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321 Geri > Exam2 > Flashcards

Exam2 Flashcards

(85 cards)

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1
Q

Arterial Disease position to alleviate pain

A

dangling, elevation makes it worse

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2
Q

Venous disease position to alleviate pain

A

elevation, dangling legs/standing makes it worse

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3
Q

arterial disease explanation of pain

A

sharp, worse at night
“rest pain”
intermittent claudication-pain from activity

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4
Q

venous disease explanation of pain

A

heavy, dull throbbing, aching

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5
Q

aterial disease skin of lower extremity

A

cool to touch
thin/dry/scaly
hairless
thick toe nails

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6
Q

venous disease skin of lower extremities

A

thick, touch skin
brownish color

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7
Q

arterial disease strength of pulse

A

very poor/absent

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8
Q

venous disease strength of pulse

A

present/typically normal

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9
Q

arterial disease, is there edema

A

not common

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10
Q

venous disease, is there edema

A

yes-tends to be worse by the end of the day

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11
Q

arterial disease lesions

A

on feet/ankles
little drainage (no blood flow)
pale/light pink
“punched out” appearance

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12
Q

venous disease lesions

A

medial parts of lower leg
swollen w/drainage
deep pink/red
irregular edges
shallow

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13
Q

overview of cardiac changes with aging

A

goes unnoticed
aorta dilation (hyperlipidemia)
stiffening of heart vessels
loss of arterial elasticity
veins thicken & loose elasticity

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14
Q

baroreceptors (tells vessels to constrict) less efficient with age which leads to risk for…

A

orthostatic hypotension

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15
Q

other age-related changes

A

-myocardial hypertrophy
-arteriosclerosis (aging)
-atherosclerosis (plague build up)
-thickening of the left ventricular wall
-myocardial musculature less efficient
-decrease in pacemaker cells

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16
Q

True/False: elevation in BP is a normal sign of aging

A

False

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17
Q

cardiac output formula

A

Stroke volume (vm) x Heart rate (HR)

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18
Q

afterload

A

resistance to ejection of blood from the ventricle

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19
Q

contractility is increased by what drugs

A

digoxin (Lanoxin)
dopamine
dobutamine
catecholamines

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20
Q

contractility is decreased by what drugs

A

beta-adrenergic blocking agents (metoprolol) [Lopressor]

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21
Q

preload

A

degree of stretch of the ventricular cardiac muscle fibers at the end of diastole

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22
Q

ejection fraction

A

% of the end-diastolic blood volume that is ejected with each heartbeat.
-normal left ventricle is 55-65%. lower than 40 requires treatment of HF

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23
Q

1 cause of disability in US

A

hypertension

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24
Q

hypertension

A

-arterial walls hypertrophy
-narrow vessels
-unable to support vasodilation
-increase rate of atherosclerosis
-left ventricular hypertrophy (increase risk for CAD)
-damage vessels to all other organs
risk for MI or CVA

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25
what system usually regulates hypertension
renal system
26
blood pressure is determined by
blood volume, cardiac output, peripheral resistance
27
papilledema
swelling of the optic nerve
28
#1 sign of hypertensive heart disease
angina/dyspnea (SOB)
29
goal of hypertension treatment
maintain acceptable BP
30
ACE inhibitors s/e
cough
31
CAD (coronary artery disease)
blood is unable to flow through the coronary arteries
32
CAD can result in
ischemia or infarction
33
CAD diagnostics
-cardiac stress -c-reactive protein -invasive perfusion techniques
34
CAD management
antiplatelet agents control chronic diseases
35
CABG
Coronary Artery Bypass graft surgery -most common cardiac surgery -CA are bypassed by the PTs venous or arterial blood vessels
36
agina
caused by imbalance between O2 supply and demand
37
women's unusual angina symptoms
nausea fatigue dizziness
38
Define Heart Failure
decreased contractility of the heart=inability of the heart to pump sufficient blood
39
cardiac output is
amount of blood pumped out of the left ventricle each minute. should be 4-8L/min at rest
40
stroke volume
amount of blood pumped per contraction (65-70mL)
41
left sided heart failure
-impaired blood to aorta -causes congestion of blood in pulmonary vessels -back up in lungs
42
right sided heart failure
-cannot empty completely -major cause is Left-sided HF -peripheral edema -systemic
43
LS-HF signs
-pulmonary congestion -nocturnal dyspnea -restlessness -confusion -tachycardia -fatigue -cyanosis -cool extremities -S3/S4 heart sounds
44
RS-HF signs
-fatigue -ascites -enlarged liver & spleen -distended jugular veins -anorexia/GI distress -weight gain -dependent edema
45
how does human B-type naturetic peptide (BNP) work
excreting NA+ and H2O through vasodilation BNP 100-300 PG/mL suggestive of HF
46
management of HF
-reduce heart's workload & improve cardiac output -conserve energy -prevent fatigue -dietary mod
47
HF drug therapy
digoxin (inotropic) toxicity= fatigue, weakness, confusion, anorexia, halos diuretic therapy loop& thiazide vasodilators ACE inhibitors
48
HF education
lifestyle changes control symptoms monitor for signs daily weights- 2lbs/day 5lbs/week
49
signs of MI (heart attack)
-pain radiating down left arm -mental status change -agitation -falls
50
MI nursing management
-bed rest/limit activity -assess for chest pain -permanent smoking cessation
51
what is meant by afib
several areas in the right atrium initiate impulse resulting in a disorganized, rapid activity of the atria blood pools and can form clots
52
implanted pacemaker facts
used for 2nd/3rd degree heart block battery life= 5-10 yrs battery power monitored frequently. hiccupping is a sign of failure
53
GI changes with aging
-tongue atrophies (decreased taste) -xerostomia (dry mouth) -saliva production decreases -swallowing becomes more difficult
54
more GI changes
-weakening of esophageal sphincter -diminished gastric motility (increases risk for indigestion & aspiration) -decreased elasticity of stomach -diminished capacity of gastric mucosa to resist damage
55
last of GI changes
-decreased in intestinal absorption, motility, blood flow -pancreas decreases in size -liver size/blood flow decreases -decreased thirst and hunger drive -decreased mucosal immune function
56
most common esophageal disorder in older people
dysphagia- could be indicative of another problem.
57
oropharyngeal dysphagia
difficulty moving from the mouth into the pharynx (more common with neuro disorders)
58
esophageal dysphagia
difficulty moving food down the esophagus
59
Gastroesophageal reflux disease (GERD)
gastric contents flow upward into the esophagus
60
GERD symptoms
-pyrosis (burning sensation in esophagus) -dyspepsia (indigestion) -belching -sour mouth -hypersalivation
61
GERD diagnostics
Barium swallow upper endoscopy esophageal manometry esophageal pH monitoring
62
GERD treatments
antacids H2 antagonists (decrease production of acid) PPI (decrease release, can increase risk for bone issues)
63
Gastritis
men/women equal effected inflammation or stomach lining erosive vs non
64
non erosive gastritis
H. pylori
65
Peptic Ulcer Disease s/s
dull/gnawing/burning pain in back heartburn nausea vomiting constipation diarrhea bleeding
66
gastric vs duodenal PUD
Gastric -pain after eating dudenal -pain 2-3 hrs after eating, increases at night
67
diverticular diease
saclike mucosal projections- trap feces-> infection/inflammation. greater risk in men Risk Factors: obesity chronic constipation hernia atrophy or intestinal wall
68
diverticular disease s/s
pain (LLQ) nausea/vomiting constipation diarrhea low grade fever blood/mucous in stool
69
foods to avoid with diverticulitis
corn, popcorn, nuts, strawberries, foods containing seeds
70
what is a small bowel obstruction
blockage that prevents the contents of the intestines from passing normally through the digestive tract common causes: adhesions, hernia, tumors
71
Nursing mgmt for bowel obstruction
NG tube- decompress the stomach, allow the bowel to rest lower intermittent sucking checking placement admin meds
72
chronic constipation defined as
two or fewer stools per week
73
nutrition in aging
-decrease in needed calories -decrease in body fluids 2/7L/day men 3.7L/day women
74
BMI measurement
<22 undernutrition (higher mortality) >25 overweight (risk for morbidity)
75
osteoblasts
bone forming
76
osteocytes
maintaining bone
77
osteoclasts
bone cells that reabsorb bone during repair and growth
78
changes of aging musculoskeletal Type 1
menopausal bone loss. 5-10 yrs after menopause
79
changes of aging musculoskeletal Type 2
senescent bone loss-affects both sexes
80
musculoskeletal changes
-bones become stiff, weak, brittle and porous -lose 1-2cm every 2 decades in ht -erosion of hyaline cartilage -vitamin D
81
which extremities atrophy earlier
lower
82
sarcopenia is
a loss of muscle tissue as a natural part of the aging process
83
leading cause of accidental death
falls. 1:3 people >65 sustain serious fall
84
exercise benefits: weight bearing, balance, swimming
wt bearing- bones balance- falls swimming- joints
85
osteoarthritis vs rheumatoid arthritis to do with inflammation
OA isn't inflammatory RA is inflammatory disease

321 Geri (2 decks)

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