Blood Pressure Alterations and Cardiac Alterations Focus Flashcards
(95 cards)
1
Q
what is the top number of BP called and what is it measuring
A
systolic - the maxium pressure the heart exudes while contracting
2
Q
what is the bottom number of BP called and what is it measuring
A
diastolic - measuring the residual pressure in the arteries
3
Q
what is the goal for diastolic BP
A
60-80
4
Q
what is mean arterial pressure
A
the average pressure in the arterial system
5
Q
what is the mean arterial pressure goal
A
60-90
6
Q
what is cardiac output
A
how much blood volume is pumped out of the hart each minute
7
Q
what is cardiac output goal
A
4-6L/min
8
Q
what is stroke volume
A
the volume of the blood pumped out of the LV during each contraction
9
Q
what is elevated BP/ hypertension stage 1 range
A
130-139 / 80-89
10
Q
what is hypertension stage 2 range
A
> 140/ >90
11
Q
what is a hypertension crisis range generally
A
> 180/>120
12
Q
what is a hypertensive crisis for people over 50
A
150/90
13
Q
what is a hypertensive crisis for people under 50
A
same has hypertension stage 2 >140/>90
14
Q
what is a hypertensive crisis
A
Severely high BP that rapidly progresses
15
Q
what could be the cause of a hypertensive emergency
A
head bleed, heart failure, heart attack, renal failure, dissecting aneurysm
16
Q
what are some ss of hypertension
A
fatigue, dizziness, palpitations, angina, dyspnea
17
Q
what labs will you take to diagnosis hypertension
A
BMP, lipid panel, TSH, ECG,
18
Q
what kind of lifestyle changes can someone do to decrease hypertension
A
lose weight, change diet (DASH) decrease ETOH (alcohol), dont smoke, decrease stress, exercise atleast 30min a day
19
Q
what is a DASH diet
A
less red meat, salt, less sweets
20
Q
what are the 1st line drugs for hypertension
A
ACE, ARB, calcium channel blockers, and diuretics
21
Q
what meds end in dipin and what are some other examples
A
calcium channel blockers, also diltiazem and verapamil
22
Q
what are some common SE of caclium channel blockers
A
peripheral edema
23
Q
who should not take calcium channel blockers and what should you not take with calcium channel blockers
A
CHF or with grape juice
24
Q
what are some side effects of ACE
A
dry cough (lisinopril), decrease potassium, decreased HR
25
what are some second line drugs for hypertension
beta blockers, potassium sparing diuretics, direct vasodialators, adrenegic inhibiting agents
26
are are some cardioselective beta blockers
bisoprolol, metoprolol, esmolol
27
what are some non-cardioselective beta blockers and where do they work
propanolol - lungs
28
what are some side effects for cardioselective beta blockers
mask hypoglycemia, increased HR
29
what are some se for non cardio selective beta blockers
bronchospasms
30
what are some mixed cardioselective beta blockers
caredilol and labetalol
31
what happens if you take hypertensive meds with NISAIDs
renal damage and retain fluid
32
what are some potassium sparing diuretics
sprinolactone and eplernone
33
what are some direct vasodilators medications
hydralazine, nitroglycerin, sodium nitropursside
34
what are some adrenergic inhibiting agents
clonidine - last resort
35
what could be the cause someone goes into hypertensive crisis
non compliant, head injury, pheochromocytoma, illegal drugs, preeclampsia
36
what is the goal for hypertensive crisis management
decrease in map by 20% and DBP of 110-115 w/ antihypertensives in 1st 2-6 hours
37
what is the labs for kidney disease caused by hypertension
creatine over 1.5 and proteinuria
38
what is the P wave on ECG and what is the normal bpm
SA node 60-100
39
what is the PR segment on ECG and what is happening
AV node the energy travels to atrium to make it contract and push blood into ventricles
40
what are the secondary pacemakers of the heart and what are there normal bpm
AV node 40-60 bmp
his purkinje fibers 20-40bpm
41
who is bradycardia normal in
athletes
42
what could be some causes for bradycardia
hypothermia, vagal stimulation, beta-blockers, calcium channel blockers, hypothyroidism , increased intracranial pressure, MI
43
what could be some causes for tachycardia
stressors, drugs like norepinephrine and epinephrine, theo-durr, or OTC cold remedies
44
what are some ss of brady cardia
decreased BP, cold skin, weakness, angina, dizziness, confusion, SOB
45
what are some ss of tachycardia
dizziness, dyspnea, decreased BP, angina( in patients with CAD)
46
what is atropine med used for and how does dosing work
for bradycardia -> 1mg every 3-5 minutes for a total of 3 mg
47
what are some interventions for bradycardia
pacemaker (temp or permanent), stop offending drugs
48
what is something someone can do to help with tachycardia
vagal manuever (bear down)
49
what meds decrease HR for tachycardia
beta blockers, calcium channel blockers
50
what is paroxysmalsupra - ventricular tachycardia
abrupt onset and ending starting above bundle of his - recitation of atria
51
who is mostly effected by paroxysmalsupra - ventricular tachycardia
young healthy females
52
what is the normal heart rate paroxysmal supra - ventricular tachycardia
150-220bpm
53
what could be some causes for paroxysmal supra - ventricular tachycardia
over excertion, emotional stress, stimulants, stimulants like caffeine and tobacco
54
what are the ss of paroxysmal supra - ventricular tachycardia
feeling unwell, weak, fatigue, heart racing, prolonged decrease in BP, dyspnea, angina
55
what are some vagal stimulants you can do for paroxysmal supra - ventricular tachycardia
carotid massage, valsalva, coughing
56
what is IV adenosine for and how does dosing work
1st drug for paroxysmal supra - ventricular tachycardia , 6mg->12mg->12mg->20ml flush
57
what needs to be monitored for IV adenosine
continued monitor on ECG
58
what are the SE IV adenosine
flushing, chest pain
59
if hemodynamically unstable and on IV adenosine what is required
direct current cardioversion
60
what does atrial flutter look like
saw toothed originating from single ectopic focus in atrium
61
what is a fib
the disorganized atrial activity caused by multi ectopic folci which causes ineffective atrial contraction and no p waves
62
how do you rate control for a fib/flutter
calcium channel blockers, beta blockers
63
what are some procedures for a fib
maze procedures with cryoblation, LA appendages occlusion
64
if someone is experiencing a fib/flutter for over 48 hours what needs to be done
anticoagulants for 3-4 weeks before cardioversion then several weeks after
65
what does a transesophogeal echocardiogram detect
sees if there are any clots in the atrium
66
what is a 1st degree AV block
impulse to AV node (send blood from atrium to ventricles) is prolonged but once through the rest is normal
67
what is the ss of 1st degree av block
Asymptomatic
68
how do you diagnosis 1st degree av block
ECG, TSH, BMP,
69
what is the treatment for 1st degree AV block
just monitor
70
what is 2nd degree av block
since that AV prolongation now its not blocking the QRS so its missing on the ECG
71
whats the difference of type 1 and 2 2nd degree av block
type 1 has a p wave
type 2 is no p wave
72
what are the 2 meds used for 2nd degree type 1 av block
digoxin or beta blockers
73
what is the med of choice of 2nd degree type 2 av block
atropin it increases hr
74
what are some other treatment options for 2nd degree type 2 av block
if they are symptomatic ->temporary pacemaker especially if they have experienced an MI is asymptomatic monitor and have a transcutaneous pace maker on standby
75
what are some ss of 2nd degree type 2 av block
decreased cardiac output, decreased BP and myocardial ischemia
76
what is 3rd degree AV block
no impulse to AV node
77
what does a 3rd degree av block look like on an ECG
2 missing QRS back to back
78
what is premature ventricular contraction
QRS is happening too soon
79
what could be some causes for premature ventricular contraction
stimulants, electrolyte imbalances, hypoxia, fever, exercise, stress, cardiac disease -> so treat the cause
80
what are some ss of premature ventricular contraction for a normal heart
not harmful
81
what are some ss of premature ventricular contraction for heart disease
decreased CO, angina, HF
82
what is an R on T phenomenon and what condition is it seen in
premature ventricular contraction - QRS happening on T wave when the heart is suppose to be recovering
83
what does R on T phenomenon cause
VT and V fib
84
what is ventricular fibrillation
run of 3 or more premature ventricular contraction can be stable (pulse) or unstable (no pulse) sustained (longer then 30 seconds) or non sustained (less then 30 seconda)
85
what is monomorphic VF
QRS has the same shape/size/ direction
86
how do you treat monomorphic VF
antidysrhythmias
87
what is polymorphic VF (torsades de pointes)
QRS gradually changes back and forth from one shape and size to another
88
what meds do you use to treat polymorphic VF (torsades de pointes)
beta blockers, aminodarone, procainamide, magnesium
89
what is pulse less electrical activity
you can see electrical activity but no mechanical activity = no pulse
90
what are the risk for pulses electrical activity
hypovolemia, hypoxia, acidosis, hypo/hyperkalemia, hypoglycemia, hypothermia, toxins, tamponade, thrombus, tension pneumothorax, trauma
91
what doe most cardiac related death result from
ventricular dysrhythmias
92
what could be the risk for stage 2 hypertension
renal disease, primary aldosterone, pheochromocytoma, Cushings syndrome, Medication
93
why would having primary aldosterone increase your risk of having stage 2 hypertension
(retaining fluid so high sodium and low vitamin K)
94
why would having pheochromocytoma increase your risk of having stage 2 hypertension
(tumor on the adrenal causing excretion of epinephrine and norepinephrine)
95
why would cushings syndrome increase your risk of having stage 2 hypertension
increase cortisol = retaining fluid)
