Cardiac/ Hypertension Flashcards
1
Q
This is the process of transporting nutrients to the cells and surrounding tissues
A
perfusion
2
Q
this system transports oxygen and nutrient throughout the blood vessels and ultimately to the tissues
A
cardio vascular system
3
Q
this is the force exerted by the blood against the walls of the blood vessels
A
blood pressure
4
Q
How to calculate the BP
A
cardiac output
systemic vascular resistance
5
Q
this is the amount of blood pumped by each ventricle in 1 minute
A
cardiac output
6
Q
this is the contraction of myocardium
A
systole
<120
7
Q
this is the relaxation of myocardium
A
diastole
<80
8
Q
this is the average pressure with in the arterial system that is felt by organs in the body
A
mean arterial pressure (MAP)
9
Q
what are the 3 functional ways to view cardiac activity?
A
electrical
muscular
vascular
10
Q
this is the minimum needed to perfuse kidneys. If that is met everything else is being perfused
A
MAP
11
Q
what are the 3 electrical parts of the heart?
A
SA node
AV node
Purkinje fibers
12
Q
this is the pacemaker of the heart
A
SA node
13
Q
what is the rate of the pacemaker of the heart
A
60-100 bpm
14
Q
this part of the heart delays the electrical signal of the heart
A
AV node
15
Q
what is the rate of the pacemaker of the heart?
A
40-60 bpm
16
Q
why does the AV node delay the electrical signal?
A
so the ventricle can fill with blood
17
Q
this part of the heart delivers shock to both ventricles
A
Purkinje fibers
18
Q
what is the rate of the Purkinje fibers
A
20-40 bpm
19
Q
“to a point, the more myocardial fibers are stretched, the greater their force of contraction” This quote identifies what law
A
Frank Sterling Law
20
Q
The greater the contraction…
A
the more force the blood is excreted out the aorta
21
Q
this type of circulation occurs during diastole
A
coronary circulation
22
Q
This vessel supplies blood to the:
Left Atrium
Left Ventricle
Interventricular septum
A
left coronary and circumflex Artery
23
Q
This vessel supplies blood to the:
Right atrium
Right ventricle
The posterior side of the left ventricle
A
right coronary artery
24
Q
this is the total peripheral resistance that your heart must overcome to provide adequate perfusion
A
systemic vascular resistance
25
what are the 3 factors that influence systemic vascular resistance?
vascular resistance
blood viscosity
turbulence
26
what are the factors that impact vascular resistance?
size of blood vessel
length (longer the tube = more resistance)
diameter (wider diameter = less resistance vise versa)
27
this measures the fluid's resistance to flow (thickness)
blood viscosity
28
Higher viscosity requires ...
higher pressure to move
29
what lab is used to measure viscosity
Hematocrit levels
30
this is the type of fluid flow that undergoes irregular fluctuations in speed
turbulence
31
what could cause turbulence?
plaque formation
32
where is turbulence assessed and what sound does it make?
carotid
"bruit"
33
How does our body monitor blood pressure?
baroreceptors
34
these are stretch receptors located in aortic arch and carotid arteries
baroreceptors
35
if the blood pressure is low how does the body compensate?
body increases
heart rate
contractility
vasoconstriction
36
if the blood pressure is high how does the body compensate?
increasing parasympathetic activity
(rest and digest)
37
where is cholesterol absorbed?
small intestine
38
how much cholesterol does the liver produce a day?
1000 mg
39
cholesterol play a role in forming what hormones
estrogen and testosterone
40
this helps transport fat around the body
lipoprotiens
41
what is the major cholesterol carrier in the blood?
LDL
42
this lipoprotein is the healthy cholesterol and collects fat and takes it to the liver?
HDL
43
this lipoprotein carries fat to needed sites and may cause plaques
LDL
44
this is the elevation of blood lipid levels
hyperlipidemia
45
what are the risk factors of hyperlipidemia?
CAD (harden blood vessels)
atherosclerosis (hardening of arteries)
thrombosis
46
what is the ideal cholesterol levels
< 200 mg/dL
47
what is the ideal level of HDL?
40-59 mg/dL
48
what is HMG-CoA?
allows for absorption of cholesterol into the small intestine
49
This drug reduces LDL and increases HDL by inhibiting HMG-CoA
Atorvastatin
50
what are the side effects of Atorvastatin?
myopathy (muscle breakdown)
rhabdomyolysis (systemic muscle breakdown)
liver toxicity
51
what are interactions of Atorvastatin?
avoid grapefruit juice
52
can you take Atorvastatin with or without food?
both
53
this drug lowers cholesterol levels by increasing the activity of lipase
niacin
54
what are the side effects of Niacin
flushing of face and chest
55
what are the interactions with Niacin?
do not use with statin, increase risk of myopathy
56
As a nurse how would you help with the side effects of Niacin?
give NSAID 30 min before
57
this drug is inhibits the absorption of cholesterol in the small intestine, decreasing blood cholesterol levels
Ezetimibe
58
what are the side effects of Ezetimibe?
increase of liver enzymes
59
what are the contraindications/precautions of Ezetimibe
active liver disease
60
Ezetimibe benefits are enhanced with what drug?
statins
61
this is when systolic BP is greater than 130 mm/Hg or diastolic BP is greater than 80mm/Hg for extended periods of time
hypertension
62
what damage does hypertension do to the body
loss of elasticity
stiffness of the myocardium
increased peripheral vascular resistance
decreased renal function
63
What is the cause of 90% of hypertension cases?
unknown (primary)
64
What are some risk factors of primary HTN?
increased sodium intake
greater body weight
excessive alcohol consumption
tobacco use
65
what is the cause of secondary HTN?
renal disease
pregnancy
endocrine disorders (DM 1/2)
66
This disease is known as the silent killer
hypertension
67
what are the main symptoms of HTN?
headache
blurry vision
chest pain
68
what nutritional therapy is used for HTN, that involves a low sodium intake?
DASH
69
what is the major problem in the long term management of the patient with HTN?
poor compliance with treatment plan
70
A BP of 120-129 or <=80 is categorized as?
prehypertension
71
A BP of 130-139 or 80-89 is categorized as?
hypertension stage 1
72
A BP >140 >=90
hypertension stage 2
73
What category of antihypertensive drug does hydrochlorothiazide and furosemide fall into?
diuretics
74
What category of antihypertensive drug does spironolactone fall into?
aldosterone antagonist
75
What category of antihypertensive drug does metoprolol fall into?
beta blocker
76
What category of antihypertensive drug does captopril fall into?
ACE inhibitor
77
What category of antihypertensive drug does losartan fall into?
ARB (angiotensin II receptor blockers)
78
What category of antihypertensive drug does Verapamil fall into?
CCB (calcium channel blocker)
79
This drug is used for pulmonary edema in heart failure. It acts in the loop of Henle to block the reabsorption of Na & Cl
furosemide (loop diuretic)
80
A side effect of these 2 antihypertensive drug is
electrolyte imbalance of K (HYPOKALEMIA) , but also Na and Cl
dehydration
hypotension
furosemide
hydrochlorthiazide
81
What are interactions with the drug furosemide?
NSAIDs decrease effect
82
furosemide causes and electrolyte imbalance of K, what high K foods would you recommend to this patient?
potatoes
83
This drug is used for HTN, blocks the reabsorption of Na, Cl, K in distal conducted tubule
hydrochlorthiazide
84
high or low K+ in blood can lead to what?
dysrhythmias
85
With this antihypertensive drug there is an increased risk of toxicity of the drug, becuase it does cause K or Mg deficiency and an increase in blood sugar
hydrochlorthiazide
86
with this antihypertensive drug urine output should increase and it is crucial to eat foods high in vitamin k
hydrochlorothiazide
87
this antihypertensive drug blocks aldosterone receptor
Increasing urinary excretion of Na & H2O and urinary retention of K
spironolactone
88
what are the side effects of spironolactone?
hyperkalemia
89
why does spironolactone have an interaction with ACE drugs
raises K levels
90
what should you avoid with spironolactone?
K supplements
salt substitutes
91
what do antiadrenergic drugs do?
suppress the sympathetic nervous system
slows and relaxes the heart and blood vessels
lower heart rate and blood pressure
92
what do beta blockers do?
decrease contractility and HR
93
this antihypertensive drug blocks cardiac beta-1 receptors
metoprolol
94
the side effects of this antihypertensive drug are bradycardia and heart failure
metoprolol
95
The patient has a heart rate < 60 and has metoprolol prescribed to take now, should you give the medication?
no (bradycaridc)
96
what do ACE inhibitors do?
blocks angiotensin
allows for veins and arteries to dilate
97
this antihypertensive drug blocks the production of angiotensin II
captopril
98
the main side-effect of this antihypertensive drugs is a
dry non productive cough
hyperkalermia
hypotension
captopril
99
what is an adverse reaction to captopril?
angioedema (swollen mouth/tongue)
100
What do ARBs do (angiotensin II receptor blocker)?
blocks angiotensin II
veins and arteries dilate
101
this antihypertensive drug blocks angiotensin II ARB receptors causing
vasodilation
urinary excretion of Na and H20
retention of K
losartan
102
what are the common side effects of losartan?
hypotension
103
you should not take spironolactone with this antihypertensive drug
losartan
104
what do CCBs do?
prevent calcium from entering the heart, lowering BP
105
this antihypertensive drug slows the SA node, slow conduction, decrease myocardial contractility
verapamil
106
the side effects of this CCBs blocker antihypertensive drug are
hypotension
bradycardia
verapamil
107
If the patient has a systolic BP of 90 and a pulse below 60 and is prescribed verapamil should you give this drug?
no
108
what is a common side effect of antihypertensive medications?
orthostatic hypotension
109
define orthostatic hypotension
decrease of systolic by 20 and diastolic by 10
110
this is a disease of the blood vessels where soft fatty deposits build up on the lining of the arteries and harden with age (atherosclerosis)
CAD
111
this disease causes an increase in O2 demand which is more than the supply >>myocardial ischemia >>chest pain
CAD
112
what is prinzmetal's angina
chest pain that comes and goes
113
what medication is used for CAD
Nitrates
114
this drug relaxes vascular smooth muscle and dilates both arterial and venous vessels
USED FOR ANGINA
Nitrates
115
side effects of this drug are
headache
hypotension
tachycardia
nitrates
116
what medication should you not take with nitrates?
viagra
117
Describe the med admin for nitrates
sublingual every 5 minutes, do 3x
if not relieved after 1st 1 call 911
may take Tylenol
118
what should be assessed always when taking nitrates
BP
