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Coronary Artery Disease. Ischemic heart disease. Angina Pectoris. Development of plaques Vessels narrow or become obstructed Ischemia Prolonged deficiency of oxygenated blood. Angina “pain in chest”. Signs and Symptoms. Distribution of pain Sensation of tightening Faint Dyspneic Pale. - PowerPoint PPT Presentation
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Angina Pectoris
Development of plaques Vessels narrow or become
obstructed Ischemia
Prolonged deficiency of oxygenated blood
Medical and Surgical treatment
Medications Diet and exercise Reduction of risk factors Invasive and intervention
procedures
Myocardial Infarction
Blockage of coronary arteries Damage to the myocardium and
conduction system Diminished blood flow Life threatening dysrhythmias Ineffective pump
Signs and Symptoms Pain Panic Restlessness Confusion Ashen Cold Clammy Dyspnea
Cyanosis Rapid thready
pulse Irregular pulse Drop in BP Drop in body temp Sense of
impending doom
Nursing Considerationsacute phase
Assessment Vital signs Cardiac monitoring I/O, daily weight Lab and xray Medications
Nursing Considerationsrecovery phase
Bowel movement Cardiac rehab-exercise Rest Diet Treatment and medications Risk factors Compliance
Thrombophlebitis
Predisposing factors Pressure Prolonged inactivity Prolonged immobilization
Venous stasis Decrease venous return
Peripheral Vascular Disorders
Intermittent claudication Tingling and numbness Coldness and difference in size Lack of new tissue growth
Buerger’s disease Thromoangiitis obliterans
Inflammation causes obstruction of blood vessels
Cramps in calf muscle-exercise Tingling, burning and numbness Edema-pitting or brawny Mottled purple red hue- dependent Pale when elevated Ulcers-infection-gangrene Amputation
Medical and surgical treatment
Mild exercise- buerger-allen exercises
Medications Clothing Diet and fluid intake
Raynaud’s Phenomenon
Spasmodic constriction of arteries Blanched cold extremities Numb-prickly- perspire-blue Progresses-cyanosis-ulcers Skin shiny and tight Avoid cold Medications to relieve spasms
Varicose Veins Weakening valves of the veins Blood pools Predisposing factors
Heredity Weakening vein walls Poor posture Prolonged standing Tumors Hypertension obesity
Signs and symptoms
Dark, tortuous superficial veins Dark protrusions when standing Pain Fatigue Feeling of heaviness Muscle cramps
Medical and Surgical treatment
Elevating legs Avoiding constriction, standing long
periods and restrictive clothing Measures aimed at promoting venous
return Surgical ligation and stripping of
varicose veins Sclerosing-injection
Nursing considerations
Teaching Measures to promote venous
return Antiembolism stockings Elevate legs Ambulation
Aneurysms Outpouching of a blood vessel
Congenital Trauma Increased pressure of arteriolosclerosis
Vessel may hemorrhage or rupture Surgical intervention if in an operable
site Surgical repair-clamping, removal or
synthetic graft
Causes of cerebrovascular accident
Contributing factors Causes of CVA
Cerebral thrombosis Cerebral hemorrhage or aneurysm Cerebral embolism
Stages of CVA
Transient ischemic attack Reversible ischemic neurological
deficit Stroke in evolution Completed stroke
Signs and Symptoms Dizzy spells Memory loss Ringing in the ears
(tinnitus) Headache-nausea and
vomiting Loss of consciousness Face red Breathing noisy and
strained BP elevated
Pulse slow but full and bounding
Inconsistent behavior
Easily fatigued Loss of bowel and
bladder control Poor balance Deep coma
Results of CVA
Hemiplegia Paralysis of one side of body
Flaccid stage Numbness and weakness
Spastic stage Muscles contracted, tense and movement
difficult Recovery stage
Therapy and rehabilitation
Aphasia and Dysphasia
Aphasia Damage to the brain’s speech center Unable to speak
Dysphasia Inability to say what one wishes to
say Dysphagia
Swallowing difficulty
Hemianopsia
Blindness in half of the visual field of one or both eyes
Approach from the unaffected side Teach client to scan to see things
Pain
Very little pain associated with CVA
Secondary health issues Infection Kidney Bladder Fecal impaction
Autonomic Disturbances
Perspiration or “goose flesh” above paralysis
Dilated pupils High or low blood pressure headache
Personality changes
Functional Frustration unable to walk or talk Useless or helpless
Organic changes Blockage of blood supply to part of
brain