OP 2: Diseases

How long must an illness be present to be considered chronic?

3 months

What percentage of deaths are caused by chronic illnesses?

70%

approx. ________ of seniors have a chronic illness and over ______ have two or more

90%, 75%

What are comorbitities defined as?

the simultaneous presence of two chronic diseases or conditions in a patient

a patient has both hypertension and hyperlipidemia. What is this an example of?

comorbidities

when a patient has comorbidity, it increses?

complexity and health risk

Why are patients w/ comorbidities complex?

1. treatment of one may contradict the other

2. adverse drug interactions

3. compounding symptoms may lead to poor compliance w/ treatment plan

4. if both illnesses affect a specific organ, patient is at increased risk of organ failure

an increase in ___________ causes excess force against the arterial walls, damaging arteries over time

blood pressure

What are risk factors of hypertension?

FHx of HTN, obesity, high sodium diet, smoking, ETOH (smoking)

What are symptoms of HTN?

• often asymptomatic

• headache is most common

How is HTN usually diagnosed?

BP reading (several high readings)

systolic BP

measures the pressure in the arteries when the heart contracts

diastolic BP

measures the pressure in the arteries when relaxed (between heart beats)

Hypotensive BP

• systolic: less than 90

• Diastolic: less than 60

normal BP

systolic: 90 to 120

diastolic: 60 to 80

Prehypertensive

systolic: 121 to 140

diastolic: 81 to 90

hypertensive

systolic: greater than 140

diastolic: greater than 90

T/F BP reading for a healthy adult, children and athletes may range

true

What other chronic illnesses can HTN lead to?

impaired vision, CVA, renal failure, CAD/MI, CHF (congestive heart failure)

How does HTN affect the eyes?

increased pressure through delicate vessels can cause them to thicken/rupture

How does HTN affect the kidneys?

increased bp through kidneys can cause weakening leading to renal failure

How does HTN lead to CVA (stroke)?

consistent increased pressure through vessels of the brain causes weakening of arteries leading to potential rupture and hemorrhagic CVA

How can HTN lead to CAD/MI?

untreated HTN causes arteriosclerosis (thickening arteries) which increases the risk of CAD or acute MI

How does HTN lead to CHF?

heart experiences increased effort and decreased efficiency, pumping excess fluid through the body

Hypertension causes high pressure through the vessels of the brain. This can cause weakening of arteries, leading to potential rupture and _____________

hemorrhagic cerebrovascular accident

What are non-pharmacological ways to manage HTN?

• low sodium diet (decreases pressure bc sodium increases it)

• exercise

• smoking and ETOH (drinking) cessation (nicotine and ETOH shrink blood vessels)

• BP log at home

What are pharmacological ways to manage HTN?

• ACE inhibitors

• Ca channel blockers

• diuretics

• ARBs

What type of drug relaxes arteries and blocks reabsorption of water by kidneys?

ACE inhibitors

What type of drug dilates the arteries and reduces the force of the hearts contractions?

Ca channel blockers

What type of drug reduces the volume of fluid in the blood vessels by urinating excess fluid?

diuretics

What type of drug dilates the arteries?

ARBs

What are examples of ACE inhibitors?

lisinopril (zestril), lotensin (benazepril)

What are examples of Ca channel blockers?

norvasac (amlodipine), cardizem (diltiazem)

What are examples of diuretics?

hydrochlorothiazide (HCTZ)

What are examples of ARBs?

cozaar (losartan), benicar (olmesartan)

Which type of diabetes is defined by pancreas is unable to produce insulin which moves glucose from the blood?

1 DM

What percentage of DM pts are 1 DM?

5%

What are 1 DM pts treated w/?

always treated w/ insulin

When are 1 DM pts usually diagnosed?

early in life (strong FHx component)

What type of diabetes os defined as consistently high blood glucose levels causing cells to become resistant to insulin?

2 DM

What percentage of 2 DM makes up DM pts?

95%

How are 2 DM pts treated?

w/ diet changes, non-insulin, or insulin

What are 2 DM risk factors?

FHx of DM, obesity, high carb diet, lack of exercise

What are symptoms of 2 DM?

unusual weight loss or gain, polyuria, polydipsia, blurred vision, none

How are pts diagnosed w/ 2 DM?

fasting blood glucose, hemoglobin A1c

What other chronic illnesses can diabetes lead to?

diabetic retinopathy, renal failure, cardiac disease, PVD, neuropathy