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Spring 2016 Nursing School > 327 Winter Break > Flashcards

327 Winter Break Flashcards

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1
Q

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

A

130/80

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2
Q

What does hypertension damage? (2)

A

Blood vessels

Organs

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3
Q

Hypertension results in (4)

A

MI

CVA

Renal failure

PVD

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4
Q

Normally the hypertension cutoff is

A

140/90

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5
Q

There is no known cause of

A

Primary hypertension

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6
Q

Primary hypertension is also known as

A

Essential hypertension

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7
Q

Risk factors for hypertension (8)

A 
Older than 60
Family hx
Obese
Sedentary 
Hyperlipidemia 
Alcohol/caffeine/smoking
African American 
Stress
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8
Q

Causes of secondary hypertension (3)

A

Renal disease

Adrenal dysfunction

Coarctation of aorta

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9
Q

Renal disease examples (2)

A

Trauma

Renal artery stenosis

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10
Q

Examples of adrenal dysfunction (3)

A

Primary aldosteronism

Pheochromocytoma

Cushing syndrome

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11
Q

Narrowing aorta is called

A

Coarctation

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12
Q

Interventions for hypertension involve two main approaches (2)

A

Reduce modifiable risk factors

Medication

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13
Q

Medications (7)

A 
ACE inhibitors 
Angiotensin II receptor blocker
Beta blockers 
Ca++ channel blockers 
Diuretics 
Central alpha agonist
Vasodilators
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14
Q

What designates hypertensive crisis

A

Diastolic BP greater than 130

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15
Q

Hypertensive crisis symptoms (8)

A 
Severe headache 
Extremely high bp
Anxiety
SOB
blurred vision
Dizziness 
Epistaxis 
Evidence of organ damage
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16
Q

Evidence of organ damage (6)

A 
MI
CVA
Papilledema 
LV overload 
Pulmonary edema 
Acute renal failure
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17
Q

Emergency care for hypertensive urgency/crisis (8)

A 
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
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18
Q

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

A

30 minutes

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19
Q

Causes of hypotension (3)

A

Dehydration

Decreased blood volume

Antihypertensive

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20
Q

Symptoms of hypotension (5)

A

Low bp

Increased HR

Weak pulse

Increased RR

Syncope

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21
Q

Assessment for hypotension (4)

A

Orthostatic BP

Mental status change

Skin turgor and color

Urine output/specific gravity

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22
Q

Hypotension interventions (2)

A

Fluid replacement

Minimize fall risk

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23
Q

Fluid replacement via (2)

A

Oral

IV

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24
Q

PVD is more common in (2)

A

Lower extremities

Arteries

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25
Q

4 stages of PAD

A

Asymptomatic

Claudication

Rest pain

Necrosis/gangrene

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26
Q

What is the most common symptom of PAD?

A

Pain

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27
Q

Assessment for PAD (3)

A

Decreased pulses

Hair loss

Skin changes

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28
Q

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

A

Pallor when elevated

Rubor when lowered

Cold feet

Thickened toenails

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29
Q

Diagnostic tests for PAD (4)

A

Arteriography

Ankle-brachial Index (ABI)

Exercise tolerance testing

Plethysmograph

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30
Q

PAD interventions (9)

A 
Exercise 
Positioning 
Promoting vasodilation 
Medications 
Percutaneous transluminal angioplasty 
Atherectomy/rotablator
Arterial revascularization surgery 
Laser assisted angioplasty
Post procedure assessment
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31
Q

After any PAD intervention, assess (3)

A

Bleeding from the site

Vital signs

Distal pulses

32
Q

Sudden arterial blockage

A

APAO

33
Q

The embolus lodged in APAO originates in the

A

Heart

34
Q

Precipitating factors of this embolus are (2)

A

MI

Afib

35
Q

6 P’s of APAO

A 
Pain
Pallor
Pulseless
Paresthesia
Paralysis
Poikilothermia
36
Q

APOA interventions (3)

A

Heparin

Surgery

Thrombolytics

37
Q

Venous thrombosis
Venous valve defects
Poor skeletal muscle contraction

All contribute to

A

PVD

38
Q

Vessel injury

Hypercoagulabiliy

Stasis

All contribute to

A

DVT

39
Q

Thrombophlebitis develops into

A

DVT

40
Q

DVT assessment (5)

A 
Calf/groin tenderness/pain
Unilateral edema
Induration
Warmth
Redness
41
Q

An outdated and dangerous DVT assessment method

A

Homan’s sign

42
Q

DVT diagnostic tests (3)

A

Venous duplex ultrasound

Doppler flow studies

Impedance plethysmography

43
Q

DVT interventions (3)

A

Heparin

Warfarin

IVC filter

44
Q

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

A

PTT

Protamine sulfate

45
Q

Things to keep in mind about Warfarin (2)

A

INR

Vitamin K

46
Q

If a pt has hx of VTE (3)

A

Avoid oral contraceptives

Drink adequate fluids

Exercise legs

47
Q

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

A

Education

Leg exercises and SCDs

Early ambulation

Adequate hydration

48
Q

Venous insufficiency assessment (2)

A

Stasis dermatitis

Stasis ulcers

49
Q

What causes venous valvular damage?

A

Hypertension

50
Q

What is stasis dermatitis?

A

Brown darkening of the ankle/calf

51
Q

Where are venous stasis ulcers most commonly located?

A

Medial malleolus

52
Q

Are venous stasis ulcers chronic and non-healing?

A

Yes

53
Q

Venous Insufficiency Interventions (5)

A 
Compression stockings 
Elevate legs, 20 min 4-5/day
Dressing (accuzyme)
Unna boot
Debridement
54
Q

Localized dilation of an artery

A

Aneurysm

55
Q

3 types of aneurysms

A

Fusiform

Saccular

Aortic dissection

56
Q

Where is the most common site for an aneurysm?

A

Abdomen

57
Q

Why are aneurysms life threatening?

A

They can rupture

58
Q

If an aneurysm bursts, what can it cause?

A

Hemorrhagic shock

59
Q

What is the most common cause of aneurysms?

A

Atherosclerosis

60
Q

AAA assessment (3)

A

Pain

Abdominal pulsation

Auscultate for bruit

61
Q

Should you auscultate for a bruit over a mass?

A

Yes

62
Q

Should you palpate a mass?

A

No

63
Q

Thoracic aneurysm assessment (3)

A

Pain

SOB

Dysphagia

64
Q

Aneurysm interventions (3)

A

Monitor growth

Maintain normal BP

Surgery

65
Q

Aneurysm surgery

A

Cardio-pulmonary bypass

66
Q

Aneurysm surgery risks (3)

A

Increased mortality if rupture

Renal failure

Paraplegia

67
Q

Aneurysm post op care (7)

A 
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
68
Q

Is Aortic Dissection an emergency?

A

Yes!

69
Q

Sudden tear in the aortic intima

A

Aortic dissection

70
Q

What contributes to Aortic Dissection? (1)

A

Hypertension

71
Q

Aortic Dissection assessment (4)

A

Pain!

Syncope

AMS

Weak pulse

72
Q

The pain in Aortic dissection is described as (3)

A

Tearing

Ripping

Stabbing

73
Q

Aortic dissection interventions (4)

A

Treat pain

Reduce BP

Decrease LV ejection velocity

Surgery

74
Q

What medication is used to lower LV ejection velocity?

A

Propranolol

75
Q

What kind or surgery is done for aortic dissection?

A

Graft repair

76
Q

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

A

Opiates

Spring 2016 Nursing School (2 decks)

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