Chapter 18- Dissorders Of Blood Flow/ BP

Question 1

Artery Structure…

• Tunica intima =
• Tunica media =
• Tunica exterminate =

Answer 1

• Tunica intima = inner layer
• Tunica media = smooth muscle
• Tunica Externia = outer layer

Question 2

Tunica intima is composed of ________________?

Answer 2

Endothelial cells

Question 3

Tunica externia is composed of ____________________________?

Answer 3

Loose connective tissue

Question 4

Tunica media is composed of ____________________?

Answer 4

Smooth muscle

Question 5

HDL stands for ?

Answer 5

High density lipoprotein

Question 6

LDL stands for ?

Answer 6

Low density lipoprotein

Question 7

________ cholesterol is good?

Answer 7

HDL

Question 8

_______ cholesterol is bad?

Answer 8

LDL

Question 9

Total cholesterol should be ____________ or lower?

Answer 9

200 mg/dL or Lower

Question 10

Medications that end in statins are for what?

Answer 10

Cholesterol

Question 11

What is Atherosclerosis?

Answer 11

Gardening of the arteries

Question 12

Atherosclerosis build up leads to ________________ ?

Answer 12

MI (Myocardial Infarction)

Question 13

Risk factors for Atherosclerosis?

Answer 13

• MAJOR RISK FACTOR = Hypercholesterolemia
• increasing age
• Family history of premature CAD
• Male sex UNTIL women hit menopause

Question 14

________ helps keep LDL low?

Answer 14

Estrogen

Question 15

What is an Aneurysm?

Answer 15

Weakening or outpouching of the vessel wall.

Question 16

What are types of Aneurysms?

Answer 16

• Aortic
• Berry (brain)
• Thoracic
• Abdominal aortic

Question 17

What is the most common type of Aneurysm?

Answer 17

Abdominal aortic

Question 18

What is the BIGGEST cause of Aneurysms?

Answer 18

Hypertension

Question 19

What are the causes of Aneurysms?

Answer 19

• Hypertension
• Congenital defects
• Trauma
• Infections
• Atherosclerosis

Question 20

Aneurysms are _________ and ____________

Answer 20

Acute

Life threatening

Question 21

Causes of Thoracic aneurysms?

Answer 21

• Atherosclerosis

- Marfan syndrome

Question 22

Manifestations of thoracic aneurysms?

Answer 22

• Asymptomatic
• Neck, Back, or substernal pain
• Hoarseness
• Brassy cough
• Dyspnea
• Stridor

** 2 down—> ALL OCCUR IN THE THORACIC REGION**

Question 23

Manifestations of Abdominal aortic aneurysms?

Answer 23

• SEVERE Back pain (NOTHING makes it better)

- Pulsating mass

Question 24

Causes of Abdominal aortic aneurysms?

Answer 24

• Hypertension
• Severe atherosclerosis
• smoking
• genetics 🧬

Question 25

Why do you have to watch/ be able to recognize aneurysms?

Answer 25

Because you don’t know when the aneurysm will rupture!

Question 26

What is Hemiplegia?

Answer 26

One sided chest pain

Question 27

What is syncope?

Answer 27

Passing out due to lack of oxygen to the brain 🧠

Question 28

Why do you want a patient with an aneurysm to be Hypotensive (low BP)?

Answer 28

To keep the aneurysm from rupturing - Ex: 100 systolic @ the highest

Question 29

Why do you want a patient with an aneurysm to be kept flat / have minimal to no movement?

Answer 29

More movement = increase HR & increase BP = rupture

Question 30

What are diagnostic tests for aneurysms?

Answer 30

- aortic angiography - Transesophageal echocardiography (TEE) - CT scan of chest, brain or abdomen - MRI

Question 31

What does PAD stand for?

Answer 31

Peripheral artery disease

Question 32

What is the primary sign and symptom of Peripheral Artery Disease (PAD)?

Answer 32

Intermittent clarification ( pain with walking) * due to arterial spasm * NOT a medical emergency 🚨 - more of a Nusence

Question 33

Acute Arterial Occlusion is a what?

Answer 33

MEDICAL EMERGENCY 🚨 **because arteries carry blood to the tissues and organs** * Venous not as important because it’s carrying deoxygenated blood back to the heart

Question 34

Emboli does what?

Answer 34

Breaks away “travels”

Question 35

Thrombosis do what?

Answer 35

Stay put

Question 36

What are types of emboli?

Answer 36

- Fat emboli - Air emboli - Amniotic fluid emboli - from childbirth

Question 37

Acute arterial occlusion is caused by either a ________ or _________.

Answer 37

Embolus OR thrombosis

Question 38

What is an Acute Arterial Occlusion?

Answer 38

Sudden event that interrupts arterial flow to affecting tissues or organs

Question 39

Acute Arterial Occlusion manifestations?

Answer 39

- First priority - ASSESS your patient - Acute onset - Cold to the touch - The 5 P’s - Pallor - Pulselessness - Pain (lack of O2) - Paralysis - Paresthesia

Question 40

What is Paresthesia?

Answer 40

Numbness and tingling

Question 41

What is paralysis?

Answer 41

Inability to move leg

Question 42

What causes Modeling?

Answer 42

Skin lacking perfusion

Question 43

What is an Embolectomy?

Answer 43

Removal of emboli

Question 44

Treatment for Acute Arterial Occlussion?

Answer 44

- FIX THE PROBLEM - Embolectomy - Local Thrombolytic ( TPA, Streptokinase therapy) - Anticoagulants

Question 45

As a nurse what should you do for a patient with an Acute Arterial Occlussion?

Answer 45

CALL THE DOCTOR IMMEDIATELY! Nurses can’t fix it! Doctor/Surgeon needs to!

Question 46

What is Raynaud Disease?

Answer 46

Intense vasospasms of the arteries and arterioles espically in the FINGERS and TOES

Question 47

Manifestations of Raynaud Disease?

Answer 47

- Pallor to cyanosis - A sensation of cold - Numbness or tingling

Question 48

Raynaud Disease is worse in which population?

Answer 48

Young women

Question 49

___________ intensifies Raynaud Disease?

Answer 49

Cold

Question 50

What is the #1 treatment for Raynaud Disease?

Answer 50

Cover the Fingers and Toes!!

Question 51

Why should smoking be stopped/ why does it make Raynaud(s) Disease worse?

Answer 51

Smoking causes vasoconstriction

Question 52

What are Manifestations of Varicose Veins?

Answer 52

- Unsightly veins - Can be painful - Edema

Question 53

What is the Treatment for Varicose Veins?

Answer 53

Sclerotherapy - they inject sclero_______ medication into the vein which literally collapses the vein and it never gets used again

Question 54

The highest pressure in the body is in the _________?

Answer 54

Aorta

Question 55

DVT leads to _______?

Answer 55

PE

Question 56

Deep Vein Thrombosis Aka _________________; ___________________.

Answer 56

Thrombophlebilits ; Venous Thromboembolism (VTE)

Question 57

VTE stands for what?

Answer 57

Venous Thromboembolism

Question 58

Causes of Deep Vein Thrombosis (DVT’s)

Answer 58

- Prolonged bed rest - Immobilization - Long airplane rides (international) - Obesity (increased pressure) - Cigarette smoking (vasoconstriction) - Oral contraceptives = MOST COMMON - Hyperactivity of blood coagulation (Pregnancy, Dehydration) - Vascular trauma (surgery)

Question 59

In patients with DVT’s generally _______________________ is affected?

Answer 59

Just one leg

Question 60

Manifestations of DVT’s?

Answer 60

- inflammatory process - pain - unilateral swelling - warm to touch - deep muscle tenderness - positive Homan’s sign - Fever - malaise (general) - elevated white count (stress or inflammation) - elevated ESR (Erythrocyte Sedimentation Rate) - due to inflammation