CVPV/Anemia/Blood products Flashcards
(265 cards)
1
Q
the amount of blood pumped in 1 minute
-the lower, the poorer the perfusion to organs and other extremities
A
cardiac output
2
Q
the force opposing movement of blood within the vessels
-as arteries narrow, resistance to blood flow increases
A
systemic vascular resistance
3
Q
the force exerted by the blood against the walls for the vessel
A
blood pressure
4
Q
what’s the consideration systolic and diastolic of hypertension?
A
140/90
5
Q
what are the risk factors of hypertension?
A
age
inactive lifestyle
high lipids
6
Q
what causes hypertension?
A
fluid overload
vasoconstricting (narrowing)
7
Q
not related to another disease or condition
A
primary hypertension
8
Q
what are the risk factors for primary hypertension?
A
age
inactivity
high lipids
9
Q
what is secondary hypertension
A
a result of other disorder or condition, once condition is treated the hypertension can be fixed
10
Q
what are the risk factors of secondary hypertension?
A
cardiovascular disorders
renal disorders
endocrine system disorders
pregnancy
medications
sleep apena**
thyroid disorder
11
Q
what is suspected on people who suddenly develop hypertension?
A
primary hypertension
12
Q
how does hypertension affect the vessels?
A
hypertrophy
hyperplasia
13
Q
cells that get larger/working harder
A
hypertrophy
14
Q
damage in cells and the cells start to replicate, inflammatory response
A
hyperplasia
15
Q
early stages of disease have no clinical manifestation other than elevated blood pressure reading
A
silent killer
16
Q
what are the signs and symptoms of early hypertension?
A
asymptomatic
17
Q
what are the signs and symptoms of hypertension later in life?
A
headaches
visual disturbances
chest pain
dyspnea
dizziness
fatigue
18
Q
sustained hypertension that has effects beyond hemodynamics
A
complicated hypertension
19
Q
what are the two major mechanisms of tissue damage with complicated hypertension?
A
ischemia
edema
20
Q
not enough oxygen going where it needs to be
A
ischemia
21
Q
fluid buildup in the tissue
A
edema
22
Q
what age does accumulation start happening for hypertension?
A
20s-30s
23
Q
what age does atherosclerosis begin with complicated hypertension?
A
30s-40s
24
Q
at what are is their irreversabile damage because of hypertension?
A
40s
25
what are nonmodifiable
age
race
genetics
gender
26
what are modifiable
smoking
drinking
sedentary lifestyle
poor diet habit
27
which organs does complicated hypertension affect?
heart
kidneys
brain
eyes
28
what are the evaluations for hypertension?
history
sedentary lifestyle
neuro
pulses
lung sounds (crackles=heart failure)
29
what is the most accurate to check for hypertension?
auscultation
sit quietly at least 5 minutes
arm at heart level
appropriate size cuff
30
what is the treatment goal for patients with hypertension?
to have bp of 130/80
31
what is are the recommendations for people with hypertension?
DASH Diet
exercise
moderate alcohol consumption
32
what is the DASH diet?
low in dietary sodium
saturated fats
dairy, total fats, carbs
red meats, and sweets
rich in fiber and potassium
includes veggies, fruits
increase in full grains products, fish, poultry, nuts
33
what are the medications you can take for hypertension?
adrenergic blockers
ace inhibitors
angiotensin receptor blockers
beta blockers
calcium channel blockers
diuretics
34
inhibit vasoconstriction
adrenergic blockers
-clonidine
-methyldopa
35
prevent peripheral vasoconstriction
ace inhibitors (-pril)
-benazepril
-captopril
-enalapril
-liniopril
36
prevent peripheral vasoconstriction as well as ace inhibitors
angiotensin receptor blockers (-sartans)
-losartan
-valsartan
37
decrease cardiac output, hr, bp, and cardiac workload
beta blockers (-olol)
-atenolol
-metoprolol
-carveidolol
-propanolol
38
who should be monitored if taking beta blockers
asthma patients
diabetic patients
39
increase blood flow to the extremities; good for vasospasm?
calcium channel blockers
-amlodipine
-diltiazem
-verapamil
40
increase blood flow to the extremities; good for vasospasm as well as calcium channel blockers?
alpha adrenergic blockers (-zosin)
-doxazosin
-prazosin
-terazosin
41
promote Na+ and H2O excretion, K+ retension
spironolactone
42
inhibit Na and CL reabsorption from the loop of henele
will be on K+ supplements
furosemide/bumetanide
43
increase Na+ and H2O excretion by inhibiting sodium reabsorption (specifically for hypertension)
thiazides
-chlorothiazide
-metolazone
-hydrochlorothiazide
44
what is the hypertension nursing care?
daily weights
i&o
urine output
response of bp
electrolytes
take pulses
ischemic episodes
complications of 4C's
-CAD
-CRF
-CVA
-CHF
45
drop of 20mmHg or greater systolic or 10mmHg or greater diastolic
-decrease in both systolic and diastolic BP upon standing
orthostatic hypotension
46
what can cause acute hypotension?
-altered electrolytes
-drug action
-prolonged immobility
-starvation
-physical exhaustion
-volume depletion
-venous pooling (sat for to long)
-postprandial**
47
what can cause chronic hypotension?
-secondary to specific disease
-endocrine
-metabolic disorders
-CNS
-PNS
48
what is idiopathic hypotension?
-no known cause
49
what is the diagnostic for orthostatic hypotension?
lying/sitting/standing
tilt table test
50
what is the nursing priority for orthostatic hypotension?
safety
-fall risk
51
what are the treatments for orthostatic hypotension?
-adjust meds
-give volume
-replace electrolytes
-assist with frequent repositioning
52
vasoconstriction leads to increased blood pressure readings? true or false
true
53
accumulation of lipid, or fatty substances in vessel walls
-inflammation process
-ischemia
-platelets
atherosclerosis
54
where is atherosclerosis most common?
coronary arteries
55
what are the non-modifiable risk factors of CAD?
-age
-gender
-family hx
-ethnicity
56
what are the modifiable risk factors of CAD?
-high cholesterol
-smoking
-hypertension
-hyperglycemia
-obesity
-physical activity
-stress
57
which cholesterol do pts want high?
HDL
58
decrease supply of blood flow/oxygen, increased demand for flow/oxygen
myocardial ischemia
59
what can myocardial ischemia cause?
atherosclerosis
thrombus formation
vasoconstriction
60
within 10 seconds you will start having what?
ischemia
61
how long are cardiac cells viable?
20 minutes
62
chest pain caused by myocardial ischemia
-insufficient coronary blood flow results in decrease oxygen supply to meet the myocardial demand for O2
angina pectoris
63
what factors can cause anginal pain
-physical exertion
-exposure to cold
-eating a heavy meal
-stress or emotional situation
64
predictable pain on exertion
-stops after 3-5 minutes after doing activites
stable
65
unpredictable (variant or vasospatic)
caused by vasospasm
prinzmetal
66
what medication can help with prinzmetal?
calcium channel blockers
67
EKG changes but no reported symptoms
silent ischemia
68
occurs at rest or during minimal activity; increasing severity or frequency
unstable (preinfarction)
69
what are will women complain of with angina?
fatigue
70
what do elderly pts complain of with angina?
SOB
71
what are some preventions for angina?
-dash diet
-exercise
-med
-tabacco cessation
-managing htn
-controlling dm
-managing stress
72
how to evaluate of chest pain?
-physical assessment (ausculation)
-EKG
-lab
-stress test
-echo
-coronary angiography
73
what are the signs and symptoms of angina?
-indigestion
-chocking or heavy pressure in sternum
-radiate to neck, jaw, shoulders, arms, usually left arm
-weakness or numbness in arms, wrists, and hands
-sob, pallor, diaphoresis
-dizziness, N/V
74
What EKG assessment is ischemia?
ST depression
75
Which EKG assessment is injury/MI?
ST elevation
76
How many minutes have to pass to have injury/MI and you will have permanent damage to the heart?
21 minutes
77
Which lab shows cardiac injury?
troponin
78
Around which amount do we want HDLs?
>40-50
79
what do LDLs do?
transport cholesterol into the cell
80
what do HDLs do?
cholesterol goes into the liver and out of the body
81
what are the medications for cholesterol?
lipid lowering agents
(-statins) Atravastatin
82
B-vitamin increase HDLs
niacin
83
lower cholesterol synthesis; watch liver enzymes
fibrates(gemfibrozil)
84
what should you monitor when taking statins?
liver function test
85
when should monitor liver enzymes?
every 6 weeks then every 6 months
86
how do they perform the stress test?
exercise/dye/MRI
87
how do they perform echo?
they evaluate wall motion, valve function, blood flow
88
how to they perform angiography?
contrast/coronary vessels/occlusion
89
what is the primary aim in therapy for myocardial ischemia and angina in reducing myocardial oxygen consumption?
decrease bp
decrease hr
assist contractility
decrease left ventricular volume
90
what are the nursing intervention in chest pain?
-oxygen
-pain assessment (position, quality, radiation/relief) severity, timing
-vital signs
-monitor respiratory status
-12 lead EKG
-nitroglycerin
91
what medication helps decrease preload and in higher doses decrease the afterload, they also reduce myocardial O2 consumption and decreases ischemia and relieves pain
nitroglycerin
92
what medication should not being taken within 4 hours of erectile dysfunction med?
nitroglycerin
93
how should nitroglycerin be stored?
brown/glass vile protected from the sun
94
how do you know if nitroglycerin is expired?
it doesn't sting/burn
95
how do you take nitroglycerin?
sublingual
96
how many times can you take nitroglycerin if pain is persitant?
3 tabs and 5 minute intervals
97
what are the side effects of nitroglycerin?
headache**
flushing
decrease bp
tachycardia
98
reduce myocardial O2 consumption blocking beta-adrenergic sympathetic stimulation
-reduces HR
-reduces bp
-reduces contractility
beta blockers
99
what can beta blockers cause in people with asthma?
bronchospasms
100
what can beta blockers cause in people with diabetes?
masks signs of hypoglycemia
101
can you abruptly stop beta blockers?
no, it'll cause rebound hypertension
102
what are nursing interventions when taking beta blockers?
monitor hr
check bp
monitor for bronchospasm
monitor glucose levels
103
helps slow down the impulse of the SA node, decrease HR, decrease BP, relax the blood vessels
calcium channel blockers
104
what medication is not recommended to take with grapefuit juice or grapefruit?
calcium channel blocker
105
what are the side effects of calcium channel blocker?
dizziness, decrease bp
106
prevents platelet activation
aspirin
107
platelet aggregate
can be used with aspirin or alone
clopidogrel (plavex)
108
what should you monitor on patients taking aspirin and clopidogrel (plavex)
increase chance for bleeding
109
how should you manage angina at home?
-reduce activities that cause chest pain or SOB
-avoid extreme temperatures
-maintain regular bp
-avoid otc meds that can increase bp
-stop smoking
-take prescribed meds
-keep nitroglycerin
110
abruptly deprived of oxygen, the longer the vessels are occluded the more damage
myocardial infarction
111
what are the signs and symptoms of a myocardial infarction?
-sudden chest pain
-no to rest or medication
-SOB, dyspnea, tachypnea
-n/v
-decrease urinary output
-cool, clammy, diaphoretic pale skin
-anxiety, restlessness, fear
112
how much should the urinary output be?
30ml/hr
113
what is the nursing care for MI?
-bed rest
-stool softner
eduction on
-diet
-caffeine
-smoking cessation
-exercise
-s/s of recurrent MI
114
mona
morphine-decrease preload, decrease workload
oxygen
nitrates
aspirin
115
what medication can you take for MI?
ace inhibitors-decrease bp & cardiac workload
beta blockers
116
what is the goal for pts with MI?
cardiac rehab
return client to work and pre-illness lifestyle
117
looks for blockages
NPO (8-12hours)
CCCA
cardiac catheterization and coronary angiography
118
what should patient be asked before going in for a CCCA?
if they're allergic to dye, shellfish
119
what medication should be stopped 48 hours before going in for a CCCA?
metformin
120
what are the nursing interventions for post op on a CCCA?
-assess catheter site for bleeding or hematoma
-check peripheral pulses, color, temp, pain, or numbness
-monitor for dysrhythmias
-bed rest 2-6 hours
-keep affected extremity straight
-HOB no higher than 30º
-encourage fluids to flush out dye
- ensure safety
121
what are patients at great risk post op of CCCA?
bleeding
122
opens a blockage w/stent or balloon
stents are medicated antiplatelet medication
PCI/PTCA
123
reroute the blood flow with bypass
coronary artery bypass
124
leaflets of the mitral valve billow upward into the atrium
mitral valve prolapse
125
control the blood flow through the heart
heart valves
126
what are the signs and symptoms of mitral valve prolapse?
often asymptomatic
palpatations
tachycardia
fatigue
weakness
chest tightness
anxiety
depression
chest pain
127
what is the diagnostic for mitral valve prolapse?
echocardiogram
128
what should be avoided when having mitral valve prolapse?
hypovolemia
129
the valve orifice is constricted or narrowed, blood can't flow through efficiently, pressure in chamber builds up and can lead to hypertrophy
stenosis
130
valves don't completely shut all the way, blood flows freely on its own. increase volume the heart has to pump, increase workload
regurgitation
131
what are the signs and symptoms of a valve disorder?
dyspnea
weakness/fatigue
murmurs
chest pain
132
what medications can be used for valve disorders?
diuretics
cardiac glycosides
b-blockers
prophylactic antibiotics
133
will make a click sound/more durable, is used more in younger patients
mechanical valve
134
less likely to cause thrombus, replaced more frequently
tissue valves
135
used from a pig or cow
xenografts
136
human cadaver or tissue donation
homografts
137
patient's own valve
autografts
138
which valve replacement will need to be on long term anticoagulation
mechanical valve
139
is most often caused by CAD, HTN, or valve disorders
heart failure
140
what are some systemic conditions of heart failure?
-fever
-hypoxia and anemai
-dysrhythmias
-electrolyte abnormalities
-renal failure
-thyroid problem
141
what are the symptoms of left heart failure?
-cough will start dry then it will progress to a pink frothy sputum
-dyspnea on exertion
-orthopnea
-paroxysmal nocturnal dyspnea
-oliguria
-confusion, anxiety, restlessness
-cyanosis
142
is pulmonary edema part of left heart failure or right heart failure?
left heart failure
143
what are the early stages of pulmonary edema?
-dry, hacking cough
-fatigue
-wt gain
-worsening edema
-degree of dyspnea
144
what is the key to pulmonary edema?
prevention
145
what are the signs and symptoms of right heart failure?
JVD
dependent edema (LE)
hepatomegaly
ascites
weakness, anoerxia, wt gain
146
what is the hallmark sign of right heart failure?
edema (feet, ankles, legs)
147
what are the diagnostics for heart failure?
B-type natriuretic peptide-BNP
148
what is the priority nursing assessment when having edema?
skin assessment
149
what is the nursing management for heart failure in hospital setting?
i&o
daily weight
lung assessment
assess for JVD
assess and evaluate dependent edema
close monitor VS (O2**)
skin turgor
s/s fluid overload
electrolyte monitoring
turn patient frequently to shift fluid
150
what should patients be taught to do when going home with heart failure?
daily weight
same time
same scale
151
how does medications help with heat failure?
reduce workload by reducing preload and afterload
152
what medications are used for heart failure?
ace inhibitors (captopril)
arbs (losartan)
beta blockers
alpha/beta blockers
153
promote vasodilation and diuresis
excrete Na+ & retain K+
ace inhibitors
154
what is a warning sign that the medication ace inhibitor isn't working properly?
dry persistent cough
155
what medication can cause birth defects?
ace inhibitors
arbs
156
what are the side effects of ace inbibitors?
dizziness
orthostatic hypotension
157
cardiac glycoside used for systolic heart failure, a-fib, and flutter
digoxin
158
what medication increases myocardial contraction and decreases ventricular rate
-promotes diuresis
digoxin
159
what are the signs and symptoms of digoxin toxicity?
fatigue
depression
malaise
n/v, anorexia
changes in heart rhythm
160
what lab should you monitor with digoxin?
potassium
161
what is the antidote for digoxin?
digibind
162
what are the medical management of heart failure?
diuretics
anticoagulants
low sodium diet
163
treating congestive heart failure
upright position
nitrates
lasix
oxygen
ace inhibitors
digoxin
fluids (decrease)
afterload (decrease)
sodium restriction
test
164
what tips for physical activity?
warm up-exercise
avoid extreme heat, cold, humid weather
should be able to talk during exercise
wait 2 hours after eating to exercise
stop activity if sob, pain, or dizziness
cool down period
165
build up of atherosclerosis or fatty substances lipids and plaque in the peripheral vessels
peripheral vascular disease
166
pain in extremities with exercise; well relieved by rest
intermittent claudication
167
-skin and temp changes
-cool and pale
-white or blanched appearance when elevated
-rubor
-cyanosis
-gangrenous changes
-loss of hair
-brittle nails
-dry,shiny,scaly skin
-bruits
peripheral arterial disease
168
nursing assessment of peripheral arterial disease
pulse changes
-presence or absense
-0 to 4+ scale
-droppler to detect flow
169
what are the risk factors for PAD?
-nicotine use
-hyperlipidemia
-hypertension
-diabetes
-stress
-sedentary lifestyle/obesity
170
what are nursing intervensions for arterial insufficiency?
-lower extremity to increase perfusion
-no constrictive clothing; no crossing legs
-protective shoes; foot care; meticulous hygiene
171
what are medications for peripheral vascular disease?
antiplatelets (clopidogrel and aspirin)
diabetes medication
lipid lowering agents
172
what are the surgical interventions for peripheral vascular disease?
aorto-iliac
aorto-femoral
femoral-popliteal
173
what are the nursing considerations for patients after peripheral vascular surgery?
no crossing let
check pulse
temperature
color
check pulse every hour for the first hours
then every 4 hours for the remainder of the 24 hours
174
chronic venous stasis
edema
brownish discoloration
pain
venous insufficiency
175
what are the nursing management of venous insufficiency?
-elevate extemities
-foot pumping
-avoid crossing legs
-avoid constrictive clothing
-compression stockings
176
intermittent claudication pain
no edema
no pulse or weak pulse
no drainage
round smooth sores
black eschar
location of sores: toes and feet
arterial
177
dull, achy pain
lower leg edema
pulse present, drainage
sores with irregular borders
yellow slough or ruddy skin
location of sores: ankles
venous
178
venous stasis
vessel wall injury
altered blood coagulation
DVT
179
what are the signs of DVT?
lower extremity
limb pain
heaviness
swelling, redness, warmth
tenderness
difference in leg circumference
180
what are the risk factors to DVT?
immobility
major surgery
fracture pelvis
prostate surgery
bed rest
oral contraceptives
181
what medication can cause DVT?
oral contraceptives
182
what is the diagnostic for DVT?
venous doppler
183
how to prevent DVT?
elastic compression stocking
active and passive leg exercise
early ambulation
TCDB
enoxaparin
184
what are treatments for DVT?
heparin
warfarin
enoxaparin
185
what lab is used for heparin?
anti-xa every 6 hours
186
what is the lab used for coumadin/warfarin?
pt & inr
187
what is the antidote for heparin?
prodamine sulfate
188
what is the antidote for warfarin/coumadin?
vitamin k
ffp
189
what do you monitor for enoxaparin?
platelets
190
how often are labs required for people on coumadin/warfarin?
every week
191
heparin induced?
thrombocytopenia
192
what should you avoid if taking antiplatelets?
nsaids
193
what are patients at higher risk when taking antiplatelets/anticoagulants?
bleeding
194
what are some patient eduction when taking anticoagulants?
avoid alcohol
do not stop unless directed
consider wearing an ID band
195
decrease amount of red blood cells or hemoglobin in the body
decrease hemoglobin=decrease O2
anemia
196
what are the common causes of anemia?
-acute blood loss (trauma, sudden blood loss)
-decreased or faulty RBC
-destruction of RBC
197
destruction of red blood cells
hemolysis
198
what labs check for anemia?
h&h (cbc)
iron
199
what are the chronic types of anemia?
Cancer
Immunodeficiency Syndrome
Renal disease
Liver disease
Autoimmune conditions
200
what are the risk factors of acute anemia?
-surgical patient
-active bleeding-trauma
-immunocompromised patient
201
what are the nutritional deficiency?
iron
folate
vit b
202
what is the hereditary anemia?
sickle cell
thalassemia
203
what are the symptoms of anemia?
-fatigue
-dyspnea
-disrythmeias
-chest pain
-cold extremities
204
what can people with anemia crave?
-dirt
-clay
-ice
205
what are the treatments of anemia?
administer blood products
hematopoiteic drug
encourage diet rich in the deficient nutrient
control the source of acute bleeding
206
what is considered anemic
<10
207
what is absorbed better by the body?
animal based products
208
what does the body use to make hemoglobin?
iron
209
how should iron supplements be taken?
on an empty stomach
w/vitamin c or orange juice
210
what should be avoided while on iron supplements?
milk
calcium
211
what foods are rich in iron?
Oysters Canned Tomatoes
White Beans Beef
Dark Chocolate Potatoes
Beef Liver Cashews
Lentils Fortified Breakfast Cereal
Eggs
Spinach
Tofu
Kidney Beans
Sardines
Chickpeas
212
inadequate intake of b12
or lack of absorption
macrocytic anemia
213
deficiency of intrinsic factor
pernicious anemia
214
what is the assessment for b12 deficiency?
severe pallor
fatigue
wt loss
smooth, beefy red tongue
215
absorb iron and folate from the diet in?
proximal small intestine
216
what color are red blood cells?
red
217
what color are platelets?
yellow
218
how much plasma?
55%
219
how much of the buffy coat?
1%
220
how much of the red blood cells?
45%
221
what is in the plasma?
water
salts/minerals
proteins
222
what is in the buffy coat?
wbc
platelets
223
what is in the red blood cells?
red blood cells
224
why is plasma given?
for volume
225
how much does a whole bag of whole blood hold?
+/-500cc
226
what are rbc's most important job in the body?
transporting O2, perfusion
227
what should always be done before administering RBCs?
cross and match
228
what color is plasma?
yellow
229
how is ffp stored?
usually frozen and thawed to give
230
how much does the bag of ffp hold?
150-200cc
231
how much does a bag of platelets hold?
50cc
232
when hypertension causes damage to other organs?
complicated hypertension
233
which part of the heart pushes blood out to the rest of the body?
left ventricle
234
what is the diet that includes veggies, low in dairy, total carbs, and fats?
dash diet
235
places besides a saltshaker that you find Na+
processed canned foods
236
what side effect included orthostatic hypotension, sexual dysfunction, vertigo, tachyardia?
alpha blockers
237
monitor K+ level with what med?
furosemide
238
what diuretic that is primary used for HTN?
hydrocholorthiazide
239
what is it called when you have a decrease in BP systolic 20mmHg or greater or diastolic 10mmHg
orthostatic hypotension
240
primary nursing intervention for orthostatic hypotension?
safety
fall risk
241
true or false vasoconstriction leave to HTN
true
242
what is it called when you have accumulation of lipid, fatty substances in the vessel walls?
athrosclerosis
243
what are age, gender, ethnicity
non modifable
244
the cholesterol that we what high?
HDL
245
what do we call inadequte blood flow or o2 content?
ischemia
246
which angina is predictable chest pain on exertion?
stable
247
how many doses of nitro can be taken?
how many minutes apart?
what kind of container?
how to know if its expired?
3tabs
5min
dark/glass
doesn't burn or sting
248
what med cannot be given within 4 hours of erectile dysfunction med?
nitroglycerin
249
what major side effect for nitroglycerin?
headache
250
this is indicated injury or infarction on EKG?
ST elevation
251
what the specific lab to identify heart injury?
troponin
252
what is the lab to identify heart failure
BNP
253
what diagnostic test is used to look at heart wall, motion, valve function?
echocardiogran
254
what lab is monitored when administering enoxaparin?
platelets
255
acronym of MI
mona
256
why is aspirin given?
flowing of blood
257
what should urine output be?
30ml/hr
258
when heart valve never completly closes and blood continues to flow even when flow should be shut?
regurgitation
259
what is vitamin k antidote?
warfarin/coumidin
260
signs of SOB, wheezing
left sided heart failure
261
classic assessment finding right side heart failure
edema
262
astha patients shouldnt take
beta blockers
263
DC pt goes home what should nurse teach about fluid balance?
same scale
same time everydat
264
leg pain induced by walking and subsides upon rest
intermittent claudication
265
use of this med puts individuals at risk for DVT
oral contraceptives
