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Foundations 1 > cardiovascular > Flashcards

cardiovascular Flashcards

1
Q

PVD risk factors

A 
Hypertension-constant stretch and pressure on the blood vessels
Hyperlipidemia
Diabetes
Smoking
Obesity
Family history
Age-increasing age
Male
African American
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2
Q

Peripheral Vascular Arterial Disease-assessments

A 
Intermittent claudication
Rest pain
Skin changes
Diminished or absent peripheral pulses
Arterial ulcerations
-Feet and toes
-Painful
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3
Q

Intermittent claudication

A

when someone walks or exercises o2 demand is increased, but the arteries cant perfuse enough blood, so muscles get cramped
•Goes away with rest

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4
Q

Peripheral Vascular Arterial Disease

skin changes

A

Hair loss-hair follicles die
•Dry, scaly, pale, or mottled
•Cool skin-no blood
•Pallor with elevation-harder it becomes for the arteries to get the blood to the location, Rubor when dependent

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5
Q

arterial ulcer

A

circular

-edges are round and smooth

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6
Q

Peripheral Vascular Arterial Disease-Intervention/Management

A
  • Slowly increase exercise-to promote the arterial blood flow
  • Body positioning-raise HOB to relieve pain, want feet down if possible, don’t raise feet above their heart
  • Promote vasodilation
  • Antiplatelet or anticoagulant to prevent blockages
  • Angioplasty-go in and remove the clot
  • bi-pass graphing
  • Surgery: Arterial revascularization
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7
Q

Peripheral Vascular Arterial Disease-Intervention/Management-promote vasodilation

A
  • No tight clothing-no tight shoes
  • Foot care
  • Environmental temperature-warm
  • Nicotine-no smoking, causes vasoconstriction of the arteries
  • Caffeine-limit bc vasoconstricts arteries
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8
Q

aneurysm assessment

A 
dependent on location
•Back pain - if below renal arteries
•Dyspnea, substernal pain-thoracic
•Pulsating abdominal mass-aortic
•Claudication(pain with movement)-femoral/popliteal
•May be asymptomatic until rupture
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9
Q

Peripheral Vascular Venous Disease

A

•Venous valves incompetent, leading to venous stasis
-if the valves no longer work as well, the blood may pool
•Venous stasis increases venous pressure which impairs arterial circulation, decreases perfusion
•Tissue hypoxia leads to cell death-necrosis
•Venous stasis ulcers can form

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10
Q

Peripheral Vascular Venous Disease

manifestations

A

Lower leg edema, aching pain, itching particularly when standing
•Cyanosis with dependency(down). Brown, leathery colog (Hemosiderosis)-from the iron leaving the blood
•Ulcer development: around ankle or medial/anterior aspect of leg
•Dermatitis-inflammation of the skin

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11
Q

Peripheral Vascular Venous Disease-ulcer

A

all the fluid in their lower extremity, skin will become wet and just fall off

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12
Q

Peripheral Vascular Venous Disease

management

A
  • Focus on symptom relief, promoting circulation, healing of affected skin
  • Reduce edema
  • Ulcer care
  • Comfort measures
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13
Q

Peripheral Vascular Venous Disease

management-reduce edema

A

Elevation of legs
•No prolonged standing or sitting
•Graduated compression dressings or stockings
-Start really tight at the toes, gradually loser towards the top
-May use an ace wrap, lace up stockings

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14
Q

Peripheral Vascular Venous Disease

ulcer care

A

Wet-dry dressings
-The area is always wet
•UNNA boot
-Looks like an ace wrap, but has medication on the inside(zinc oxide)
-Chemical reaction when it contacts with air and it becomes hard, so it hardens like a cast
-Promotes venous return, prevent stasis, makes a sterile environment for wound healing
-If a lot of drainage, may change it like 1-2 times a week

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15
Q

Venous ulcers S/S

A

dull, achy pain

  • lower leg edema
  • pulse present
  • drainage
  • sores with irregular borders
  • yellow slough or ruddy skin
  • location: ankles
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16
Q

arterial ulcers s/s

A

intermittent claudication pain

  • no edema
  • no pulse/weak pulse
  • no drainage
  • round smooth sores
  • black eschar
  • location: toes and feet
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17
Q

Nursing Diagnoses for Peripheral Vascular Disease

A

Ineffective Tissue Perfusion
Risk for decreased cardiac tissue perfusion
Chronic Pain

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18
Q

HR is controlled by

A

sympathetic(speed up) and parasympathetic(slow down)

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19
Q

Stroke Volume (SV)

A

The volume of blood pumped forward with each ventricular contraction.

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20
Q

SV affected by 3 things

A

preload, afterload, contractility

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21
Q

Preload

A

(end diastolic pressure)-the ventricle is full of blood

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22
Q

Contractility

A

how efficiently the myocardial muscle contracts and pushes the blood out

23
Q

Afterload

A

(mean arterial pressure)-how hard heart has to work to push the blood out of the heart

24
Q

Hypertension Systems of Control

Arterial baroreceptors

A

ANP and BNP-respond to stretching in the cardiac chamber that release peptides which tell the kidneys to excrete sodium and then water will follow, which will decrease BP

25
Q

Hypertension Systems of Control

Fluid volume changes

A

Fluid too high-BV high, kidneys respond to ADH and aldosterone
-Kidneys will excrete the fluid to decrease the BP

26
Q

Hypertension Systems of Control

Renin-angiotensin-aldosterone

A

In response to low BP
•Both cause vasoconstriction
•Aldosterone-na and water reabsorption

27
Q

Hypertension Systems of Control-•Vascular autoregulation

A

Pressure would stimulate the sympathetic nervous system, heart rate would go up, putting more strain on cardiac system

28
Q

Mechanisms That Increase BP

A
  • Constriction of arterioles
  • Constriction of veins
  • Stimulation of cardiac beta-adrenergic receptors
  • Retention of fluid by kidneys
  • Secretion of renin by kidneys
29
Q

Mechanisms That Increase BP

Stimulation of cardiac beta-adrenergic receptors

A

•↑HR and force of myocardial contraction

30
Q

Mechanisms That Increase BP

Retention of fluid by kidneys

A
  • ↑ blood volume

* ↑ cardiac output

31
Q

Mechanisms That Increase BP

Secretion of renin by kidneys

A
  • ↑ vasoconstriction
  • ↑ aldosterone
  • ↑ ADH
32
Q

Mechanisms That Decrease BP

A

Kidneys excrete more fluid
•Fluid loss reduces extracellular fluid volume and blood volume

•Decreased blood volume

•Decreased cardiac output decreases BP
-Blood being pushed out of the heart

33
Q

Mechanisms That Decrease BP

decreased BV

A
  • ↓ blood flow to the heart

* ↓ cardiac output

34
Q

normal BP

A

Systolic 120

Diastolic 80

35
Q

elevated BP

A

120-129/less than 80

36
Q

HTN stage 1

A

130-139/80-89

37
Q

HTN stage 2

A

> 140/>90

38
Q

HTN crisis

A

> 180 and/or >120

39
Q

Essential (primary) HTN

A

•sustained elevated BP that results in damage to the organs, thickening in BP, decrease perfusion, circulation issues, stroke, CKD

  • Based on risk factors
  • Age-older
  • Other risk factors-diabetes, African American, lifestyle, stress, family
  • usually cant fix the risk factors to make the HTN go away
40
Q

secondary HTN

A

once you remove the problem, the HTN will go away
•medical conditions
-CKD-causes elevation in BP
•Specific medications
-Steroid causes fluid retention
•Pregnancy-preeclampsia, deliver baby goes back to normal

41
Q

Malignant HTN

A

HTN crisis
•Medical emergency
-Thyroid crisis

42
Q

HTN can cause

A
  • TIA/stroke
  • CHD, HF
  • renal failure
  • PVD
  • retinopathy
43
Q

Interventions for Hypertension

DASH Diet

A
  • (Dietary Approaches to Stop Hypertension)
  • Decrease in saturated fat, total fat, and cholesterol
  • Increases potassium, calcium, magnesium-good for cardiac function
  • More fruits and vegetables
  • Fiber foods-makes you feel full, improve GI function
44
Q

monounsaturated fats

A

triglycerides in which most of the fatty acids have one point of unsaturation
EX: canola, olive, peanut oils; also, avocados, many nuts and seeds

45
Q

polyunsaturated fats

A

triglycerides in which most of the fatty acids have two or more points of unsaturation
Ex: corn, sunflower, soy beans oil, fish, nuts and seeds

46
Q

Omega 3

A 
decrease triglyceride levels (good fats)
EX: fish
flaxseed
walnuts
leafy greens
47
Q

saturated fats

A

fats that are solid at room temperature

Ex: meat, dairy products such as butter, beef, egg yolks, lard, butter

48
Q

transfat

A 
chemically altered polyunsaturated fat
Increases LDL, decreases HDL
Ex: Crackers, cookies, cakes, frozen pies, and other baked goods.
Snack foods (such as microwave popcorn)
Frozen pizza.
Fast-food.
Vegetable shortenings and some stick margarines.
Coffee creamer.
Refrigerated dough products
49
Q

Diuretics

A

Increase renal secretion of water, sodium and other electrolytes
Decrease preload

50
Q

Adrenergic-Blocking Agents

A 
•metoprolol (Toprol)
Inhibits activity of the sympathetic nervous system: results in decreased BP
•Blocks the beta cells
•Decreases contractility, BP, HR
•Causes vasodilation

↓CO and ↓ PVR
↓ myocardial oxygen demand
↓ renin

51
Q

Calcium Channel Blockers

A

diltiazem (Cardizem)
act by blocking Ca movement into muscle cells, causing less muscular contraction
-Ca builds up in the cells, decreases contractility in the arteries and the muscles
•Relaxation of peripheral arteries so PVR is decreased

52
Q

Angiotensin II Receptor Antagonists

A

Losartan (Cozaar)
block effect of angiotensin II on receptors to turn into aldosterone
•Block the vasoconstriction and sodium reabsorption

•Potent vasodilator
-First dose hypotension

53
Q

Angiotensin Converting Enzyme Inhibitors

A

enalapril (Vasotec)
Interferes with the renin angiotensin-aldosterone system of BP control
•Block enzyme that converts Angiotensin I to Angiotensin II
-Decreases vasoconstriction
•Decreases aldosterone
-Decreases Na reabsorption
•Reduces preload and afterload

Foundations 1 (8 decks)

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