cardio vascular stressors Flashcards
get 85 or higher!!!
two types of aneurysms
abdominal (AAA)
thoracic (TAA)
3layers of aorta
- intima-endothelial connective tissue (inner)
sub-endothelial connective tissue - tunica media- smooth muscle cells
- adventitia- connective tissue(outer)
normal aorta size
3cm at origin; 2.5cm descending thoracic; 1.8cm abdominal
aneurysms
- means permanent, pathologic dilatation of a segment of a vessel
- caused by injury, disease, or conginetal weakness
- aorta is prone to high pressures and shear stress
- occurs usually bet the renal arterier and aortic bifurcation (where aorta spreads off to the kidney)
who’s at risk for aneurysm
men, age 40, family hx, congenital defect at birth, pregnancy, smoker, COPD, hyperlipidemia, poorly controlled diabetes, htn, connective tissue disorders, infx:Syphillis and TB.
types of abdominal aneurysm
true:
- involves 3 layers
- describe by shape
a. saccular-one sided
b. fusiform-two sides
types of abdominal aneurysm
false (Pseudoaneurysm)
- does not involve all 3 layers
- caused by a trauma
- perivascular clot may be present
sx of thoracic aneurysm
asymptomatic pain in the jaw, neck, and upper back chest or back pain coughing, hoarseness, or difficulty breathing dysphagia
sx of abdominal aneurysm
often asymptomatic
chest,lower, back, or scrotum pain,
strong pulsation, sensation of abd, palpable nontender upper abdominal mass,cystolic bruit
treatment options
- first priorities-aortic dissection-hemodynamic
- limit dissection by lowering systemic arterial pressure and reduce cardiac contractility
a. beta blocker
b. nitroprusside-nitrate= lowers bp
* DO NOT give hydralazine contraindicated-direct vasodilation can worsen the dissection
surgical tx of aneurysm
- open repair
- emergency or scheduled
- percutaneous -endovascular stent grafting
Post op assessment
neurologic status cardiac rhythm and vital signs hemodynamic urine output >30/hr pain surgical sites neurovascular checks for lower extremities
post op nursing care
monitor for complications
- endoleaks
- trauma to arteries
- occlusion of the renal or hypogastric arteries
- infx
- renal impairment
post op goals
prevent htn SBP<120
cardiac support fx
nitroprusside with esmolol or labetalol
monitor for renal fx and ischemic colitis
arteriosclerosis
arteriosclerosis refers to any stiffening or hardening of arteries often asso with HTN
atherosclerosis
hardening of an artery specifically due to PLAQUE; most common form of arteriosclerosis
effects of atherosclerosis
- occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called PLAQUES
- plaques can make the artery narrow and less flexible, restricting blood flow
- pieces of plaque can break off and move thru the affected artery to smaller bld vessels, blocking them and causing tissue damage or death (embolization)
- Bld clots can also form around a tear or fissure in the plaque leading to blocked blood flow (complicated lesions)
risk factors for atheros
diabetes High bld pressure heavy alcohol use hi fat diet increasing age obesity personal or family history of heart disease smoking
symptoms atheros
usually do not occur until blood flow becomes restricted or blocked
can affect many different organ systems, including the heart, lungs, brain, intestines, kidneys, and limbs (extremities)
Atheros tx
include life style changes, meds, and medical procedures or surgery.
goal of tx
relieving sx, reducing risk factors lowering the risk of bld clots forming widening or bypassing plaque-clogged arteries preventing Atheros-related disease
