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Pharmocology > PERFUSION (EXAM 2) > Flashcards

PERFUSION (EXAM 2) Flashcards

1
Q

what are the contributing factors in perfusion

A

Heart
veins
arteries

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2
Q

what is the normal range for MAP

A

60 mmHg or greater

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3
Q

what is the main consequence of hypertension

A

there will be alot of perfusion issues

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4
Q

what are negative outcomes of bad perfusion

A

necrosis
loss of tactile function
fainting
confusion
DVT
decrease in organ function
ischemic pain

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5
Q

Normal BP

A

systolic <120
diastolic <80

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6
Q

Elevated BP

A

systolic 120-129
diastolic <80

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7
Q

Stage 1 high BP

A

systolic= 130-139
diastolic=80-89

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8
Q

stage 2 high BP

A

systolic= 140 or higher
diastolic= 90 or higher

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9
Q

Hypertensive crisis

A

systolic=higher than 190
diastolic=higher than 120

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10
Q

what is hypotension the most important risk factor for?

A

stroke
HF

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11
Q

Essential hypertension

A

the specific cause is unknown

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11
Q

Additive factors to contribute to essential hypertension

A

Genetics
behavioral
environmental factors
obesity
hyperlipidemia
African American

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12
Q

Secondary hypertension

A

it is the result of another disease
related to other issues

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13
Q

Example of secondary hypertension

A

renal artery disease
endocrine
cns disorders
sleep apnea

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14
Q

what happens when the cause of the hypertension is eliminated

A

hypertension goes away
BP return to normal

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15
Q

what can happen when hypertension is left untreated

A

cause end stage organ damage

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16
Q

GOAL of hypertension

A

reduce cardiovascular and renal morbidity and mortality

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17
Q

goal of hypertension

A

reduce cardiovascular and renal morbidity and mortality

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18
Q

Autoregulation

A

-the body tissues regulate their own blood flow to preserve 02
-think automatic

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19
Q

Parasympathetic N.S

A

little to no effect on vessels
dilates to blood vessels

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20
Q

Sympathetic N.S

A

Contraction of blood vessels to maintain BP
Maintain renin-angiotensin-aldosterone system (RAAS) in the kidneys

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21
Q

what factors affect blood flow

A

atherosclerosis
thrombus
embolus

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22
Q

what is the first action with a patient who has hypertension

A

non pharmological interventions

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23
Q

what is the BP goal

A

systolic less than 120
diastolic less than 80

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24
Q

name some lifestyle modifications

A

weight
Na intake
regular physical activity
moderate alcohol
no smoking

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25
Q

lifestyle management

A

exercise 30 minutes/day at least 4 times a week

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26
Q

what lab test should you take

A

liver
BUN
creatinine

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27
Q

Name some manifestations of hypertension

A

headache
blurry vision
nausea
vomiting

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28
Q

symptoms reflect target organ damage

A

angina
MI
HF
stroke
renal disease

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29
Q

categories of medications with hypertension do what

A

decrease BP
decrease peripheral vascular resistance

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30
Q

what is peripheral vascular resistance

A

resistance that the blood encounters as it circulates through the body

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31
Q

where do these drugs work

A

Heart
veins

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32
Q

what do alpha blockers do

A

they block vasoconstriction
they open the veins and decrease vasoconstriction
vasodilation of veins

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33
Q

what is clonidine and what does it do

A

it is an alpha blocker
lowers BP

34
Q

how does clonidine decrease BP

A

relaxing the arteries (vasodilation) and increasing the blood supply to the heart

35
Q

what kind of alpha blocker is clonidine

A

alpha 2 agonist

36
Q

what do clonidine do

A

-decrease sympathetic response
-stimulate the alpha 2 receptor
-reduce peripheral vascular resistance and increase vasodilation

37
Q

what the main action of clonidine

A

reduce the peripheral vascular resistance which increases vasodilation

38
Q

what happens when peripheral vascular resistance is decreased

A

there is vasodilation

39
Q

what are some side effects of alpha 2 agonist

A

Remember it vasodilates
-drowsiness
-drymouth
dizziness
-bradycardia

40
Q

why does alpha 2 agonist cause drowsiness

A

when the blood pressure decrease from vasodilation the brain will not get enough blood causing that drowsiness

41
Q

alpha 2 agonist interventions

A

-monitor serum liver enzyme
-do not stop abruptly
-take as prescribed
-may cause sodium and water retention

42
Q

why must alpha 1 agonist do not stop abruptly

A

they might cause hypertensive crisis

43
Q

what should be ordered with alpha 2 agonist

A

-A diuretic
-there is a chance of sodium and water retention which causes that peripheral edema

44
Q

who should avoid clonidine

A

those who are pregnant

45
Q

how do you administer clonidine

A

oral
transdermal patch

46
Q

how do you take a patient off clonidine

A

gradually
worst case scenario hold the medication and do assessment

47
Q

What must be administered with clonidine

A

a diuretic
clonidine is known to cause a lot of peripheral edema from the sodium and water retention

48
Q

side effects/adverse effects of clonidine

A

Rebound hypertension if stopped abruptly
drowsiness
dizziness
fatigue
orthostatic hypertension

49
Q

administration for clonidine with patients with hypertension

A

oral
transdermal patch

50
Q

when should clonidine be given and why

A

at bedtime
because they cause drowsiness

51
Q

how often should the patch be changed

A

every 7 days

52
Q

before administering new patch what should you do

A

remove the old patch
don’t place the new one at the same spot

53
Q

what is the most important pt teaching with clonidine

A

taper off
DO NOT STOP ABRUPTLY
REBOUND HYPERTENSION!!!!

54
Q

What is the function of an ACE

A

it is a vasoconstrictor

55
Q

what does an ace inhibitor do?

A

decreases vasoconstriction

56
Q

Captopril is an example of a what

A

ace inhibitor

57
Q

MOA of captopril

A

decrease effects of renin angiotensin
crease vasoconstriction

58
Q

captopril is medication of choice for who

A

patients with HTN and HF

59
Q

what else does captopril do

A

decrease retention of sodium and water

60
Q

Captopril is a first line drug for who
why?

A

patients with diabetes
slow the progression of renal impairment

61
Q

primary effect of ACE inhibitor

A

cardiovascular effects
decrease morbidity and mortality in those with HF

62
Q

SE/AE of ACE inhibitors

A

dry non productive cough
angioedema
hypokalemia

63
Q

what is the most common effect of ACE inhibitors

A

hyperkalemia

64
Q

Interventions with ACE inhibitors

A

GO LOW AND SLOW!!!!!
do not give with potassium sparing diuretics or salt subsitutes that contain potassium
monitor dry cough, angiedema,BP,potassium

65
Q

most important thing to note with ACE inhibitors

A

START LOW AND GO SLOW!!!!!

66
Q

what should you not give ACE inhibitor with

A

-potassium sparing diuretics=spironolactone
-salt substitutes that contain potassium
TOO MUCH POTASSIUM

67
Q

what should you do before administering ACE inhibitors

A

take BP

68
Q

what are some S/S of hyperkalemia that you should educate your patient to look out for

A

muscle twitching
palpitations
weakness
paresthesia

69
Q

what else should you teach your patient

A

-report dry hacking cough
-assess bp, hr, respiratory status
-report swelling around the face, mouth and throat
-refrain from taking potassium supplements

70
Q

how do you know if a patient has angioedema

A

swelling in face
mouth
throat

71
Q

can you give ACE inhibitors to a preg lady

A

NOOOO!!!!

72
Q

what does ARBs stand for

A

angiotensin 2 receptor blockers

73
Q

why is it better to give ARBs than ACE inhibitors

A

ARBs is less likely to cause hyperkalemia and dry cough

74
Q

most ACE inhibitors end with?

A

PRIL

75
Q

most ARBs end with

A

SARTAN

76
Q

MOA of valsartan

A

they block the effects of angiotensin 2

77
Q

SE/AE of ARBs

A

erectile dysfunction
orthostatic hypotension
NEUTROPENIA

78
Q

what is neutropenia
what should you do to monitor

A

low WBC count
CBC

79
Q

Interventions teaching with ARBs

A

treat angioedema
monitor and report CNS effects
Monitor BP and apical pulse
hypotension
fluid volume

80
Q

nursing intervention with potassium high or low

A

monitor cardiac
EKG

81
Q

ARBs administration

A

oral with or without food

82
Q

what should you do if ARBs is being taken with a diuretic or pt have liver failure

A

reduce the dose

83
Q

what can ARBs be used with

A

diuretics if treating HTN or HF

Pharmocology (14 decks)

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