Chapter 15 Respiration and Circulation - PowerPoint PPT Presentation

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Chapter 15 Respiration and Circulation

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  1. Chapter 15Respiration and Circulation

  2. Factors That Can Alter Tissue Perfusion • Cardiovascular Disease • Arteriosclerotic heart disease, hypertension, congestive heart failure, varicosities • Other Diseases • Diabetes mellitus, cancer, renal failure • Blood Dyscrasias • Anemia, thrombus, transfusion reactions

  3. Factors That Can Alter Tissue Perfusion (cont.) • Hypotension • Anaphylactic shock, hypovolemia, hypoglycemia, hyperglycemia, orthostatic hypotension • Medication Side Effects • Antihypertensives, vasodilators, diuretics, antipsychotics • Other Conditions • Edema, inflammation, prolonged immobility, hypothermia, malnutrition

  4. Assessing Tissue Circulation • Review the individual’s health history. • Evaluate vital signs. • Inspect the tissues. • Note signs or symptoms.

  5. Indications of Ineffective Tissue Perfusion • Hypotension • Tachycardia; decreased pulse quality • Claudication • Edema • Loss of hair on extremities • Tissue necrosis; stasis ulcers • Dyspnea; increased respirations

  6. Indications of Ineffective Tissue Perfusion (cont.) • Pallor; coolness of skin • Cyanosis • Decreased urinary output • Delirium (altered cognition and level of consciousness) • Restlessness • Memory disturbance

  7. Interventions to Improve Tissue Circulation • Maintain blood pressure within an acceptable range. • Prevent and eliminate sources of pressure on the body. • Remind or assist patients to change positions frequently. • Prevent pooling of blood in the extremities. • Encourage physical activity. • Prevent hypothermia, maintaining body warmth.

  8. Interventions to Improve Tissue Circulation (cont.) • Monitor drugs for the side effect of hypotension. • Educate to reduce risks. • Periodically evaluate physical and mental health to identify signs and symptoms of altered tissue perfusion.

  9. Measures to Prevent Respiratory Infections in Older Adults • Obtain vaccines. • Avoid exposure to people with infections. • Seek medical attention if signs of infection appear. • Report changes in character of sputum.

  10. Using Oxygen with the Elderly • Monitor blood gases. • Observe the patient for symptoms of carbon dioxide narcosis: • Confusion • Muscle twitching • Visual defects • Profuse perspiration

  11. Using Oxygen with the Elderly (cont.) • Hypotension • Progressive degrees of circulatory failure • Cerebral depression

  12. Interventions for Ineffective Breathing Patterns • Instruct patient in breathing exercises. • Control symptoms that could threaten effective respirations. • Raise head of bed at least 30° when patient is lying down.

  13. Interventions for Ineffective Breathing Patterns (cont.) • Instruct patient to turn, cough, and deep breathe at least once every 2 hours. • Monitor rate, depth, and rhythm of respirations; coloring; coughing pattern; blood gases; and mental status.

  14. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).