Week 9: Cardiovascular System Flashcards
1
Q
What causes the atrioventricular (AV) valves to close?
A
Increased intraventricular pressure
2
Q
Describe the pericardial cavity- It is a potential space containing a very small amount of:
A
serous fluid.
3
Q
The function of the baroreceptors is to:
A
signal the cardiovascular control center of changes in systemic blood pressure.
4
Q
What is a result of increased secretion of epinephrine?
A
Increased heart rate and force of contraction
5
Q
The cardiac reserve is:
A
the ability of the heart to increase cardiac output when needed.
6
Q
Vasodilation in the skin and viscera results directly from:
A
relaxation of smooth muscle in the arterioles.
7
Q
A drug taken in small doses on a continuing basis to reduce platelet adhesion is:
A
acetylsalicylic acid (ASA).
8
Q
Cigarette smoking is a risk factor in coronary artery disease because smoking:
A
promotes platelet adhesion.
9
Q
A modifiable factor that increases the risk for atherosclerosis is:
A
leading a sedentary lifestyle.
10
Q
Typical early signs or symptoms of myocardial infarction include:
A
persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse.
11
Q
Calcium-channel blocking drugs are effective in:
A
reducing cardiac and smooth muscle contractions.
12
Q
The most common cause of death immediately following a myocardial infarction is:
A
cardiac arrhythmias and fibrillation.
13
Q
What is most likely to cause left-sided congestive heart failure?
Uncontrolled essential _______________
A
Uncontrolled essential hypertension
14
Q
Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include:
increased __________ & ______________ secretions.
A
increased renin and aldosterone secretions.
15
Q
Which drug improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions?
A
Digoxin
16
Q
An incompetent mitral valve would cause:
_____________ output from the ______ ventricle.
A
decreased output from the left ventricle.
17
Q
Rheumatic heart disease usually manifests in later years as:
A
cardiac arrhythmias and heart murmurs.
18
Q
Pericarditis causes a reduction in cardiac output as a result of:
Excess fluid in the ______________________, which decreases ventricular ___________
A
Excess fluid in the pericardial cavity, which decreases ventricular filling
19
Q
Shock follows a myocardial infarction when:
A
a large portion of the myocardium is damaged.
20
Q
With shock, anaerobic cell metabolism and decreased renal blood flow cause:
A
metabolic acidosis.
21
Q
Which of the following is NOT true of the drug nitroglycerin?
It decreases myocardial workload by causing systemic vasodilation.
It may be administered sublingually, transdermally, or by oral spray.
Dizziness or syncope may follow a sublingual dose.
It strengthens the myocardial contraction.
A
It strengthens the myocardial contraction.
22
Q
Heart block, in which a conduction delay at the AV node results in intermittent missed ventricular contractions, is called:
A
second-degree block.
23
Q
In patients with congestive heart failure, ACE inhibitor drugs are useful because they:
A
reduce renin and aldosterone secretion.
24
Q
Aortic stenosis means the aortic valve:
A
cannot fully open during systole.
25
The circulatory system is composed of:
* Vessels
* Fluid
* Pump
26
Name the heart valves
* Atrioventricular valves
* Semilunar valves
27
Sinoatrial (SA) node
* ______________
* _________ rhythm
* Pacemaker
* Sinus rhythm
28
Atrioventricular (AV) node
* Located in floor of :
the right atrium
29
V bundle (bundle of His)
* Right and left __________
branches
30
Purkinje fibers
* ________ fibers
Terminal
31
(ECG)
* P wave
Depolarization of atria
32
(ECG)
* QRS wave
Depolarization of ventricles
33
(ECG)
* T wave
Repolarization of ventricles
34
Cardiac control center in ___________________
* Controls rate and ____________________
* Located in the ___________
Cardiac control center in medulla oblongata
* Controls rate and force of contraction
* Located in the medulla
35
Baroreceptors
* Detect changes in _____________
* Located in the _____ and internal ________________
* Detect changes in blood pressure
* Located in the aorta and internal carotid arteries
36
Sympathetic stimulation (cardiac accelerator nerve in Cervical Spine)
* __________ heart rate (_____________)
* Increases heart rate (tachycardia)
37
Parasympathetic stimulation (cranial nerve [CN] X; vagus nerve)
* ___________ heart rate (___________)
* Decreases heart rate (bradycardia)
38
Factors that Increase Heart Rate
* Increased _________ hormones or epinephrine
* Elevated __________________, infection, [Fever]
* Increased environmental ____________, specially in high humidity
* Exertion or exercise
* Smoking
* __________ response
* Pregnancy
* Pain
* Increased thyroid hormones or epinephrine
* Elevated body temperature, infection, [Fever]
* Increased environmental temperature
* Especially in high humidity
* Exertion or exercise
* Smoking
* Stress response
* Pregnancy
* Pain
39
Smoking nicotine is a __________________ , so it increases HR and decreases blood supply/oxygen
vasoconstrictor
40
Right and left coronary arteries
* Branch of aorta immediately distal to the ___________
* Part of the __________ circulation
* Branch of aorta immediately distal to the aortic valve
* Part of the systemic circulation
41
_____________________ artery divides into:
* Left anterior descending or interventricular artery
* Left circumflex artery
Left coronary
42
Right coronary artery branches
* Right _____________ artery
* Posterior ________________ artery
* Right marginal artery
* Posterior interventricular artery
43
Many small branches extend from the arteries to supply
the ______________________________
myocardium and endocardium
44
* ______________ circulation is extremely limited.
Collateral
45
Diastole
* _______________________________ required for filling chambers
* Relaxation of myocardium required for filling chambers
46
Systole
* ____________________________ provides increase in pressure to eject blood
* Contraction of myocardium provides increase in pressure to eject blood
47
Cycle begins with
* Atria relaxed, filling with blood >
____ valves open >
blood flows into ventricles >
atria contract, remaining blood forced into ventricles >
_________ relax >
_________ contract >
AV valves close >
___________ valves open >
blood into aorta and pulmonary artery >
___________ relax
* Atria relaxed, filling with blood >
AV valves open >
blood flows into ventricles >
atria contract, remaining blood forced into ventricles >
atria relax >
ventricles contract >
AV valves close >
semilunar valves open >
blood into aorta and pulmonary artery >
ventricles relax
48
“Lubb-dub”
* “Lubb”— ?
* “Dub”— ?
* “Lubb”—closure of AV valves
* “Dub”—closure of semilunar valves
49
Murmurs
* Caused by:
incompetent valves
50
Pulse
* Indicates:
heart rate
51
Pulse deficit
* Difference in rate between ________________ pulses
apical and radial
52
Systolic pressure
* Exerted when blood is _________________________
ejected from ventricles (high)
53
Diastolic pressure
* Sustained pressure when ______________________
* _____________________ is altered by cardiac output, blood volume, and peripheral resistance to blood flow.
* Sustained pressure when ventricles relax (lower)
* Blood pressure (BP) is altered by cardiac output, blood volume, and peripheral resistance to blood flow.
54
* BP is directly proportional to :
blood volume.
55
Antidiuretic hormone ( ___ BP)
↑
56
aldosterone (__ blood volume, __ BP)
(↑ blood volume, ↑ BP)
57
renin-angiotensin-aldosterone > (vasoconstriction; ___ BP)
(vasoconstriction; ↑ BP)
58
Cardiac output (CO)
* Blood ejected by ___________________
* CO = ___ x HR (heart rate)
* Blood ejected by a ventricle in 1 minute
* CO = SV x HR (heart rate)
59
Stroke volume (SV)
* Volume of blood pumped _____________________________
* Volume of blood pumped out of ventricle—contraction
60
Preload
* Amount of blood delivered _______________________
* Amount of blood delivered to heart by venous return
61
Afterload
* Force required to _________________________
* Determined by ___________________ in arteries
* Force required to eject blood from ventricles
* Determined by peripheral resistance in arteries
62
Electrocardiography
* Useful in the initial diagnosis and monitoring of __________________________________________________________________________
dysrhythmias, myocardial infarction, infection, pericarditis
63
Auscultation
* Determination of _________________________ or abnormal _________ of blood that cause murmurs
* Detected by listening through ___________________
* Determination of valvular abnormalities or abnormal shunts of blood that cause murmurs
* Detected by listening through a stethoscope
64
Echocardiography
* Used to record _______________ movements, _______ flow, and ___________ output
* Used to record heart valve movements, blood flow, and cardiac output
65
Exercise stress tests
* Used to assess ____________________________
general cardiovascular function
66
Chest x-ray films
* Used to show ___________________
* Nuclear imaging
* Tomographic studies
shape and size of the heart
67
Cardiac catheterization
* Measures pressure and assesses ___________________
* Determines ________________________ pressure and pulmonary capillary wedge pressure
* Measures pressure and assesses valve and heart function
* Determines central venous pressure and pulmonary capillary wedge pressure
68
Angiography
* Visualization of blood flow in:
the coronary arteries
69
Doppler studies
* Assess blood flow in ____________________
* Record sounds of ________________________________
* Assess blood flow in peripheral vessels
* Record sounds of blood flow or obstruction
70
General Treatment Measures for Cardiac Disorders
[non drug]
* Dietary modifications
~decrease total fat intake
~weight reduction
~Reduce salt intake
* Regular exercise
~Increases high-density lipoprotein levels
~Lowers serum lipid levels
~Reduces stress levels
* Cessation of smoking
~Decreases risk of coronary disease
71
Vasodilators
* Reduce _____________________
peripheral resistance
72
Beta blockers
* Treatment of ______________________________
* Reduction of __________ attacks
* Treatment of hypertension and dysrhythmias
* Reduction of angina attacks
73
Calcium channel blockers
* Decrease cardiac ______________
* Antihypertensives and vasodilators
* Prophylactic against ________
* Decrease cardiac contractility
* Antihypertensives and vasodilators
* Prophylactic against angina
74
Digoxin
* Treatment for _________________
* Antidysrhythmic drug for atrial ______________
* Treatment for heart failure
* Antidysrhythmic drug for atrial dysrhythmias
75
Antihypertensive drugs
* Used to:
lower blood pressure
76
Adrenergic blocking drugs
* Act on :
SNS centrally or on the periphery
77
Angiotensin-converting enzyme (ACE) inhibitors
* Block conversion of :
angiotensin I to angiotensin II
78
Diuretics
* Remove excess ____________________
* Treat ___________&_______________
* Remove excess sodium and/or water.
* Treat high BP and congestive heart failure
79
* Anticoagulants
* Reduce risk of:
blood clot formation
80
Cholesterol-lowering drugs
* Reduce low-density ____________________________ levels
lipoprotein and cholesterol
81
Arteriosclerosis
* General term for all types of ___________________
* ________________ changes in small arteries and arterioles
* Loss of ____________
* Lumen gradually narrows and may become obstructed
* Cause of increased ____
* General term for all types of arterial changes
* Degenerative changes in small arteries and arterioles
* Loss of elasticity
* Lumen gradually narrows and may become obstructed
* Cause of increased BP
82
Atherosclerosis
* Presence of atheromas in _______________
* ___________ consisting of lipids, calcium, and possible clots
* Related to _______, _______________, ________ .
* Presence of atheromas in large arteries
* Plaques consisting of lipids, calcium, and possible clots
* Related to diet, exercise, and stress
83
Lipids are transported in combination with ____________
proteins.
84
Low-density lipoprotein (LDL)
* Transports cholesterol from __________________
* Major factor contributing to ____________ formation
* Transports cholesterol from liver to cells
* Major factor contributing to atheroma formation
85
High-density lipoprotein (HDL)
* Transports cholesterol away from the _________________________—“good” lipoprotein
* Catabolism in ________ and excretion
* Transports cholesterol away from the peripheral cells to liver—“good” lipoprotein
* Catabolism in liver and excretion
86
Cardiac issues risk factors-
Nonmodifiable
?
?
?
Modifiable
?
* _____________ lifestyle
?
?
* Poorly controlled _________________
* Combination of _____________ and _____________
Nonmodifiable
* Age
* Gender
* Genetic or familial factors
Modifiable
* Obesity
* Sedentary lifestyle
* Cigarette smoking
* Diabetes mellitus
* Poorly controlled hypertension
* Combination of oral contraceptives and smoking
87
Atherosclerosis * Diagnostic tests
* Serum lipid levels
88
Atherosclerosis * Treatment
* Weight loss
* Increase ___________
* Lower total serum cholesterol and LDL levels with _____
* Reduce ______________
* Control hypertension.
* Cessation of ____________
* Antilipidemic drugs
* Surgical intervention, such as coronary artery bypass grafting
* Weight loss
* Increase exercise.
* Lower total serum cholesterol and LDL levels with diet
* Reduce sodium intake.
* Control hypertension.
* Cessation of smoking
* Antilipidemic drugs
* Surgical intervention, such as coronary artery bypass grafting
89
Angina Pectoris
* Occurs when there is a deficit of ____________ to meet _______________ needs
* Chest pain may occur in different _____________
* Occurs when there is a deficit of oxygen to meet myocardial needs
* Chest pain may occur in different patterns.
90
Angina Pectoris has various patterns
* ____________ or _____________ angina
* __________ angina - Vasospasm occurs at rest.
* ____________ angina - Prolonged pain at rest—may precede myocardial infarction
* Classic or exertional angina
* Variant angina - Vasospasm occurs at rest.
* Unstable angina - Prolonged pain at rest—may precede myocardial infarction
91
Angina Pectoris (Cont.)
* Recurrent, intermittent brief episodes of substernal _____________
* Triggered by physical or ____________________
* Attacks vary in severity/duration; become frequent & long as disease progresses.
* Relieved by rest and administration of coronary _______________ [ex): nitroglycerin]
* Primarily acts by reducing systemic resistance, decreasing the demand for _________
* Recurrent, intermittent brief episodes of substernal chest pain
* Triggered by physical or emotional stress
* Attacks vary in severity/duration; become frequent & long as disease progresses.
* Relieved by rest and administration of coronary vasodilators [ex): nitroglycerin]
* Primarily acts by reducing systemic resistance, decreasing the demand for oxygen
92
Emergency Treatment for Angina
* Rest, stop activity
* Patient seated in upright position
* Administration of ________________ —sublingual
* Check pulse and respiration.
* Administer ______________ , if necessary.
* Patient known to have angina > 2nd dose of ________________
* Patient without history of angina > ______________ medical aid
* Rest, stop activity
* Patient seated in upright position
* Administration of nitroglycerin—sublingual
* Check pulse and respiration.
* Administer oxygen, if necessary.
* Patient known to have angina > 2nd dose of nitroglycerin
* Patient without history of angina > Emergency medical aid
93
Warning Signs of Heart Attack
* Feeling of pressure, heaviness, or burning in chest—especially with _______________
* Sudden _______________ breath, weakness, fatigue
* ___________, indigestion
* __________ and fear
* ________ may occur and, if present, is usually
-Substernal
-Crushing
-Radiating
* Feeling of pressure, heaviness, or burning in chest—especially with increased activity
* Sudden shortness of breath, weakness, fatigue
* Nausea, indigestion
* Anxiety and fear
* Pain may occur and, if present, is usually
-Substernal
-Crushing
-Radiating
94
Myocardial Infarction
* Occurs when coronary artery is _________________
* Thrombus from atheroma may __________ artery
* ______________ is cause in a small percentage.
* Size and location of the infarct determine the _________
* Occurs when coronary artery is totally obstructed
* Thrombus from atheroma may obstruct artery
* Vasospasm is cause in a small percentage.
* Size and location of the infarct determine the damage.
95
Atherosclerosis is most common cause of
Myocardial Infarction
96
Myocardial Infarction diagnostic tests
* Changes in _____
* __________________ and isoenzyme levels
* Serum levels of _______ and cardiac ___________ are elevated.
* ____________, elevated CRP and ESR common
* Arterial blood gas measurements may be altered in severe
cases.
* Pulmonary artery pressure measurements helpful
* Changes in ECG
* Serum enzyme and isoenzyme levels
* Serum levels of myosin and cardiac troponin are elevated.
* Leukocytosis, elevated CRP and ESR common
* Arterial blood gas measurements may be altered in severe
cases.
* Pulmonary artery pressure measurements helpful
97
Myocardial Infarction:
Complications
* Sudden _______
* Cardiogenic shock
* Congestive _______________
* Rupture of necrotic heart tissue/cardiac tamponade
* Thromboembolism causing cerebrovascular accident
(CVA; with left ventricular MI)
* Sudden death
* Cardiogenic shock
* Congestive heart failure
* Rupture of necrotic heart tissue/cardiac tamponade
* Thromboembolism causing cerebrovascular accident
(CVA; with left ventricular MI)
98
Myocardial Infarction:
Treatment
* Reduce __________ demand.
* __________ therapy
* Analgesics
* Anticoagulants
* Thrombolytic agents may be used.
* Tissue plasminogen activator
* Medication to treat:
~Dysrhythmias, hypertension, congestive heart failure
~Cardiac rehabilitation begins immediately
* Reduce cardiac demand.
* Oxygen therapy
* Analgesics
* Anticoagulants
* Thrombolytic agents may be used.
* Tissue plasminogen activator
* Medication to treat:
* Dysrhythmias, hypertension, congestive heart failure
* Cardiac rehabilitation begins immediately
99
Cardiac Dysrhythmias (Arrhythmias)
* Deviations from normal cardiac ________________
~Caused by ___________ abnormalities, fever, __________ , stress,
infection, drug toxicity
~Electrocardiography—for monitoring the conduction system
* Detects abnormalities
* Reduction of the efficiency of the heart’s _______________
~Many types of abnormal conduction patterns exist.
* Deviations from normal cardiac rate or rhythm
~Caused by electrolyte abnormalities, fever, hypoxia, stress,
infection, drug toxicity
~Electrocardiography—for monitoring the conduction system
* Detects abnormalities
* Reduction of the efficiency of the heart’s pumping cycle
~Many types of abnormal conduction patterns exist.
100
Bradycardia
* Regular but _______________
slow heart rate
101
Tachycardia
* Regular ________________
rapid heart rate
102
SA node
* ____________ of the heart; rate can be altered.
Pacemaker
103
Sick sinus syndrome
* Marked by altering ______________ & ______________
* Often requires mechanical pacemaker
bradycardia and tachycardia
104
Atrial flutter VS fibrillation
Atrial flutter
* Atrial heart rate of 160 to 350 beats/min
Atrial fibrillation
* Rate over 350 beats/min
105
Treatment of Cardiac Dysrhythmias
* Cause needs to be determined and treated.
* ______________ drugs are effective in many cases.
* SA nodal problems or total heart block require ____________
* _____________ may be implanted for conversion of ventricular fibrillation.
* Cause needs to be determined and treated.
* Antidysrhythmic drugs are effective in many cases.
* SA nodal problems or total heart block require pacemaker
* Defibrillator may be implanted for conversion of ventricular fibrillation.
106
Cardiac Arrest:
_________ of all heart activity
* No conduction of _________
* _____ ECG
Cessation of all heart activity
* No conduction of impulses
* Flat ECG
107
Reasons for Cardiac Arrest
* Excessive vagal nerve stimulation
* ___________ imbalance
* Cardiogenic shock
* _____ toxicity
* Insufficient ________
* Respiratory arrest
* Blow to heart
* Excessive vagal nerve stimulation
* Potassium imbalance
* Cardiogenic shock
* Drug toxicity
* Insufficient oxygen
* Respiratory arrest
* Blow to heart
108
Congestive Heart Failure
* Heart is unable to pump out sufficient blood to meet _______________________ of the body.
* Usually a complication of another cardiopulmonary condition
* May involve a combination of factors
* Various ___________ mechanisms maintain cardiac output.
~Some of these often aggravate the condition.
* Heart is unable to pump out sufficient blood to meet metabolic demands of the body.
* Usually a complication of another cardiopulmonary condition
* May involve a combination of factors
* Various compensation mechanisms maintain cardiac output.
~Some of these often aggravate the condition.
109
Congestive Heart Failure (Cont.)
* When heart cannot maintain _________ capability
Cardiac output or stroke volume __________.
*Less blood reaches the various _______
*Decreased _____ function
*Fatigue and lethargy
*Mild acidosis develops.
*Backup and congestion develop as coronary demands for oxygen and glucose are not met.
*Output from ventricle is less than the inflow of blood.
*Congestion in venous circulation draining into the affected side of the heart
* When heart cannot maintain pumping capability
Cardiac output or stroke volume decreases.
*Less blood reaches the various organs.
*Decreased cell function
*Fatigue and lethargy
*Mild acidosis develops.
*Backup and congestion develop as coronary demands for oxygen and glucose are not met.
*Output from ventricle is less than the inflow of blood.
*Congestion in venous circulation draining into the affected side of the heart
110
Rheumatic fever
* Acute systemic ____________ condition
* May result from an abnormal ___________ reaction
* Can occur a few weeks after an untreated infection (usually
group A B-hemolytic Streptococcus)
* Involves heart as well as ________
* Usually occurs in children ages _______ years
Long-term effects
* Rheumatic heart __________
* May be complicated by infective endocarditis and heart failure in older adults
* Acute systemic inflammatory condition
* May result from an abnormal immune reaction
* Can occur a few weeks after an untreated infection (usually
group A B-hemolytic Streptococcus)
* Involves heart as well as joints
* Usually occurs in children ages 5 - 15 years
Long-term effects
* Rheumatic heart disease
* May be complicated by infective endocarditis and heart failure in older adults
111
Rheumatic Fever and Rheumatic Heart Disease
* Signs and symptoms
Low-grade fever
leukocytosis
malaise
anorexia
fatigue,
tachycardia
112
Rheumatic Fever and Rheumatic Heart Disease
Diagnostic tests
* _______________ test
* Electrocardiography
* ASO titer
Treatment
* Prophylactic ______________ agents
* Anti-______________ agents
Diagnostic tests
* Heart function test
* Electrocardiography
* ASO titer
Treatment
* Prophylactic antibacterial agents
* Anti-inflammatory agents
113
Infective Endocarditis
Acute endocarditis
*______________ onset—spiking fever, chills, drowsiness
Subacute endocarditis
* __________ onset—increasing fatigue, anorexia, cough, and dyspnea
Acute endocarditis
* Sudden, marked onset—spiking fever, chills, drowsiness
Subacute endocarditis
* Insidious onset—increasing fatigue, anorexia, cough, and dyspnea
114
Infective Endocarditis
diagnosis & treatment
* Blood culture to identify causative agent
* Antimicrobial drugs for several weeks, often IV
115
Pericarditis
* Usually secondary to another condition
* Classified by cause or type of _________
* Acute pericarditis may involve simple inflammation of _____________
* Chronic pericarditis
* Results in the formation of adhesions between pericardial
_____________
* Fibrous tissue often results from tuberculosis or radiation to
the mediastinum.
* Limiting movement of the heart during _____________________
→ reduced cardiac __________
* Usually secondary to another condition
* Classified by cause or type of exudate
* Acute pericarditis may involve simple inflammation of pericardium
* Chronic pericarditis
* Results in formation of adhesions between pericardial
membranes
* Fibrous tissue often results from tuberculosis or radiation to
the mediastinum.
* Limiting movement of the heart during diastole and systole
→ reduced cardiac output
116
Hypertension
* Common
* May occur in any age group
* Blood pressure consistently above _________ mm Hg
* Increase in arteriolar vasoconstriction
* Over long period of time—damage to ______________
* Blood supply to involved area is ___________
* Ischemia and necrosis of tissues, with loss of function
* Common
* May occur in any age group
* Blood pressure consistently above 140/90 mm Hg
* Increase in arteriolar vasoconstriction
* Over long period of time—damage to arterial walls
* Blood supply to involved area is reduced.
* Ischemia and necrosis of tissues, with loss of function
117
Areas most frequently damaged by hypertension-
* Kidneys
* Heart
* Brain
* Retina
118
* Predisposing factors to hypertension
* older age
* ____ affected more frequently & severely
* Incidence in women increases after _______ ______
* Genetic factors
* Sodium intake, alcohol intake, obesity, smoking, prolonged
or recurrent stress
* older age
* Men affected more frequently & severely
* Incidence in women increases after middle age.
* Genetic factors
* Sodium intake, alcohol intake, obesity, smoking, prolonged
or recurrent stress
119
Aortic Aneurysm
* Localized dilation and weakening of ______________
* Develops from a defect in the ______________
* Different shapes
* Localized dilation and weakening of arterial wall
* Develops from a defect in the medial layer
* Different shapes
120
Causes of Aortic Aneurysm
* Atherosclerosis
* Trauma
* Syphilis and other infections
* Congenital defects
121
Varicose Veins
* Irregular, dilated, tortuous areas of _____________________
* Familial tendency
* Increased body mass index, parity, and weight lifting are risks.
* In the ______
Treatment
* Keep legs _________, support stockings
* ___________ clothing, crossing legs to be avoided
* Irregular, dilated, tortuous areas of superficial veins
* Familial tendency
* Increased body mass index, parity, and weight lifting are risks.
* In the legs
Treatment
* Keep legs elevated, support stockings
* Restricted clothing, crossing legs to be avoided
122
Thrombophlebitis
* Thrombus development in ________________________
inflamed vein (e.g., IV site)
123
Phlebothrombosis
* Thrombus forms __________________________________;
attached loosely
spontaneously without prior inflammation
124
Factors for thrombus development
* Stasis of blood or sluggish _____________
* ______________ injury
* Increased blood ____________
* Stasis of blood or sluggish blood flow
* Endothelial injury
* Increased blood coagulability
125
Thrombophlebitis and Phlebothrombosis
Signs and symptoms
* Often _______
* Aching, burning, tenderness in affected ______
* Systemic signs—fever, malaise, _______________
* Often unnoticed
* Aching, burning, tenderness in affected legs
* Systemic signs—fever, malaise, leukocytosis
126
Thrombophlebitis and Phlebothrombosis
Complication—
pulmonary embolism
127
Treatment of Thrombophlebitis and Phlebothrombosis
* Preventive measures
~_________, elevating legs
* _______________ therapy
* ___________ intervention
* Preventive measures
~Exercise, elevating legs
* Anticoagulant therapy
* Surgical intervention
128
Hypovolemic shock
* Loss of circulating:
blood volume
129
Cardiogenic shock
* Inability of heart to maintain ____________________ to circulation
cardiac output
130
Compensation mechanisms for shock
* SNS and _________________ stimulated—increase HR, force of contraction, systemic vasoconstriction
* Renin secretion _________
* __________ADH secretion
* Secretion of glucocorticoids
* Acidosis stimulates increased respiration.
~With prolonged shock, cell metabolism is diminished, waste
not removed—leads to lower pH
* SNS and adrenal medulla stimulated—increase HR, force of contraction, systemic vasoconstriction
* Renin secretion increases.
* Increased ADH secretion
* Secretion of glucocorticoids
* Acidosis stimulates increased respiration.
~With prolonged shock, cell metabolism is diminished, waste
not removed—leads to lower pH
