Unit 3 CVD Powerpoint Flashcards
How do vessels contribute to overall health
Transporting blood for metabolic activities
Transporting waste
what desease has these clinical manifestations?
Headaches Chest pain Vision changes Shortness of breath Renal dysfunction dizzines fatigue nosebleeds
Hypertension
what disease has this
Medical Management –
Diagnosis
Two or more bp readings on >2 office visits
Hypertension
what disease has this
Medical Management – Treatment
Lifestyle changes
Medications
Hypertension
what disease has this
Medical Management – Medications
Diuretics
Antihypertensives
Hypertension
what disease has this
Lifestyle Management Weight Diet Alcohol consumption Exercise Stress
Hypertension
what disease has this
Complications Dilated cardiomyopathy Systolic dysfunction Renal failure Stroke Hypertensive crisis
Hypertension
what disease has this
assessment and analysis
typically no symptoms until disease is advanced
Hypertension
what disease has this
Nursing Management – Nursing diagnoses
Risk for ineffective therapeutic regimen management
Risk for decreased cardiac output
Hypertension
what disease has this
Nursing Interventions – Assessments
Neurological assessment Blood pressure Examination of optic fundi Auscultation for bruits Palpation for edema and pulses Labs B M I and waist circumference
Hypertension
what disease has this
Nursing Interventions – Actions
Administer medications as ordered
Provide DASH diet
Hypertension
what disease has this
Nursing Interventions – Teaching
Adherence to medication regimen
Adherence to lifestyle changes
Monitor blood pressure at home
Signs and symptoms of complications
Hypertension
what disease has this
Nursing Management – Evaluating care outcomes
Increased energy
Absence of energy, headache, dizziness, vision changes
Hypertension
what disease has this
Involves progressive narrowing and degeneration of arteries of upper and lower extremities
Atherosclerosis is leading cause in majority of cases
Patients with PAD are more likely to have coronary artery disease and/or cerebral artery disease
Peripheral Artery Disease
what disease has this
Epidemiology;
Majority are 65 years or older
African Americans are affected more often than any other group
Peripheral Arterial Disease
what disease has this
Pathophysiology;
Progressive and chronic condition
Obstruction of blood flow through the large peripheral arteries causes arterial occlusion
Peripheral Arterial Disease
what disease has this
Risk Factors;
Atherosclerosis Smoking Hypertension Diabetes Dyslipidemia Sedentary lifestyle Ineffective stress management
Peripheral Arterial Disease
what disease has this
Description
may affect Iliac artery Femoral artery Popliteal artery Tibial artery Peroneal artery
Peripheral Arterial Disease
what disease has this
Clinical Manifestations;
Intermittent claudication
Peripheral Arterial Disease
what disease has this
Medical Management – Diagnosis
Ankle-brachial index
Peripheral Arterial Disease
what disease has this
Medical Management – Treatment;
Prevent progression of disease
Manage symptoms
Peripheral Arterial Disease
what disease has this
Medical Management – Medications;
Antihypertensives
Antiplatelets
Statins
Peripheral Arterial Disease
what disease has this
Surgical Management;
Percutaneous transluminal angioplasty
Laser-assisted angioplasty
Rotational artherectomy
Peripheral Arterial Disease
what disease has this
Complications;
Critical limb ischemia Acute limb ischemia Atrophy of skin and underlying muscles Delayed healing Wound infection Tissue necrosis Arterial ulcers
Peripheral Arterial Disease
what disease has this
Nursing Management – Assessment and analysis;
Manifestations depend on tissues involved and severity of altered blood flow
Peripheral Arterial Disease
what disease has this
Nursing Management – Nursing diagnoses;
Ineffective peripheral tissue perfusion
Risk for impaired skin integrity
Chronic pain
Peripheral Arterial Disease
what disease has this
Nursing Interventions – Assessments;
Bilateral blood pressures Palpate all pulses in both legs Visual assessment of feet and limbs Temperature of extremities Assess bilateral muscle tone Pain
Peripheral Arterial Disease
what disease has this
Nursing Interventions – Actions;
Administer medications as ordered
Proper positioning
Peripheral Arterial Disease
what disease has this
Nursing Interventions – Teaching;
Positioning
Inspect feet daily
Report chest discomfort
Lifestyle changes
Peripheral Arterial Disease
what disease has this
Nursing Management – Evaluating care outcomes;
Pain free
Able to participate in normal activities
Peripheral Arterial Disease
what disease has this
Epidemiology;
Prevalent in 16.5 million people over age 20
Most common cause of heart disease
Incidence increases with age
Racial and gender differences
Coronary Artery Disease
what disease has this
Risk Factors;
Modifiable
Increased total cholesterol, hypertension, diabetes, obesity, smoking, physical activity
Nonmodifiable
Gender, race, heredity, age
Coronary Artery Disease
what disease has this
Pathophysiology;
Atherosclerosis forms and occludes coronary arteries
* Unstable angina
* Myocardial infarction
* Sudden cardiac death
Reduced blood flow through coronary microvasculature
*Ischemic symptoms
Coronary Artery Disease
in what stage of atherosclerosis do
lipids accumulate and migrate into smooth muscle cells
fatty streak
in what stage of atherosclerosis do
collegen cover the fatty streak
vessel lumen is narrowed
blood flow is reduced
fissures can develop
fibrous plaque
in what stage of atherosclerosis do you see
plaque rupture
thrombus formation
further narrowing or total occlusion of vessel
complicated lesion
in what stage of atherosclerosis do you see
damaged endothelium due to
hypertension tobacco use toxins infections diabetes hyperhomocysteinemia hyperlipidemia
chronic endothelial injury
what disease has this
Etiology and Pathophysiology;
Collateral circulation
Arterial anastomoses (or connections) within the coronary circulation
Increased with chronic ischemia
May be inadequate with rapid-onset CAD
Coronary Artery Disease
what disease has this
Clinical Manifestations;
Stable angina
Unstable angina
Prinzmetal’s angina
Coronary Artery Disease
what disease has this
Lack of oxygen and glucose leads to anaerobic metabolism
Lactic acid irritates nerve fibers → pain in cardiac nerves
Referred pain from transmission to the upper thoracic posterior nerve roots
Angina
what disease has this
Etiology and Pathophysiology
Deterioration of once stable plague
Rupture
Platelet aggregation
Thrombus
Acute Coronary Syndrome
what disease has this
Medical Management – Medications;
Stop aggregation of blood components to endothelium
Control factors leading to endothelial damage
Relief of symptoms
Coronary Artery Disease
what disease has this
Surgical Management;
Percutaneous transluminal coronary angioplasty
Coronary artery bypass graft
Coronary Artery Disease
what disease has this
Nursing Management:
Prevention and early treatment
Manage high-risk persons by controlling modifiable risk factors
Encourage lifestyle changes
- Education
- Clarify personal values
- Set realistic goals
Identification of people at high risk
- Health history, including family history
- Presence of cardiovascular symptoms
- Environmental patterns: diet, activity
- Psychosocial history
- Values and beliefs about health and illness
Coronary Artery Disease
what disease has this
Nursing Management;
Nutritional therapy ↓ Saturated fats and cholesterol ↑ Complex carbohydrates and fiber ↓ Red meat, egg yolks, whole milk ↑Omega-3 fatty acids
Coronary Artery Disease
what disease has this
Complications;
Myocardial infarction
Coronary Artery Disease
what disease has this
Gerontologic Considerations;
Increased incidence and mortality associated with CAD in older adults
Strategies to reduce risk and treat CAD are effective
Treat hypertension, ↑lipids
Smoking cessation
Coronary Artery Disease
what disease has this
Assessment and analysis;
Careful assessment of chest pain
Be mindful of nonspecific symptoms
Coronary Artery Disease
what disease has this
Nursing diagnoses;
Decreased tissue perfusion
Coronary Artery Disease
what disease has this
Interventions – Assessments;
Vital signs Pain Electrocardiogram Physical assessment Patient history Recreational drug use Depression screening Laboratory values
Coronary Artery Disease
what disease has this
Nursing Interventions – Actions;
Administer oxygen
Obtain E C G
Administer medications as ordered
Coronary Artery Disease
what disease has this
Nursing Interventions – Actions after P C I;
Cardiac catheterization care Report and treat chest pain immediately Administer anticoagulants Maintain fluids Maintain bedrest
Coronary Artery Disease
what disease has this
Nursing Interventions – Teaching;
Medication regimen Angina management Bleeding precautions Risk factor reduction When to call emergency services Encourage cardiac rehabilitation
Coronary Artery Disease
what disease has this
Evaluating care outcomes
Comply with medication therapy
Maintain healthy diet
Limit alcohol
Engage in regular exercise
Coronary Artery Disease
what disease has this
Risk Factors;
C A D, hypertension, D M, metabolic syndrome, obesity, smoking, high sodium intake
Heart Failure
what disease has this
Pathophysiology;
Myocardial cell dysfunction
Inability of heart to meet needs of body
Heart Failure
what disease has this
Medical Management – Treatment;
Reduction of risk factors
Manipulation of cardiac output
Heart Failure
what disease has this
Medical Management – Medications;
Beta blockers Aldosterone antagonist diuretics A C E inhibitors Calcium channel blockers Digoxin
Heart Failure
what disease has this
Surgical Management;
Internal cardiac defibrillator
Ventricular assist device
Heart Failure
what disease has this
Self-Management;
Symptom monitoring
Medication adherence
Lifestyle changes
Heart Failure
what disease has this
Complications;
Pulmonary edema
Renal failure
Heart Failure
what disease has this
Assessment and analysis;
Signs and symptoms related to weakened cardiac contraction, decreased cardiac output, back up of blood, poor peripheral perfusion
Heart Failure
what disease has this
Interventions – Assessments;
- Vital signs
- Breath sounds
- Monitor rate and rhythm
- Skin color, temperature, *peripheral pulses
- Dry, persistent cough
- Activity intolerance
- Urine output
- Daily weight
- Laboratory data
- Depression screening
- Social support
Heart Failure
what disease has this
Nursing diagnoses;
Impaired oxygenation
Decreased cardiac output
Ineffective peripheral perfusion
Heart Failure
what disease has this
Interventions – Actions;
Oxygen therapy
Elevate head of bed
Administer medication as ordered
Fluid and sodium restriction
Heart Failure
what disease has this
Interventions – Teaching;
Medication management Maintain activity as tolerated Low-salt diet Daily weight Cardiac rehabilitation Signs and symptoms of worsening heart failure
Heart Failure
what disease has this
Evaluating care outcomes;
Reduced dyspnea
Absence of fatigue
Participates in activities of daily living
Reduced hospitalizations
Heart Failure
what disease has this
Heart Failure
what disease has this
Risk Factors;
Smoking Hypertension Diabetes Dyslipidemia Sedentary lifestyle Obesity Ineffective stress management
Carotid Artery Disease
what disease has this
Pathophysiology;
Vessel wall thickening and plaque formation occluding blood in carotid artery
Carotid Artery Disease
what disease has this
Clinical Manifestations;
Asymptomatic until cerebral perfusion is impaired
Stroke or T I A
Carotid Artery Disease
what disease has this
Diagnosis;
Carotid bruit Carotid duplex scan Computed tomography angiography Magnetic resonance imaging Carotid angiography
Carotid Artery Disease
what disease has this
Medications;
Optimal medical therapy
Healthy lifestyle changes
Management of comorbidities
Carotid Artery Disease
what disease has this
Surgical Management;
Carotid endardectomy
Carotid artery stenting
Carotid Artery Disease
what disease has this
Assessment and analysis;
Symptoms of stroke Slurred words Weakness Severe headache Sudden vision loss Facial droop Dizziness
Carotid Artery Disease
what disease has this
Nursing diagnoses;
Risk for ineffective tissue perfusion
Anxiety
Carotid Artery Disease
what disease has this
Intervention Assessments;
Vital signs Neurological assessment Auscultation of carotid arteries Stroke history Signs of stroke
Carotid Artery Disease
what disease has this
Interventions – Assessments;
Postprocedure CEA/CAS
Respiratory rate, SpO2, stridor, tracheal deviation
Vital signs, HR, BP
Post-CEA—Cranial nerves, specifically VII, X, XI, and XII
Post-CAS—Renal function
Carotid Artery Disease
what disease has this
Interventions – Actions;
Administer medications as ordered
Manage diabetes
Carotid Artery Disease
what disease has this
Interventions – Actions;
Postprocedure CEA/CAS
Keep systolic blood pressure strictly within ordered parameters
If patient is hypotensive:
Reposition patient flat
Anticipate orders for vasoactive drips or intravenous fluid bolus
If patient is hypertensive:
Maintain head of the bed at
30 degrees
Post-CEA—Keep head in neutral position
Post-CAS - Encourage fluid intake/Maintain IV fluids
Carotid Artery Disease
what disease has this
Nursing Interventions – Teaching;
Clinical manifestations of stroke
Lifestyle changes
Carotid Artery Disease
what disease has this
Risk Factors;
Family history Advanced age Male gender Smoking Atherosclerosis Hypertension High cholesterol Known C A D Genetic/metabolic abnormalities
Aortic Artery Disease (Aneurysm)
what disease has this
Pathophysiology;
Middle layer (media) of artery is weakened, stretching inner layer (intima) Artery widens, tension increases, further widening occurs
Aortic Artery Disease (Aneurysm)
what disease has this
Clinical Manifestations;
Asymptomatic until dissection or rupture
Aortic Artery Disease (Aneurysm)
what disease has this
Diagnosis;
Computed tomography
Transthoracic echocardiogram
Cardiac M R I
E C G
Aortic Artery Disease (Aneurysm)
what disease has this
Medications;
Control hypertension
Statins
Aortic Artery Disease (Aneurysm)
what disease has this
Surgical Management;
Surgical repair and grafting
Aortic Artery Disease (Aneurysm)
what disease has this
Complications;
Aortic dissection
Aneurysm rupture
Aortic Artery Disease (Aneurysm)
what disease has this
Assessment and analysis;
Usually symptomatic until rupture or dissection
Aortic Artery Disease (Aneurysm)
what disease has this
Nursing diagnoses;
Risk for ineffective tissue perfusion
Acute pain
Fear
Aortic Artery Disease (Aneurysm)
what disease has this
Interventions – Assessments;
Vital signs Neurological assessment Pain Peripheral pulses Peripheral sensation and motor response Gentle abdominal auscultation and palpation
Aortic Artery Disease (Aneurysm)
what disease has this
Interventions – Actions;
Administer medications as ordered
Create calm environment
Aortic Artery Disease (Aneurysm)
what disease has this
Interventions – Teaching;
Signs and symptoms of aortic aneurysm and dissection
Follow strict treatment regimen
Aortic Artery Disease (Aneurysm)
what disease has this
Evaluating care outcomes;
No abdominal, back, or chest pain
No wheezing or shortness of breath
No dysphagia or hoarseness
Normal neurological assessment
Aortic Artery Disease (Aneurysm)
