STNA Module 4

topic: cardiovascular system

….

Note:

Veins are depicted blue, arteries are red in textbooks

Note: arteries

Blood is coming from the heart to the arteries (oxygenated and under pressure) and then depleted from there and then back with veins (deoxygenated)

Image: Heart

The heart has 4 chambers; list them and the positions (will be plural)

Top: atrium ( left and right )

Bottom: ventricles ( left and right )

Where does the blood get pumped out from the heart?

ascending aorta (artery)

time of cardiac cycle

60 seconds

Circulatory system (composition)

made up of heart, blood vessels, and blood

what does blood carry?

food, oxygen, and essential substances to cells

heart functions in how many phases?

2

diastole and systole

diastole

resting phase when blood fills up in the chamber

systole

contracting phase when ventricles pump blood

major functions of circulatory system / cardiovascular system (what do they supply)?

supply food, oxygen, hormones to cells

supply antibodies

Other major functions of circulatory system (cardiovascular system)

remove waste products

control body temp

aging (circulatory system) changes 3

How can NA assist with circulatory system?

Image: Important observations and reports for circulatory system

hypertension (HTN) (and measure)

high blood pressure, regularly measuring 140/90 mm Hg or higher (for elderly)

diuretics

medications that reduce fluid volume in body (water pill) (would allow more urination by pulling fluid from cells)

Image: plaque formation in arteries can build up high blood pressure

high cholesterol

excess fat circulating in blood stream which becomes plaque in arteries head to toe in various sections (years of build up)

(consumption milk cheese meat butter)

major cause of hyertension

atherosclerosis- hardening and narrowing of blood vessels ( such as build up of plaque)

symptoms of HTN

headache, blurred vision, dizziness; sometime nothing noticeable

normal blood pressure

140/90

normal pulse

60 to 100 bpm

Care for hypertension (2)

1. Regular trip to bathroom

2. Encourage residents to follow their diet and exercise programs. Measure blood pressure as directed (VS before giving medication)

angina pectoris

chest pain, pressure, or discomfort

Coronary artery disease CAD

blood vessels in coronary arteries (near heart) narrow and reduce blood flow to heart

result of CAD?

angina pectoris

guideline for angina pectoris (4— important to know the medication tablet)

1. encourage rest

2. nitroglycerin (dilator of blood) medication tablet or patch

3. only nurse should do it. tell them if resident needs help

4. residents avoid heavy meals, overeating, intense exercise, or cold humid weather

MI

myocardial infarction— heart attack

myo(muscle) cardial(heart)

death of heart muscle which is caused by block of blood flow to heart muscle

MI dead tissue area can be… (2)

large or small

result in serious heart damage or death

note

the closer the blockage is to the first or main branch of blood vessel, the more sever the MI and the parts that doesn’t get the supply of blood dies off

stroke is similar to heart attack…. as it is….

blockage in the brain

Care after heart attack/ surgery

1. low cholesterol, low fat, and sodium diet;

2. exercise program; medications for heart rate and blood pressure;

3. Avoid: smoking; cold temp; s

4. tress management

why a low salt (sodium) diet for heart attack care?

salt retains fluid; heart has to pump harder; strain on heart

Congestive heart failure CHF

failure of heart muscle to pump effectively due to damage

symptoms of CHF

coughing or gurgling (fluid in lungs)

Fluid won’t be able to get pumped back into heart so it builds up in lower body

can medications help control CHF?

yes

guidelines for CHF

1. medications

2. toilet

3. follow diet— high potassium can help with dizziness

4. rest

5. intake and output of fluid measure

6. weigh residents

7. ROM

8. Extra pillow for breathing— elevate head of bed

Peripheral vascular disease PVD

fatty deposits in blood vessels that harden (peripheral meaning around hands, feet, etc)

symptoms of PVD

cool arms and legs

swelling in hands and feet

pale or bluish hand and feet

bluish nail

ulcers on legs and feet

pain when walking

treatment of PVD

quit smoking, medications, exercise, surgery

topic: respiratory system

…..

Image: respiratory system

inspiration

breathing in

expiration

breathing out

respiration

inspiration + expiration

Respiratory system function (2)

bring oxygen into body

eliminate carbon dioxide produced by body

Normal changes of respiratory system (due to age)

loss of strength (lung)

decreased lung capacity

decreased oxygen in blood

weakened voice

NAs can help residents by

1. avoid exposure to polluted air (like smoke or pollens)

2. rest

3. exercise and movement

4. deep breathing exercises

5. positions into ease breathing (high fowlers—sitting upright)

Image: observations for respiratory system

chronic obstructive pulmonary COPD

lung disease that makes it difficult to breath

is COPD chronic?

yes

two types of COPD

chronic bronchitis and emphysema

COPD resident has high risk of what?

pneumonia

COPD residents may have….

fear of suffocation—> not sleep

poor appetite due to lack of sleep

COPD symptoms

cough or wheeze (chronic)

trouble breathing

shortness of breath

pale,cyanotic, reddish-purple skin

confusion

weakness

appetite loss

fear and anxiety

Image: Observations for COPD

aveoli

air sacs attached to bronchioles (can’t be regenerated)

(has blood vessels)

emphyzema

type of COPD caused by prolonged smoking, by over-inflating the lung and alveoli

Note: asmtha

Bronchioles cross-section similar to arteries

inflammation that tightens the bronchioles making it hard to breathe (Bronchitis— mucous build up in it)

note

emphyzema patients have damaged lungs so they are used to running on lower oxygen levels. Giving too much oxygen during therapy can trigger respiratory arrest

Topic: endocrine system and diabetes

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image: Endocrine system

Endocrine system

Made up of different glands

glands

organs that produce and secrete different hormones

Hormone

chemical substance that the body usses

what does pituitary gland secrete (an example)? What is another function?

oxytoxin— for uterus contraction (labor)

commands other glands on when to produce the hormones

Thyroid gland (in charge of?)

metabolism

parathyroids

regulate calcium in blood stream

thymus (usage)

before adolescence—> growth for puberty

after puberty if shrinks

adrenal glands (secretes?)

1. epinephrine (fight or flight response— dilator of blood vessels)

2. Norepinephrine (vasoconstrictor)

3. Cortisol—secreted under stress, decreases the immune system

pancreas (secrete)

insulin (brings blood sugar down)

glucose (sugar-not hormone)

ovaries (secrete)

estrogen

progesterone

testes (secrete)

testosterone

how are hormones carried to organs?

blood

what does hormones achieve?

maintain homeostasis

growth and development

blood sugar levels

calcium and phosphate levels

reproduction

burning food (calories) for energy

Normal age change in endocrine system

NAs help the endocrine system by

Image: observations

polydypsia

excessive thirst

polyphagia

excessive hunger

polyuria

excessive urination

symptoms of diebetes (some signs)

polyphagia, polydypsia, polyuria

diabetes

pancreas produces little insuline or no proper use of insulin

insulin

hormone that converts glucose from blood into cell for energy

pre diabetes

blood glucose level are above normal but not high enough

gestational diabetes

appears in pregnant women who never had diabetes before but who have high glucose level during pregnancy

diabetes; what can glucose do?

glucose can collect in blood causing circulatory problems

type 1 diabetes

found in children and young adults; pancreas produces little to no insulin. Managed with daily injections of insulin or pump and special diet. Blood testing must be done.

which is more common, type 1 or 2 diabetes?

type 2

type 2 diabetes

Either body produce little to no insulin or fails to properly use insulin. Insulin resistance. It develops slowly and mildly. Develops after 35 (typically); the risk of getting this type increases with age.

signs of diabetes

Diabetes complications

1. circulatory system change—→ stroke, MI, poor circulation

2. Damage to eye/blindness

3. leg foot uclers/ wound infections

4. insulation reactions and biabetic ketoacidosis

image: diabetic guidelines

topic: vital signs

……

normal pulse rate

60-100 bpm (beats per minute)

normal respiratory rate

12-20 respirations per minute