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med/surg 2 > class 9 hypertension, angina, MI > Flashcards

class 9 hypertension, angina, MI Flashcards

1
Q

what is stage 1 hypertension

A

130-139/80-89

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2
Q

what is stage 2 hypertension

A

> =140/>=90

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3
Q

what is hypertensive crisis

A

> 180/>120

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4
Q

what is primary or essential hypertension

A

hypertension resulting from an unknown cause
-gradual development
-most common

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5
Q

what is secondary hypertension

A

hypertension resulting from a known cause
-#1 cause is pregnancy
-once identified: tx and meds

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6
Q

what is isolated systolic hypertension (ISH)

A

when diastolic is normal but systolic is elevated
“white coat” hypertension
-needs to happen on many occasions to dx

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7
Q

nonmodifiable risk factors of HTN

A

-family history
-age
-gender
-ethnicity

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8
Q

modifiable risk factors of HTN

A

-diabetes
-dyslipidemia
-stress
-obesity
-high Na intake
-substance abuse

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9
Q

clinical manifestations of early stages hypertension

A

asymptomatic

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10
Q

clinical manifestations of hypertension

A

-headache
-fatigue
-dizziness
-palpitations
-flushing
-blurred vision
-epistaxis

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11
Q

patient assessment for HTN

A

-history and physical exam
-blood work/lab tests
-EKG
-Blood Pressure Monitoring (2 elevated readings)

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12
Q

Hypertension Management

A

-lifestyle modifications
-weight reduction
-sodium reduction
-dietary fat modification “DASH” diet
-decrease alcohol intake
-physical activity
-medication

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13
Q

medications are used to:

A

-reduce peripheral resistance
-decrease blood volume
-strengthen or increase the rate of contraction

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14
Q

types of medications used

A

-diuretics (K sparing/thiazide/loop)
-beta blockers
-ACE inhibitors (chronic cough)
-ARBs
-calcium channel blockers
-adrenergic blockers
-vasodilators
-may need cholesterol meds

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15
Q

consequences of hypertension

A

-left ventricular hypertrophy
-coronary artery disease
-angina
-MI
-heart failure
-CVA
-peripheral vascular disease
-retinopathy
-renal disease

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16
Q

nursing care for hypertension

A

-history and risk factors
-assess potential symptoms of target organ damage
-cardiovascular assessment
-medication education

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17
Q

potential symptoms of target organ damage

A

-angina
-SOB
-altered speech
-altered vision
-nosebleed
-headaches
-dizziness
-balance problems
-nocturia

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18
Q

what is hypertensive urgency

A

> 180/110
-no major organ damage
-BP must be lowered within a few hours
-stat dose of med ordered

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19
Q

what is hypertensive emergency

A

> 220/140
-management necessary to prevent/halt damage to target organs
-IV vasodilators & hooked up to monitor

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20
Q

what is athersclerosis

A

-abnormal accumulation of lipids in the arterial blood vessel walls
-blood flow is reduced
-leads to collateral circulation to prevent ischemic injury

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21
Q

what is angina

A

chest pain resulting from myocardial ischemia
-ischemia=pain

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22
Q

what is angina associated with

A

-athersclerosis
-blockage of coronary artery
-coronary artery spasm

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23
Q

what is stable angina (chronic)

A

exacerbated by activity & resolved with rest

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24
Q

what is unstable angina

A

pain continually gets worse & is not relieved with rest or nitroglycerin

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25
Q

what is intractable or refractory angina

A

severe reoccuring chest pain

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26
Q

what is variant angina (prinzmetal’s angina)

A

chest pain at rest due to vessel spasm

27
Q

what is silent ischemia

A

no chest pain, doesn’t know ischemia is happening

28
Q

what is microvascular angina

A

chest pain brought on by ischemia of the microvasculature in the heart

29
Q

potential triggers for angina

A

-physical exertion
-temperature extremes
-emotions
-heavy meals
-tobacco use
-sexual activity
-stimulants
-circadian rhythm patterns

30
Q

diagnostic testing for angina

A

-EKG
-exercise electrocardiograpthy (stress test)
-radioisotope imaging
-electron-beam computed tomography (CT)
-chest x-rays
-coronary angiography
-lab values

31
Q

management for angina

A

-goal: decrease o2 demand of myocardium and increase o2 supply
-medications (vasodilators)
-control and reduce risk factors

32
Q

medications given for angina

A

-morphine (dec pain & RR)
-o2
-nitro (may get headache)
-antiplatelet/anticoagulant
-beta blocker
-calcium channel blockers

33
Q

nursing management for angina

A

-avoid activities which precipitate angina
-management of hypertension
-medication information
-exercise
-quit smoking
-weight loss
-stress reduction

34
Q

what is acute myocardial infarction

A

-life threatening condition
-complete or almost total occlusion of coronary artery
-an abrupt cessation or decreased blood and o2 to the heart muscle
-prolonged ischemia leading to irreversible damage

35
Q

what is acute coronary syndrome (ACS)

A

spectrum of acute myocardial infarction

36
Q

what does ST-elevation myocardial infarction (STEMI) indicate

A

indicates possible necrosis of myocardial tissue

37
Q

what does non-ST elevation myocardial infarction (NSTEMI) indicate

A

indicates ischemia of myocardial tissue
-allows for more time to treat/can manage with meds

38
Q

cardiovascular s&s of myocardial infarction (heart attack)

A

-chest pain that radiates to jaw/arm
-palpitations
-increased Jugular vein distension
-HTN
-EKG changes

39
Q

respiratory s&s of myocardial infarction (heart attack)

A

-SOB
-tachypnea
-crackles
-possible pulmonary edema

40
Q

gastrointestinal s&s of myocardial infarction (heart attack)

A

-nausea and vomiting
-indigestion

41
Q

skin s&s of myocardial infarction (heart attack)

A

-cool
-clammy
-diaphoretic
-pale appearance

42
Q

genitourinary s&s of myocardial infarction (heart attack)

A

-decreased urine output

43
Q

neurologic s&s of myocardial infarction (heart attack)

A

-anxiety
-restlessness
-lightheaded

44
Q

psychological s&s of myocardial infarction (heart attack)

A

-fear
-impending doom

45
Q

s&s of myocardial infarction (heart attack) in diabetes/women

A

-stomach pain/reflux/indgestion
-SOB
-dizziness
-nausea

46
Q

diagnostic testing for myocardial infarction

A

-EKG
-PET scan
-MRI
-echocardiogram
-transesophageal echocardiography
-labs: CK-MB, myoglobin, tropoin, imaging studies

47
Q

what is CK-MB

A

indicates muscle damage (inc with myocardial damage)
-may be increased after sugery

48
Q

what is troponin

A

-protein found in heart muscle cells
-highly sensitive
-elevated indicates heart damage
-can differentiate STEMI or NSTEMI

49
Q

treatment for myocardial infarction

A

-EKG
-labs asap
-aspirin, nitro, morphine, o2 (sats >92%)
-beta blockers
-ACE inhibitors
-Thrombolytic therapy
-bed rest
-maybe antilipid

50
Q

what is afib

A

-common dysrhythmia
-contracting rapidly at an irregular, fast rate
-quivering leads to blood pooling in atria

51
Q

risk factors for atrial fibrillation

A

-HTN
-diabetes
-obesity
-mitral valve disease
-heart failure
-obstructive sleep apnea
-hyperthyroid
-cardiac ischemia
-cardiac inflammatory disease
-myocardial hypertrophy, fibrosis, dilation

52
Q

characteristics of afib

A

-irregular rhythm
-palpitations
-fatigue
-light-headed/syncope

53
Q

what is paroxysmal afib

A

erratic heart rates begins suddenly and stops on its own before 7 days

54
Q

what is persistent continuous afib

A

abnormal heart rhythm that lasts more than 7 days

55
Q

what is long-standing persistent continuous afib

A

abnormal heart rhythm than last lasted longer than a year

56
Q

what is permanent persistent afib

A

when abnormal heart rhythm is present all the time regardless of efforts to restore rhythm

57
Q

what is non valvular afib

A

abnormal heart rhythm NOT due to valve involvement

58
Q

diagnostic test for afib

A

-history and physical
-chets xray
-exercise stress test
-holter monitor
-EKG
-transthoracic echocardiogram (TEE)
-blood work

59
Q

atrial and ventricular rate in untreated afib

A

atrial: 300-600 bpm
ventricular: 120-200 bpm
-highly irregular

60
Q

QRS shapes and duration with afib

A

usually normal, may be abnormal

61
Q

P wave with afib

A

-no discernible P waves; irregular undulating waves that vary in amplitude and shape are seen and referred to as fibrillatory or f waves

62
Q

pr interval in afib

A

cannot be measured

63
Q

treatment for afib

A

-depends on cause, pattern, and duration
-cardioversion
-antiarrhythmic medications

64
Q

medical management of afib

A

-medication is based on risk of stroke
-anticoags
-antiplatelet
-calcium channel blocker
-beta blockers
-ACE inhibitors
-Angiotensin receptor blockers (ARBs)
-cholesterol lowering drugs

med/surg 2 (17 decks)

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