How would you answer this question?
Which of the following statements about geriatric cardiac function is not true?
a. Cardiac output decreases
b. Orthostatic hypotension is common
c. Afterload decreases
d. Arterial compliance increases
The correct answer is "c" it is not true that afterload decreases.
In geriatric patients, a variety of events occur that cause a decrease in cardiovascular function. Due to fibrosis and atherosclerosis arterial compliance (elasticity) decreases causing an increase in systemic vascular resistance and an increase in afterload. Cardiac output decreases about 10% per decade after the age of 30 related to decreases in stroke volume and slowed cardiac conduction. Decreased baroreceptor response causes an increased potential for orthostatic hypotension.
The physiologic changes of aging have important implications for nursing practice. Decreases in stroke volume, cardiac electrical conduction, and increased arterial resistance cause a decrease in cardiac output. The decrease in cardiac output will make your patient less tolerant to activity and orthostatic hypotension could make activity unsafe.
Decreased cardiac output stimulates compensatory mechanisms from: 1) the sympathetic nervous system that causes tachycardia, 2) the renin-angiotensin system that causes hypertension, and 3) from aldosterone that leads to fluid retention. Treatment of cardiac conditions often focus on blocking compensatory mechanisms with beta-blockers, ACE inhibitors, and spirolactone.
Congratulations to Reno Santini who won this week's drawing for an autographed copy of my 101 Tips to Improve Your Nursing Care book!
Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
This week's question comes from our Geriatric Emergencies program.
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