GALEN NUR 257 Chapter 22 Review: Cardiovascular & Respiratory Disorders Questions with Detailed Answers

GALEN NUR 257 Chapter 22 Review: Cardiovascular & Respiratory Disorders Questions with Detailed Answers 1. Implications for GERI nursing (Respiratory Disorders: Interventions) - ANSWER many cannot be cured so palliative and controlling disease process Goals: reduce risk of exacerbations/hospitalizations, maximum function, preventing premature disability Teaching (e.g. smoking, breathing, O2, ID infection) very important Treatment can occur in home settings in most cases Implications for GERI nursing (Respiratory Disorders: Teaching Interventions) - ANSWER smoking cessation, secretion clearance techniques, identification/mgmt of exacerbations, breathing retraining, mgmt of depression/anxiety, nutritional support, proper med admin, (including inhaler, nebulizer) peak flow meter cleaning equipment importance of good oral care after inhalation treatments proper O2 use coping strategies maintaining sexual activity 2. Implications for GERI nursing (Respiratory Disorders: Multidisciplinary Care - GOALS) - ANSWER - Inc. independence - improve function - dec. hospitalizations - inc. exercise toleraqnce - inc. self-esteem/self-care skills - improve quality of life and comfort 3. Implications for GERI nursing (Respiratory Disorders: Multidisciplinary Care - Dietary Education) - ANSWER address reasons for weight monitoring s/s of malnutrition weight loss can be rapid b/c energy for breathing while eating early satiation (fullness) caused by congested abd anorexia occurs b/c sputum production, gastric irritation from bronchodilators/steroids monitor for fluid overload in HF pts 4. Implications for GERI nursing (Respiratory Disorders: Multidisciplinary Care - Activity/Exercise Tolerance) - ANSWER Assessed by RT and OT activities prescribed to inc. endurance and improve resp status may be done w/ or w/o O2 supp referral should be done as soon as condition allows teach sexual activity still possible 5. Implications for GERI nursing (Respiratory Disorders: Multidisciplinary Care - Medications) - ANSWER primarily to treat infection and control SOA/sputum production inhalers can be difficult with dexterity issues/strength (e.g. arthritis) - special adaptive devices available consider economic concerns, know options consider transport/limited income Medicare coverage for O2 and nebulizers determined by need ( 88% sat improved by O2) Supplemental oxygen NEVER covered by insurance when comfort measures income can cause anxiety and a focus on most basic phys needs 6. Implications for GERI nursing (Respiratory Disorders: Multidisciplinary Care - Prevention) - ANSWER Pneumococcal vaccine (Pneumovax) - ≥65 yrs - usually a one-time dose but sometimes second dose recommended by PCP streptococcal vaccine (Prevnar) - ≥ 65 yrs - one-time dose and outside of 1 year before or after Pneumovax in order to be covered by Medicare Streptococcal pneumonia most lethal form Annual flu immunizations each fall, additional may be recommended by public health 7. Modifiable Factors to Minimize Risk for Heart Disease - ANSWER - control BP - maintain healthy trigs and lipid levels - prevent/control DM - cease/never use tobacco products - reduce exposure to pollutants - healthy diet and maintain acceptable weight - regular exercise - control alcohol intake 1/day women, 2/day men - reduce stress - treat depression 8. Benefits of Reducing BP by 5% - ANSWER 34% fewer strokes 21% less ischemic heart disease 9. Home Measurement of BP (Tips for Best Practice) - ANSWER - Observe the technique uses, in both arms, using personal device - duplicate the measurement with same device, but with the nurse - measure BP with a reliable device / manual method - if discrepancy, teach correct technique or replace device 10. Signs of Potential Exacerbation of Illness in an Older Adult with Coronary Heart Disease - ANSWER - light headedness/dizziness - gait/balance disturbance - loss of appetite or weight - inability to concentrate / short attention span - changes in personality or mood - unusual patterns in urination / defecation - vague pain/discomfort - frequent bouts of anxiety - excessive fatigue - withdrawal from sources of pleasure 11. Chest Pain (Gender Differences) - ANSWER Instead of typical s/s of CP, women will experience s/s: - SOA - weakness - fatigue - indigestion - sense of dread Risk factors: - life stressors / events - sense of loss of control - illness/death of significant others