Cardiovascular and Respiratory Disorders (Chp. 36) Day 4

nursing assistant class

Cardiovascular Disorders

- Cardiovascular and respiratory system disorders are the leading cause of death in the United States

- Many people have these disorders

Hypertension (Info 1)

- With hypertension, the resting blood pressure is too high
  - Narrowed blood vessels are a common cause
  - Signs and symptoms develop over time
  - Hypertension can lead to:
    - Stroke
    - Hardening of the arteries
    - Heart attack
     - Heart failure
     - Blindness
- A persons can be unaware of hypertension for many years. That is why hypertension is called the “silent killer”
- Hypertension is found when blood pressure is measured
- Signs and symptoms include headache, blurred vision, dizziness, and nose bleeds

Hypertension (Info 2)

- With hypertension, the systolic pressure is 140 mm Hg or higher (hyper). Or the diastolic pressure is 90 mm Hg or higher. Such measurements must occur several times.
These measurements can lower blood pressure:
- A diet low in fat and salt
- A healthy weight
- Regular exercise
- No smoking
- Limiting alcohol and caffine
- Managing stress and sleeping well
- Certain medications

Coronary Artery Disease (CAD) (info 1)

- The coronary arteries supply the heart with blood
- In CAD, the coronary arteries become hardened and narrow. The heart muscle gets less blood and O2 (oxygen)
- The most common cause is atherosclerosis
- The major complications of CAD are:
   - Angina
   - Myocardia infraction (heart attack)
   - Irregular heartbeats
   - Sudden death

Coronary Artery Disease (CAD) (Info 2)

These risk factors can be controlled;
  - Being overweight
  - Lack of exercise
  - High blood cholesterol and hypertension 
  - Smoking
  - Diabetes
These risk factors cannot be controlled:
  - Gender (Men are at greater risk than women)
  - Age 
  - Family History
  - Race (Blacks are at greater risks than other groups)
The more risk factors the greater chance of CAD and its complications

Coronary Artery Disease (CAD) (Info 3)

Treatment goals are to:
  - Relive symptoms
  - Slow or stop atherosclerosis
  - Lower the risk of blood clots
  - Widen or bypass clogged arteries
  - Reduce cardiac events

Angina

- Angina is chest pain
- It occurs when the heart need more oxygen
- Chest pain is described as a tightness, pressure, squeezing, or burning in the chest
- Pain is in the jaw, neck, and down one or both arms is common
- Symptoms are relieved by rest and a nitroglycerin tablet. Rest often relives symptoms in 3 to 15 minutes
- Chest pain lasting longer than a few minutes and not relived by rest and nitroglycerine can lead to a heart attack

Myocardial Infraction (MI)

- Myocardial refers to the heart muscle
- In MI, blood flow to the heart muscle is suddenly blocked
- Part of the heart muscle dies
- MI is an emergency
- Sudden cardiac death (arrest) can occur 
Efforts are made to:
  - Relieve pain
  - Restore blood flow to the heart
  - Prevent death and life-threatening problems
- CAD, angina, and previous MI are risk factors
- There may be a need for medical or surgical procedures to open or bypass the diseased artery
The goal is to:
  - Prevent another MI
  - Prevent complications such as heart failure or sudden cardiac arrest

Heart and Failure or CHF (Info 1)

- Heart failure or congestive heart failure (CHF) occurs when the heart is weakened and cannot pump normally  
   - Left-sided failure. Blood backs up into the lungs. Respiratory congestion occurs
   - Right-sided failure. Blood backs up into the venous system. Feet and ankles will swell

Heart and Failure or CHF (Info 2)

Some common causes:
   - Damaged or weak heart
   - CAD
   - MI 
   - HTN
   -  Diabetes
   - Age
Treatment includes:
   - Medications to strengthen the heart and reduce the amount of fluid in the body
   - Sodium-controlled diet
   - Oxygen
   - Semi-Fowler position

Respiratory Disorders

- The respiratory system brings oxygen into the lungs and removes carbon dioxide from the body
- Respiratory disorders interfere with this function and threaten life

Chronic Obstructive Pulmonary Disease (COPD) (Resp. Disorders)

COPD involves two disorders:
   - Chronic bronchitis
   - Emphysema
- These disorders interfere with oxygen and carbon dioxide exchange int he lungs
- Cigarette smoking is the most important risk factor
- Not smoking is the best way to prevent COPD
- COPD has no cure

Chronic Bronchitis

- Bronchitis means inflammation of the bronchi
- Chronic bronchitis occurs after repeated episodes of bronchitis
- Mucus and inflamed breathing passages obstruct airflow into the lungs
- The person has difficulty breathing of oxygen
- Smoking is the major cause
   - The person must stop smoking
   - Oxygen therapy and breathing exercises are often ordered
   - Respiratory tract infection are prevented; if one occurs, the person needs prompt treatment

Emphysema

- In emphysema, the alveoli enlarge and become less elastic
- Some air is trapped in the alveoli when exhaling
   - Oxygen and Carbon Dioxide exchange cannot occur in affected alveoli
   - As more air is trapped in the lungs, a barrel chest can develop
- Smoking is the most common cause
- The person has shortness of breath and a cough
- Breathing is easier when the person skits up right and slightly forward
Treatments:
  - The person must stop smoking
  - Respiratory therapy, breathing exercise, oxygen, and medications are ordered

Asthma (Respiratory Disorder)

- With asthma, the airway becomes inflamed and narrow
- Wheezing and coughing are common, as are pain and tightening in the chest
- Extra mucus is produced
- Asthma usually is triggered by allergies
- Sudden attacks (asthma attacks) can occur
- Asthma is treated with medications
- Severe attacks may require emergency care

Influenza (Flu)

- Respiratory infection caused by viruses
- Most deaths from flu occur in older persons
- Older persons may not have typical sings and symptoms
- Flu virsu’s are spread through coughing and sneezing
   - Standard precautions must be followed

Pneumonia (Respiratory disorders)

Pneumonia is an inflamed and infection of lung tissue - affected tissues fill with fluid
- Bacteria, viruses, and other microbes are causes
- The person is very ill
- Signs and symptoms include:
  - High fever, chills, painful cough, chest pain on breathing, and rapid pulse
-When lung tissue fill with fluid, oxygen and carbon dioxide exchange is affected

Covid 19

- Caused by a virus, part of the coronavirus family
- Like many other respiratory viruses, coronaviruses spread quickly through droplets that project from the mouth and nose when you breathe, cough, sneeze, or speak
- Facilities receive directions from the CDC to help protect residents

Tuberculosis (TB)

- TB is a bacterial infection in the lungs
- TB is spread by airborne droplets with coughing, sneezing, speaking, singing, or laughing
- Chest x-ray and TB testing can detect the disease
Risk Factors include:
   - Close, request contact with an infected person
   - Living in close, crowded areas
- Age
- Poor nutrition
- HIV infection
- Medications are given to treat TB
- If TB is not treated, the person can die
- The mouth and nose are covered with tissue when the person sneezes, coughs, or procedures sputum
- Standard Precautions and isolation precautions must be followed