Cardiovascular Disorders, Exams of Nursing

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Cardiovascular Disorders

Hypertension

• (^) Hypertension means a systolic pressure

that is equal to or greater than

130 mm Hg and a diastolic pressure

that is equal to or greater than 80 mm

Hg when taken at least twice and

averaged on two different occasions 2

weeks apart.

• (^) Normal: 120/
• (^) Untreated hypertension can cause

myocardial infarction (MI), cerebral

hemorrhage, and heart failure.

Signs and

Symptoms of HTN

• (^) Hypertension has been called the “silent killer”

because in early stages it does not usually

cause discomfort or any other subjective signs

and symptoms to indicate its presence.

• (^) Patients with symptoms may complain of headache,

dizziness, blurred vision, blackouts,

irritability, angina, dyspnea, or fatigue.

• (^) Hypertensive patients develop coronary heart

disease at a rate two to three times greater

than that of persons with normal blood pressure.

• (^) An electrocardiogram (ECG), echocardiogram, and

cardiac stress test may be ordered to determine

whether any damage has been done to the heart

muscle.

Treatment

• The goals of treatment are (1) reduction of high blood pressure and (2) long-term control to decrease the risk of stroke, heart attack, loss of vision, and kidney disease.
• (^) For elevated blood pressure, smoking cessation, weight reduction, sodium restriction, alcohol restriction, exercise, a low-fat diet, and stress control are instituted.
• (^) Sodium should be kept to less than 2400 mg/day with the DASH (Dietary Approaches to Stop Hypertension) eating plan.
• Alcohol intake should not exceed one serving of liquor, wine, or beer per day for women or two servings per day for men.
• Aerobic exercise of 30 to 45 minutes on most days of the week is recommended.
• (^) Patients should monitor their blood pressure at home and keep records of the readings. Periodic visits to the health care provider's office for regular examinations are necessary.

Complications of Uncontrolled Hypertension

• (^) Hypertension can cause damage to arteries, making them less elastic. This places an increased workload on the heart. This may cause MI, left ventricular hypertrophy, aortic aneurysm, and congestive heart failure.
• Small vessel damage to the brain disrupts circulation and may lead to dementia, transient ischemic attacks (TIAs), and ischemic stroke.
• (^) Hypertension may cause an already weakened area in a blood vessel to rupture. This may cause an intracranial bleed known as a hemorrhagic stroke.
• (^) Hypertension may cause damage to the small vessels of the kidney and may lead to kidney failure.
• (^) Hypertension damages the arteries of the eye, causing the formation of clots or occurrence of hemorrhage that may lead to blurred vision or blindness.

Abdominal Aortic

Aneurysm

• (^) https://www.youtube.com

/watch?v=jJUJN7EjOKk

Claudication

• (^) Claudication is a pain, cramp or sense of

fatigue in a muscle group of the lower

extremity related to sustained exercise

and relieved promptly by a few minutes of

rest while standing evenly on both feet.

• (^) Claudication is usually a symptom

of peripheral artery disease, in which

the arteries that supply blood to the

arms or legs, usually the legs, are

narrowed.

5 Ps of

Arterial Disease

• (^) The most common etiology of peripheral arterial

disease (PAD) is atherosclerosis. The vessel

walls become narrowed or the lumen obstructed,

leading to loss of blood flow to the extremity.

• (^) Restriction of arterial blood flow may cause

arterial ulcers. Cessation of blood flow in the

arteries leads to ischemia and tissue death

(necrosis). PAD may be acute or chronic.

• (^) Embolism is the most common cause of acute

interruption of arterial blood flow.

• The best treatment for arterial occlusive

disease is regular exercise.

Peripheral Vascular

Disease (PVD)

• (^) A circulatory condition in which narrowed blood vessels, obstructed veins , thrombophlebitis, or defective valve function reduce blood flow to the limbs.
• (^) Peripheral vascular disease is a sign of fatty deposits and calcium building up in the walls of the arteries (atherosclerosis).
• (^) Risk factors include aging (loss of vessel wall weakened muscled, sedentary lifestyle), diabetes, stress and smoking.
• Signs and symptoms may include leg pain, particularly when walking and pitting edema.
• (^) Prevention: Stress relief, Smoking cessation, exercise, Diabetes control, Weight control
• (^) https://www.youtube.com/watch?v=B3frDIqVE_

PAD vs. PVD

Etiology

• (^) The most common causes are coronary artery disease and uncontrolled hypertension
• (^) African Americans have a higher incidence of HF and have higher mortality rates than other populations.
• (^) Half of patients diagnosed with HF will die within 5 years
• (^) LAB: BNP Heart Failure 16

S/S of Right Sided Heart Failure 20

THINK FLUID IN ABDOMEN &

EXTREMETIES

THINK FLUID IN ABDOMEN &

EXTREMETIES

fatigue^ fatigue

pitting^ pitting edemaedema

hepatomegaly^ hepatomegaly

abdominal distention /^ abdominal distention / ascitesascites

weight gain^ weight gain

JVD^ JVD