Introduction to Cardiovascular Changes (Nursing)

by Rhonda Lawes

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    00:01 Hello, welcome to our geriatric nursing series.

    00:04 Now in this part of our series, we're going to talk about the age-related changes in health, specifically in the cardiovascular system.

    00:12 So let's go back to our friends.

    00:14 Picture being a summer Sunday, and our friend Ricardo here decides he's going to visit his granddad Jose.

    00:20 Now, Jose lives close by, but it's really hot outside and as Ricardo is walking to his granddad's house, he started to think this wasn't exactly a good idea.

    00:31 It's like 90 degrees outside and Ricardo can definitely feel it in his skin.

    00:36 After a while, he's just wanting to get there and get into the air conditioning.

    00:41 Ricardo finally gets air he knocks on the door and he walks into the house.

    00:45 He says hi to his granddad then realizes, "Oh, my Lanta, it is even hotter inside here.

    00:52 This is ridiculous." So he looks at the thermostat, and look at that.

    00:57 How can my granddad feel comfortable in this? Ricardo thinks.

    01:02 Now, we're going to break that down, but if you have an elderly person in your life, my mom and dad kept the house so warm, and I live in Oklahoma so I can really relate to what Ricardo was saying.

    01:16 So let's look at why in the world an elderly person in the heat of summer would have the thermostat that hot in their home.

    01:25 Because the answer to this question is really kind of interesting.

    01:29 Now, here's Jose, remember, he's our example of someone who has aged successfully so the changes in his body are simply due to aging, not due to chronic illness.

    01:39 So look at his skin.

    01:40 Now this is when he was like 30 years old.

    01:43 Look at the bottom, you see that layer of fat tissue and then the other layers of his skin.

    01:48 Now this is Jose as he's aged.

    01:51 Whoa, that's a bit of a drastic difference.

    01:54 Before we go on, I want you to pause the video and see if you can list all the changes between young Jose's layer of skin, and aged Jose's layer of skin.

    02:15 Okay, welcome back.

    02:17 What we just had you do is called prediction.

    02:20 Now, when you're studying and you're preparing, if you want to get the most out of the time you're investing in studying, I want you to keep using that skill.

    02:28 Prediction is, even before you have the answer or all of the information, I want you to try to guess and make a logical guess.

    02:36 Research shows us that if you'll do that, when you do know the answer, and you have more of the information, it will stay in your brain much more effectively and you'll be able to recall it when you need it, like on an exam or when you're caring for an elderly patient.

    02:53 So let's walk through the specific differences.

    02:56 First of all, older Jose has a thinner layer of fat underneath his skin.

    03:02 So look at those two pictures, and kind of lay that in your mind let's see how the fat layer is thinner than when he was younger.

    03:10 Next, sadly, your metabolism slows down as you age, it's something I'm dealing with myself.

    03:17 So as your metabolism slows down, your ability to respond to cold environments might not be quick enough or appropriate.

    03:25 So that makes sense why he would be keeping the temperature of the home so high.

    03:30 So first reason was, thinner layer of fat, right? The second factor is, as everyone ages, their metabolism slows down.

    03:41 So that's why Jose is keeping that place so hot as he ages, because he likely has a slower response to cold environments so it might not be quick enough or appropriate enough to help him stay warm, which is why he keeps that thermostat cranked way up.

    03:57 Okay, so let's pause and review.

    03:59 What are the first two factors we've talked about? Right, thinner layer of fat now and the second one is a slower metabolism.

    04:09 Now what we just did there together is a great way for you to reinforce information in your mind.

    04:16 So don't ever hesitate as you're going through our videos to pause and ask yourself a question about the content you just heard.

    04:23 See, as you're going along, if you check for your own comprehension, that's beautiful.

    04:29 That's going to help you encode that information in your brain in a way that it's going to stick with you and help make more sense.

    04:37 Now we're going on to the third.

    04:41 The third factor is, the blood vessels lose their elasticity.

    04:45 Now look at our graphic on the screen there.

    04:48 You'll see how the younger Jose, his blood vessels are showing you how they can shrink and enlarge.

    04:53 So when we talk about elasticity, that's the blood vessel's ability to constrict, right and to dilate.

    05:01 Now as we age even with normal aging without disease process, those vessels become stiffer.

    05:07 They lose elasticity.

    05:10 That means you're going to have less effective blood flow, and less blood flow means it's harder for the person to retain heat.

    05:17 So that's the third reason that Jose likely has that thermostat cranked up.

    05:23 So the next time you walk into an elderly person's place, see if you can remember the three reasons why they likely have that thermostat cranked all the way up.

    05:33 Now, as you can see, our bodies keep changing as we grow old, and these are the kinds of changes we're going to discuss in this series of lectures.

    05:41 So here we have Jose and Enrique.

    05:43 Remember, these two guys are best friends.

    05:46 So think of them as starting kind of at the same place.

    05:49 We're going to show you how Jose aged successfully and without chronic disease, and how Enrique aged challenged by some disease and events.

    05:59 So here they are in their 80s, Jose and Enrique.

    06:04 Let's take a look at Jose first because understanding what is normal is the best way to recognize what is slightly abnormal.

    06:12 So Jose, look at him there, he was always very active.

    06:15 He's a runner, he made sure that he got regular exercise and that's one of the most important reasons why he experienced normal aging.

    06:22 So since we're talking about the cardiovascular system, this is what Jose's looked like: He had normal cardiac function at rest, he had a normal resting heart rate, and he had a normal cardiac output and ejection fraction.

    06:36 So that means his heart was pumping efficiently for a man of his age.

    06:41 Now, this is a very different story.

    06:45 Enrique on the other hand, if you just looked at him, he looks overall more tired than Jose.

    06:51 He had a heart attack at age 52, which is why we've labeled this, 'very eventful aging' because he had a cardiac event at a relatively early age.

    07:00 Now after his heart attack, his hearts ability to pump efficiently was decreased so his heart didn't pump the same after the initial heart attack.

    07:10 He's also developed congestive heart failure, so he becomes pretty short of breath with exercise.

    07:16 So let's compare Enrique to Jose.

    07:21 Now he has abnormal cardiac function at rest, he has an abnormal resting heart rate, and he has an abnormal cardiac output and ejection fraction.

    07:30 So pause for just a minute, look away from your notes, and see if you can remember the three cardiac factors that we've talked about comparing Enrique to Jose

    About the Lecture

    The lecture Introduction to Cardiovascular Changes (Nursing) by Rhonda Lawes is from the course Assessment of the Geriatric Patient: Cardiovascular System (Nursing).

    Included Quiz Questions

    1. The metabolism slows
    2. Loss of elasticity in blood vessels
    3. The subcutaneous fat layer thickens
    4. Sensitivity to cold decreases
    5. Epidermis and dermis thickens
    1. “As we age, our metabolism slows, we lose elasticity in blood vessels, and our layer of subcutaneous fat thins, making our bodies more sensitive to cold. This response is a normal result of the aging process.”
    2. “As we age, our bodies become more susceptible to infection. Infections can trigger a response in the hypothalamus, raising the body’s temperature, making the air around us seem cold in comparison.”
    3. “As we age, we become more sensitive to heat. Therefore, it is highly unusual that the client has the heat on and is likely a sign that they are experiencing an acute illness.”
    4. “As we age, the onset of chronic illness can trigger changes in the body, such as decreased blood pressure and heart rate, which can in turn decrease temperature sensitivity. However, this reaction is seen only in clients with chronic illness.”
    1. The 50-year-old client with a history of cardiac arrest and a resting heart rate of 105
    2. The 40-year-old client with a resting heart rate of 78 and normal cardiac output
    3. The 45-year-old client who runs daily and has a resting heart rate of 60
    4. The 60-year-old client with normal cardiac function at rest and a resting heart rate of 80

    Author of lecture Introduction to Cardiovascular Changes (Nursing)

     Rhonda Lawes

    Rhonda Lawes

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