Cardiovascular Dr soad abd el hameed system
Out line
Out line
I- Introduction II- Normal heart function III- Age related changes IV- Heart failure V- Coronary heart diseases VI- Hypertension
Objectives
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:II- Normal heart function Normally, the cardiovascular system serves as a .closed system for the flow of blood This system functions to deliver oxygen, nutrients, and other substances to all body cells and to remove the waste products of .cellular metabolism The heart drives blood through the blood vessels :into two separate The right side of the heart: is concerned with pulmonary circulation and pumps blood to the . lungs The left side of the heart: pumps blood to the systemic circulation through the aorta, supplying blood to all areas of the body except .the lungs
Age-related changes of the cardiovascular :system The muscular layer of the left ventricle becomes25% thicker Myocardial elasticity decreases, and there is an. increase in rigidity of the heart muscle Cardiac output decreases by 25% (i.e., volume of(.blood pumped by the ventricles The aorta and other large arteries lose.elasticity The ability of the vessels to stretch decreases.approximately 50% by the age of 80 The valves of the veins become less efficient,increasing the risk of varicose veins or stasis . ulcers
In general, blood vessels become less elasticand narrower, in part because of calcium deposits that accumulate on the vessel .walls A gradual rise in blood pressure occurs withage. The increase in blood pressure is a result of a decline in arterial elas足ticity . and an increase in peripheral resistance Blood flow through the kidneys alsodecreases. These changes in vessel arterial elasticity and blood flow to the kidney account for the gradual increase in .blood pressure with age
HEART FAILURE Heart failure is a condition that occurs when the heart is unable to pump enough blood to meet the body's metabolic . demands
Symptoms of heart failure (Edema (general or dependent Fatigue Poor exercise tolerance Dyspnea on exertion Paroxysmal nocturnal dyspnea Orthopnea Altered mental status (e.g., confusion, (especially in the elderly
Disorders that increase the risk of • :developing heart failure include Angina (MI (myocardial infarction (Diabetes (uncontrolled Hypertension Coronary artery disease
:Diagnostic Tests Electro-cardiography (ECG) Chest X-ray Cardiac catheterization Echocardiography and Laboratory blood test
:Medical Treatment Diuretics decrease total blood- 1 volume and circulatory congestion Digoxin is also used in the- 2 management of heart failure to strengthen myocardial contractil足ity
Nursing care Assessment of the immune system • Health History- 1 Medication- 2 Physical Examination- 3 Diagnostic Tests- 4
Nursing Diagnosis .Interventions
CORONARY ARTERY DISEASE Angina Angina is caused by atherosclerotic heart disease. The most prominent symptom of angina is chest pain. The chest pain with angina typically is severe and causes a feeling of tightness, pressure, or suffo足 cation. The pain may radiate down the left side of the body to the neck, jaw, . shoulders, or arms
The pain of angina may result from Exercise or physical exertion (eg,- • ( climbing stairs Exposure to coldEating a large meal
-Stress -
Risk factors for coronary heart disease • • • • • • • •
Aging High blood pressure ·.Elevated blood pressure Smoking :cigarettes Diabetes mellitus (hyperglycemia ) Obesity Stress Lack of exercise Family history of a myocardial infarction
Myocardial Infarction MI (Myocardial Infarction) occurs when areas of the heart are deprived of blood, . causing tissue death and destruction Symptoms indicating an MI include chest pain (not relieved by rest or by nitroglycerin). The pain occurs suddenly over the (lower) substernal area and is the most common . symptom
HYPERTENSION :Definition Hypertension is a sustained elevation in blood pressure. "Systolic pressure is greater than 140 mmHg or the .diastolic pressure is above 90 mmHg
Caring for the Patient :with Hypertension There are many drugs available; the physician may prescribe a different antihypertensive drug as
.diuretics and beta blockers
The patient is monitored for any adverse reactions related to the medications. Common side effects of the antihypertensives include orthostatic hypoten足sion, hypotension, dizziness, fatigue, .nausea, vomit足ing, depression, and impotence Obtain the blood pressure and pulse rate immediately before each dose of an .antihypertensive
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Patient and Family Teaching medication
. rise slowly from a sitting or lying position. Follow dietary restrictions concerning sodium or fatDo not use a salt substitute unless approved by the . physician Take the diuretics early in the morning unless directed . otherwise . Avoid the use of alcoholLose weight if overweight and weigh weekly to monitor. weight loss or gain Stop smoking, and reduce the intake of dietarysaturated fat and cholesterol for overall cardiovascular . health If taking an antihypertensive that causes hypokalemia,include foods high in potassium in the diet (e.g., (. bananas, orange juice