Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Basic Med-Surg > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the process of atherosclerosis?

A

Plaque collects under damaged intima. Plaque collects in artery walls, causing the artery to narrow. The plaque ruptures and blood clots form.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are interventions for atherosclerosis and CAD? Explain?

A

Aimed at life-style changes and early detection/intervention. Diet and lifestyle changes are tried first before medication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should fasting cholesterol level be? What are the elements of cholesterol?

A

<200 mg/dL
HDL (high-density lipoprotein)
LDL (low-density lipoprotein)
Triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the mechanism of action of statins?

What is it contraindicated in?

A

Mechanism of action is to lower LDL and triglycerides, increase the HDL, decrease synthesis of cholesterol in the liver.Contraindicated in liver disease (can cause increased LFTs). Don’t use for folks with severe muscle pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are common potential side effects of statins?

Most serious adverse reactions?

A

Common potential side effects include abdominal cramps, diarrhea, constipation, flatus, heartburn, rash. Contraindicated in liver disease (can cause increased LFTs). Don’t use for folks with severe muscle pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is needed to diagnose hypertension (HTN)?

A

Systolic BP consistently > or equal to 140 mm/Hg and a diastolic consistently > or equal to 90 mm/Hg on two or more different occasions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is normal BP in adults?

A

SBP is less than 120

DBP is less than 80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are risk factors for secondary HTN?

A

Coarction of aorta, brain tumors, encephalitis, medications, pregnancy, renal disease, endocrine disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Early clinical manifestations of HTN?

A

Initially, asymptomatic. Headache, dizziness, fainting, vertigo, flushed face, spontaneous epistaxis, blurred vision, retinal changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What occurs as HTN progresses?

A

Dyspnea, orthopnea, chest pain, leg edema, nausea, vomiting, drowsiness, confusion, numbness or tingling of extremities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Very late signs and symptoms of HTN?

A

Angina, MI, heart failure, kidney changes, stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical manifestations of hypertensive crisis or malignant HTN?

A

Systolic greater than 240, diastolic greater than 120. Blurred vision, severe headache, dyspnea, epistaxis, disorientation, dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How much fluid is equal to a kilogram of pt weight when it comes to fluid loss and gain?

A

1 liter of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the mechanism of action of thiazide diuretics?

A

Increased excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule of kidney.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common potential side effect of thiazide diuretics? Serious adverse reactions?

A

Most common potential side effect is hypokalemia

Most serious adverse reaction is none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nursing considerations for thiazide diuretics?

A

Nursing considerations: monitor for dehydration and hypokalemia. Usually used first as a cost-effective drug to treat uncomplicated HTN. Not used for emergency diuresis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the mechanism of action for loop diuretics?

A

Mechanism of action is inhibited reabsorption of sodium and chloride from of Henle and distal renal tubule. Increased renal excretion of water, sodium, chloride, magnesium, potassium and calcium to promote diuresis and decrease in BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the most common potential side effects of loop diuretics? Adverse reactions?

A

Most common potential side effects are hypokalemia, hypomagnesemia, hyponatremia, dehydration
Most potential adverse reactions are aplastic anemia, agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are nursing considerations for loop diuretics?

A

dehydration. Evaluate electrolytes frequently. Strict I and O. Can be given PO or IV. Used when there is an emergent need for rapid mobilization of fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mechanism of action for calcium channel blockers?

A

Inhibits transport of calcium into myocardial and vascular smooth muscle cells which leads to systemic vasodilation and relaxation of smooth muscles which leads to decreased BP. Acts on myocardium, SA node, and AV node.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Side effects and adverse effects of calcium channel blockers?

A

Side effects: Headache, facial flushing, peripheral edema, hypotension, irregular heartbeats, constipation Adverse reactions: heart block or heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Nursing considerations for calcium channel blockers?

A

Check BP, IO, daily weight. Constipation. Teach pt to monitor bowel function. Avoid grapefruit juice. Regular dental care-may cause gingivitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mechanism of action for ACE inhibitors?

A

blocks conversion of angiotensin I to angiotensin II. Blocks release of aldosterone which leads to decreased sodium and water retention. Antihypertensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Side effects and adverse reactions for ACE inhibitors?

A

Side effects: Hypotension, cough
Adverse effects: Angioedema (swelling of tissues in lips, face, throat, tongue, and oropharynx). Emergency situation that constitutes an allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Nursing considerations for ACE inhibitors?

A

Safety. Pt should remain on bedrest for the first few hours after initial dose to prevent injury related to the “first dose effect.” May cause annoying cough.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is included in Virchow’s Triad?

A

At least one of these factors is necessary for development of VTE. Endothelial damage, venous stasis, altered coagulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is included in a venous thromboembolism (VTE)?

A

Deep vein thrombosis and pulmonary embolism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Risk factors for DVT?

A

Age, prior history of DVT, surgical and invasive procedures, coagulation abnormalities, oral contraceptives, pregnancy, HF, obesity, immobility, trauma, ulcerative colitis, lupus, sepsis, advanced neoplasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Clinical manifestations of DVT?

A

Pain in the area of thrombosis. Sudden onset, unilateral edema. Red, warm, indurated vein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What’s involved in the diagnosis of DVT?

A

Physical exam. Assess S/S. Venous duplex ultrasonography (aka venous doppler). Venogram (invasive). D-Dimer blood test that measures fibrin breakdown. It’s only suggestive of DVT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Treatment of existing DVT?

A

Rest and elevation of extremity. Do not rub or massage the area. No SCD stockings or ROM to affected extremity. Compression stockings. Anticoagulation therapy. Assess neurovascular status of extremity. IVC filter.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Pathophysiology of a pulmonary embolism?

A

Thrombus causes an obstruction of blood flow to the pulmonary circulation. There is ventilation but no perfusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Manifestations of a pulmonary embolism?

A

Sudden onset SOB. Sharp, stabbing chest pain. Anxiety or apprehension. Cyanosis, tachycardia, tachypnea. Cough, hemoptysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Diagnosis of PE?

A

Patient history. EKG, CXR to rule out other conditions. D-Dimer. V/Q scan (ventilation-perfusion). Spiral CT scans. Pulmonary angiography.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are some lab tests for monitoring heparin

A

Activated partial thromboplastin time (APTT)
Partial thromboplastin time (PTT). Therapeutic should be 1.5-2.5 the norm or 60-80 seconds
Evaluate baseline labs: CBC, platelets, urinalysis, stool, creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Who are candidates for home enoxaparin (Lovenox) therapy?

A

Stable DVT/PE. Reliability, low risk for bleeding, adequate renal functioning, normal vital, able to monitor and report bleeding

37
Q

What drugs should NEVER be given concurrently?

A

Heparin and enoxaparin (Lovenox)

38
Q

Lab test for warfarin (Coumadin)?

A

International normalized ratio (INR/PT).
Hold dose of warfarin if INR is 3.0+ and consult with HCP for dosing. Seek parameters from HCP as to when to hold warfarin r/t INR level

39
Q

How to wean a pt from heparin or enoxaparin to warfarin?

A

Administer warfarin & heparin OR enoxaparin concurrently for 3-5 days until INR reaches its therapeutic range of 1.5-2.5. Then maintain on warfarin w/ close monitoring of INR.
Warfarin takes 48-72 hrs to affect PT/INR

40
Q

Pt teaching for warfarin?

A

s/s report to HCP. Safety, labs, take as directed. Notify all HCP/dentists that you’re on the med. Avoid NSAIDs, salicylates, and OTC drugs

41
Q

Diet with warfarin?

A

Avoid foods high in vitamin K. Keeping diet consistent and with low amount of vitamin K is more important than trying to keep intake low. Green leafy veg, certain legumes, and veg oil are avoided.

42
Q

A clinical syndrome resulting from structural or functional cardiac disorders that impair the ability of the ventricles to fill or eject blood. Results in?

A

Heart failure resulting in inadequate CO, tissue perfusion, hypertrophy of the myocardium, pulmonary, systemic congestion

43
Q

Types of HF and what they are?

A

Systolic HF, the most common. Decreased ability of the ventricle to contract.
Diastolic HF, less common. Stiff, noncompliant heart muscle making it difficult for the ventricles to fill.

44
Q

Percentage of blood volume in the ventricles at the end of diastole that is ejected during systole, measure contractility.

A

Ejection fraction.
Normal is 55-65%.
Systolic HF: decreased
Diastolic HF: normal

45
Q

What is the initial compensatory mechanism of the heart to counteract HF? Most start out as what?

A

Sympathetic stimulation

Left-sided

46
Q

What is the major underlying cause of HF?

A

Chronic HTN and myocardial infarction (MI). Any condition that results in direct damage to the heart, ventricular overload. Constriction of the ventricles, limiting ventricular filling and decreasing stroke volume.

47
Q

Risk factors for HF?

A

HTN, CAD, MI, cardiomyopathy, valve disease, cardiac infections, substance abuse, arrhythmia, diabetes, smoking, family HX, metabolic diseases

48
Q

Left-sided heart failure?

A

The left ventricle isn’t pumping with enough force to eject blood during systole→↓ tissue perfusion r/t ↓ CO & Pulmonary congestion r/t ↑ pressure in pulmonary vessels
CO from left ventricle ↓ than the volume of blood received from pulmonary circulation→ pulmonary congestion

49
Q

Clinical manifestations of left-sided HF?

A

Relate to the respiratory system and will produce s/s related to the respiratory system as blood accumulates in the lungs.

50
Q

s/s of left-sided heart failure?

A

Asymptomatic initially. Pain, exercise intolerance, unable to perform ADLs, anxiety, deceased urine output during the day, nocturne, possible edema

51
Q

Right-sided heart failure?

A

The failing heart can’t pump volume of blood received from body into lungs for oxygenation; “back up” of fluid develops →to peripheral edema
Right ventricular CO ↓ than volume received from peripheral circulation → edema.
Right-sided HF produces s/s of vascular congestion in body

52
Q

Right-sided HF failure risk factors?

A

Left-sided HF: As fluid accumulates in lungs r/t left sided HF,→↑ pressure in lungs causes ↑resistance to blood flow into lungs over time→ to right sided HF. Right ventricular MI. COPD.

53
Q

s/s of right-sided heart failure?

A

Peripheral edema, decreased urine output during waking hours. Diuresis at rest, nocturia. Weight gain, hyper or hypotension. May have s/s of left-sided HF

54
Q

Distinguishes between dyspnea of HF and dyspnea of lung disease

A 
Brain natriuretic peptide (BNP)
↓100 pg/mL = none
100-300 pg/mL= present 
↑300 pg/mL = mild  
↑600 pg/mL = moderate 
↑900 pg/mL = severe
55
Q

Considered to be the best tool to diagnose HF. Used to determine cardiac ejection fraction (EF).

A

Echocardiography

56
Q

Medications for HF?

A

Diuretics, vasodilators, ACE inhibitors, beta blockers, digoxin (Lanoxin)

57
Q

Mechanism of potassium sparing diuretics

A

inhibits sodium reabsorption in kidney while saving potassium and hydrogen ions (antagonizes aldosterone receptors)

58
Q

Side effects and adverse effects of potassium sparing diuretics

A

Most common side effect is hyperkalemia

Most serious adverse reaction is none

59
Q

Considerations of potassium sparing diuretics

A

Nursing considerations: should not administer K+ supplements. Monitor for hyperkalemia. Strict I and O. Usually used in combination with other diuretics. Has a weak effect on its good, good synergistic effect. Used mainly to counteract K+ loss from other diuretics.

60
Q

Mechanisms of ARBS

A

blocks vasoconstrictor and aldosterone producing effects of angiotensin II at receptor sires at vascular smooth muscle which leads to decreased BP, decreased release of aldosterone which leads to increased renal excretion of Na+ and water.

61
Q

Side and adverse effects of ARBS

A

Side effects: Dizziness, hypotension

Adverse effects: Angioedema

62
Q

Nursing considerations of ARBs

A

Monitor for angioedema and heart failure. Not as effective in black folks unless taken in conjunction with other antihypertensive. Safety: assist the pt in activities r/t potential dizziness r/t orthostatic hypotension

63
Q

Mechanisms of beta blockers non cardio selective

A

Blocks stimulation of beta 1 (myocardial) and beta 2 (pulmonary, vascular, uterine) adrenergic receptor sites to decreased BP and HR. Improves cardiac output, slows progression of HF.

64
Q

Effects of beta blockers non cardio selective

A

Side effects: Dizziness, fatigue, weakness, erectile dysfunction
Adverse reactions: Bradycardia, heart failure, arrhythmia, orthostatic hypotension

65
Q

Considerations of beta blockers non cardio selective

A

Non cardio selective BB given with care to pt with lung disorders due to possible bronchospasm. Contraindicated in asthma, chronic bronchitis, and emphysema (COPD). Assess BP and HR prior to administration. Monitor for respiratory distress.

66
Q

Mechanisms of alpha II adrenergic agonists

A

Stimulates alpha adrenergic recpetors in the CNS which leads to deceased SNS inhibiting HR and vasocontriction centers to decreased BP, decreased systemic vascular resistance.

67
Q

Effects of alpha II adrenergic agonists

A

Side effects: Drowsiness, dry mouth

Adverse effects: Can cause severe rebound hypertension if stopped abruptly.

68
Q

Considerations of alpha II adrenergic agonists

A

Try to give at night: causes drowsiness. Can be given by transdermal patch, not to be used as a first line treatment for hypertension. Orthostatic hypotension and safety. If patch used, consult with HCP for removal of patch at night to avoid tolerance

69
Q

Mechanisms of vasodilators

A

produces vasodilation and increased myocardial bloodflow

70
Q

Effects of vasodilators

A

Side effects: Dizziness, headache, hypotension, tachycardia
Adverse effects: Concurrent use of sildenafil, tadalafil, or vardenafil may lead to significant, potentially fatal hypotention.

71
Q

Considerations of vasodilators

A

Take BP prior to administration. If systolic is less than 90, don’t administer, ask for vitals parameters and trend BP. May produce severe headaches until pt becomes acclimated to the med. May take Tylenol for it. Educate

72
Q

Causes of PE?

A

DVT, air, fat, amniotic fluid, septic

73
Q

Mechanisms for heparin?

A

Potentiates inhibitory effect of anti-thrombin and thrombin. Prevents conversion of prothrombin to thrombin. Prevents thrombus formation and prevents extension of existing thrombi. Used when rapid anticoagulation needed.

74
Q

Effects of heparin?

A

Side effect: spontaneous bleeding (hematuria, bleeding gums, positive blood in stool, ecchymosis, petchiae)
Adverse reactions: Hemorrhage, altered LOC, decreased platelets (heparin induced thrombocytopenia (HIT))

75
Q

Considerations for heparin?

A

special considerations with use in thrombocytopenia, untreated hypertension, ulcer disease, spinal cord/brain injury, bleeding disorders, malignancy, use cautiously in late trimester pregnancy. Monitor for bleeding and PTT.

76
Q

Mechanism for enoxaparin

A

Potentiates inhibitory effect of antithrombin on factor Xa and thrombin. Prevention of thrombus formation. Used for prevention and treatment of DVT.

77
Q

Effects for enoxaparin

A

Side effects: anemia, spontaneous bleeding

Adverse: thrombocytopenia, hemorrhage

78
Q

Considerations of enoxaparin

A

PTT not checked regularly because dosing of LMWH not adjusted. Monitor CBC, platelet count, stools and urine for occult blood. Assess for bleeding. If platelet is less than 150,000 may have HIT would need to d/c lovenox. Use cautiously with spinal and severe uncontrolled HTN and bleeding disorders.

79
Q

mechanism for warfarin

A

Interferes with hepatic synthesis of vitamin K dependent clotting factors: II, VII, IX, and X. Prevention of thromboembolitic events.

80
Q

effects of warfarin

A

Side effects: alopecia, urticaria, skin necrosis, dermatitis, fever, Gi distress, red/orange discoloration of urine
Adverse: Bleeding

81
Q

considerations for warfarin

A

Therapeutic effects take 3-4 days to develop. Usually on the drug for greater than or equal to 3-6 or more if indicated. Assess PT/INR daily until INR 2.0 and frequently per orders. Hold dose if INR greater than 3.0. Consistency in eating green leafy veg. Lab monitoring PT/INR

82
Q

mechanism of alteplase

A

converts plasminogen to plamin which berak down fibrin clots causing a destruction of the thrombi and emboli.

83
Q

effects of alteplase

A

Side effects: none

Adverse: Bleeding

84
Q

considerations for alteplase

A

Long list of exclusive criteria, must be given within certain time frame, given IV. Should have all the blood draws and IV’s started prior to administering their med. Antagonist is aminocaproic acid/amicar

85
Q

Antiplatelet meds?

A

Aspirin and clopidogrel/plavix. Prevents the development of thrombosis in the arteries by suppressing platelet aggregation

86
Q

Manifestations of PVD?

A

Brown pigmentation of skin and legs, aching pain relieved by elevation, edema around the ankles, cyanosis, stasis ulcers

87
Q

Mechanism beta blockers cardio selective

A

Blocks stimulation of bet 1 myocardial adrenergic receptors to decrease blood pressure and heart rate, decrease peripheral vascular resistance and decrease force of myocardial contractility. Cardio selective works only on cardio system. Blocks sympathetic stimulation to heart and decreases heart rate.

88
Q

Side and adverse of beta blockers cardio selective

A

Side: weakness, fatigue, erectile dysfunction
Adverse: bradycardia, orthostatic hypotension, HF

89
Q

Considerations cardio selective beta blockers

A

Check BP and HR prior to administration. Assist prn with activities related to potential dizziness. Caution as early signs of hypoglycemia will not be seen

Basic Med-Surg (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions