Adult Health one - exam #3 Flashcards
Perfusion, Oxygenation (terms are included from learning map)
Hypertensive crisis
what is it? a severe elevation in the blood pressure that can cause damage to the organs such as the kidney or the heart
what does it look like? blood pressure reading greater than 180/120, patient could have symptoms of morning headache, blurred vision, anxiety, nosebleed, dyspnea, and malignant hyperthermia
what causes it? underlying health conditions or intervention that did not occur from elevated blood pressure / kidney disease
what does the nurse do for it? administer oxygen and monitor O2 saturation while administering IV hydralizine to stabilize blood pressure
wheezing
high pitched whistling noise upon expiration
crackles
fluid in lungs
Primary Hypertension
What is it? most common type of hypertension it is not caused by an underlying health condition
What does it look like? Patient that has elevated blood pressure of >120 SBP and Diastolic Blood pressure >80
what causes it? thickening of the arterioles, obesity, environmental factors and psychological factors
what does the nurse do for it? the nurse administers ACE inhibitors to lower the blood pressure (-pril)
Rhonchi
in large airways cleared with a cough
Secondary hypertension
what is it? elevated blood pressure that is caused by a specific disease or drug.
what does it look like? Patient that has kidney failure and a patient that is on glucocortoid or erythropoietin.
what causes it? certain medications or kidney failure from the RAAS system not properly functioning
what does the nurse do for it? assess the patient by drawing labs for kidney such as AST, ALT, BUN, creatinine clearance
while patient is on the medication administer a vasodilator
Cardiac dysrhythmias
what is it? a disorder of the heartbeat involving a disturbance in cardiac rhythm; irregular heartbeat
what does it look like? Abnormal EKG reading
what causes it? perfusion of the heart impaired
what does the nurse do for it? depending on the dysrhythmia the nurse would administer Beta-adrenergic blockers (-olol) or Angiotensin-II receptor blockers (-sartans)
Pleural friction rub
sounds like grinding
Room air percentage
21%
Oxygen concentrator
machine that removes nitrogen from room air increasing oxygen air over 90%
Diuretics
furosemide, spironolactone, metolazone, polythiazide, hydrocholothiazide
what are diuretics related to cardiac output
they are the 1st defense of lowering blood pressure
Beta-adrenergic blockers
Atenolol, Nadolol, Timolol, maleate, Metoprolol -olol medications mostly
How do diuretics affect the heart
can become electrolyte imbalance, glucose control can be affected so do not give to diabetic patients, do not give to patients with gout uric acid is production
Vasodilators
Hydralazine, Hydrochloride, Minoxidil
what can a vasodilator effect in the body
decrease your blood pressure and lower swelling present as well as decrease your heart rate
stage 1 HTN
130-139 mm Hg or 140-159 mm Hg / 80-89 mm Hg or 90-99 mmHg
stage 2 HTN
greater than or equal to 140 mmHg or greater than 160 mmHg / greater than or equal to 90 mmHg or greater than 100 mmHg
what is prehypertension?
120-139 mm/Hg SBP and 80-89 mm/Hg DBP
what are the 2 breathing techniques for COPD patients
Pursed Lip Breathing and Diaphragmatic breathing
Diaphragmatic breathing
relax muscles while inspiration and push out abdomen with upper hand above breast bone and the lower hand on the abdomen in the supine position
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Pursed Lip Breathing
deep inspiration followed by prolonged expiration through pursed lips, while sitting up.
meant to prevent bronchiolar collapse and air trapping
How do vasodilators work in terms of treatment of hypertension
decrease the blood pressure
Chronic Obstructive Pulmonary Disease term
collection of lower airway disorders that interfere with air flow and gas exchange
how many liters can be used on a nasal cannula
1-6 lpm
how many liters can be used on a partial and nonrebreather
10-15 lpm
Cor Pulmonale
right-sided heart failure due to pulmonary disease
how many liters can be used on a simple mask
6-12 lpm
Chronic Obstructive Pulmonary Disease
what is it? collection of lower airway disorders that interfere with air flow and gas exchange
what does it look like? lower o2 saturation below 90% on RA, patient who was a chronic chain smoker or presently is, patient who has trouble breathing on RA,
Chronic bronchitis, Emphysema, patient in a tripod position
what causes it? Smoking, smoke inhalation, lower respiratory disorders that mess with the alveoli when gas exchange occurs
what does the nurse do for it? the nurse will administer breathing treatments, the nurse will administer oxygen device, the nurse will teach patient different breathing techniques to help breathe
Chest physiotherapy
external chest wall manipulation using percussion, vibration, or high-frequency chest wall compression
what are the 2 processes associated with COPD
Chronic bronchitis and Emphysema
Chronic Bronchitis
affects the lungs by inflammation of the Bronchi
Emphysema
affect the lungs by destruction and dilation of the alveolis
Afterload
the pressure or resistance that the ventricles must overcome to eject blood through the semilunar valves and into the peripheral blood vessels
Apical Impulse or point of maximal impulse (PMI)
the pulse located at the left fifth intercostal space in the midclavicular line
Baroreceptors
sensory receptors in the arch of the aorta and at the origin of the internal carotid arteries that are stimulated wehn the arterial walls are stretched by an increased blood pressure
Blood pressure
the force of blood exerted against the vessel walls
Bradycardia
below 60 beats per minute in adults
abnormal slow heart rate
Cardiac Index
a calculation of cardiac output requirements to accoutn for differences in body size ; equation is CO/surface area
Cardiac output
the volume of blood ejected by the heart each minute
CO=HR x Stroke volume
Cholesterol
serum lipid that includes High Density lipoprotein and low density lipoprotein
Diastole
phase of cardiac cycle that consists of relaxation and filling of atria and ventricles ; normally 2/3 of the cardiac cycle
Diastolic Blood pressure
the amount of pr pressure of force against the arterial walls during the relaxation phase of the cardiac cycle
Essential Hypertension
also known as primary hypertension the most common type of hypertension; not caused by an existing health problem
Heart Rate
term referring to the number of times the ventricles contract each minute.
High-density Lipoprotein (HDL)
part of your total cholesterol values that should be more than 45 mm/dL for men and women more than 55 mg/dL the good cholesterol
what is the lab values for HDL
more than 45 mm/dL for men and women are more than 55 mm/Hg for women
High-sensitive C-reactive protein (hsCRP)
a serum marker of inflammation and a common and critical component of the development of atherosclerosis
Homocysteine
an amino acid that is produced when proteins break down; elevated values may be a risk factor for the development of cardiovascular disease
Hypertensive Crisis the term what is it
a severe elevation in blood pressure, which can cause damage to organs such as the kidneys or the heart
Low-density lipoproteins (LDL)
part of the total cholesterol cale that should be less than 130 mg/dL; bad cholesterol
what is the value for LDL
less than 130 mg/d:
Ischemia
diminished blood supply to any tissue or organ of the body, causing a shortage of oxygen
Korotkoff sounds
sounds heard during taking a blood pressure
what are examples of lipids
Total cholesterol, Triglycerides, HDL, LDL
Malignant Hypertension
Hypertensive state that is 200/120 and is an emergency that requires IV antihypertensive medication
Mean Arterial Pressure (MAP)
MAP= SBP+2 x DBP /3
the arterial blood pressure that is necessary to maintain perfusion of major body organs, such as kidneys and the brain
Myocardium
the heart muscle
Orthostatic Hypotension the term
abnormally low blood pressure that occurs when a person stands
Pack years
Packages per day x years smoked = pack years
used to record a patients smoking history
Palpitations
bounding or racing of the heart associated with normal emotions or a heart disorder
Paradoxical blood pressure
an exaggerated decreased in systolic blood pressure by more than 10 mm/Hg during the inspiratory phase of the respiratory cycle
Peripheral vascular Disease (PVD)
disorders that change the natural flow of blood through the arteries and veins of the peripheral circulation, causing decreased perfusion to body tissues
Preload
the degree of myocardial fiber stretch at the end of diastole and just before contraction
Pulse Pressure
the difference between systolic and diastolic blood pressures
Secondary hypertension the term
elevated blood pressure that is related to a specific disease or medication
Stroke volume
the amount of blood ejected by the left ventricle during each contraction
Systole
the phase of the cardiac cycle that consists of contacting and emptying the atria and the ventricles
Systolic Blood pressure
the amount of force or pressure generated by the left ventricle to distribute blood into the aorta with each contraction of the heart
Triglycerides
Serum Lipid profile that includes measurement of cholesterol and lipoprotein
Troponin
a myocardial muscle protein released into the bloodstream with injury to myocardial muscle
what is the order of medications in which you prescribe
Diuretics, Beta-adrenergic blockers, Calcium-channel blockers, Angiotensin-converting enzyme inhibitors, Angiotensin-II receptor blockers (ARBs)
Calcium channel blockers
Diltiazem, Verapamil, hydrochloride, Nifedipine, Nicardipine,
Atlectasis
collapsed lung
Bronchoscopy
invasive diagnostic assessment
capnography
noninvasive diagnostic test
Chest Physiotherapy
external chest wall manipulation using percussion, vibration, or high frequency chest wall compression
Cheyne-stokes respirations
deep rapid breathing and slow and shallow breathing with periods of apnea
Chronic Bronchitis
inflammation of the bronchi in the lungs
COPD term
collection of lower airway disorders that interfere with airflow and gas exchange
Crepitus
air trapped in and under the skin, felt as a crackling sensation beneath the fingertips.
Dyspnea
labored breathing or shortness of breath that is painful
Emphysema
affects the lungs by destruction and dilation of the alveoli
Gas exchange
the actions happening with the echange of CO2 and O2 in the alveoli
Hypoxemia
arterial blood oxygen levels less than 60 mm/Hg; low oxygen level in the blood
Hypoxia
Inadequate tissue oxygenation at the cellular level
Incentive Spirometry
enpands the lungs, clears mucus secretions, increase amount of O2 delivered to bronchi and alveoli, often prescribed for postop patients as well as some pulmonary alterations
Nasal Cannula
oxygen delivery device that 1-6 lpm
Nebulization
process of adding moisture to inspired air by adding water droplets ; interventions for breathing
Orthopnea
difficulty breathing when supine
Perfusion
ability of the cardiovascular system to pump oxygenated blood to the tissues and return oxygenated blood to the lungs
Ventilation
process of moving gases into and out of the lungs with air flowing into the lungs during inhalation and out of the lungs during exhalation
what are the primary functions of the vascular system
provides a route for blood to travel from the heart to nourish the various tissues of the body/ carries cellular wastes to the excretory organs/ Allows lymphatic flow to drain tissue fluid back into the circulation/ returns blood to the heart for recirculation
what are the primary functions of the arterial system
delivers oxygen and nutrients to various body tissues
what are the primary functions of the venous system
Circulation of blood by returning blood from capillaries to the right side of the heart
what is part of the lower respiratory tract
trachea, two mainstream bronchi, lobar, segmental and subsegmental bronchi, bronchioles, Alveolar ducts and alveoli
what is part of the upper respiratory tract
nose, sinus, pharynx, larynx
what is the minimal mean arterial pressure for the patient to be adequately perfusing the organs
60-70 mm/Hg
what type of labratory assessment will need to be done for antihypertensives
Serum cardiac enzymes (troponin T and I), Serum Lipids
what are the AV valves
Tricuspid and Mitral
what are the Semilunar valves
Pulmonic and Aortic
what is part of blood pressure regulation
Autonomic nervous system, Kidneys, Endocrine system, SBP, DBP, Baroreceptors
what are the 6 p’s of arterial insufficiency
Pain, Pallor, Pulselessness, Parasthesia, Paralysis, coolness
what is the anatomy and physiology of the lower airway
trachea, two mainstream bronchi, lobar, segmental and subsegmental bronchi, bronchioles, alveolar ducts and alveoli
what are some bronchodilators?
Albuterol and Proventil
what is the point of short acting bronchodilators?
rescue to dilate the airways when narrowing of the airways occur
what are some anticholinergics?
Atrovent
what do anticholinergics do
dry up secretions to ease the WOB
What is an example of a long acting bronchodilators
Serevent
what are some examples of a corticosteroids
Flovent (inhaler) and Prednisone (systemic)
what is the difference between a systemic corticosteroid and a inhaler
Inhaler is it does not circulate in the blood
what is the point of a long acting bronchodilator
maintenance
what is the point of a corticosteroid
to treat inflammation of the lungs
how many lobes are in the right lung
3
how many lobes are in the left lung
2
what does the pleural lining of the lungs do
aids in respiration and separates lungs
Angiotensin-converting enzyme inhibitors
-pril
Angiotensin II receptor blockers
-sartan
Barrel chest
diameter is increased 1:1 is barrell chested
Cardiac index equation
Cardiac output/ body surface area = cardiac index
what are the mechanical properties of the heart
cardiac output, heart rate, stroke volume, preload and afterload
Mr Carlos blood pressure is 128/89 what is the mean arterial pressure? what type of hypertension are they at risk of developing?
109 mm Hg, prehypertension
what are some cardiovascular changes that happen with older adults
cardiac valves, conduction system, left ventricle, aorta and other large arteries and baroreceptors
what history are you to ask for cardiac assessment of the patient
Modifiable and nonmodifiable factors, psychological factors, Medical history, Previous treatment for Coronary Vascular Disease, Drug history, Social history, Nutrition, Family history and genetic risk, current health problems, Functional history
what is part of the physical assessment of the cardiovascular system
General appearance, Skin color and temperature, Extremities, blood pressure, venous and arterial pulses, precordium, (Inspection, palpation, percussion, auscultation,) Normal heart sounds and abnormal heart sounds
what are some diagnostic assessments for cardiovascular
PA and Lateral CXR, Angiography, Cardiac catheterization, ECG, EOS, Exercise electrocardiography, Echocardiography, Transesophageal echocardiography, Myocardial nuclear perfusion imaging, CT, MRI
what is the cholesterol lab value
< 200mg/dL
what is the troponin T value
< 0.1 ng/mL
what is the troponin I value
<0.03 ng/mL
What medication is for artial fibrillation or a fib
Beta Blockers (-olol)
