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Medical Nursing > Q2 > Flashcards

Q2 Flashcards

(104 cards)

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1
Q

Anemia

A

Low supply of RBCs
Result: transportation of o2 & co2 to organs & tissue will be insufficient
Function of organs will decrease

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2
Q

Where is S1 fit in based on an EKG?

A

Top of QRS

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3
Q

Where does S2 fit in based on EKG?

A

T wave

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4
Q

Age-Related Considerations - Aging on CVS

A

Chest wall - kyphosis
Heart
Blood vessels - arterial stiffening

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5
Q

Cardiac biomarkers

A

Troponin
CK-MB
Myoglobin

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6
Q

Troponin

A

Detected 4-6 hrs after MI and lasts for 14 hours

S: chest pain

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7
Q

CK-MB

A

MB - Specific to the heart

Elevated during injury within myocardium

Starts to Rise 3-6 hours and peaks at 12-24 hours and returns to baseline between 12-48 hours - must be caught

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8
Q

Myoglobin

A

Protein; comes from skeletal muscle

Note: Just checking on myoglobin will not indicate that there is a heart problem

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9
Q

C-reactive protein

A

Used for inflammation in general

If pt has history of MI or chest pain, they will have this protein elevated

If CRP increases = risk of cardiac problems

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10
Q

Homocysteine

A

Released with protein breakdown - if this is present, it indicates cardiovascular disease, peripheral vascular

Should be monitored; family history, MI, chest pain

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11
Q

Cardiac Natriuretic Peptide Markers

A

Released from atrium and ventricles - distinguish if SOB is respiratory or cardiac

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12
Q

Silent Killer

A

Hypertension = Risk of MI = Risk of Heart Failure = Risk of Stroke = Renal Disease

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13
Q

Why is it called a silent killer?

A

Creeps up on you, and symptoms are not apparent and you can catch it too late

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14
Q

Cardiac output

A

Total blood flow through circulatory system per minute

Affects: Renal fluids volume control, renin angiotensin II

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15
Q

Primary Hypertension

A

Majority of adults related to increased sodium intake, increased BMI, diabetes, alcohol consumption, increased SNS activity

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16
Q

Secondary Hypertension

A

Unprovoked
Hypokalemia
Family history of renal disease

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17
Q

Isolated systolic hypertension

A

Older Adults’

Related to loss of elasticity in large arteries

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18
Q

Urinalysis

A

Testing urine

If “it” affects our kidney, we will see protein in our urine

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19
Q

Age-Related Consideration: Hypertension

A

Loss of tissue elasticity
Increased collagen content and stiffness of myocardium
Increased peripheral vascular resistance
Decreased kidney function
Blunting of baroreceptor reflexes

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20
Q

Medications for Hypertension

A

Diuretic
Adrenergic inhibitors
Angiotensin inhibitors

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21
Q

What should you eat to increase potassium?

A

Bananas

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22
Q

Side Effects with Diuretics

A

Increased voiding

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23
Q

Nursing Intervention: Knowing that hypertension is modifiable, what can you do as a nurse to educate patient?

A

Lifestyle changes;
Proper diet
Exercise

Medications
Such as; thiazide diuretic
ACE-I
ARB
Long-acting CCB
Beta-blocker
Single pill combination

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24
Q

What is preferred over shorter acting diuretics?

A

Long-acting (indapamide and chlorthalidone

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25
Vascular Disorders
Includes disorders of the arteries, veins and lymphatic vessels
26
Peripheral Arterial Disease
Progressive narrowing & degeneration of arteries of neck, abdomen & extremities
27
Why are sections of arteries narrowed?
Thickening of vessel wall
28
Atherosclerosis
Narrowing, hardening & "pieces" that break off (thrombus become embolus)
29
Common locations of atherosclerotic lesions
Abdominal aorta and lower extremities
30
PAD of lower extremities
Aortoiliac, femoral, popliteal, tibial, & peroneal arteries
31
Hyperemia
When foot becomes "redder"
32
PAD complications
Atrophy of muscles Increased damage from minor trauma *Slowed wound healing (important complication) Increases risk of infection - because of poor circulation Nonhealing arterial ulcers Gangrene (blood flow to large area is cut off - need to improve circulation) Amputation
33
Treatment of PAD - To help
Get a proper diagnosis Pressure checks; thigh, below knee, and foot
34
Nursing Intervention; PAD
Help decrease the risk; education regarding tobacco Anti-platelets side effects; aspirin
35
What are the 6 P's?
Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermic (inability to maintain core temperature)
36
Virchow's Triad
Venous stasis Damage to endothelium Hypercoagulability of blood LEAD TO - thrombus formation
37
Venous stasis
Dysfunctional vein valves Change in unidirectional blood flow
38
Endothelial
Release of clotting factors Activation of platelets
39
Blood hypercoagulability
Imbalance in clotting mechanisms
40
What does CWCM mean?
Colour Warmth Circulation Movement
41
What can be used to treat DVT or PE?
Anticoagulants - help reduce clots from developing
42
Types of Shock
Cardiogenic Hypovolemic Neurogenic Anaphylactic Septic
43
Low Volume Shock
Cariogenic Hypovolemic
44
Distributive
Neurogenic Anaphylactic Septic
45
What are the three components of defining shock?
Cellular oxygen supply Decrease tissue perfusion Impaired cellular metabolism
46
Neurogenic Shock
Clinical Manifestations - hypotension - bradycardia - temperature - dry skin
47
Septic Shock
Systemic inflammatory response to documented or suspected infection
48
Clinical Manifestations of Septic Shock
Increased coagulation and inflammation No single symptom or group of symptoms is specific to diagnosis Hyperdynamic state ; increased CO and creased SVR
49
What is the cornerstone of therapy for septic, hypovolemic, and anaphylactic shock?
Volume Expansion - Crystalloids - PRBC
50
What is vital to decreasing morbidity from shock?
Nutrition - monitor weight, protein, nitrogen balance, BUN, glucose and electrolytes
51
What is hematology
Study of blood and blood-forming tissues
52
Why is it important to have an understanding of hematology?
Useful to evaluate a patient's ability to transport oxygen and carbon dioxide - combat infections
53
Where does blood cell production occur?
Bone marrow
54
What is the THREE major function of blood?
Protection Regulation Transportation
55
Major Components of blood
Plasma and blood cells
56
The term serum refers to what?
Plasma without its clotting factors
57
Composition of Blood
Plasma 55% Blood Cells 45%
58
Erythrocytes (RBC)
Transport of gases and assistance in maintaining acid-base balance
59
Leukocytes (WBC)
Primary purpose is to treat infections; low WBC - more susceptible to infections
60
Primary function of granulocytes
Phagocytosis
61
What is phagocytosis? (think of: criminals)
WBCs engulf unwanted organisms, digest, and kill it
62
Where does absorption take place?
Duodenum and upper jejunum
63
What is hemostasis? Why is it important?
Stopping of blood flow. Important because it minimizes blood loss when structures are injured
64
What is thrombocytopenia? Why is this a big deal?
Low platelets - A big deal because it can cause bleeding in the brain (fatal) Prolonged bleeding from minor trauma to spontaneous bleeding without injury3 .
65
What do platelets do?
Stop bleeding
66
T/F number of platelets is unaffected by the aging process
True
67
What is Neutropenia? How does it occur?
Occurs when bone marrow does not produce enough neutrophils This leads to an increase of infection and death from sepsis
68
An anticoagulant such as warfarin that interferes with prothrombin production will alter the clotting mechanism during what process?
Activation of thrombin
69
What is anemia?
Deficiency in erythrocytes (not enough RBCs)
70
What is leukemia
Malignant diseases affecting the blood and blood forming tissues of bone marrow
71
What are the two major types of Lymphomas
Hodgkin's and Non-Hodgkin's
72
What is Hodgkin's Lymphoma?
Abnormal, giant, multinucleated cells Cause is unknown Affects lungs, spleen, liver Onset of symptoms is gradual; enlargement of cervical, axillary or inguinal lymph nodes Patient may notice: weight loss, fatigue, weakness, fever, tachycardia
73
74
What is multiple myeloma?
A cancer of the blood
75
Where do lymphomas originate from?
Bone marrow and lymphatic structures
76
How does iron deficiency develop?
Dietary intake, malabsorption, blood loss or hemolysis
77
What is the major cause of iron deficiency in adults?
Blood loss
78
What is the most common nutritional disorder in the world?
Iron-deficiency anemia (caused by decreased RBC production)
79
Electrocardiography
Used to assess cardiac function; P, QRS, T Anything abnormal can indicate problems with heart functions
80
What blood serum component will be included in a lipid profile?
Cholesterol Triglycerides Lipoproteins (HDL, LDL)
81
What is atherosclerosis sometimes referred to?
Hardening of arteries
82
What is a major cause of CAD?
Atherosclerosis
83
What is a fatty streak an indication of? What can we do to treat it?
Atherosclerosis LAB work - can show how it can be treated / make it go away
84
Nonmodifiable Risk of CAD
Age, gender, ethnicity, family history
85
Cholesterol-lowering drug therapy - Management of CAD
Restrict lipoprotein production Increase lipoprotein removal Decrease cholesterol absorption
86
Antiplatelet therapy
ASA Clopidogrel
87
Increased demand for oxygen is?
Myocardial ischemia
88
Chronic Stable Angina Indicators
Chest, occurs intermittently over a long period with same pattern of onset Rarely sharp or stabbing Pain usually lasts 3-5 minutes
89
Silent Ischemia
No subjective symptoms Places client at higher risk for adverse outcomes and death
90
Nocturnal angina
Occurs only at NIGHT but not during sleep
91
Prinzmental angina
Occurs at rest Seen in clients w/ migraine, headaches, Raynaud's phenomenon
92
Microvascular angina
Common in women Occur in absence of significant coronary atherosclerosis
93
Angina - Treatment
Nitrates B-adrenergic Blockers Calcium Channel Blockers
94
What can develop if ischemia does not get treated?
acute coronary syndrome
95
Most common complication of Myocardial Infarction?
Dysrhythmias
96
Automaticity
Ability to initiate an impulse and continue
97
Contractility
Heart responds to impulse by contracting
98
Conductivity
Transmission of that impulse
99
Excitability
Electrically stimulated
100
What's the most commonly used diagnostic tool?
Electrocardiogram
101
Cardiac Arrhythmias
Flutter Contracting rapidly in flutter waves RATE IS 250-350 beats/min
102
What's a common dyrhythmia?
Atrial Fibrillation Must do APICAL pulse
103
Junctional Dysrhythmias
When SA failed to fire, or impulse has been blocked - so heart beat starts at AV node instead of the usual, SA node
104
Ventricular Tachycardia
Life-threatening b/c of decreased CO Very rapid heart rate

Medical Nursing (3 decks)

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