Touhy Ch. 22 Cardiac Touhy Ch. 25
Respiratory
CARDIAC & CEREBROVASCULAR HEALTH correct answers Age-related cardiac
changes:
•Heart muscle function declines, lower cardiac reserve - longer for heart to accelerate &
longer to return to resting state
•Valves thicken & stiffen - increased lipid deposits in valves à murmur
HYPERTENSION & CAD correct answers -Most common chronic CVD
-S/S vary - See Touhy
-Hypertension Guidelines - check 2020
-Complications of HTN: increased level of stroke, heart failure, heart attack (MI), CAD &
dementia
-Risks: age, weight, diet, exercise, race, DM, stress, etc.
levels of prevention correct answers Diet, exercise, stress management
Dietary Approaches to Stop Hypertension (DASH Diet)
Medications - Pharmacology Class
Dietary Approaches to Treat Hypertension: DASH correct answers -The DASH diet
emphasizes vegetables, fruits and low-fat dairy foods — and moderate amounts of
whole grains, fish, poultry and nuts.
-Typical American Diet = up to 3400 mg of sodium per day!!
-Standard DASH diet. Up to 2,300 mg of sodium a day. The DASH diet generally
includes about 2,000 calories a day.
-Lower sodium DASH diet. Up to 1,500 mg of sodium a day
-The DASH diet is low in saturated fat, trans fat and total fat
-Mayo Clinic, 2020
DASH Recommendations Mayo Clinic, 2020 correct answers -Vegetables: 4 to 5
servings a day
-Fruits: 4 to 5 servings a day
-Dairy: 2 to 3 servings a day
-Lean meat, poultry and fish: 6 one-ounce servings or fewer a day
-Nuts, seeds and legumes: 4 to 5 servings a week
-Fats and oils: 2 to 3 servings a day
-Sweets: 5 servings or fewer a week
, Coronary Artery Disease (CAD) - Atherosclerosis correct answers -Thickening of the
walls of the arteries. Altered lipid, cholesterol metabolism.
-Body compensates by 'remodeling'. Heart enlarges & changes shape à decreased
pump efficiency
-Risk Factors: Family hx, HTN, obesity, physical inactivity, unhealthy diet, and smoking
-S/S: various - sob, fatigue, light headedness, disturbances in gait and balance
-Most common complication: MI, stroke
Atrial fibrillation correct answers -Cardiac Rhythm disturbance - Right atrium initiates
impulses in a disorganized, rapid manner à rapid, irregular rhythm à blood clots & stroke
-Many causes - diabetes, sleep apnea, thyroid disorders, alcohol abuse, and several
cardio myopathies including CHD and hypertension
-S/S - fatigue, SOB, palpitations
-Meds: Pharmacology - goal = rate control, anti-coagulation
heart failure (HF) correct answers Inability of the heart to pump efficiently to meet
body's demands
-The #1 most common cause of hospitalization, rehospitalization & disability
-Ejection fraction - estimate of pumping action of the heart.
-Normal EF is 55-70%. Measured via Echocardiogram done via Ultrasound
-Causes: HTN, drug and alcohol abuse, hyperthyroidism, and valvular heart disease
-Symptoms same as CAD: SOB, edema, weight gain, weakness/fatigue, abd pain.
Many more S/S depending on type of HF.
Systolic Heart Failure - correct answers This is the most common cause of heart failure
and occurs when the heart is weak and enlarged. The muscle of the left ventricle loses
some of its ability to contract or shorten. In turn, it may not have the muscle power to
pump the amount of oxygenated and nutrient-filled blood the body needs.
Two types of heart dysfunction can lead to heart failure, including: correct answers
Systolic Heart Failure and Diastolic Failure
Diastolic Failure - correct answers The muscle becomes stiff and loses some of its
ability to relax. As a result, the affected chamber has trouble filling with blood during the
rest period that occurs between each heartbeat. Often the walls of the heart thicken,
and the size of the left chamber may be normal or reduced.
left sided heart failure correct answers -Left ventricle fails to eject blood into aorta and
fluid accumulates in the pulmonary vasculature
-Fluid backs up into the lungs causing dyspnea on exertion, orthopnea, nocturnal
dyspnea & dyspnea at rest
-Other S/S:
-Cough with white or pink-tinged, sometimes 'frothy' sputum
-Crackles or other abnormal lung sounds
-Tachycardia, S3 heart sound
-Cyanosis
