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Gereontology > Week 4- Cardiac Case > Flashcards

Week 4- Cardiac Case Flashcards

1
Q

What is the most chronic risk factor for CVD?

A

Hypertension

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2
Q

What is the goal of hytertension treatment?

A

to treat modifiable risk factors for persons with diabetes and other chronic diseases and to maintain a systolic BP <140 mm Hg and a diastolic BP <90 mm Hg and reduce CVD risk

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3
Q

What is Coronary artery disease?

A

when the coronary arteries are unable to send enough blood through the heart muscles due to atherosclerosis (hardening and closing of arteries)

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4
Q

What are symptoms are CAD?

A

Symptoms can be “silent” for a long time; usually include: Angina, shortness of breath, fatigue.

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5
Q

What are cardiovascular diseases that effect older people?

A

-Hypertension
-Coronary artery disease
- Heart valve disease
-Heart failure or congestive heart failure (right and left)

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6
Q

What can atherosclerosis lead to?

A

MI or CVA

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7
Q

What is heart valve disease?

A

disruption of flow through the valves

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8
Q

What are signs and symptoms of heart valve disease?

A

heart murmur
chest pain
abdominal swelling, fatigue,
SOB, swelling of feet/ ankles
dizziness and fainting
cardiac dysrhythmias

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9
Q

What is the most frequent cause of hospitilization of older adults?

A

Heart failure

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10
Q

What is the prognisis for heart failure

A

50% of people dx with HF will die within 5 years of dx

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11
Q

What organs are commonly effected because of the fluid build up of HF?

A

kidneys, lungs and extremities

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12
Q

What is right sided heart failure

A

The heart’s right ventricle is too weak to pump enough blood to the lungs. As blood builds up in the veins, fluid gets pushed out into the tissues in the body

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13
Q

What is left sided HF?

A

The left ventricle of the heart no longer pumps enough blood around the body. As a result, blood builds up in the pulmonary veins (the blood vessels that carry blood away from the lungs)

(remember L is lungs)

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14
Q

What are the main risk factors for cardiovascular disease?

A
  • Age >55 for men, >65 for women
  • Family history of CVD
  • Microalbuminuria
  • Hypertension
  • Smoking
  • Central obesity
  • Physical inactivity
  • Dyslipidemia
  • Diabetes, impaired glucose tolerance/ impaired fasting glucose
  • Metabolic syndrome
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15
Q

What is the age risk factors for CVD in women and men?

A

-Women: age greater then 65
-Men: age greater then 55

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16
Q

What 4 factors from the Lancet 2020 report were found to effect CVD?

A

Temperature
Climate change
Food insecurity (1.4 million deaths due to CVD were attributed to diets low in seafood omega 3 fatty acids)
Increased pollution

17
Q

How may CVD effect the patients perspective of their life?

A
  • Disruptions and distress
  • Sense of loss of power
  • Role dysfunction
  • Beliefs about disease progression
  • Coping strategies
  • Adjustment of living with CHF
18
Q

What are 3 roles the nurse plays in supporting a patient with CVD?

A
  • Focus on support systems
  • Providing “hope” in managing (even if not halting) disease progression
  • Further understanding for cultural differences in adjustment process
19
Q

What does 50% stenosis of the circumflex artery mean?

A

50%= moderate blockage

20
Q

What is orthostatic hypotension?

A

(also called postural hypotension)- dissiness or fainting due to the blood pressure not being enough from being at rest to activitiy
-fall risk for olde rpeople

21
Q

What is cardiomegaly

A

enlarged heart

22
Q

How can you use the assessment tool FANCAPES to assess a patient with CVD?

A

Fluids: How much do you drink daily? Have you gained weight/ urinary output decreased? → Fluid retention

Aeration: do you have a cough? Is it productive? If so, describe sputum. What happens when you wake up gasping for breath? How often does this happen? How many pillows do you use? Do you/ did you smoke?

Nutrition: What are your favourite foods? What did you eat in the last 48 hours? Explain the main “problem” re salty foods. Try understand onset of symptoms with possible food intake

Communication: Do speak the same language? Any auditory/ visual problems that might affect communication?

Activity: What makes you tired? Are there activities that affect your breathing? Sleep problems?

Pain: Are you experiencing chest pain/ discomfort/ numbness in shoulders/ arms/ hands/ neck/ jaw? How
does it feel? Any other cardiac sensations?

Elimination: urinary output (see fluids)

Socialisation/ support: What support do you have at home? Does it feel adequate? How often do you leave the house?

23
Q

How can hypertension lead to heart failure?

A

Hypertension: Heart is having to pump hard against the resistance in the vessels→cardiac muscle hypertrophy→cardiomegaly (which effects the ability to pump blood through the heart)

24
Q

How does coronary artery disease cause HF?

A

Ischaemic myocardium is not able to produce adequate stroke levels

25
Q

How does anemia contribute to HF?

A

decreases oxygen availability to all body tissues→heart responds by increasing blood flow→increasing oxygen demand of the heath→myocardial ischaemia. Low Hct due to hemodilution

26
Q

What are some symptoms of left sided heart failure?

A

Weakness, hacking cough/ worse at night, exertional dyspnea, S3/S4 gallop, crackles/wheezes in the lungs

27
Q

What are signs of right sided heart failure

A

Jugular neck distention, dependent oedema, enlarged liver and spleen, distended abdomen, weight gain

28
Q

How do these drugs help treat HF?
-Enalapril
-Furosemide
-Cavediol
-Digoxin
-Potassium Chloride

A

Enalapril: ACE inhibitor to decrease blood volume and blood return to heart→ decrease workload of the heart

Furosemide: Loop diuretic→decrease fluid volume

Carvedilol: Non-specific beta blocker→decrease heart rate

Digoxin: decreases myocardial contractility→enhanced cardiac efficiency and output

Potassium Chloride: electrolyte→replace potassium that may be lost with diuretic therapy

29
Q

Why should we monitor potassium levels for a pt. who is taking diuretics, ACE inhibitors and digoxin?

A

-The diuretic causes K to be secreted
-ACE inhibitors cause K retention
-Digoxin already increases digoxin levels in the body

if K levels are too high or too low it can contribute to digoxin toxicity

30
Q

What do you need to monitor for when a patient is on digoxin?

A

hypokalaemia can increase susceptibility to digoxin toxicity;

31
Q

what are symptoms of digoxin toxicity?

A

anorexia
nausea
vomiting
neurological symptoms
trigger fatal arrythmias

32
Q

What foods are high in sodium and should be avoided for pt. with heart failure?

A

Canned soups
cheddar cheese
processed meats

Gereontology (6 decks)

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