NURS 1730 Lecture Notes - Lecture 7: Paroxysmal Nocturnal Dyspnoea, Smoking Cessation, Stroke Recovery
11-63-173
Week Seven: February 26 - March 2, 2018
Introduction to Nursing
Vascular Health: “The Pump and The Periphery” - Part Two
Complementary Therapies
- Augment conventional health care practices
- Not discipline specific
- Wide range of treatment modalities:
- Herbal therapies
- Acupuncture
- Aromatherapy
- The nurse “must consider how a particular intervention will enhance the overall care for
the client”.” is this going to benefit my patient for the health concern they are seeking ⇒
treatment for.
- Must be done in collaboration with other members of the health care team and be
incorporated into the plan of care (CNO)
- A nurse may propose the use of a complementary therapy to a client if has the
knowledge to believe that the treatment would benefit the client” (CNO, 2014).
-May have moderate heart-health benefits:
- Soy protein
- Omega 3 fatty acids (fish oils) (part of mediterranean diet)
- Fibre
- Flax seed
- Vitamin C, E, folic acid and garlic → no clear benefit
Managing Lipids
- HDL → remove cholesterol from body; good
- LDL → transport cholesterol into cells and muscles and if there’s extra cholesterol in the
body, its deposited into the arteries;bsd
Lipid Profile Screening: Who?
- Men 40 years of age and older
- Women 50 years of age or older, or who are postmenopausal
- Anyone with diabetes, hypertension or obesity, a first-degree relative under the age of
60 with premature CAD, familial lipidemia
- Current smokers, impaired renal function, autoimmune disorders, xanthomas,
xanthelasmas, premature arcus
Lipid Profile Screening: What?
→ The profile should include:
- Total cholesterol (TC)
- High-density lipoprotein cholesterol (HDL-C)
- Lab will calculate the LDL-C value
- A fasting glucose test should be done to identify patients with impaired fasting glucose or
diabetes.
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11-63-173
Week Seven: February 26 - March 2, 2018
- For the test:
- Fasting not required
- Preferable abstention from alcohol for 24 to 48 hours prior to the screen
- Reassess every three years
Lipid Profile: Goals
Assessment of Risk
- Framingham Risk Assessment
- Reynolds Risk Score
- Heart and Stroke Foundation
Managing Abnormal Lipid Profiles: What the Evidence Says
- Collaborative approach is essential: health education, follow-up and ongoing
management
- nursing, nutrition & medicine
- Lifestyle modifications are the essential modality for reducing LDL - nutrition and
physical activity
- Statins (a grouping of drugs that improve lipid profiles)
When Primary Prevention Fails
- Morbidity and mortality
- Alterations in mobility, swallowing, communication, cognition, vision, kidney function,
wound healing
- Mental health concerns
- Decreased quality of life
Signs and Symptoms: Heart Attack
- Pain (discomfort) → radiating to jaw or left arm
- Shortness of breath
- Indigestion/vomiting
- Sweating, coolness or clamminess
- Fear, anxiety, denial these delay people from going⇒
- Squeezing pain.
Signs and Symptoms: Stroke
- Sudden
- Weakness or numbness in face, arm or leg
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11-63-173
Week Seven: February 26 - March 2, 2018
- Trouble speaking, understanding or confusion
- Trouble with vision
- Severe and unusual headache
- Loss of balance
Signs and Symptoms: Peripheral Vascular Disease
- Painful cramping in the hips, thighs or calves when walking, climbing stairs or exercising
- A marked decrease in the temperature of lower leg or foot particularly compared to the
other leg
- Foot or toe wounds that won't heal or heal very slowly
Signs and Symptoms: Diabetes
- Polyphagia (increased eating), polyuria (increased urine), polydipsia (thirsty), weight
loss**
- Recurrent infections/ non-healing wound
- Neuro dysfunction
- Arterial disease (cardiovascular, cerebrovascular, peripheral vascular)
- Microvascular disease (kidneys, eyes)
- Endocrine-metabolic complications – dyslipidemia, obesity, thyroid/adrenal problems
erectile dysfunction; another problem in older adults. Diabetes and other drugs can ⇒
cause this.
When Primary Prevention Fails
- Tertiary prevention
- Collaborative approach:
- Cardiac rehabilitation – exercise, nutrition, psychosocial, smoking cessation,
sexuality issues
- Stroke rehabilitation
- Diabetes management
- Psychosocial & spiritual support
- Adaptive care & symptom management
Congestive Heart Failure
- Most frequent cause for hospitalization of an older adult.
- No cure.
- Between 2005-2006, 54333 hospitalizations were to to congestive heart failure.
- About 50% of persons with HF die within 5 years of diagnosis; the vast majority of these
persons are less than 65 years old.
- Left-sided, right-sided, both-sided (biventricular) failure.
- Left sided: weakened heart muscle that doesn’t squeeze as well; not as much
blood being pumped out of right side of heart; so blood backflows into lungs.
Results in shortness of breath
- Right sided: bad pump; thickened walls of heart muscles. Blood backflows into
find more resources at oneclass.com
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Document Summary
Vascular health: the pump and the periphery - part two. The nurse must consider how a particular intervention will enhance the overall care for the client . is this going to benefit my patient for the health concern they are seeking treatment for. Must be done in collaboration with other members of the health care team and be incorporated into the plan of care (cno) A nurse may propose the use of a complementary therapy to a client if has the knowledge to believe that the treatment would benefit the client (cno, 2014). Omega 3 fatty acids (fish oils) (part of mediterranean diet) Vitamin c, e, folic acid and garlic no clear benefit. Hdl remove cholesterol from body; good. Ldl transport cholesterol into cells and muscles and if there"s extra cholesterol in the body, its deposited into the arteries;bsd. Men 40 years of age and older. Women 50 years of age or older, or who are postmenopausal.
