geri week 10 pt2

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justbejanice
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12510
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geri week 10 pt2
Updated:
2010-03-30 14:20:24
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janice geri week 10 pt 2 cardiovascular
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Cardiovascular lecture pt2
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  1. Hypertension
    • Diastolic blood pressure reading is 90 or higher
    • or Systolic reading is 140 or higher on two separate occasions
    • The older adult is concerned with a systolic blood pressure over 200
  2. Hypertension increases the risk for ____
    • Cardiac disease
    • - coronary heart disease (CHD), Atrial fibrillation, and heart failure
    • - Acute cardiovascular and cerebrovascular events such as myocardial infarction (MI), stroke, and sudden death
  3. Modifiable factors that increase the risk for essential Hypertension:
    • Cigarette smoking or tobacco use
    • Excessive alcohol intake
    • Sedentary lifestyle
    • Inadequate stress and/or anger management
    • High-sodium diet
    • High-fat diet
  4. Benefits of controlling blood pressure
    • Stroke decreases: 35-40%
    • Myocardial infarction decreases: 20-25%
    • Heart failure decreases: 50%
  5. Coronary Heart Disease
    - main killer: 2nd heart attack, 3rd stroke, 4th COPD
    • Blockage of the vessels that supply the heart with blood
    • The blockage is caused by arteriosclerosis, or the "hardening of the arteries"
  6. Cont.- Silent MI
    • Discomfort mild and localized to the back, abdomen, shoulder, or either or both arms
    • Nausea and vomiting, or merely a sensation of heartburn
  7. Heart failure (HF)
    Disease of the heart muscle in which the muscle is damaged, malfunctions, and can no longer pump enough blood to meet the needs of the body
  8. Heart failure causes
    • Hypertension
    • Fever
    • Hypoxia
    • Anemia
    • Metabolic Disease
    • Infection
  9. Heart failure
    • Left-sided, right-sided, or both-sided failure
    • Signs and symptoms:
    • Fatigue or shortness of breath (dyspnea) with exertion
    • Inability to lie flat without getting short of breath (orthopnea)
    • Waking up at night gasping for air
    • weight gain
    • Swelling in the lower extremities
  10. Implications for Gerontological nursing and healthy aging for the heart
    • Assessment:
    • Pertinent history of the events leading up to and including the presentation of cardiovascular problems
    • monitor vital signs, laboratory results, and kidney function
    • assess cardiac and respiratory function
    • conduct a mental status exam
  11. Implications (cont)
    • Interventions:
    • Response to prescribed exercise
    • medication administration and the evaluation of the medication effects
    • monitoring for signs and symptoms of CHF
    • monitoring fluid intake and output and diet
    • monitoring weight (either daily, biweekly, or weekly)
    • Auscultating heart and lung sounds
    • Monitoring laboratory values
    • Education related to all of the above
  12. Minimizing Risk for Heart Disease
    • Maintain:
    • Blood pressure <=130/80
    • Total cholesterol <200
    • LDL <100
    • HDL >40
    • Triglycerides <150
  13. Respiratory Disorders
  14. Chronic Obstructive Pulmonary Disease (COPD)
    • Asthma, bronchitis, and emphysema: conditions that affect airflow
    • Fourth leading cause of death
  15. COPD signs and symptoms for emphysema, bronchitis, acute episode of COPD
    • Emphysema:
    • - Little sputum production and patients appear pink as they are receiving adequate oxygen

    • Bronchitis:
    • - Chronic sputum production, frequent cough, pale and somewhat cyanotic (chronic = smoking, acute = infection of respiratory system)

    • Acute episode of COPD:
    • - Characterized by significantly worsened dyspnea and increased volume and purulence of sputum
  16. Pneumonia
    • A bacterial or viral lower respiratory tract infection that causes inflammation of the lung tissue
    • High Risk
    • - elders with coexisting morbidity: alcoholism, asthma, COPD, or heart disease, or those who live in institutional settings
    • - Normal age changes of the respiratory system: Diminished cough reflex, increased residual volume, ad decreased chest compliance
  17. Pneumonia in the nursing home
    most frequent causes of aspiration pneumonia are reflex from a feeding tube or from regular eating by someone with difficulty swallowing
  18. Signs and symptoms of Pneumonia
    • Cough, fatigue, and dyspnea
    • falling, mental status changes or signs of confusion, general deterioration, weakness, anorexia, rapid pulse, and rapid respirations
    • Positive chest x-ray, fever, and elevated white blood count
  19. Implications for gerontological nursing and healthy aging in pneumonia
    Assessment: objective: obeservations of oxygen saturation, sputum production, or coughing

    Subjective: reports of dyspnea, affect on functional status and quality of life

    Observation of airway clearance, breathing patterns, and mobility; the measurement of pulse oximetry; a mental status examination, and a functional assessment
  20. implications (cont)
    • Interventions:
    • education
    • diet
    • education
    • activity and exercise tolerance
    • medication
  21. Tuberculosis
    • A communicable and infectious disease
    • Caused by the bacteria Mycobacterium tuberculosis
    • Tuberculosis infection
    • Refer to a positive TB skin test with no evidence of active disease
    • Tuberculosis Disease:
    • Refers to cases that have positive acid-fast smear or culture for M. Tuberculosis, or radiographic and clinical presentation of TB
  22. Tuberculosis symptoms
    • unexplained weight loss or fever
    • cough lasting more than 3 weeks, regardless or age group
    • Night sweats
    • generalized anxiety may be present
    • more advanced stages, the person will also dyspnea, chest pain, and hemoptysis.
  23. Implications for geri nursing for TB
    —The nurse must be proactive in the prevention of contagious disease and in the prompt treatment of those who become or are ill


    —TB is a reportable condition, which means that all suspected and confirmed cases are reported to the local or state health authorities


    • —The gerontological nurse participates
    • in screening, educating regarding the seriousness of the infection, and helping persons obtain the appropriate treatment as needed. —The nurse must be proactive in the prevention of contagious disease and in the


    prompt treatment of those who become or are ill


    • —TB
    • is a reportable condition, which means that all suspected and confirmed cases are reported to the local or state health authorities


    —The gerontological nurse participates in screening, educating regarding the seriousness of the infection, and helping persons obtain the appropriate treatment as needed

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