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Chapter 40
CARDIOVASCULAR AND
RESPIRATORY SYSTEM
DISORDERS
2
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
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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.