidney disease
Describe the diagnostic results used to support the diagnosis of hypertension
urinalysis -protein in the urine specifically albumin
Urine Test- Protein and creatinine BMP CMP has albumin Lipid profile EKG ECG
Describe the lifestyle modifications and medication therapy for hypertension
Dietary-dash diet Limit sodium Psychical activity Consume alcohol in moderation 8-10 servings of veggies and fruit Arugula - has nitric oxide which vasodilates Baked chicken (usually the healthier option) over foods that are high in sodium such as ham Wheat bread over White bread
Create a care plan for care of the patient with hypertension
Obtain blood pressure
Educate pt and family on S/S of SEVERE HTN ONLY - increased bp, anxiety, early morning HA, irregular heart rhythm, buzzing in ear, chest pain, muscle tremors and vision changes.
Educate on importance of taking medication
Cluster care to provide rest between activities
Monitor Is and Os
Discuss the management of hypertension among older adults
Exercise 150 min a week Limit alcohol 1 drink women 2 drink men Eat mostly plants Fresh food rich in potassium Consider less rigid bp control - lower target can increase risk for orthostatic hypotension/fall risk
Describe hypertensive crises and their management
Emergency- life threatening requiring immediate TX to prevent organ damage
Use of IV vasodilators to gradually decrease BP
HTN urgency- BP elevated but no evidence of organ damage
Fast acting antihypertensive PO med recommended
Identify factors affecting movement and alignment
Developmental Physical health Mental health Lifestyle Attitude and values Fatigue and stress External factors
Discuss movement and alignment changes related to older adults
Loss of muscle tone
Increased convexity in the thoracic spine from disk shrinkage and decreased height
Subcutaneous fat loss
Arthritic joint changes may be present
Differentiate isotonic, isometric and isokinetic exercises
Isotonic
Muscle shortening and deactivate movement - fixed resistance
Examples include ADLs, swimming and jogging
Weights resistance
Isometric
Muscle contraction without shortening
Examples include yoga, planks
Isokinetic
Muscle contraction (lengthening) with resistance - speed is the same throughout arch of movement
Examples include weight training - varied resistance
Swimming, jogging
Compare the effects of exercise and immobility on the body
Immobility Increase C.O Increase risk for orthostatic hypotension Blood clots Decreased muscle strength Pressure sores Depression Resp issues Slower metabolism and decreased appetite and bowel movements Exercises Increased strength Endurance Improved appetite Improved respiratory and bowel function
Create a care plan for a patient with activity intolerance
Monitor vitals during and after activity
Encourage alternating activity and rest
Have pt perform return demonstration collab with PT
Educate pt about underlying condition if appropriate
What are the three postural reflexes?
They are responsible for the subconscious maintenance of the body’s posture when movement and position are altered
Righting reactions
A reflex that corrects the orientation of the body when it is taken out of its normal upright position
Placing reactions
Eliciting the placing reaction is the dangling leg posture
When baby moves their leg up, their arm on the same side moves up as well
Equilibrium reactions
The last of the motor reflexes to mature
Multidirectional range of movements
Identify factors affecting urinary elimination
Age
Diet
Exercise
Medication
Discuss urinary elimination changes related to older adults
Bladder muscles weaken
For women, urethra shortens and becomes thinner
Prostate problems for men
Describe characteristics of normal and abnormal urine
Normal
clear/ pale yellow color Slightly aromatic/ ammonia odor Specific gravity 1.001-1.035 Abnormal red-red/brown color Cloudy Veggies can change smell acetone/fruity odor
Create a care plan for a patient with impaired urinary elimination, urinary retention and urinary incontinence
For urinary retention
Assess pt bladder fullness
Encourage fluids
Monitor Is and Os
Monitor for s/s of UTI
Lower: symptoms in bladder, cystitis,
Upper: pyelonephritis, fever- only in upper, N/V, CVA tenderness, systemic symptoms - kidneys symptoms
For urinary incontinence
Assess impairments that can hinder ability to get to the bathroom
Encourage avoiding caffeine, alcohol and carbonated drinks
Assess signs of infection
Assess bladder distention
Develop voiding schedule
Assess for skin breakdown
Monitor for signs of UTI
Lower: symptoms in bladder, cystitis, frequent urination with pain (dysuria), dark, cloudy tinged
Upper: pyelonephritis, fever- only in upper, N/V, CVA tenderness, systemic symptoms; high temperature i.e. fever, can see symptoms of lower UTI can be seen in upper UTI
