327 Winter Break

Question 1

If a person has Diabetes or Chronic Kidney Disease (CKD), the cutoff is

Answer 1

130/80

Question 2

What does hypertension damage? (2)

Answer 2

Blood vessels

Organs

Question 3

Hypertension results in (4)

Answer 3

MI

CVA

Renal failure

PVD

Question 4

Normally the hypertension cutoff is

Answer 4

140/90

Question 5

There is no known cause of

Answer 5

Primary hypertension

Question 6

Primary hypertension is also known as

Answer 6

Essential hypertension

Question 7

Risk factors for hypertension (8)

Answer 7

Older than 60
Family hx
Obese
Sedentary 
Hyperlipidemia 
Alcohol/caffeine/smoking
African American 
Stress

Question 8

Causes of secondary hypertension (3)

Answer 8

Renal disease

Adrenal dysfunction

Coarctation of aorta

Question 9

Renal disease examples (2)

Answer 9

Trauma

Renal artery stenosis

Question 10

Examples of adrenal dysfunction (3)

Answer 10

Primary aldosteronism

Pheochromocytoma

Cushing syndrome

Question 11

Narrowing aorta is called

Answer 11

Coarctation

Question 12

Interventions for hypertension involve two main approaches (2)

Answer 12

Reduce modifiable risk factors

Medication

Question 13

Medications (7)

Answer 13

ACE inhibitors 
Angiotensin II receptor blocker
Beta blockers 
Ca++ channel blockers 
Diuretics 
Central alpha agonist
Vasodilators

Question 14

What designates hypertensive crisis

Answer 14

Diastolic BP greater than 130

Question 15

Hypertensive crisis symptoms (8)

Answer 15

Severe headache 
Extremely high bp
Anxiety
SOB
blurred vision
Dizziness 
Epistaxis 
Evidence of organ damage

Question 16

Evidence of organ damage (6)

Answer 16

MI
CVA
Papilledema 
LV overload 
Pulmonary edema 
Acute renal failure

Question 17

Emergency care for hypertensive urgency/crisis (8)

Answer 17

semi-fowler's
O2
Normal Saline IV
Nitroprusside/nitropress
Oral meds when stable 
Check BP q 5-15 minutes until below 90
Then monitor BP q 30 minutes
Watch for neuro or cardio complications

Question 18

During hypertensive crisis, the patient’s BP should be checked every 5-15 minutes until the diastolic BP is below 90, then check every

Answer 18

30 minutes

Question 19

Causes of hypotension (3)

Answer 19

Dehydration

Decreased blood volume

Antihypertensive

Question 20

Symptoms of hypotension (5)

Answer 20

Low bp

Increased HR

Weak pulse

Increased RR

Syncope

Question 21

Assessment for hypotension (4)

Answer 21

Orthostatic BP

Mental status change

Skin turgor and color

Urine output/specific gravity

Question 22

Hypotension interventions (2)

Answer 22

Fluid replacement

Minimize fall risk

Question 23

Fluid replacement via (2)

Answer 23

Oral

IV

Question 24

PVD is more common in (2)

Answer 24

Lower extremities

Arteries

Question 25

4 stages of PAD

Answer 25

Asymptomatic Claudication Rest pain Necrosis/gangrene

Question 26

What is the most common symptom of PAD?

Answer 26

Pain

Question 27

Assessment for PAD (3)

Answer 27

Decreased pulses Hair loss Skin changes

Question 28

What are some specific skin changes in PAD? (4)

Answer 28

Pallor when elevated Rubor when lowered Cold feet Thickened toenails

Question 29

Diagnostic tests for PAD (4)

Answer 29

Arteriography Ankle-brachial Index (ABI) Exercise tolerance testing Plethysmograph

Question 30

PAD interventions (9)

Answer 30

``` Exercise Positioning Promoting vasodilation Medications Percutaneous transluminal angioplasty Atherectomy/rotablator Arterial revascularization surgery Laser assisted angioplasty Post procedure assessment ```

Question 31

After any PAD intervention, assess (3)

Answer 31

Bleeding from the site Vital signs Distal pulses

Question 32

Sudden arterial blockage

Answer 32

APAO

Question 33

The embolus lodged in APAO originates in the

Answer 33

Heart

Question 34

Precipitating factors of this embolus are (2)

Answer 34

MI Afib

Question 35

6 P's of APAO

Answer 35

``` Pain Pallor Pulseless Paresthesia Paralysis Poikilothermia ```

Question 36

APOA interventions (3)

Answer 36

Heparin Surgery Thrombolytics

Question 37

Venous thrombosis Venous valve defects Poor skeletal muscle contraction All contribute to

Answer 37

PVD

Question 38

Vessel injury Hypercoagulabiliy Stasis All contribute to

Answer 38

DVT

Question 39

Thrombophlebitis develops into

Answer 39

DVT

Question 40

DVT assessment (5)

Answer 40

``` Calf/groin tenderness/pain Unilateral edema Induration Warmth Redness ```

Question 41

An outdated and dangerous DVT assessment method

Answer 41

Homan's sign

Question 42

DVT diagnostic tests (3)

Answer 42

Venous duplex ultrasound Doppler flow studies Impedance plethysmography

Question 43

DVT interventions (3)

Answer 43

Heparin Warfarin IVC filter

Question 44

What may be necessary for a patient on heparin? (2)

Answer 44

PTT Protamine sulfate

Question 45

Things to keep in mind about Warfarin (2)

Answer 45

INR Vitamin K

Question 46

If a pt has hx of VTE (3)

Answer 46

Avoid oral contraceptives Drink adequate fluids Exercise legs

Question 47

What can be done about thromboembolism for inpatient setting? (4)

Answer 47

Education Leg exercises and SCDs Early ambulation Adequate hydration

Question 48

Venous insufficiency assessment (2)

Answer 48

Stasis dermatitis Stasis ulcers

Question 49

What causes venous valvular damage?

Answer 49

Hypertension

Question 50

What is stasis dermatitis?

Answer 50

Brown darkening of the ankle/calf

Question 51

Where are venous stasis ulcers most commonly located?

Answer 51

Medial malleolus

Question 52

Are venous stasis ulcers chronic and non-healing?

Answer 52

Yes

Question 53

Venous Insufficiency Interventions (5)

Answer 53

``` Compression stockings Elevate legs, 20 min 4-5/day Dressing (accuzyme) Unna boot Debridement ```

Question 54

Localized dilation of an artery

Answer 54

Aneurysm

Question 55

3 types of aneurysms

Answer 55

Fusiform Saccular Aortic dissection

Question 56

Where is the most common site for an aneurysm?

Answer 56

Abdomen

Question 57

Why are aneurysms life threatening?

Answer 57

They can rupture

Question 58

If an aneurysm bursts, what can it cause?

Answer 58

Hemorrhagic shock

Question 59

What is the most common cause of aneurysms?

Answer 59

Atherosclerosis

Question 60

AAA assessment (3)

Answer 60

Pain Abdominal pulsation Auscultate for bruit

Question 61

Should you auscultate for a bruit over a mass?

Answer 61

Yes

Question 62

Should you palpate a mass?

Answer 62

No

Question 63

Thoracic aneurysm assessment (3)

Answer 63

Pain SOB Dysphagia

Question 64

Aneurysm interventions (3)

Answer 64

Monitor growth Maintain normal BP Surgery

Question 65

Aneurysm surgery

Answer 65

Cardio-pulmonary bypass

Question 66

Aneurysm surgery risks (3)

Answer 66

Increased mortality if rupture Renal failure Paraplegia

Question 67

Aneurysm post op care (7)

Answer 67

``` VS q 15 min, for 1st hour Changes in pulse Cold extremities below the graft White/blue extremities Severe pain Abdominal distention Decreased urine output ```

Question 68

Is Aortic Dissection an emergency?

Answer 68

Yes!

Question 69

Sudden tear in the aortic intima

Answer 69

Aortic dissection

Question 70

What contributes to Aortic Dissection? (1)

Answer 70

Hypertension

Question 71

Aortic Dissection assessment (4)

Answer 71

Pain! Syncope AMS Weak pulse

Question 72

The pain in Aortic dissection is described as (3)

Answer 72

Tearing Ripping Stabbing

Question 73

Aortic dissection interventions (4)

Answer 73

Treat pain Reduce BP Decrease LV ejection velocity Surgery

Question 74

What medication is used to lower LV ejection velocity?

Answer 74

Propranolol

Question 75

What kind or surgery is done for aortic dissection?

Answer 75

Graft repair

Question 76

The pain from aortic dissection is so great that it is treated with

Answer 76

Opiates