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Chapter 40
CARDIOVASCULAR AND
RESPIRATORY SYSTEM
DISORDERS
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CARDIOVASCULAR DISORDERS
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Problems occur in the heart or blood vessels.
With hypertension, the resting blood pressure is too
high.
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The systolic pressure is 140 mm Hg or higher or the
diastolic pressure is 90 mm Hg or higher.
Causes
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Narrowed blood vessels
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Kidney disorders
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Head injuries
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Some pregnancy problems
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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)
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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.
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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
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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
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Persons with complications from CAD may need cardiac
rehabilitation.
• Exercise training
• Education, counseling, and training
Angina (pain)
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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.
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Myocardial infarction (MI)
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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
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Coronary occlusion
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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.
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Heart failure (congestive heart failure [CHF])
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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).
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Common causes of heart failure are:
 CAD
 MI
 Hypertension
 Age
 Diabetes
 Irregular heart rhythms
 Damaged heart valves
 Kidney disease
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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
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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.
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Chronic obstructive pulmonary disease (COPD)
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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.
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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.
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• If one occurs, the person needs prompt treatment.
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In emphysema, the alveoli enlarge and become less elastic.
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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.
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With asthma, the airway becomes inflamed and narrow.
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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.
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Influenza (flu)
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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.
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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
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Pneumonia
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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.
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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
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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.
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Tuberculosis (TB) is a bacterial infection in the lungs.
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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
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TB
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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.