PERFUSION (EXAM 2)

Question 1

what are the contributing factors in perfusion

Answer 1

Heart
veins
arteries

Question 2

what is the normal range for MAP

Answer 2

60 mmHg or greater

Question 3

what is the main consequence of hypertension

Answer 3

there will be alot of perfusion issues

Question 4

what are negative outcomes of bad perfusion

Answer 4

necrosis
loss of tactile function
fainting
confusion
DVT
decrease in organ function
ischemic pain

Question 5

Normal BP

Answer 5

systolic <120
diastolic <80

Question 6

Elevated BP

Answer 6

systolic 120-129
diastolic <80

Question 7

Stage 1 high BP

Answer 7

systolic= 130-139
diastolic=80-89

Question 8

stage 2 high BP

Answer 8

systolic= 140 or higher
diastolic= 90 or higher

Question 9

Hypertensive crisis

Answer 9

systolic=higher than 190
diastolic=higher than 120

Question 10

what is hypotension the most important risk factor for?

Answer 10

stroke
HF

Question 11

Essential hypertension

Answer 11

the specific cause is unknown

Question 11

Additive factors to contribute to essential hypertension

Answer 11

Genetics
behavioral
environmental factors
obesity
hyperlipidemia
African American

Question 12

Secondary hypertension

Answer 12

it is the result of another disease
related to other issues

Question 13

Example of secondary hypertension

Answer 13

renal artery disease
endocrine
cns disorders
sleep apnea

Question 14

what happens when the cause of the hypertension is eliminated

Answer 14

hypertension goes away
BP return to normal

Question 15

what can happen when hypertension is left untreated

Answer 15

cause end stage organ damage

Question 16

GOAL of hypertension

Answer 16

reduce cardiovascular and renal morbidity and mortality

Question 17

goal of hypertension

Answer 17

reduce cardiovascular and renal morbidity and mortality

Question 18

Autoregulation

Answer 18

-the body tissues regulate their own blood flow to preserve 02
-think automatic

Question 19

Parasympathetic N.S

Answer 19

little to no effect on vessels
dilates to blood vessels

Question 20

Sympathetic N.S

Answer 20

Contraction of blood vessels to maintain BP
Maintain renin-angiotensin-aldosterone system (RAAS) in the kidneys

Question 21

what factors affect blood flow

Answer 21

atherosclerosis
thrombus
embolus

Question 22

what is the first action with a patient who has hypertension

Answer 22

non pharmological interventions

Question 23

what is the BP goal

Answer 23

systolic less than 120
diastolic less than 80

Question 24

name some lifestyle modifications

Answer 24

weight Na intake regular physical activity moderate alcohol no smoking

Question 25

lifestyle management

Answer 25

exercise 30 minutes/day at least 4 times a week

Question 26

what lab test should you take

Answer 26

liver BUN creatinine

Question 27

Name some manifestations of hypertension

Answer 27

headache blurry vision nausea vomiting

Question 28

symptoms reflect target organ damage

Answer 28

angina MI HF stroke renal disease

Question 29

categories of medications with hypertension do what

Answer 29

decrease BP decrease peripheral vascular resistance

Question 30

what is peripheral vascular resistance

Answer 30

resistance that the blood encounters as it circulates through the body

Question 31

where do these drugs work

Answer 31

Heart veins

Question 32

what do alpha blockers do

Answer 32

they block vasoconstriction they open the veins and decrease vasoconstriction vasodilation of veins

Question 33

what is clonidine and what does it do

Answer 33

it is an alpha blocker lowers BP

Question 34

how does clonidine decrease BP

Answer 34

relaxing the arteries (vasodilation) and increasing the blood supply to the heart

Question 35

what kind of alpha blocker is clonidine

Answer 35

alpha 2 agonist

Question 36

what do clonidine do

Answer 36

-decrease sympathetic response -stimulate the alpha 2 receptor -reduce peripheral vascular resistance and increase vasodilation

Question 37

what the main action of clonidine

Answer 37

reduce the peripheral vascular resistance which increases vasodilation

Question 38

what happens when peripheral vascular resistance is decreased

Answer 38

there is vasodilation

Question 39

what are some side effects of alpha 2 agonist

Answer 39

Remember it vasodilates -drowsiness -drymouth dizziness -bradycardia

Question 40

why does alpha 2 agonist cause drowsiness

Answer 40

when the blood pressure decrease from vasodilation the brain will not get enough blood causing that drowsiness

Question 41

alpha 2 agonist interventions

Answer 41

-monitor serum liver enzyme -do not stop abruptly -take as prescribed -may cause sodium and water retention

Question 42

why must alpha 1 agonist do not stop abruptly

Answer 42

they might cause hypertensive crisis

Question 43

what should be ordered with alpha 2 agonist

Answer 43

-A diuretic -there is a chance of sodium and water retention which causes that peripheral edema

Question 44

who should avoid clonidine

Answer 44

those who are pregnant

Question 45

how do you administer clonidine

Answer 45

oral transdermal patch

Question 46

how do you take a patient off clonidine

Answer 46

gradually worst case scenario hold the medication and do assessment

Question 47

What must be administered with clonidine

Answer 47

a diuretic clonidine is known to cause a lot of peripheral edema from the sodium and water retention

Question 48

side effects/adverse effects of clonidine

Answer 48

Rebound hypertension if stopped abruptly drowsiness dizziness fatigue orthostatic hypertension

Question 49

administration for clonidine with patients with hypertension

Answer 49

oral transdermal patch

Question 50

when should clonidine be given and why

Answer 50

at bedtime because they cause drowsiness

Question 51

how often should the patch be changed

Answer 51

every 7 days

Question 52

before administering new patch what should you do

Answer 52

remove the old patch don't place the new one at the same spot

Question 53

what is the most important pt teaching with clonidine

Answer 53

taper off DO NOT STOP ABRUPTLY REBOUND HYPERTENSION!!!!

Question 54

What is the function of an ACE

Answer 54

it is a vasoconstrictor

Question 55

what does an ace inhibitor do?

Answer 55

decreases vasoconstriction

Question 56

Captopril is an example of a what

Answer 56

ace inhibitor

Question 57

MOA of captopril

Answer 57

decrease effects of renin angiotensin crease vasoconstriction

Question 58

captopril is medication of choice for who

Answer 58

patients with HTN and HF

Question 59

what else does captopril do

Answer 59

decrease retention of sodium and water

Question 60

Captopril is a first line drug for who why?

Answer 60

patients with diabetes slow the progression of renal impairment

Question 61

primary effect of ACE inhibitor

Answer 61

cardiovascular effects decrease morbidity and mortality in those with HF

Question 62

SE/AE of ACE inhibitors

Answer 62

dry non productive cough angioedema hypokalemia

Question 63

what is the most common effect of ACE inhibitors

Answer 63

hyperkalemia

Question 64

Interventions with ACE inhibitors

Answer 64

GO LOW AND SLOW!!!!! do not give with potassium sparing diuretics or salt subsitutes that contain potassium monitor dry cough, angiedema,BP,potassium

Question 65

most important thing to note with ACE inhibitors

Answer 65

START LOW AND GO SLOW!!!!!

Question 66

what should you not give ACE inhibitor with

Answer 66

-potassium sparing diuretics=spironolactone -salt substitutes that contain potassium TOO MUCH POTASSIUM

Question 67

what should you do before administering ACE inhibitors

Answer 67

take BP

Question 68

what are some S/S of hyperkalemia that you should educate your patient to look out for

Answer 68

muscle twitching palpitations weakness paresthesia

Question 69

what else should you teach your patient

Answer 69

-report dry hacking cough -assess bp, hr, respiratory status -report swelling around the face, mouth and throat -refrain from taking potassium supplements

Question 70

how do you know if a patient has angioedema

Answer 70

swelling in face mouth throat

Question 71

can you give ACE inhibitors to a preg lady

Answer 71

NOOOO!!!!

Question 72

what does ARBs stand for

Answer 72

angiotensin 2 receptor blockers

Question 73

why is it better to give ARBs than ACE inhibitors

Answer 73

ARBs is less likely to cause hyperkalemia and dry cough

Question 74

most ACE inhibitors end with?

Answer 74

PRIL

Question 75

most ARBs end with

Answer 75

SARTAN

Question 76

MOA of valsartan

Answer 76

they block the effects of angiotensin 2

Question 77

SE/AE of ARBs

Answer 77

erectile dysfunction orthostatic hypotension NEUTROPENIA

Question 78

what is neutropenia what should you do to monitor

Answer 78

low WBC count CBC

Question 79

Interventions teaching with ARBs

Answer 79

treat angioedema monitor and report CNS effects Monitor BP and apical pulse hypotension fluid volume

Question 80

nursing intervention with potassium high or low

Answer 80

monitor cardiac EKG

Question 81

ARBs administration

Answer 81

oral with or without food

Question 82

what should you do if ARBs is being taken with a diuretic or pt have liver failure

Answer 82

reduce the dose

Question 83

what can ARBs be used with

Answer 83

diuretics if treating HTN or HF