Session 10 & 11: Ch 12 PowerPoint Presentation
- 1. Lecture Notes Classroom Activity to Accompany Diseases of the Human Body Fifth Edition Carol D. Tamparo Marcia A. Lewis 1 2Cardiovascular System Diseases and Disorders
- 2. Copyright © 2011 by F.A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise— without written permission from the publisher.
- 3. 3 Nobody has ever measured, not even poets, how much the heart can hold. —Zelda Fitzgerald
- 4. 4 Common Signs and Symptoms of Cardiovascular and Lymphatic System Diseases and Disorders • Fatigue • Fever • Weakness • Tachycardia, palpitations • Pallor • Hypertension • Chest pain • Night sweats • Edema • Nausea,vomiting, anorexia • Anxiety • Headache • Claudication
- 5. 5 Myocarditis • Description • Inflammation of the cardiac muscle without evidence of an MI • May be acute or chronic MI = myocardial infarction.
- 6. 6 Myocarditis • Etiology • Caused by bacteria or more commonly a viral infection • May also be caused by toxins, side effect of drugs, or radiation therapy
- 7. 7 Myocarditis • Signs and symptoms • Nonspecific • Dyspnea, palpitations, fever, myalgia, and fatigue • Pleuritic pain and chest discomfort, shortness of breath, and tachycardia
- 8. 8 Myocarditis • Diagnostic procedures • Medical history of recent respiratory infection • Blood tests, WBC, ESR • ECG • Echocardiogram or MRI WBC = white blood cell count; ESR = erythrocyte sedimentation rate; ECG = electrocardiogram; MRI = magnetic resonance imaging.
- 9. 9 Myocarditis • Treatment • Aimed to manage symptoms and prevent myocardial damage • Antibiotics if bacteria is cause • Oxygen therapy • Diuretics • Digoxin
- 10. 10 Myocarditis Complementary therapy • Well-balanced diet high in complex carbohydrates and minimal saturated fat Client communication • Encourage bed rest and the importance of sedentary lifestyle for 6 to 12 months to allow the heart to heal • Dietary information to reduce sodium intake
- 11. 11 Myocarditis • Prognosis • Good for uncomplicated myocarditis • Complications include congestive heart failure, pulmonary edema, ventricular failure or cardiogenic shock • Prevention • None
- 12. 12 Mitral Insufficiency/Stenosis • Description • Mitral insufficiency: blood from the left ventricle flows back into the left atrium • Mitral stenosis: blood flow is obstructed from the left atrium to the left ventricle
- 13. 13 Mitral Insufficiency/Stenosis • Etiology • Most often secondary to childhood rheumatic fever, MI, or infective endocarditis where vegetation on valves causes stenosis • Left-sided heart failure, mitral valve prolapse, or a falling of the valve tissue may occur
- 14. 14 Mitral Insufficiency/Stenosis • Signs and symptoms • Orthopnea, dyspnea • Fatigue • Palpitations • Peripheral edema
- 15. 15 Mitral Insufficiency/Stenosis • Signs and symptoms (cont.) • Atrial fibrillation • Pulmonary hypertension • Distention of jugular veins • Abnormal heart sounds
- 16. 16 Mitral Insufficiency/Stenosis • Diagnostic procedures • Echocardiography • ECG • Cardiac catheterization
- 17. 17 Mitral Insufficiency/Stenosis • Treatment • Surgical replacement with artificial valve • Balloon valvuloplasty
- 18. 18 Mitral Insufficiency/Stenosis Complementary therapy •None Client communication •Preparation of client preoperatively and postoperatively
- 19. 19 Mitral Insufficiency/Stenosis • Prognosis • Good because the disease is usually not progressive • Prevention • None other than to prevent rheumatic fever, infections, and MI
- 20. 20 Essential Hypertension • Description • High blood pressure (BP) that persists and develops over many years • Stage 1 = more than 140/90 mm Hg • Stage 2 = more than 160/100 mm Hg
- 21. 21 Essential Hypertension • Etiology • Idiopathic • Persons at risk include • African Americans; those who are chronically stressed, obese, smoke; those who eat a diet high in salt, saturated fat • Those with sedentary lifestyles; take oral contraceptives; genetic factors; insulin resistant; older persons
- 22. 22 Essential Hypertension • Signs and symptoms • Asymptomatic for months/years; or until vascular changes in heart, brain, kidneys occur • Light-headedness • Tinnitus • Nocturia • Tires easily • Palpitations
- 23. 23 Essential Hypertension • Diagnostic procedures • Resting BP greater than 140/90 mm Hg, taken on at least 2 separate occasions • Bruits • ECG • Chest x-ray
- 24. 24 Essential Hypertension • Treatment • Change in lifestyle and diet (low-salt, low-fat) • Antihypertensive drugs • Moderate exercise • Reduction in stress • Diuretics, vasodilators
- 25. 25 Essential Hypertension Complementary therapy • Diet high in fruits, vegetables, and omega-3 fatty acids • Supplements of ground flaxseed, cod liver oil, and calcium • Weight reduction, biofeedback, relaxation, meditation Client communication • Teach lifestyle modification, stress reduction methods, weight reduction • Encourage exercise and self-monitoring and self-monitoring of BP
- 26. 26 Essential Hypertension • Prognosis • Good if detected early and follows treatment regime • Complications include CVA, heart failure, kidney failure • Prevention • Minimize risk factors such as stress, obesity, sedentary lifestyle; do not smoke CVA = cerebrovascular accident.
- 27. 27 Essential Hypertension • The cause of essential hypertension is usually 1. genetic 2. congenital 3. iatrogenic 4. idiopathic
- 28. 28 Coronary Artery Disease • Description • Narrowing of coronary arteries with inadequate blood supply to portions of myocardium • Ischemia results; followed by scar tissue
- 29. 29 Coronary Artery Disease • Etiology • Atherosclerosis • Predisposing factors include age, heredity, obesity, elevated serum cholesterol, decreased serum high- density cholesterol, diabetes mellitus, hypertension, smoking, stress • More common in men, postmenopausal women, middle-aged persons, elderly persons
- 30. 30 Coronary Artery Disease • Signs and symptoms • Angina • Nausea, vomiting • Sweating • Feeling of panic
- 31. 31 Coronary Artery Disease • Diagnostic procedures • Risk factors, pattern of angina • ECG • CT scan • Stress test with or without echocardiogram • MRA or cardiac catheterization
- 32. 32 Coronary Artery Disease • Treatment • Lessen angina • Nitroglycerin, cholesterol reducers, beta and channel blocker medications, aspirin, ACE inhibitors • Bypass surgery, laser angioplasty • Dietary restrictions, regular exercise • No smoking ACE = angiotensin-converting enzyme.
- 33. 33 Coronary Artery Disease Complementary therapy • Vitamin D supplements • Diet high in complex carbohydrates and reduced fat and sodium Client communication • Instruct in stress and weight reduction; smoking cessation
- 34. 34 Coronary Artery Disease • Prognosis • Varies depending on amount of arterial blockage, extent of heart muscle damage • Prevention • Minimize controllable risk factors
- 35. 35 Atrial Fibrillation • Description • Atria beats irregularly often rapidly and out of rhythm with ventricles • Medical emergency • Blood can stagnant in the atria and clot; if clot travels to brain, a CVA may occur
- 36. 36 Atrial Fibrillation • Etiology • Cause is heart injury or abnormality • Hypertension, congenital heart defects, MI, viral infections, sleep apnea
- 37. 37 Atrial Fibrillation • Signs and symptoms • Can be sporadic or chronic • “Racing” of the heart and palpitations • Confusion, chest pain, weakness, and shortness of breath
- 38. 38 Atrial Fibrillation • Diagnostic procedures • ECG • Holter monitor • Chest x-ray • Echocardiogram
- 39. 39 Atrial Fibrillation • Treatment • Beta or calcium channel blockers • Cardioversion, electrically or with medication • Radiofrequency catheter ablation
- 40. 40 Atrial Fibrillation Complementary therapy • Advise clients to cough a number of times during fibrillation • Diet modification Client communication • Instruct clients on what constitutes a medical emergency
- 41. 41 Atrial Fibrillation • Prognosis • Can cause CVA or MI • Long-term monitoring will be necessary • Prevention • Elimination of causative factors
- 42. 42 Myocardial Infarction (Heart Attack) • Description • Medical emergency • Occurs when blood flow to section of the heart muscle becomes blocked, usually by a clot • If blood not restored, muscle becomes damaged and begins to die
- 43. 43 Congestive Heart Failure • Description • Heart’s pumping ability progressively impaired • Circulatory congestion may occur in systemic venous circulation (resulting in peripheral edema) or pulmonary circulation (resulting in pulmonary edema—life threatening)
- 44. 44 Congestive Heart Disease • Etiology • Result of many cardiac, pulmonary diseases • Degenerative conditions; or from MI
- 45. 45 Congestive Heart Disease • Signs and symptoms • Dyspnea • Fatigue • Distended neck veins • Hepatomegaly • Tachypnea, palpitations • Edema • Diaphoresis • Cyanosis • Hemoptysis • Pitting edema of the ankle
- 46. 46 Congestive Heart Disease • Diagnostic procedures • ECG • Chest x-ray, cardiac CT, and MRI • Elevated central venous pressure • Echocardiography • Stress testing • Cardiac catheterization
- 47. 47 Congestive Heart Disease • Treatment • Improve heart’s pumping action, relieve symptoms, improve quality of life • Diuretics, rest, vasodilators, digoxin • Restrict dietary sodium
- 48. 48 Congestive Heart Disease Complementary therapy • Vitamin D supplements • Diet high in complex carbohydrates; reduce fats and sodium Client communication • Teach about activity limitations, treatment plan
- 49. 49 Congestive Heart Disease • Prognosis • Good unless congestion is severe • Prevention • Avoid any predisposing factors
- 50. 50 Congestive Heart Disease • Peripheral and pulmonary edema are caused by the impairment of the heart’s ability to 1. conduct 2. relax 3. pump 4. dilate
- 51. 51 Cardiac Arrest • Description • A sudden, unexpected interruption of heart function when a heart arrhythmia causes the heart to stop beating — medical emergency • Clients will have no pulse, no respiration, and be unresponsive
- 52. 52 Arteriosclerosis, Atherosclerosis • Description • Arteriosclerosis: widespread thickening of walls of small arteries, arterioles with resulting loss of elasticity • One type is atherosclerosis (accumulation of yellowish plaques of cholesterol, lipids, cellular debris on inner layers of large, medium-sized arteries) • Commonly affects coronary, cerebral arteries
- 53. 53 Arteriosclerosis, Atherosclerosis • Etiology • Unclear; complicated, multifaceted • Trauma • Accumulation of lipids due to dietary excesses, faulty carbohydrate metabolism, sedentary lifestyle, smoking, genetic defect • Associated with aging, obesity, scleroderma, diabetes mellitus, hypertension, nephrosclerosis
- 54. 54 Arteriosclerosis, Atherosclerosis •Signs and symptoms • Depend on vessels involved and extent of obstruction; may be asymptomatic • Symptoms include • Intermittent claudication • Changes in skin temperature, color • Bruits over involved artery • Headache, dizziness
- 55. 55 Arteriosclerosis, Atherosclerosis • Diagnostic procedures • History and physical examination • CT scan • Doppler ultrasound • ECG and angiogram • Lab tests show elevated cholesterol, triglyceride, lipids
- 56. 56 Arteriosclerosis, Atherosclerosis • Treatment • Vasodilators • Thrombolytic therapy • Exercise • Diet low in saturated fat, cholesterol, calories • Medications to reduce LDL and increase HDL • Surgery: angioplasty with stent placement LDL = low-density lipoprotein; HDL = high-density lipoprotein.
- 57. 57 Arteriosclerosis, Atherosclerosis Complementary therapy • Weight loss, cessation of smoking, regular exercise • Eat more fruit and vegetables • Manage stress Client communication • Instruct relationship of diet, exercise, stress to disease process • Lifestyle changes required
- 58. 58 Arteriosclerosis, Atherosclerosis • Prognosis • Varies with site, amount of arterial occlusion, person’s overall physical condition • Complications include MI, CVA, gangrene, infections, CAD • Prevention • Adequate diet, rest, exercise • Avoid stress CAD = coronary artery disease.
- 59. 59 Thrombophlebitis • Description • Inflammation in a vein when clot forms • Abnormal mass of platelets on the vascular wall • Vein can be partially or completely obstructed • Occurs most often in a leg
- 60. 60 Thrombophlebitis • Etiology • Caused by a blood clot related to trauma, reduced blood flow, infection, chemical irritation, prolonged immobility; idiopathic • Predisposition includes smoking, use of oral contraceptives, hormone replacement therapy, and being overweight
- 61. 61 Thrombophlebitis • Signs and symptoms • May be asymptomatic • Dull aching, warmth, tingling, induration, redness, tenderness, induration along vein • If severe, there may be shortness of breath
- 62. 62 Thrombophlebitis • Diagnostic procedures • Physical examination • Phlebography; ascending venography • Doppler ultrasonography • CT scan and MRI
- 63. 63 Thrombophlebitis • Treatment • If superficial, bed rest, elevate the limb, apply heat • Lysin may be injected • Anticoagulant therapy • Vein ligation or femoral vein thrombectomy
- 64. 64 Thrombophlebitis Complementary therapy •None Client communication •After surgery it is important for client to be ambulatory and exercise the legs
- 65. 65 Thrombophlebitis • Prognosis • For superficial veins the prognosis is good • For severe clots the formation may be life threatening • Prevention • Support hose • Walk after sitting for long periods of time, traveling, or working
- 66. 66 Iron Deficiency Anemia • Description • Inadequate reserves of iron in body; formation of unusually small, hemoglobin- poor RBCs • Occurs more frequently in premenopausal women, adolescents • Most common anemia in United States RBCs = red blood cells.
- 67. 67 Iron Deficiency Anemia • Etiology • GI bleeding, excessive blood donation, excessive menstrual flow • Low dietary intake during pregnancy • Chronic intestinal diseases associated with malabsorption of iron • Inadequate intake of iron rich foods • Overuse of NSAIDs NSAIDs = nonsteroidal anti-inflammatory drugs.
- 68. 68 Iron Deficiency Anemia • Signs and symptoms • Pallor • Lassitude • Headache • Irritability • Dyspnea • Tachycardia • Brittle hair, nails
- 69. 69 Iron Deficiency Anemia • Diagnostic procedures • History and physical examination • Blood tests reveal low hemoglobin, hematocrit values • Blood tests reveal low serum iron, serum ferritin • RBC indicates unusually high numbers of microcytic red cells • Colonoscopy to detect colon tumors
- 70. 70 Iron Deficiency Anemia • Treatment • Oral, parenteral (IM/IV) administration of iron • Dietary modifications to restore lost iron reserves • In elderly clients, red cell transfusion may be necessary
- 71. 71 Iron Deficiency Anemia Complementary therapy • Food high in iron (sesame seeds, sunflower seeds, pistachios, pecans, almonds, Swiss chard, barley, oats, beans, peas) • Vitamin C, calcium • Limit sugar, alcohol, caffeine Client communication • Educate clients about risk factors
- 72. 72 Iron Deficiency Anemia • Prognosis • Good if treated early • Chronic in some cases • Prevention • Sufficient iron intake • Identify high-risk persons
- 73. 73 Iron Deficiency Anemia • One cause of iron deficiency anemia is 1.GI bleeding 2.scanty menses 3.old age 4.obesity
- 74. 74 Folic Acid Deficiency Anemia • Description • Characterized by abnormally large RBCs (megaloblasts) that form when folic acid is deficient • Folic acid is one of the B complex vitamins and helps make RBCs
- 75. 75 Pernicious Anemia • Description • Characterized by abnormally large RBCs from inadequate levels of vitamin B12
- 76. 76 Aplastic Anemia • Description • Insufficiency or absence of blood cell production because the bone marrow stops production • Cannot fight infection; have tendency to bleed
- 77. 77 Acute Myeloid (or Myelogenous) Leukemia • Description • Neoplasm characterized by hyperproliferation of abnormal, immature white cell precursors or blasts • Accumulate in blood, bone marrow, body tissues • Most common of nonlymphatic leukemia • More frequently in men over age 50
- 78. 78 Acute Myeloid (or Myelogenous) Leukemia • Etiology • Unknown • Risk factors include exposure to high levels of radiation, working with certain chemicals, chemotherapy • Genetic disorders
- 79. 79 Acute Myeloid (or Myelogenous) Leukemia • Signs and symptoms • Appear and worsen quickly • Fever, night sweats • Frequent infection • Fatigue, headache • Bleeding, especially the gums; bruise easily • Swelling or discomfort in abdomen
- 80. 80 Acute Myeloid (or Myelogenous) Leukemia • Diagnostic procedures • History and physical examination • Blood work reveals abnormal cell levels • Bone marrow biopsy • Spinal tap, chest x-rays may be ordered
- 81. 81 Acute Myeloid (or Myelogenous) Leukemia • Treatment • Depends on extent, person’s general health, age • Chemotherapy, biological therapy, radiation therapy, bone marrow transplantation, alone or in combination
- 82. 82 Acute Myeloid (or Myelogenous) Leukemia Complementary therapy • Identify ways to prevent nausea, vomiting, and diarrhea • Provide recipes to boost nutrition • Relaxation techniques, visualization Client communication • Help client, family understand disease process, treatment and side effects • Refer to support systems
- 83. 83 Acute Myeloid (or Myelogenous) Leukemia • Prognosis • Highly variable • Curable, although older clients have poorer prognosis • Prevention • Address risk factors as possible
- 84. 84 Other Leukemias • Description • Acute lymphocytic leukemia (ALL): abnormal growth of lymphocyte precursors called lymphoblasts; common in young children • Chronic myeloid leukemia (AML): proliferation of white blood cell precursors called granulocytes in the bone marrow; usually affects older adults
- 85. 85 Other Leukemias • Description (cont.) • Chronic lymphocytic anemia (CLL): accumulation of immature, immunologically ineffective B lymphocytes; most common form of leukemia
- 86. 86 Hodgkin Lymphoma • Description • Neoplastic malignancy of lymphatic system, causing painless enlargement of nodes, spleen • Two incidence peaks, early 20s, after age 50 • More common in men
- 87. 87 Hodgkin Lymphoma • Etiology • Unknown • Genetic predisposition • Suspect viruses, Epstein-Barr • Compromised immune system
- 88. 88 Hodgkin Lymphoma • Signs and symptoms • Abnormal B cells (Reed-Sternberg) • Enlarged, firm, nontender, painless regional lymph nodes in neck, chest, abdomen • Fever • Fatigue • Weight loss • Diaphoresis • Pruritus
- 89. 89 Hodgkin Lymphoma • Diagnostic procedures • Lab work reveals lymphocytopenia, anemia • Identify presence of Reed-Sternberg cells • Lymph node or bone marrow biopsy • X-rays, CT scan, MRI
- 90. 90 Hodgkin Lymphoma • Treatment • Depends on stage • Chemotherapy, usually short term, followed by radiation; chemotherapy in later stages • If recurs, chemotherapy with autogenous bone marrow cell transplantation
- 91. 91 Hodgkin Lymphoma Complementary therapy • Identify ways to prevent nausea, vomiting, and diarrhea • Provide recipes to boost nutrition • Relaxation techniques Client communication • Educate about disease process with careful follow up • Treat side effects
- 92. 92 Hodgkin Lymphoma • Prognosis • Varies with staging • If stage I, II; good • Prevention • Address the risk factors
- 93. 93 Hodgkin Lymphoma • The virus suspected of being a cause of Hodgkin lymphoma is 1. Guillain-Barre 2. herpes zoster 3. Epstein-Barr 4. varicella
- 94. 94 Credits Publisher: Margaret Biblis Acquisitions Editor: Andy McPhee Developmental Editors: Yvonne Gillam, Julie Munden Backgrounds: Joseph John Clark, Jr. Production Manager: Sam Rondinelli Manager of Electronic Product Development: Kirk Pedrick Electronic Publishing: Frank Musick The publisher is not responsible for errors of omission or for consequences from application of information in this presentation, and makes no warranty, expressed or implied, in regard to its content. Any practice described in this presentation should be applied by the reader in accordance with professional standards of care used with regard to the unique circumstances that may apply in each situation.