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Cardiovascular System

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Jennifer Tonks

on 16 November 2012

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Transcript of Cardiovascular System

The Cardiovascular System Gerontological Nursing Intro Video Normal Changes of Aging

1. Myocardium

2. Cardiac Conductivity

3. Vascular System

4. Pulmonary Changes

5. Renal System

a. Thickening of intimal
& medial layers; "hardening" of the arterial walls
b. Decreased elasticity of lung tissue & stiffness of thoracic & spinal joints.
c. Decreased blood flow & glomerular filtration.
d. Increase in size of the muscle cells, hypertrophy
e. Decreased number of normal pacemaker cells; increase in fat &
collagen; stiffening
of heart valves
1. d.
2. e.
3. a.
4. b.
5. c. Normal Changes
in the Cardiovascular System Heart weight
Myocardial cells
Left ventricle
Elastin levels
Collagen Levels
Left atrium size Aortic distensibility
Vascular tone
Decreased diastolic BP
Increased PR, QRS & Q-T intervals Heart Failure Heart Failure is the most common
diagnosis in hospital patients
age 65 years and older,
and more than
65,000 persons with chronic HF
receive home care each year Pathophysiology
of Heart Failure Causes of
Heart Failure - Hypertension
- Circulatory Overload
- Hypovolemia
- Sepsis
- Electrolyte
- Myocardial
- Pacemaker
Failure Staging
of Heart Failure Subjective
Cardiovascular Assessment Demographic Information
Chief Complaint
History of Present Illness
Past Medical History
Review of Systems
Family History
Social History
Functional Health Pattern Assessment Functional Health
Pattern Assessment Health perception/health management
Coping/stress tolerance
Value/belief Objective
Cardiovascular Assessment Heart Sounds
Apical-Radial Pulse
Blood Pressure
Pulsus Alternana
Peripheral Pulses
Hepatojugular Reflex Oxygenation
Auscultate Lung Sounds
Use of Accessory Muscles
Respiratory Rate Color
Mucus Membranes
Nail Beds N/V/D
Ascites Decrease GFR
Dark Urine and SG >1.030
Proteinurea and Glucosuria
Metabolic Acidosis or Alkalosis Cardiac Pulmonary GI Renal Skin Nursing Diagnoses Decreased Cardiac Output Fluid Volume Excess Fatigue/Activity Intolerance Self-care deficit Knowledge deficit: medications, disease process, risk complications, diet, activity, socioeconomic resources Sleep Deprivation Ineffective Management of Therapeutic Regimen Article: Predicting Survival
in Elderly Patients
with Heart Failure
Michael W. Rich, MD
Bao Huynh, MD
Aleksandr Rovner, MD These are the independent
predictors of shorter survival time:
Serum Sodium <135 mEq/L
Coronary Heart Disease
Peripheral Artery Disease
Systolic Blood Pressure per 10 mmHg
Serum urea nitrogen per 10 mg/dL 1 year mortality 5 year mortality
0-1 risk factors 9.0% 57.3%
-low risk (n=89)
2-3 risk factors 22.2% 79.1%
-intermediate risk (n=153)
4 or more risk factors
-high risk (n=37) 73.0% 100% Interventions Medications Patient Education References Larsen, Pamela. (2009). A review of Cardiovascular
Changes in the Older Adult. ARN Network, 25(6),
Retrieved from http://www.rehabnurse.org/pdf/
Rice, R. (2006). Home care nursing practice concepts
and application. 4th edition. St. Louis, MO: Mosby.
Rich, M. W., Bao, H., & Rovner, A. (2007). Predicting
survival in elderly patients with heart failure.
Cardiology Review, 24(9), 34-37. Retrieved from http:
Tabloski, P. (2010). Gerontological Nursing. 2nd
edition. New Jersey: Pearson. - Coronary Artery
- Congenital Heart
- Cor Pulmonale
- Valvular Heart
- Cardiomyopathy O2
ACE Inhibitors
Angiotensin II Receptor Blockers
Cardiac Glycosides
Vasodilators Medications
Signs and Symptoms of Concern
Specific Diet
Coping Mechanisms
Self-Care Strategies
Daily Weights
Sodium Restriction
Fluid Restriction
Cardiac Rehab and Pacing Activities Risk Reduction Advance Directives Caregiver Support Stage:
A. High risk for developing HF
B. Asymtomatic HF

C. Symtomatic HF

D. Refractory end-stage HF Description
HTN, DM, CAD, FMH of Cardiomyopathy
Previous MF, LV Dysfunction, Valvular Dysfunction
Structural Heart Disease, Dyspnea & Fatigue, Impaired Exercise Tolerance
Marked Symptoms at rest Class I: no limitation is experienced in any activities; there are no symptoms
from ordinary activities. Class IV: any physical activity brings on
discomfort and symptoms
occur at rest. Class III: marked limitation of any activity; the patient is
comfortable only at rest. Class II: slight, mild limitation of activity; the patient is comfortable at
rest or with mild exertion. New York Heart Association Functional Classification American College of Cardiology/American Heart Association
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