Body Systems, Disorders & CNA Care – Comprehensive Lecture Notes

Coronary Artery Disease (CAD) & Angina

  • Narrowed coronary arteries → ↓ blood flow to myocardium → ischemic chest pain (“angina”)
  • Angina presentation: pressure, discomfort, pain; precipitated by exertion, stress, extreme temperatures
  • Nitroglycerin (SL tabs, spray, patch)
    • Rapid vasodilation of coronary vessels
    • Care teaching: rise slowly, avoid heat/cold extremes & vigorous exercise while patch/onset active, encourage rest
  • Complete occlusion of a coronary artery = myocardial infarction (MI)

Myocardial Infarction (Heart Attack)

  • Pathophysiology: total blockage like stepping on a hose → zero distal perfusion → tissue death
  • Classic S/S
    • Crushing chest pain/pressure
    • Radiation: left arm, jaw; may track from jaw → arm
    • Diaphoresis: “wring-out” sweating
    • Dyspnea, sudden fatigue, nausea
  • Atypical / female presentations
    • Heartburn, back pain, breast tenderness, vague indigestion, menstrual-like cramps
    • Women have higher fatality rate—delayed self-care & provider bias
  • Immediate CNA actions
    • Sit resident, loosen tight clothing (tie, collar) to reduce work of breathing & fall risk
    • Stay with pt; send for nurse; prepare for CPR/AED if needed
  • Post-MI care: cardiac rehabilitation = monitored exercise, diet, labs to recondition heart muscle

Congestive Heart Failure (CHF)

  • Definition: ineffective pumping → fluid overload in tissues & lungs
  • Assessment
    • Generalized or dependent edema (pitting; fingerprint remains)
    • Rapid weight gain > 10 lb10\text{ lb} in a week alarming
  • Nutrition/Medications
    • Sodium restriction (↓ fluid retention)
    • Diuretics (e.g., furosemide) → ↑ urine output; anticipate frequent toilet trips
    • Potassium loss with diuretics → supplement with bananas, leafy greens, K⁺ tabs
  • CNA Focus
    • Daily weights, I&O, offer bathroom, elevate legs, monitor skin integrity

Peripheral Vascular Disease (PVD)

  • Atherosclerotic plaque in limb vessels → numbness, pain, swelling, poor wound healing
  • Risk modifiers: smoking cessation, exercise, possible surgical re-vascularization

Respiratory System Overview

  • Primary function: gas exchange (O₂ intake, CO₂ removal)
  • Key structures: pharynx, larynx, trachea, bronchi, bronchioles, lungs (L > R)
  • One respiration = 1 inspiration + 1 expiration
  • Normal breathing effortless; labored = dyspnea
Age-Related Changes
  • ↓ chest muscle strength & lung elasticity → ↓ vital capacity
  • Thickened alveolar capillaries → ↓ O₂ in blood
  • Weaker voice; cough less effective → ↑ pneumonia risk
Chronic Obstructive Pulmonary Disease (COPD)
  • Umbrella: asthma, chronic bronchitis, emphysema
  • Issues: poor gas exchange; eating consumes significant energy → weight loss, fatigue
  • Appearance: pale/cyanotic, confusion (↓ O₂), pursed-lip breathing
  • CNA Interventions
    • High-Fowler’s or pillow support to ease breathing
    • Small, unhurried meals; allow 5–6 breaths between bites
    • Observe for fever, altered patterns (tachypnea, apnea) and report

Urinary System & UTIs

  • Organs: 22 kidneys → ureters → bladder → urethra
  • Women’s shorter urethra → higher UTI risk
  • Elderly UTI hallmark: sudden confusion, strong urine odor, dysuria
  • Age changes
    • Weaker bladder muscles & ability to delay voiding
    • ↓ kidney size/function; prostate enlargement in men → BPH
  • CNA Care
    • Frequent toileting, prompt call-bell response
    • Encourage fluids unless restricted; meticulous pericare; document incontinence episodes
    • Incontinence ≠ normal aging; maintain dignity & skin health

Gastrointestinal (GI) System

  • Purpose: digestion → absorption → elimination
  • Structures: mouth, salivary glands, pharynx, esophagus, stomach, liver, gallbladder, pancreas, small & large intestines, rectum, anus
Aging Effects
  • Tooth loss, ↓ taste bud sensitivity → ↑ sugar/salt use
  • Slower peristalsis → constipation, diverticulosis
  • ↓ nutrient absorption; slower alcohol/drug metabolism
Common Conditions & Care
  • Constipation: monitor BM pattern; intervene by day 33; high-fiber diet, fluids, stool softeners/suppository/laxative
  • Fecal impaction: watery leakage, abdominal pain; nurse performs manual disimpaction
  • Diarrhea: risk dehydration & electrolyte loss; encourage fluids, bland diet
  • GERD
    • Gastric acid reflux causes severe burning; chronic
    • Nursing: serve evening meal 3–43–4 h before bed; keep HOB elevated after meals; avoid laying flat
  • Ostomies
    • Surgical opening (stoma) in intestine → external pouch
    • Stool consistency: liquid if small intestine, formed if large intestine

Endocrine System & Diabetes Mellitus

  • Glands (pituitary, thyroid, pancreas, adrenals, etc.) secrete hormones (chemical messengers)
  • Diabetes types
    • Type 1: no insulin production → insulin injections mandatory
    • Type 2: insufficient insulin/insulin resistance → oral meds ± insulin
    • Gestational: develops during pregnancy; resolves post-partum but ↑ future DM risk
    • Prediabetes: elevated glucose not meeting DM criteria
Cardinal Signs/Symptoms (memorize)
  • Polyuria, polydipsia, polyphagia
  • Unexplained weight loss, fatigue
  • Blurred vision, numb/tingling hands & feet
  • Slow-healing wounds, recurrent infections, dry skin
Complications
  • Neuropathy, retinopathy, nephropathy, poor wound healing, amputations
Monitoring & CNA Role
  • Blood glucose via glucometer/Accu-Chek; insulin dosing per reading
  • Foot care: inspect daily for sores, redness, cracks; cotton socks, well-fitting shoes; no barefoot walking

Reproductive System Changes & Issues

  • Male
    • Sperm production ↓ but persists lifelong
    • Benign prostatic hyperplasia (BPH) → hesitancy, weak stream, retention; meds or TURP surgery
  • Female
    • Menopause = ≥1212 months without menses → ↓ estrogen → ↓ calcium → osteoporosis risk
    • Vaginal walls thinner & drier; vaginitis common (yeast, tight clothing, damp briefs) → antifungal cream/suppository
  • Sexuality in elderly
    • Desire & activity may persist; provide privacy for consenting couples
    • Inappropriate behavior is not normal; report per policy

HIV & AIDS

  • Transmission: unprotected sex, shared needles, blood exposure, perinatal
  • HIV attacks immune CD4 cells → if untreated progresses to AIDS
  • Early S/S: flu-like, swollen lymph nodes; confirmed via blood test
  • AIDS complications: opportunistic infections (PCP pneumonia), Kaposi sarcoma
  • Elderly at rising risk due to low condom use; educate on safe sex
  • Symptom management (p.112-114):
    • N/V: small, slow, bland meals; avoid spices
    • Peripheral neuropathy: loose slippers, bed cradle to lift linens
    • Weight loss: high-calorie, high-protein diet
    • Dementia: safety measures, orientation aids

Cancer Considerations

  • Radiation therapy: skin markings guide beams → do not wash off; avoid lotions/creams on site unless ordered
  • Chemotherapy/radiation adverse effects: fatigue, pain, mucositis, N/V, bleeding gums
    • Oral care with soft toothbrush or foam toothettes; baking-soda rinse instead of alcohol mouthwash
  • Pain & positioning: gentle back rubs, pillows; report uncontrolled pain

CNA Study Checklist (Exam Focus)

  • Directional terms, joint vs muscle, skin functions
  • Spinal cord injuries & MS care
  • Nervous, circulatory, respiratory structures & functions
  • Weight-bearing terminology (PWB, NWB)
  • 75%75\% meal intake rule (report ≤ 75%75\%)
  • CHF: fluid restrictions, excess fluid signs
  • UTI prevention strategies
  • Lymphatic/immune basics: lymph = yellow drainage; role in waste removal

These bullet-point notes consolidate every major & minor concept, examples, numerical reference, and practical CNA implication discussed in the lecture transcript.