common conditions in older adults (CCHF & cognitive decline)

what are two effective communication techniques for people with cognitive impairments

plain language, active listening

what is congestive heart failure

heart is unable to pump blood sufficiently; can be acute or chronic

what phase of heart pumping is affected in congestive heart failure

systolic and diastolic

primary symptoms of left ventircular failure

pulmonary congestion & edema, breathing issues / difficulty breathing, noisy wet breathing, profuse sweating, hypertension / TPs in accessory breathing muscles, evening fatigue / weakness, cerebral hypoxia

common breathing issues that occur from left ventricular failure

dyspnea (shortness of breath), orthopnea (SOB when supine), paroxysmal nocturnal dyspnea (sudden nighttime SOB), chest breathing

symptoms of cerebral hypoxia (decrease blood to brain)

restlessness, anxiety, irritability, restlessness, confusion, loss of concentration, memory issues, insomnia

primary symptoms of right ventricular failure

ascites, weight gain, edema distal to heart, liver / kidney / spleen dysfunction, distension, coldness / pallor of limbs,

right ventricular failure typically causes distension in what vein

jugular vein

what is ascites

fluid accumulates in abdominal cavity → swelling / edema

what type of congestive heart failure is breathing more affected

left ventricular failure

massage contraindications with congestive heart failure

full body MLD, elevation of limbs above heart, hypertension CIs, stimulating techs

remex contraindication with congestive heart failure

vigorous resistance training

what type of exercise is most appropriate in congestive heart failure

progressive aerobic training, continuous, using large muscle groups (e.g., stationary bike, rower, stepper)

is congestive heart failure an acute or chronic condition

can be either

primary etiology of congestive heart failure

underlying heart pathologies

what is high-output failure

a rare condition causing CHF due to excessive need, not a pathology

common compensatory mechanisms in CHF

frank-starling, renin-angiotensin-aldosterone, sympathetic, myocardial hypertrophy / remodeling

clinical manifestations of heart failure

reduced cardiac output, SOB, fatigue, edema, cyanosis, tachycardia/arrythmia, cachexia, compensatory mechanisms

what is the Frank-starling mechanism

increase muscle stretch by allowing increased filling → increased contraction

what is symmetric myocardial hypertrophy

a normal process that occurs in athletes

what does concentric myocardial hypertrophy result from most often

hypertension

what does eccentric myocardial hypertrophy occur from most often

dilated cardiomyopathies

key characteristics of class I CHF

no symptoms during normal activity

key characterisitcs of class II CHF

slight limitations but no extreme symptoms during normal activity

key characteristics of class III CHF

ordinary activity produces fatigue, palpitations, dyspnea, angina pain

key characteristics of class IV CHF

marked progressive cardiac disease with discomfort at rest

treatment for acute heart failure

medical emergency

treatment for chronic heart failure

oxygen, pace-maker,meds

common medications for chronic heart failure

diuretics, ACE inhibitors, beta blockers

right sided heart failure affects the body’s ability to do what

receive blood from the body or pump blood to the lungs effectively