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Nur 333 fundamentals 2 > WK 2: HTN and HLD > Flashcards

WK 2: HTN and HLD Flashcards

(51 cards)

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1
Q

Afterload

A

pressure ventricles must work against to open the semilunar valves to pump blood out of the heart to the lungs/body

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2
Q

Preload

A

amount the ventricles stretch at end of of diastole
-the relaxation / filling phase of ventricles

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3
Q

myocardial contractility

A

strength of cardiac cells to contract or shorten

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4
Q

cardiac output

A

the amount of blood that the heart pumps out in one minute
CO= HR x SV
it maintains tissue perfusion

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5
Q

Ejection fraction
What is it?
what is a normal ejecton fraction?

A

% of blood pumped out of the left ventricle with EACH contraction
NML= >50%
heart failure = <40%

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6
Q

infarction

A

blocking of blood flow to a certain area, causing tissue death

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7
Q

ischemia

A

tissue perfusion has decreased but is not totally cut off, resulting in hypoxia

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8
Q

stroke volume

A

amount of blood pumped by a ventricle with each beat
stroke volume is affected by: contractility, preload and afterload

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9
Q

pulsus alternans

A

an arterial pulse with alternating strong and weak beats

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10
Q

venous thromboembolism

A

obstruction of a blood vessel by a a clot that has been dislodged from another site
commonly starts in legs and moves to lungs (PE)

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11
Q

perfusion

A

passage of fluid through the circulatory system to tissue, oxygenating the tissue

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12
Q

perfusion

A

passage of fluid through the circulatory system to tissue, oxygenating the tissue

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13
Q

what is the formula for cardiac output ?

A

CO= HR x SV

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14
Q

What can alter a persons cardiac output?

A

HR
SV
myocardial contractility

EX. medications, Dz processes, activity

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15
Q

What is pulse pressure?

A

the difference between systolic and diastolic BP
NML= 1/3 of SBP

Ex: BP of 120/80
120-80= a pulse pressure of 40, this is normal

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16
Q

what is peripheral vascular resistance?

A

the amount of effort that the heart has to overcome in order to get the blood out of the heart and into the periphery

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17
Q

HTN

A

pressure in your arteries is higher than it should be
-causes adverse effects to arterial walls
-changes in arterial walls leads to PVR, leading to decreased peripheral perfusion over time

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18
Q

What is an elevated BP range

A

systolic: 120-129
Diastolic: less than 80

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19
Q

What is the range for stage 1 HTN

A

systolic: 130-139
diastolic: 80-89

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20
Q

what is the range for stage 2 HTN

A

systolic: 140 or higher
diastolic: 90 or higher

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21
Q

what is the range for a hypertensive crisis

Study These Flashcards
A

systolic: higher than 180
diastolic: higher than 120

22
Q

What are some modifiable factors that influence blood pressure?

Study These Flashcards
A

DM, elevated lipid serum lipids, excess sodium intake, obesity, sedentary lifestyle, stress, tobacco use, alcohol use

23
Q

what are some non-modifiable risk factors that influence blood pressure?

Study These Flashcards
A

genetics, family hx, race/ethnicity, increasing age, gender, chronic kidney Dz, obstructive sleep apnea

24
Q

complications of HTN

Study These Flashcards
A

cardiovascular Dz
MI
HF
stroke
PVD
renal Dz
retinal Dz

25
nursing care of HTN
-determine risk factors and assist with changing -promote heart healthy nutrition -weight reduction if needed -encourage balance of rest & activity -smoking cessation -medication management -BP monitoring -collaboration -patient education
26
What symptoms indicate that you are having a hypertensive crisis and should see a physician ?
BP >180/110 severe HA dyspnea or CP Dizziness, numbness, and weakness loss of vision difficulty speaking nosebleed/ epistaxis severe anxiety unresponsive
27
what is the difference between a hypertensive emergency and hypertensive crisis
HTN emergency: develops in hours-days, BP>220/140, targets organ diseases HTN urgency: develops over days to weeks, BP>180/110, NO target organ disease. EMERGENCY requires fast reversal wile URGENCY requires slow reversal
28
what are some causes of hypertensive crises?
medication non-compliance drug abuse head injury preeclampsia/eclampsia phenochromocytoma Acute aortic dissection
29
lifestyle modifications of HTN
manage BP control cholesterol reduce BG if a diabetic eat better (DASH diet) loose weight stop smoking limit alcohol stress modifications
30
What is hypotension? why do we care if a patient is hypotensive?
systolic BP is less than 90 we care d/t concerns about the patients tissues getting perfused -before reacting, check patients baseline BP and see if they are symptomatic
31
Sx of hypotension
pallor/ skin mottling/ clamminess decreased brain perfusion -> LH/dizzy/syncope/confusion burred vision CP increased HR decreased urine output N/V
32
nursing implementations of hypotension
monitor VS frequently assess symptoms treat cause consider adding salt to diet increased fluid intake compression stockings medications
33
what kind of patients typically get orthostatic hypotension?
elderly bed rest pt pregnant pt pt w/o high blood volume
34
How do you diagnose someone with orthostatic hypotension?
-measure BP lying down/sitting/standing -measurements done within 3 minutes of position change SBP-decreases by 20 DBP- decreases by 10
35
nursing care for a patient with orthostatic hypotension
-slow position changes -don't cross legs -early ambulation -balance rest and activity -isometric exercises before standing -compression stockings -don't stand for long periods of time -risk factor for falls
36
why do we care if a patient has high cholesterol levels?
it can lead to atherosclerosis which overtime can lead to poor perfusion, CAD, peripheral artery Dz and MI's
37
When should a person get tested for HLD?
test at 20 y/o, then test evert 4-6 years
38
how long does a person need to fast prior to their cholesterol testing?
9-12 hours
39
What should a patients levels be for cholesterol? overall cholesterol LDL HDL
cholesterol <200 LDL <130 HDL males should be >45 females should be >55
40
HLD Nursing Care
-check, change, control -maintain healthy weight -be active -limit smoking and alcohol -dietary modifications -lipid-lowering drug therapy
41
what diet modifications should be enacted for a patient with HLD?
-reduce saturated and trans fats -increased complex carbs (whole grains, fruits, veggies) -limit major sources of cholesterol (yolk, whole milk) -limit alcohol and simple sugars -eat fatty fish weekly -eat foods high in omega 3 (soybean oils, canola, walnuts, flax seed)
42
what diet modifications should be enacted for a patient with HLD?
-reduce saturated and trans fats -increased complex carbs (whole grains, fruits, veggies) -limit major sources of cholesterol (yolk, whole milk) -limit alcohol and simple sugars -eat fatty fish weekly -eat foods high in omega 3 (soybean oils, canola, walnuts, flax seed)
43
who is at risk for a venous thromboembolism
pt wit venous stasis (bed rest) pt with hyper-coagulability(thick blood) pt with endothelial damage
44
S/Sx of VTE (venous thromboembolism)
localized redness, tenderness, and swelling warmth, tenderness, firmness over muscle calf calf pain w/ ambulation unilateral size of legs
45
how would one diagnose of VTE?
obtain Hx physical assessment vascular US
46
nursing care to prevent VTE
assess symptoms measure calf check for calf tenderness/phlebitis early ambulation/ activity TED stockings SCD's calf pumping
47
VTE treatment
prevention is key anticoagulation thrombolytic IVC filter
48
diagnostics related to cardiovascular system
1. CBC Hgb: iron containing pigment needed for O2 to travel females should be 12-16, males should be 14-18 Hct: % of total volume of blood that is made up of RBC. women should be 37-47% men should be 42-52% 2. fasting lipid panel LDL, HDL, triglycerides 3. CXR 4. EKG: conduction of the heart
49
What are some cardiovascular nursing problems?
risk for unstable BP activity intolerance decreased cardiac output ineffective tissue perfusion fatigue impaired gas exchange ineffective airway clearance fluid volume issues risk for injury
50
S4
atrial gallop "TEN-nes-see"
51
S3
ventricular gallop "ken-TUCK-y"

Nur 333 fundamentals 2 (7 decks)

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