Beruflich Dokumente
Kultur Dokumente
Cardiovascular health
Hypertension
Hypertension
Common complications include stroke, end-stage renal failure, and heart failure
(Miller, 1999)
Adoption of a healthier lifestyle, starting in childhood and youth, can prevent and
reverse abnormal blood pressure patterns
Blood pressure and pulse pressure increase progressively with age. According to
Famingham data, adults at age 55 with normal blood pressure have an estimated 90%
lifetime risk for developing hypertension. (Vasan et al, 2002)
Blood pressure screening must be done during every health care encounter with an
older adult to detect hypertension and prevent its complications
Hypertension (cont.)
CATEGORY
Normal
<120
And
<80
Prehypertension
120-139
or
80-89
Stage 1 hypertension
140-159
Or
90-99
Stage 2 hypertension
160
Or
100
Stage 3
180
Or
110
Oslers maneuver
Primary hypertension: The most common form, exact cause is unknown (family
history, age, race, diet (foods high in saturated fats and saturated salt;
decreased potassium, magnesium, and calcium intake, smoking, stress, alcohol
and drug consumption, physical activity, and hormonal intake))
Pharmacological
Treatment
Pharmacological Treatment
Increase the dose of the first drug, and then add a second drug of a different
class or substitute a drug from another class.
Diuretics
Beta-Blockers
Coronary Artery
Disease
Atherosclerosis
CAD is the major cause of morbidity, disability and mortality in the adult
population
Angina
Diagnostic
Tests and
Procedures
ECG
Chest-x-ray examination
Myocardial imaging
Cardiac catheterization
Stress test
Pharmacological
Treatment
Treatment is directed toward restoring the balance between
myocardial oxygen demand and oxygen supply for the prevention of
CAD
Nitrates
Beta-Blockers
Nonpharmacologic
Treatment
Nonpharmacologic Treatment
Invasive
Percutaneous
Transluminal Coronary
Angioplasty (PTCA)
Stents
Coronary
Arrhythmia
Arrhythmia
Can originate in the atria, ventricles, or artiroventricular junctions, and can result in
decreased cardiac output and impaired perfusion of coronary arteries.
Older adults can develop any type of arrhythmia; however atrial fibrillation, sick sinus
syndrome, and heart block occur more often in the older population.
The incidence of atrial fibrillation increases with age and is the most common contributing
factor for ischemic stroke in older adults
Atrial fibrillation can occur during intense emotional stress, exercise, or alcohol intoxication
Treatment
Treatment should be limited to symptomatic clients
with significant arrhythmias Antiarrhythmic
medications should be avoided when possible
Treatment
Heart Block: Treatment for first degree heart block includes observation to
prevent deterioration into severe heart block. 2nd and 3rd degree block,
vagolytic and sympathomimetic agents are usually employed.
Orthostatic Hypotension
Orthostatic Hypotension
It is even more common among persons with certain risk factors such as
authonmic dysfunction, low cardiac output, and hypovolemia
exercise
Nurse should be sensitive to the needs and initiate discussion with the client,
family, and physician
Thermoregultion
Sexual activity should be discussed with older adults. Safe :4-6 wks after MI
Health teaching
Place pt. at a higher risk for fainting and falls especially those who are
experiencing tachycardia, bradycardia and long sinus pause
Encourage to limit alcohol intake, avoid large meals, and monitor, and control
diabetis mellitus
Encourage support
Heart failure
Assess BP, apical pulse, heart rate, heart and lung sounds, and peripheral
edema, to detect early s/sx of cardiac output
anemia
Health education
Ental safety
1.
2-3.
4.
5.
6-10.