perfusion Flashcards
1
Q
condition or process that affects the arteries and veins in the body
A
vascular disease
2
Q
hardening of the arteries. not flexible anymore. buildup of muscle fibers that can cause some narrowing
A
arteriosclerosis
3
Q
Buildup of plaque of fatty deposits, cholesterols, blood clots, lipids. Anything that can narrow the opening of the artery.
A
atherosclerosis
4
Q
most common arteries affected in atherosclerosis
A
abdominal aorta
coronary
popliteal
carotid
5
Q
diet for atherosclerosis
A
healthy heart diet: low fat, low cholesterol
6
Q
three med classes for atherosclerosis
A
lipid lowering agents like statins
antihypertensive
antidiabetics
7
Q
inhibit an enzyme thats involved in lipid synthesis and thats how they decrease cholesterol.
A
HMG-CoA reductase inhibitors (statins)
8
Q
statin examples
A
atorvastatin, simvastatin
9
Q
nursing implications for statins
A
no grapefruit juice
10
Q
work by oxidizing cholesterol. They change it into bile acids where its able to be removed from the body so it decreases fat absorption and coverts cholesterol to bile and lowers LDL
A
Bile acid sequestrants
11
Q
example of bile acid sequestrants
A
choestyramine
12
Q
work to lower triglicerides
A
Fibric acid inhibitors
13
Q
example of fibric acid inhibitors
A
fenofibrate
14
Q
inhibit absorption of cholesterol in the small intestine. So they lower LDL
A
cholesterol absorption inhibitors
15
Q
example of cholesterol absorption inhibitors
A
ezetimibe
16
Q
myalgia and arthralgia are common adverse effects
A
statins
17
Q
metoprolol, propranolol, labetalol
A
beta blockers
18
Q
lisinopril, enalapril
A
ACE inhibitors
19
Q
losartan, valsartan
A
ARB’s
20
Q
Amlodipine
A
calcium channel blockers
21
Q
disease where narrowed arteries reduce the blood flow to the extremities. Can occur in upper or lower extremities but more common in lower.
A
peripheral artery disease (PAD)
22
Q
hallmark symptom of peripheral artery disease
A
intermittent claudication
23
Q
if we have narrowed arteries like pad what education is important?
A
don’t elevate legs, no compression stockings, don’t cross legs
24
Q
Meds for PAD
A
phosphodiesterase inhibitors like cilostazol (pletal) which is a vasodilator and antiplatelet
aspirin(antiplatelet)
clopidogrel (plavix)
statins (lipid lowering)
25
treatment specific to PAD. It’s a vasodilator and antiplatelet. Helps open the arteries and helps prevent further occlusion. Most common med for PAD.
cilostazol
26
atherectomy
shave away the plaque buildup
27
endarterectomy
make incision in artery and remove plaque
28
localized sac or dilation formed at a weak point in the wall of the artery. once it forms it usually enlarges over time
aneurysms
29
some causes of aneurysms
Atherosclerosis
HTN
Congenital weakness
trauma
disease
30
two common forms of aneurysms
saccular which projects from just one side of the artery
fusiform which is an outpouching of the entire artery
31
what should closely be monitored when u have an aneurysm
blood pressure
32
thoracic aortic aneurism hallmark sign
pain which usually happen when their supine because of the way the pressure is.
33
manifestations of abdominal aortic aneurysm
severe back or abdominal pain
pulsatile mass or abdominal throbbing
bruit
34
pharmacological management for aneurysms
antihypertensives
lipid lowering agents because atherosclerosis can be a cause
35
tera that occurs in a weakened layer of the aorta causing the inner and middle layers to separate
aortic dissection
36
what are some causes of aortic dissection
HTN, Blunt chest trauma, cocaine use
37
meds for dissection
beta blockers because high bp is one of the main causes of it
38
-condition in which some areas of the body get very cold and lose color under certain circumstances
raynauds
39
whats a thrombus
blood clot
40
when a piece of a thrombus breaks off and travels its called an
embolus
41
where the blood clot forms
deep vein thrombosis
42
piece of a blood clot typically breaks off from a dvt and travels to lungs
pulmonary embolism
43
-Virchow triad. These r the three things that put u at the most risk for developing a blood clot.
Endothelial damage so damage to the vessels. Venous stasis which is blood that’s pooling. Any disease or disorder that can cause altered coagulation
44
diagnosis for DVT
-D-dimer is a blood test. Protein that’s produced by blood clots. Almost all who have DVT have an elevated D dimer. A normal D dimer can rule out a pulmonary embolism. Not used alone to diagnose. Its like a first step, then followed up with ultrasound
45
med management for dvt
treated with anticoagulants or blood thinner
-anticoagulants do not thin blood, they inhibit a step in the coagulation process and slow down the clot. Prevent/slow down clot formation. Doesn't dissolve blood clots. Can prevent an existing clot from getting any bigger and prevents from getting anymore.
46
three main goals for treatment of dvt
-prevent the clot from getting bigger, prevent it from breaking loose and traveling somewhere else, and reduce chances of another DVT
47
vitamin k anatgonist
oldest anticoagulants
warfarin/coumadin po
48
indirect thrombin inhibitors
-blocks the formation of thrombin
-heparin IV or subQ
-monitor APTT or anti-Xa for IV heparin
-for sub Q heparin we only look at platelets for heparin induced thrombocytopenia
-half life of heparin is very short so it’s the med of choice so if they stop heparin, they can perform surgery quicker.
-heparin can be used as bridge therapy like if their waiting for an INR level to go up or if someone needs surgery.
-enoxaparin sub q, labs not required
-reversal agent for both is protamine
49
direct thrombin inhibitors
attach directly to thrombin and inhibits it
-dabigtran (pradexa) PO, reversal agent praxbind
-argatroban given when allergy to heparin
-bivalruding IV
50
Factor Xa inhibitor
directly inhibits factor Xa
-rivaroxaban (xarelto), apixaban (eliquis), fondaparinux (arixtra)
-labs not required
-reversal is andexxa
51
some reasons we dont give anticoagulants
allergy, bleeding disorder, GI bleed
52
IVC filter is for
when we cant give anticoagulants
-Inserted into inferior vena ceva, deploy the filter, and it tacks onto the inside of the vessel and it would catch any blood clots.
-Prevents dvts from going to lungs
53
thrombectomy
go in and remove the thrombus
54
main symtpom and some symptoms of PE
-main: sudden chest pain and sob
-other: red pink frothy sputum; impending feeling of doom, tachycardia, fever, cough, diaphoresis, hemoptysis, syncope
55
main diagnosis for PE
CT
56
medical management for PE
anticoagulation
thrombolytics
embolectomy
57
thrombolytic therapy
dissolves blood clots, anticoagulants cant
-Tissue plasminogen activator for severe DVT or PE.
-streptokinase, urokinase, prourokinase
-alteplase, reteplase, tenecteplase, anistreplase
58
occurs when your leg veins don’t allow or don’t assist blood and facilitate blood flow back up to your heart. When these valves don’t work well, blood can flow backwards and pool.
chronic venous insufficiency
59
chronic venous insufficiency manifestations
dark leathery cracked appearance. The mots concerning complication would be these ulcerations that a lot of times don’t heal well.
-edema, dry, itchy, cracked skin, altered pigmentation, stasis dermatitis, ulcerations
60
medical management for chronic venous insufficiency
-elevation
-compression therapy
61
pain at rest, ulcers themselves are usually small, circular, deep, and more commonly found on tips of toes and between toes
-pain not relieved by opioids
arterial ulcer
62
wounds are large, superficial, and very exudative
-achin or heavy pain
-foot and ankle may have edema
venous ulcers
63
diagnostics for ulcers
-doppler to locate pulses that aren’t palpable
-ultrasound venous or arterial and looking for blockages
-angiography is one of the most definitive because u inject the dye and itll show exactly where the blockages are
64
medical management of ulcers
-antiseptic agents
-antibiotics
-compression therapy
-topical
-wound dressing
65
the leading cause of death for men and women
cardiovascular disease
66
it is a cluster of metabolic abnormalities that are major risk factors for cardiovascular disease.
metabolic syndrome
67
3/5 for metabolic syndrome
-enlarged waist circumference
-elevated triglycerides: greater than or equal to 175 or currently being treated for high triglycerides
-reduced HDL or currently on treatment
-HTN: systolic greater than or equal to 130, or diastolic greater than or equal to 80, or currently being treated for HTN
-elevated fasting glucose: greater than or equal to 100 on 2 separate occasions or currently on treatment for it
68
to diagnose coronary vascular disease
-ECG is a graphic representation of the electrical current of the heart. It assists in ruling out or ruling in an MI
-stress testing: patient walks on treadmill and then they watxh the ekg strips to see if they have any altered perfusion during it
-pharmacological stress testing: if they cant walk on treadmill, they can use medications instead
-nuclear stress testing: radioactive substance that they inject before and after exercise and itll kind of light up where there’s an area of altered perfusion
-echo: looking at structure and function of heart. Measure ejection fraction, size and shape
-cardiac catheterization is the most definitive way to determine it. Can also tell u the extent of it.
69
70
normal LDL
less than 100
71
triglycerides normal
less than 150
72
protein released from necrotic myocardial cells into circulation- an accurate indicator of myocardial injury
troponin
73
specific to myocardial cells
CK-MB
74
caused by the buildup of plaques, lipids, clots in the coronary arteries
-most prevalent type of cardiovascular disease
CAD
75
manfiestations of CAD
angina
76
chest pain caused by insufficient coronary blood flow
angina
77
stable angina
would be u exercise, u have chest pain, u rest and it goes away
78
meds for angina
nitrates (vasodilator)
antiplatelts, anticoagulants
oxygen
beta adrenergic blocking agents
calcium channel blocking agents
79
antiplatelet
-adenosine diphosphate receptor inhibitors
-make platelets less ticky
-clopidogrel, ticagrelor, ticlopidine, prasugrel
-adenosine reuptake inhibiors
-block enzymes involved in clotting
-dipyridamole
-Glycoprotein platelt inhibitors
-block substances that help clots stick together
-abciximab, eptifibatide, tirofiban
80
