JAZZLE GEORGE E.

OTEYZA NCMB 314 LEC

BSN 3Y1-3A CU8

1. Identify non-modifiable and modifiable risk factors for hypertension.

 NON-MODIFIABLE
 Race
 Heredity
 Increase with Age
 Male Gender
 Diabetes and Renal Disease
 MODIFIABLE
 Sedentary Lifestyle
 High Sodium Intake
 Heavy Alcohol consumption
 Obesity
 Pregnancy
 Some Oral Contraceptives
2. What are the major sign and symptoms of congestive heart failure? Give nursing interventions
for each sign and symptoms.
 Signs and symptoms of congestive heart failure
 Shortness of Breath
 Edema
 Coughing or wheezing
 Fatigue
 Lack of appetite or nausea
 Confusion
 Increased heart rate

S/SX NURSING INTERVENTION

Shortness of breath  Assess and record respiratory rate and
depth at least every 4 hours.
 Place patient with proper body
alignment for maximum breathing
pattern. (sitting position)
Edema  Monitor weight regularly
 Elevate edematous extremities, and
handle with care.
Coughing or Wheezing  Encourage client to use pursed-lip
breathing for exhalation.
 Encourage the client to take a deep
breath, hold for 2 seconds, and cough
two or three times in succession
Fatigue  Teach energy conservation methods.

Lack of appetite or nausea
Confusion
Increased Heart Rate
Collaborate with occupational therapist
as needed.
 Aid the patient with developing a
schedule for daily activity and rest.
Emphasize the importance of frequent
rest periods.
 Provide an emesis basin within easy
reach of the patient.
 Allow the patient to use
nonpharmacological nausea control
techniques such as relaxation, guided
imagery, music therapy, distraction, or
deep breathing exercises.
 Orient patient to surroundings, staff,
necessary activities as needed. Present
reality concisely and briefly. Avoid
challenging illogical thinking—
defensive reactions may result.
 Modulate sensory exposure. Provide a
calm environment; eliminate
extraneous noise and stimuli.
 Facilitate giving digoxin medication as
ordered by the doctor.
 Make sure to take heart rate first before
giving to avoid bradycardia

3. How will you decrease the workload of the heart of the patient with heart disease?
 Important lifestyle changes may include:
 Quitting smoking
 Maintaining or losing weight
 Tracking your daily fluid intake
 Avoiding or limiting alcohol
 Avoiding or limiting caffeine
 Eating a heart-healthy diet
 Being physically active
 Managing stress
 Medications will include:
o Ace inhibitors (usually end in “pril”) – widen your blood vessels and reduce your heart’s
workload
o Angiotensin II receptor blocker (usually end in “sartan”) – widen your blood vessels
and reduce your heart’s workload
o Beta blockers (usually end in “lol”) – lower your blood pressure and slow your heart rate
to reduce the workload on your heart
o Anticoagulants or “blood thinners” – thin your blood, preventing blood clots
o Vasodilators – widen the blood vessels and reduce your heart’s workload
o Calcium channel blockers – lower blood pressure and slow your heart rate, helping to
reduce your heart’s workload
 Diuretics or “water pills”– remove extra fluid from your body which helps to improve
o
symptoms like swollen legs
o Digoxin – helps your heart to pump more blood and slow your heart rate down
o Potassium or magnesium – if you are taking fluid tablets, your levels of potassium or
magnesium may decrease, so you may need to take supplements
o Statins (cholesterol-lowering medications) – statins control the level of cholesterol in
your blood, and very large studies have demonstrated that they reduce the risk of blood
vessel diseases, heart attacks and stroke.
4. Make a drug study of common medication use for heart disease.
NAME OF MECHANISM OF INDICATION CONTRAINDICATION ADVERSE NURSING INTERVENTION
MEDICAT ACTION REACTIONS
ION
Digoxin Inhibits sodium- Heart failure,  CNS: Drug-induced arrhythmiasmay increase the severity of
Classificat potassium- paroxysmal Contraindicated fatigue,generalizedm heart failure andhypotension.
ion: activated supraventricu inpatients uscleweakness,agitati 
Inotropic adenosine lar hypersensitive to drug on,hallucinations,
Antiarrhyt triphosphatase, tachycardia, and in those with CV:
hmic promoting atrial digitalis-induced arrhythmias,heart Before giving loading dose,obtain baseline data
Cardiacgl movement of fibrillation toxicity, ventricular block. (heartrate and rhythm, bloodpressure, and
ycoside calcium from and flutter fibrillation, or EENT: electrolytes)and ask patient about use of cardiac
extracellular to ventricular tachycardia yellow-green glycosides within theprevious 2 to 3 weeks.
intracellular unless caused by heart halosaround 
cytoplasm and failure. visualimages,blurred
strengthening  vision,light Loading dose is usuallydivided over the first 24hours
myocardial Patients with Wolff- flashes,photophobia, with approximatelyhalf the loading dose given inthe
contraction. Also Parkinson-White diplopia. first dose.
acts on CNS to syndrome unless the GI: 
enhance vagal conduction accessory anorexia,nause
tone, slowing pathway has been
conduction pharmacologically or Before giving drug, takeapical-radial pulse for
through the SA surgically disabled. 1minute. Record and notifyprescriber of
and AV nodes  significantchanges (sudden increase ordecrease in
Elderly patients and in pulse rate, pulsedeficit, irregular beats and,particularly,
those with acute MI, regularization of a previously irregularrhythm). If these
incomplete AV block, occur, checkblood pressure and obtain a12-lead ECG
sinus bradycardia,
PVCs, chronic
constrictive
pericarditis