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Med Surg 1 > Ch 27 > Flashcards

Ch 27 Flashcards

1
Q

The forced produced by the volume of blood in the arterial

A

BP

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2
Q

Older adults are at increased risk for development of ___ from __ drugs

A

Hypokalemia
Potassium-waisting diuretic

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3
Q

The ___,___ & ___ regulate arterial pressure

A

Autonomic nervous system
Kidneys
Various endocrine glands

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4
Q

Determined by the force & volume of blood that the LEFT VENTRICLE ejects during systole and the ability of the arterial system to distend at the time of ventricular contraction

A

Systolic BP

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5
Q

Reflects arterial pressure during ventricular relaxation. It depends on the resistance of the arterioles and the diastolic filling times

A

Diastolic BP

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6
Q

Central aortic systolic pressure (CASP), the pressure of blood at the ____ as blood is pumped from the left ventricle, can be lowered by as much as 30 mm hg than the corresponding ___ systolic pressure

A

Root of the aorta
Brachial arm

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7
Q

Pre hypertension

A

Systolic 120-139
Diastolic 80-89

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8
Q

When elevated BP causes cardiac abnormalities

A

Hypertensive heart disease

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9
Q

When vascular damage is present without heart involvement

A

Hypertensive vascular disease

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10
Q

Sustained elevated BP with no known cause .. about 95% of cases

A

Essential hypertension

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11
Q

Elevated BP that results from or is secondary to some other disorder

A

Secondary hypertension

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12
Q

____ (elevated serum sodium level) increases blood volume which raises BP

A

Hypernatremia

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13
Q

A low serum potassium level may cause ___ as the kidneys try to maintain a balanced number of cations in body fluid

A

Sodium retention

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14
Q

Defects in BP regulation may result from impairment in the __

A

Renin-angiotensin-aldosterone system

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15
Q

A chemical that kidneys release to raise BP
And increase vascular fluid volume in response to renal HYPOperfusion

A

Renin

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16
Q

Normal BP

A

Systolic less than 120
Diastolic less than 80

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17
Q

Elevated BP

A

Systolic 120-129
Diastolic less than 80 (bc systolic is still elevated)

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18
Q

For people with a ___ response, hypertension may be correlated with a higher than usual release of ___ such as __ and ___ which elevate BP

A

Heightened stress
Catecholamines
Epinephrine
Norepinephrine

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19
Q

Secondary hypertension may accompany any primary condition that affects ___ or __ or causes ___

A

Fluid volume
Renal function
Arterial vasoconstriction

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20
Q

Predisposing conditions of secondary hypertension
SATA ( 9)

A

-Kidney disease
-Pheochromocytoma (benign tumor of adrenal medulla)
-Hyperaldosteronism(increased secretion of mineralocorticoid by adrenal cortex)
-Atherosclerosis
-Use of cocaine
-Use of cardiac stimulants
*Weight control drugs
*Caffeine
-Use of oral contraceptives

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21
Q

Hypertension causes the heart to __

A

Work harder to pump against the increased resistance

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22
Q

The size of the heart muscle ___

A

Increases

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23
Q

When the heart can no longer pump adequately to meet the body’s metabolic needs ___ occurs

A

HF

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24
Q

The extra work and the greater mass increases the hearts need for __

A

Oxygen

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25
Q

In addition to its direct effects on the heart, high BP damages the __ system

A

Arterial vascular system

26
Q

The increased resistance of the Arterioles to the flow of blood causes serious complications in other body organs including ___,___,___, & ___

A

Eyes
Brain
Heart
Kidneys

27
Q

Hemorrhage of tiny arteries in the retina may cause ___

A

Marked visual disturbances or blindness

28
Q

A CVA accident may result from

A

Hemorrhage or occlusion of blood vessels in the brain

29
Q

MI may result from occlusion of a

A

Branch of a coronary artery

30
Q

Impaired circulation to the kidneys may result in

A

Renal failure

31
Q

The onset of hypertension is considered

A

“The silent killer”

32
Q

As the BP becomes elevated, clients may identify sympathetic such as a ___ or ___, ___,___,____,____,___ &___
(8)

A

Throbbing or pounding
Headache
Dizziness
Fatigue
Nose bleeds (epistaxis)
Blurred vision
Confusion

33
Q

An___ exam may reveal vascular changes in the eyes, retinal hemorrhages or edema of the optic nerves knows as ___

A

Ophthalmic
Papilledema

34
Q

3 tests that may reveal an enlarged LEFT ventricle

A

Electrocardiography
Echocardiography
Chest radiography

35
Q

A test that detects how well or inefficiently the heart pumps, can detect HF that may be associated with hypertension

A

MUGA (multiple gated acquisition) scan

36
Q

An ophthalmologic test using IV dye, often reveals leaking retinal blood vessels

A

Flourescein angiography

37
Q

If the causes is related to dysfunction of the adrenal gland, a ___ detects elevated Catecholamines

A

24- hour collected urine specimen

38
Q

The primary objective of therapy for hypertension is to

A

Lower the BP & prevent major complications

39
Q

Items that contain significant sodium
SATA(10)

A

Pickles
Green olives
Sauerkraut
Mustard
Catsup
Bbq sauce
Pizza sauce
Canned soup
Packaged mixes
Cheese

40
Q

Believed that in persons older than __ reducing the __ below __ is more important than that decreasing the ___

A

60
Systolic pressure
150 mm Hg
Diastolic BP

41
Q

Clients who require drug therapy may be treated initially with one drug, usually a___. However, most people with hypertension will need two or more antihypertensives meds to reduce their BP to target level

A

Thiazide diuretic (potassium waisting)

42
Q

Secondary hypertension often resolves by

A

Treating it’s cause

43
Q

All drugs used to reduce BP can produce __ & __ when rising to a sitting or standing position. Teach clients how to reduce symptoms of ___ as they adjust to their meds

A

Dizziness and syncope
Hypotension

44
Q

___ may cause a persistent cough until the med is D/C

A

ACE inhibitors (-prils)

45
Q

Intended use of calcium channel blockers

A

Relieve angina by DILATING arteries, improving myocardium blood supply and reduces myocardial oxygen demand

46
Q

Calcium channel blockers
1-1trade

A

Nifedipine (Procardia)

47
Q

Safety warnings for nurses with beta blockers

A

Drug is held if HR is less than 60 or above 120
*count apical 1 full minute

48
Q

Risk for decreased cardiac output, nursing process

A

-encourage adherence to treatment with salt/sodium restrictions (doing so decreases blood volume and improves the potential for greater CO)
-administer prescribed antihypertensives (they use various mechanisms to control BP, including INCREASING URINE ELEMINATION, blocking production of angiotensin, & dilating blood vessels)

49
Q

Injury risk related to syncope & dizziness secondary to side effect of antihypertensive drugs

A

Monitor postural changes in BP by assessing client while lying sitting & standing
Orthostatic hypotension - ortho vitals - lie down- call Dr

50
Q

More serious forms of elevated BP that can develop in clients with either essential or secondary hypertension

A

Accelerated and malignant hypertension

51
Q

Considered a hypertensive crisis

A

Accelerated hypertension

52
Q

Accelerated hypertension is manifested by ___ accompanied by __ and ___

A

Markedly elevated BP
Hemorrhages and exudates in the eyes

53
Q

If untreated accelerated hypertension may progress to

A

Malignant hypertension

54
Q

Malignant hypertension is ___ accompanied by ___

A

Dangerously elevated BP
Papilledema

55
Q

Malignant hypertension is ___ unless BP is quickly reduced

A

Fatal

56
Q

Even with intensive treatment of malignant hypertension the ___,___ and __ may be ___

A

Kidneys, brain & heart
Permanently damaged

57
Q

Consequences are life threatening when the BP in the ___ system becomes extremely elevated. Some ___ already may have ruptured or will soon

A

Vascular
Arterial blood vessels

58
Q

Retinal hemorrhages can lead to

A

Blindness

59
Q

A stroke occurs if__ in the ___ rupture & bleed

A

Vessels
Brain

60
Q

If a __ has developed in the __ from ___ it may burst and cause __ & ___

A

Aneurysm
Aorta
Chronic hypertension
Hemorrhage
Shock

61
Q

The onset of sudden ___ accompanied by ___ indicates that an aortic ___ is ___ or has __

A

Severe back pain
Hypotension
Aneurysm
Dissecting
Ruptured

62
Q

In true hypertensive emergencies the goal is to lower the BP within __ to ___ hrs by using ___

A

1 to 2 hours
Potent IV drugs

Med Surg 1 (19 decks)

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