CARDIOVASCULAR AND RESPIRATORY SYSTEM

DISORDERS

Chapter 40

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CARDIOVASCULAR DISORDERS Problems occur in the heart or blood vessels. With hypertension, the resting blood

pressure is too high. The systolic pressure is 140 mm Hg or higher

or the diastolic pressure is 90 mm Hg or higher.

Causes Narrowed blood vessels Kidney disorders Head injuries Some pregnancy problems Adrenal gland tumors

3 Hypertension can lead to:

Stroke Hardening of the arteries Heart attack Heart failure Kidney failure Blindness

Life-style changes can lower blood pressure. A diet low in fat and salt A healthy weight Regular exercise Not smoking Limiting alcohol and caffeine Managing stress and sleeping well

Certain drugs can lower blood pressure.

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Coronary artery disease (CAD, coronary heart disease, heart disease)

coronary arteries are in the heart. In CAD, one or all coronary arteries become

hardened and narrow. most common cause is atherosclerosis. major complications of CAD are:

Angina Myocardial infarction (heart attack) Irregular heartbeats Sudden death

The more risk factors, the greater the chance of CAD and its complications.

These risk factors cannot be controlled: Gender (Men are at greater risk than women.) Age (Risk increases with age.) Family history Race (African-Americans are at greater risk

than other groups.) These factors can be controlled:

Being overweight Lack of exercise High blood cholesterol Hypertension Smoking Diabetes Stress

The goals of treatment : Relieve symptoms Slow or stop atherosclerosis Lower the risk of blood clots forming Widen or bypass clogged arteries Reduce cardiac events

Persons with CAD: Quit smoking, exercise, and reduce stress Eat a healthy diet If overweight, lose weight

Some may need medications: Decrease the heart’s workload and relieve

symptoms Prevent a heart attack or sudden death Delay the need for medical and surgical

procedures

Persons with complications from CAD may need cardiac rehabilitation.

• Exercise training• Education, counseling, and training

Angina (pain) is chest pain from reduced blood flow to part of the

heart muscle (myocardium). described as tightness, pressure, squeezing, or

burning in the chest. Symptoms can be relieved.

Rest often relieves symptoms in 3 to 15 minutes.

A nitroglycerin tablet is taken when angina occurs.

Some persons have nitroglycerin patches. Things that cause angina are avoided. Exercise programs are supervised by the doctor. Chest pain lasting longer than a few minutes

and not relieved by rest and nitroglycerin may signal heart attack. The person needs emergency care.

Myocardial infarction (MI) With MI, part of the heart muscle dies.

Sudden cardiac death (sudden cardiac arrest) can occur.

MI also is called: Heart attack Acute myocardial infarction (AMI) Acute coronary syndrome (ACS) Coronary Coronary thrombosis Coronary occlusion

CAD, angina, and previous MI are risk factors. MI is an emergency

Relieve pain Restore blood flow to the heart Stabilize vital signs Give oxygen Calm the person Prevent life-threatening problems

If the person survives: He or she may need medical or surgical

procedures to open or bypass the diseased artery. Cardiac rehabilitation is needed.

Heart failure (congestive heart failure [CHF]) the heart is weakened and cannot pump

normally. the left side of the heart cannot pump blood

normally, blood backs up into the lungs. the right side of the heart cannot pump blood

normally, blood backs up into the venous system. A very severe form of heart failure is

pulmonary edema (fluid in the lungs).

Common causes of heart failure are: CAD MI Hypertension Age Diabetes Irregular heart rhythms Damaged heart valves Kidney disease

Treatment Drugs are ordered to strengthen the heart. Drugs are ordered to reduce the amount of fluid

in the body. A sodium-controlled diet is ordered. Oxygen is given. Semi-Fowler’s position is preferred for breathing. The person must reduce the risk factors for CAD. If acutely ill, the person needs hospital care.

RESPIRATORY DISORDERS The respiratory system brings oxygen (O2)

into the lungs and removes carbon dioxide (CO2) from the body.

Respiratory disorders interfere with this function and threaten life.

Chronic obstructive pulmonary disease (COPD) Chronic bronchitis, emphysema, and asthma are

grouped under COPD. Risk factors for COPD include:

Cigarette smoking Pipe, cigar, and other smoking tobaccos Exposure to second-hand smoke

Not smoking is the best way to prevent COPD. COPD has no cure. COPD affects the airways and alveoli.

Chronic bronchitis occurs after repeated episodes of bronchitis. Bronchitis means inflammation of the bronchi. Smoking is the major cause. Infection, air pollution, and industrial dusts are

risk factors. Smoker’s cough in the morning is often the first

symptom. Treatment involves:

The person must stop smoking. Oxygen therapy and breathing exercises are

often ordered. Respiratory tract infections are prevented.

• If one occurs, the person needs prompt treatment.

In emphysema, the alveoli enlarge and become less elastic.

Some air is trapped in the alveoli when exhaling. O2 and CO2 exchange cannot occur in affected

alveoli. Smoking is the most common cause. Air pollution and industrial dusts are risk factors. The person has shortness of breath and a cough. Breathing is easier when the person sits upright and

slightly forward. Treatments

The person must stop smoking. Respiratory therapy, breathing exercises, oxygen,

and drug therapy are ordered.

With asthma, the airway becomes inflamed and narrow.

Extra mucus is produced. Signs and symptoms include:

Dyspnea Wheezing and coughing Pain and tightening in the chest

Asthma usually is triggered by allergies. Sudden attacks (asthma attacks) can occur. Asthma is treated with drugs.

Severe attacks may require emergency care. Repeated attacks can damage the respiratory

system.

Influenza (flu) Influenza is a respiratory infection. Caused by viruses, flu season is usually from

November through March. Most deaths from flu occur in older persons. Treatment involves fluids, rest, and relief of

symptoms. Coughing and sneezing spread flu viruses.

Standard Precautions are followed. The flu vaccine is the best way to prevent the

disease.

The Centers for Disease Control and Prevention (CDC) recommends the flu vaccine for persons who: Are 50 years of age and older Have chronic heart, lung, or kidney diseases Have diabetes Have immune system problems Have a severe form of anemia Will be more than 3 months pregnant during the

flu season Are nursing center or assisted-living residents Are in close contact with children 0 to 23 months

of age

Pneumonia Pneumonia is an inflammation and infection of lung

tissue. Affected tissues fill with fluid.

Bacteria, viruses, and other microbes are causes. Microbes reach the lungs in these ways:

Being inhaled Aspirated Carried in the blood

Children under 2 years of age and adults over 65 years of age are at risk.

Older adults are at great risk of dying from the disease.

Factors that increase the risk of pneumonia Smoking Aging Stroke Bedrest Immobility Chronic diseases Tube feedings

Treatment : Drugs for infection and pain Increased fluid intake to treat fever and to thin

secretions Intravenous therapy and oxygen Semi-Fowler’s position to ease breathing

Rest is important. Standard Precautions are followed. Isolation Precautions are used depending on

the cause. Mouth care is important. Frequent linen changes are needed because of

fever.

Tuberculosis (TB) is a bacterial infection in the lungs.

can occur in other parts of the body. not treated, the person can die. spread by airborne droplets with coughing,

sneezing, speaking, singing, or laughing. Those who have close, frequent contact with an

infected person are at risk. Risk factors :

Living in close, crowded areas Age Poor nutrition HIV infection

TB can be present in the body but not cause signs

and symptoms. Only persons with an active infection can spread

the disease to others. Chest x-rays and TB testing can detect the disease. Treatment =drugs for TB. Standard Precautions and Isolation Precautions The person must cover the mouth and nose with

tissues when sneezing, coughing, or producing sputum.

Tissues are flushed down the toilet, placed in a biohazard bag, or placed in a paper bag and burned.

Hand washing is essential.