Question

Cardiovascular system:

A nurse is preparing educational materials for a group of older adults regarding cardiac function and health promotion.

1. What structures should the nurse include in the patient’s education information?
2. What information concerning the conduction system of the heart will the nurse include in the information?
3. How will the nurse discuss risk factors for coronary heart disease?
4. Describe the information that will be included in the discussion of risk reduction and health promotion strategies to minimize the risk of coronary heart disease.

The Peripheral Vascular System and Lymphatic System

1. A nurse is preparing to discharge an adult patient who has a history of peripheral vascular disease. In order to minimize the patient’s risk for injury related to this diagnosis, the nurse plans to educate both the patient and his family to strategies that are directed toward identifying and minimizing the risks for peripheral artery disease, chronic venous stasis, and thromboembolic disease.

What strategies should the nurse include in the patient’s education information?

2. A patient has arrived at the vascular clinic complaining of severe lower leg pain to the point that they can barely walk 10 ft without needing to stop and rest. The health care practitioner suspects arterial insufficiency.

Which assessment findings correlate to advanced arterial insufficiency and not venous insufficiency?

Answer 1

A
Aorta Circumflex Left anterior descending artery Right coronary artery

A. I will discuss the above structures with my patients .

B. For the conduction of heart I will tell them that the cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers. The SA node (anatomical pacemaker) starts the sequence by causing the atrial muscles to contract. From there, the signal travels to the AV node, through the bundle of His, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an Electrocardiogram (EKG or ECG). Doctors use an EKG to monitor the cardiac conduction system's electrical activity in the heart.

LA SINOATRIAL (SA) NODE ATRIOVENTRICULAR (AV) NODE RA RA=ATRIUM _RIGHT LV RIGHT RV=VENTRICLE LA=LEFT RV ATRIUM LV=LEFT VENTRICLE

C. The traditional risk factors for coronary artery disease are high LDL cholesterol, low HDL cholesterol, high blood pressure, family history, diabetes, smoking, being post-menopausal for women and being older than 45 for men. Obesity may also be a risk factor.

D. Life style modification is the best way to reduce the chances of CAD.

Here are some things you can do-

•Quit smoking, if you smoke.

•Eat lots of fruits, vegetables, and foods with a lot of fiber. Avoid foods that have a lot of sugar.

•Walk or do some form of physically activity on most days of the week.

•Lose weight, if you are overweight.

1. At first nurse will provide General informations regarding PVD.

She can say that Peripheral vascular disease (PVD) is a problem with poor blood flow. It affects blood vessels outside of the heart and brain and gets worse over time. Parts of the body, like the brain, heart, arms, or legs, may not get enough blood. The legs and feet are most commonly affected.

Now she can tell them about the risk factors for this eg.

• Age over 50 years
• Heart disease
• High blood cholesterol
• High blood pressure (hypertension)
• Diabetes
• No longer having menstrual periods (postmenopausal)
• Family history of high cholesterol, high blood pressure, or PVD
• Overweight or obesity
• Physical inactivity
• Smoking or use of tobacco products

Those who smoke or have diabetes have the highest risk of complications from PVD because these risk factors also cause poor blood flow.

Then she will inform the patient and family members about the symptoms of PVD -

• Changes of the skin of the legs and feet, including red to blue color, coldness, or thin, shiny skin
• Weak pulses in the legs and the feet
• Dead tissue due to lack of blood flow (gangrene)
• Hair loss on the legs
• Wounds that will not heal, like on the heels or ankles
• Numbness, weakness, or heaviness in the leg muscles
• Pain in the legs that may be specific, like in the toes at night
• Thickened, discolored toenails
• Inability to have an erection (impotence)

Then she will teach them some steps to prevent PVD eg.

• Stop smoking, including staying away from secondhand smoke
• Healthy eating including reduced fat, cholesterol, and sugar, and increased fruits, vegetables, whole grains, and healthy protein (lean meats, fish, and soy)
• Treatment of high cholesterol with diet, exercise, and medicine
• Losing weight if overweight
• Limiting the amount of alcohol you drink
• Taking medicine to reduce your risk for blood clots
• Regular exercise
• Control of blood sugar levels
• Control of blood pressure

2.

Skin Arterial Disease cool or cold, hairless, dry, shiny, pallor on elevation, rubor on dangling sharp, stabbing, worsens w/ activity and walking, lowering feet may relieve pain Pain Venous Disease warm, tough, thickened, mottled, pigmented areas aching, cramping activity and walking sometimes help, elevating the feet relieves pain moderately painful, pink base, found on medial aspect of the ankle Ulcers severely painful, pale, grey base, found on heel, toes, dorsum of foot often absent or diminished in frequent Pulse usually present Oedema frequent, esp. at the end of the day and in areas of ulceration