Cardiovascular & Peripheral Vascular Disorders Flashcards
Unoxygenated Blood comes from the
Superior Vena Cava, Inferior Vena Cava, and Coronary Sinus
Right Atrium then what valve
Tricuspid Valve
responsible for Ventricular Filling, Preload
Right Ventricle
Pulmonary Artery then to the
Lungs for pulmonary circulation
Oxygenated Blood comes from the
Pulmonary Vein
what part of the heart follows the Pulmonary Vein
Left Atrium
what valve follows after the left atrium
Mitral Valve
responsible for Ventricular Filling, Afterload, Cardiac Output
Left Ventricle
what valve follows after the left ventricle
aortic valve
what carries oxygenated blood for systemic circulation throughout the body
Ascending Aorta, Descending Aorta, and Coronary Artery
AKA elevated blood pressure
Hypertension
Systolic and diastolic blood pressure of hypertension in the general population
greater than 140/90 mmHg
Most common form of hypertension, exact cause is unknown.
Some causes - aging, family history, smoking, high fat diet,
salty foods, caffeine, stress, DM, sedentary lifestyle
Primary hypertension
Caused by underlying disease
Secondary hypertension
Signs of hypertension
High blood pressure (>140/90 mmHg), Headache, Neck pain, Nuchal headache, Epistaxis, Dizziness, Vagueness, discomfort, fatigue
<120 AND <80 mmHg bp is what type
Normal BP
120 AND <80 mmHg
Elevated BP
130 over 80 mmHg
Mild (Stage 1)
140 over 90 mmHg
Moderate (Stage 2)
150 over 100 mmHg
Severe (Stage 3)
> 180 and >120 mmHg
Hypertensive Crisis
> 180 over >120 Without Target-organ Damage
Urgency
> 180 over >120 With Target-organ Damage
Emergency
Retinal hemorrhage, Cotton-wool spots, Papilledema, Spots, Blurred vision
Severe Hypertension Signs
Complications of severe hypertension
Coronary diseases, heart failure, renal failure, stroke
Identify what pharmacologic class:
Clonidine
ALPHA-blockers
Identify what pharmacologic class:
Metoprolol
BETA-blocker
Identify what pharmacologic class:
-OLOL
BETA-blocker
Identify what pharmacologic class:
-DIPINE
CALCI-block
Identify what pharmacologic class:
-PRIL
ACE
Identify what pharmacologic class:
Captopril
ACE
Identify what pharmacologic class:
-SARTAN
ARBS
Identify what pharmacologic class:
Prazosin
ALPHA-blockers
Identify what pharmacologic class:
Atenolol
BETA-blocker
Identify what pharmacologic class:
Nifedipine
CALCI-block
Identify what pharmacologic class:
Enalapril
ACE
Identify what pharmacologic class:
Valsartan
ARBS
Identify what pharmacologic class:
Losartan
ARBS
Identify what pharmacologic class:
Methyldopa
ALPHA-blockers
Identify what pharmacologic class:
Doxa
ALPHA-blockers
Rest ques
Rest ques
Regular BP monitoring is needed for hypertension px
true
Dietary approaches to stop hypertension what is it called
DASH DIET
DASH Diet includes what
Grains and grain products
Fruits and vegetables
Low fat or nonfat dairy
Lean meats, fish, and poultry
Nuts, seeds, and legumes
Fats and sweets
First intervention in hypertension?
Give antihypertensive drugs as ordered
Health teachings of hypertension
Weight reduction and control
Regular exercise
Alcohol restriction
Smoking cessation
Relaxation techniques (deep-breathing exercises)
Stress reduction
Paroxysm or episodes of pain and pressure in anterior chest caused by insufficient coronary blood flow
ANGINA PECTORIS
predictable consistent chest pain during exertion; relieved by rest
Stable Angina
pain at rest
Prinzmetal or variant
unpredictable, more frequent, unrelieved by rest
Unstable or preinfarction
intractable incapacitating; severe chest pain
Refractory
Diagnostic Tests for hypertension
12 lead ECG
Stress test
Echocardiogram
C-reactive protein
what test is done for the marker for inflammation of vascular endothelium with High homocysteine
C-reactive protein
Most common cause of angina pectoris
Atherosclerotic
Common first manifestation of angina pectoris
Chest pain and discomfort
common presenting symptom for elderly
Dyspnea
other causes of angina pectoris
○ Smoking
○ Physical exertion
○ Cold exposure
○ Stressful situation
○ Eating heavy meal
○ Excess weight
angina means
pectoris means
angina means “pain”
pectoris means “chest”
other Manifestations of angina pectoris
○ Retrosternal pain
○ Radiating pain
○ SOB
○ Weakness and numbness of arms
○ Pallor
○ Diaphoresis
○ Undue fatigue
○ Apprehension
○ Dizziness
Complications of angina pectoris
○ Myocardial infarction
○ Sudden death
indicated position for patients with angina pectoris
as this promotes increase in myocardial oxygen supply
Bed rest, semi-fowlers
anti-anginal drugs
Nitroglycerin, ISMN-imdur, ISDN-isordil (isosorbide nitrate)
(mainstay treatment)
antiplatelet drugs
aspirin, clopidogrel, heparin
Other NURSING INTERVENTIONS for Angina Pectoris
○ Stop all activities (exercise, isometric, stressful situation,
smoking)
○ Low fat diet, high fiber diet, control BP
Also known as Ischemic Heart Disease
CORONARY ARTERY DISEASE (CAD)
A broad heart condition characterized by partial and complete
obstruction of blood flow to the heart muscles
CORONARY ARTERY DISEASE (CAD)
Usual Cause of CORONARY ARTERY DISEASE (CAD)
Atherosclerosis
local accumulation of lipid, fat deposit, plaques, atheromas, and fibrous tissues along intima layer of artery; inflammatory response to artery wall injury
Atherosclerosis
4 Major Risk Factors of CORONARY ARTERY DISEASE (CAD)
Sm
Hy
Hi
Di
Oth
○ Smoking
○ Hypertension
○ High cholesterol
○ Diabetes
○ Others: family history, old age, women, obesity, physical
inactivity
Most common Sign of CAD
Chest pain
Other signs and symptoms of CAD
○ Murmur
○ Bradycardia
○ Extra heart sound
○ Dyspnea
○ Fatigue
○ Syncope
○ High BP
○ Weak PR
○ Wide PP
NURSING INTERVENTIONS of CAD
Decrease cardiac output
Cardiac rehabilitation program
Regular exercise should be
30 minutes daily; 3x-5x weekly
COLLABORATIVE INTERVENTIONS
Monitor VS such as:
○ BP
○ PR
○ Triglyceride
○ HDL
○ LDL
○ Total lipid profile
Surgeries for CAD
Prepare patient for Angioplasty, Coronary Artery Bypass Graft (CABG)
Identify what pharmacologic class:
Simvastatin
Antilipemics
Identify what pharmacologic class:
Nitroglycerin
Antiangina
Identify what pharmacologic class:
Fenofibrate
Niacin, Fibric Acid
Identify what pharmacologic class:
Cholestyraminase
Bile acid sequestrants
Identify what pharmacologic class:
Beta-blocker, Calcium channel blocker
Antihypertensive
Causes inflammation of the endocardium (inner layer)
RHEUMATIC ENDOCARDITIS
Diagnosis for RHEUMATIC ENDOCARDITIS
○ (+) Throat culture
○ High ESR/WBC
○ Antistreptolysin titer
Causes of RHEUMATIC ENDOCARDITIS
U
M
O
○ URTI and pharyngitis (most common cause)
○ Malnutrition
○ Overcrowding
most common cause of RHEUMATIC ENDOCARDITIS
URTI and pharyngitis
one Complication of RHEUMATIC ENDOCARDITIS
Valvular heart diseases
first sign of RHEUMATIC ENDOCARDITIS
Sore throat
most common sign of RHEUMATIC ENDOCARDITIS
polyarthritis
Most important sign of RHEUMATIC ENDOCARDITIS
Carditis (murmur, muffled heart, cardiomegaly)
Others signs of RHEUMATIC ENDOCARDITIS
erythema marginatum, high fever, rhinitis, precordial pain
NURSING INTERVENTIONS for RHEUMATIC ENDOCARDITIS
Acute Pain
○ S
○ P
○ C
○ Strict bed rest
○ Proper joint alignment
○ Comfort measures: hot compress, fowlers
Drug for RHEUMATIC ENDOCARDITIS that is NSAIDS
NSAIDS- mild to moderate
Ibuprofen
Drug for RHEUMATIC ENDOCARDITIS that is corticosteroids
Corticosteroid- severe
prednisone
NURSING INTERVENTIONS for RHEUMATIC ENDOCARDITIS
Risk for infection
○ Treat S
○ Increase O
○ Proper H
○ R
○ Treat sore throat
○ Increase OFI
○ Proper hygiene
○ Rest
Prophylactic antibiotics, (invasive procedure) for RHEUMATIC ENDOCARDITIS. It is the antibiotics of choice
Starts with the letter P
Penicillin
Inflammation of the endocardium (inner layer) is called
INFECTIVE ENDOCARDITIS
Caused by bacteria, viral and fungal infections (Streptococcus viridans, staphylococcus aureus)
INFECTIVE ENDOCARDITIS
Diagnostics for INFECTIVE ENDOCARDITIS
○ Blood culture (definitive)
○ Echocardiography
most valuable tool for INFECTIVE ENDOCARDITIS
Echocardiography
Cause of INFECTIVE ENDOCARDITIS
○ Infections (systemic, dental and skin)
○ IV therapy, foley, corticosteroid
Clinical signs of INFECTIVE ENDOCARDITIS
Febrile syndrome (Fever, chills, vomiting, body weakness, anorexia), petechiae, osler node, janeway lesion, murmur
main sign of INFECTIVE ENDOCARDITIS
heart murmur
Complications of INFECTIVE ENDOCARDITIS
○ Heart failure (left and right sided)
○ Arterial embolization
major Complication of INFECTIVE ENDOCARDITIS
Arterial embolization
NURSING INTERVENTIONS of INFECTIVE ENDOCARDITIS
Risk for infection
○ Monitor
○ Increase
○ Hand
○ Perform
○ Paracetamol
○ Monitor body temp
○ Increase OFI, rest, adequate nutrition
○ Hand hygiene, oral care, skin care
○ Perform asepsis, avoid crowd/people
○ Paracetamol (for fever)
medication of choice for INFECTIVE ENDOCARDITIS
A
P and
A
Antibiotic (mainstay tx), penicillin and amphotericin B (if fungal in nature)
Inflammation of the myocardium
MYOCARDITIS
confirmatory diagnosis of MYOCARDITIS
CT scan
other Diagnostics of MYOCARDITIS
○ 2D echo
○ Blood test (increase WBC, ESR and C-reactive protein)
most common cause of MYOCARDITIS
Infections
other Causes of MYOCARDITIS
○ Rheumatic fever
○ Immunosuppressive therapy
most common Manifestation of MYOCARDITIS
Flu like symptoms
other Manifestations of MYOCARDITIS
○ Murmur
○ Fatigue
○ Dyspnea
○ SOB palpation
○ Positional chest pain
○ Gallop
other Complications of MYOCARDITIS
○ Cardiomyopathy
○ Heart failure
○ Dysrhythmia
○ Venous Thrombosis
○ Mural thrombi
NURSING INTERVENTIONS
● Infection
○ Immunization (what are the 2?)
flu, hep B
other NURSING INTERVENTIONS MYOCARDITIS
● Infection
○ Check body _________
○ Antibiotic therapy (what drug?)
○ Check body temperature
○ Antibiotic therapy (penicillin)
NURSING INTERVENTIONS MYOCARDITIS
● Activity intolerance
○ Bed
○ Limit
○ Gradual i
○ Bed rest
○ Limit sports
○ Gradual increase in physical activity
NURSING INTERVENTIONS MYOCARDITIS
● Impaired circulation
what kind of stockings?
Compression stockings
NURSING INTERVENTIONS MYOCARDITIS
● Impaired circulation
what kind of exercises?
ROM exercises
Inflammation of the pericardium (outer layer)
PERICARDITIS
confirmatory diagnosis of PERICARDITIS
CT scan
other diagnostic of PERICARDITIS
High ESR C-reactive protein
Causes of PERICARDITIS
○ URTI
○ TB
○ Pneumonia
○ HIV
○ Cancer
○ MI
○ Cardiac procedure
○ RF
○ RA
○ Lupus
hallmark sign of PERICARDITIS
Clue: PFR
Pericardial friction rub
other Clinical signs of PERICARDITIS
○ Severe chest pain
○ Pericarditic pain
○ Substernal precordial pain
Complications of PERICARDITIS
P
C
R
Pericardial effusion
cardiac tamponade
right-sided heart failure
“Hardening of the arteries” caused by thickening of muscle
fibers and the endothelial lining of small arterial walls
Arteriosclerosis
Narrowing (stenosis) of the intima of large and medium-sized
arteries caused by the accumulation of lipids, fatty deposits,
calcium, fibrous tissue, atheromas, and plaques
Atherosclerosis
strongest risk factor of ARTERIOSCLEROSIS
Smoking
other Causes of Arteriosclerosis
○ Age
○ Gender
○ Family history
○ High-fat diet
○ Hyperlipidemia
○ Hypercholesterolemia
○ Hypertension
○ Diabetes Mellitus
○ Stress
○ Sedentary lifestyle
marker of developing CAD; sign of generalized atherosclerosis
Clue: I C
Intermittent claudication
NURSING INTERVENTIONS of Arteriosclerosis
Behavior modification
Elevate feet
control exercise program
moderate walking
isometric exercises
stress management strategies
Warmth temperature
relaxation therapy
Avoid cold exposure
constrictive clothing
cross legs
emotional upset
Stressful situation
prolong sit/ stand
Dietary modification
low-fat diet
low cholesterol diet
vitamin B3 (niacin)
highly/strong recommended NURSING INTERVENTION of Arteriosclerosis
smoking cessation
vascular surgical procedure for arteriosclerosis
angioplasty, PTA, stent graft
Medication for arteriosclerosis
Bile sequestrant (what drug? C)
Antilipemics (what drug? S)
Cholestyramine
Statins
Weakness, dilatation, outpouching, damage and distention of the
tunica media (mid layer of the blood vessel) of the artery in
abdomen (AAA) thoracic (TAA) what disease?
ANEURYSM
standard, most accurate Diagnosis of ANEURYSM
CT scan
other Diagnostic tests for ANEURYSM
○ Chest x-ray
○ Duplex UTZ
○ Cardiac cath
○ Stress test
○ Trans echo
most common cause of ANEURYSM
Atherosclerosis
other Causes of ANEURYSM
○ Family history
○ Men
○ Elderly
○ Aging
○ HPN
○ Smoking
○ Alcohol,
○ Obesity
○ Trauma
Most important indication of ANEURYSM
It is a visible abdominal pulsating bulge/ mass mid-upper abdomen
It is a periumbilical mass, bruit, feel heart beating in the abdomen, abdominal pain/ throbbing
Abdominal Aortic Aneurysm (AAA)
What kind of aneurysm has
Constant boring pain (most prominent), pain in supine
position
DOB, SOB, paroxysmal cough, stridor
Hoarseness, aphonia, dysphagia
Thoracic Aortic Aneurysm (AA)
Complications of an Aneurysm that has a sign of impending rupture
severe back/ abdominal pain
NURSING INTERVENTIONS for Aneurysm
Avoid:
○ s
○ P
○ H
○ C
○ V
○ S
○ P
○ stimulation environment
○ Physical exertion
○ HTN
○ Caffeine
○ Valsalva
○ Straining
○ Palpating mass
Urgent surgeries for aneurysm
Aneurysmectomy and
Endovascular stent graft
drug of choice for aneurysm
propanolol
NURSING INTERVENTIONS for ANEURYSM
● Ineffective Tissue Perfusion
○ Control BP
○ Opioid analgesic
○ Blood products
○ Hydration
○ IV fluids
○ Oxygen
○ Mechanical ventilator
○ ICU/ CCU care
propanolol belongs to what pharmacologic class of hypertensive drugs?
beta blockers
Acute vascular occlusion caused by clot, embolus, thrombus
ARTERIAL EMBOLISM, THROMBOSIS
causes of ARTERIAL EMBOLISM THROMBOSIS
Iatrogenic injury, invasive procedure (IABP, PTA), fracture, trauma, atrial fibrillation, MI, HF, atherosclerosis, plaques, aneurysm
Clinical signs of ARTERIAL EMBOLISM THROMBOSIS
6Ps
pain
pallor
pulselessness
paresthesia
paralysis
poikilothermia (coldness) below the occluded limb
pale (above limb)
Diagnostics of ARTERIAL EMBOLISM THROMBOSIS
2D echo
ECG
duplex UTZ
ankle brachial index/ABI
NURSING INTERVENTIONS of ARTERIAL EMBOLISM THROMBOSIS
● Impaired Circulation
○ Avoid heating and cooling pads (to prevent trauma)
○ Apply sheepskin foot cradle (to protect legs from trauma)
○ Leg movement
○ Embolectomy (procedure of choice), percutaneous thrombectomy
○ Medication - heparin anticoagulant therapy (prevent thrombus) thrombolytic therapy
AKA Thromboangitis Obliterans
It is the Inflammation of the arteries and vein of the hands and feet
BUERGER’S DISEASE
primary cause of BUERGER’S DISEASE
This can can cause vasoconstriction that impairs blood flow of the px (Pack of cigarette)
Smoking
High blood sugar cause blood viscosity
True or False?
true
Can DM cause Decrease in blood supply and ischemia?
True or False
True
first sign of BUERGER’S DISEASE
Pain in palm & arch
Drug of choice for BUERGER’S DISEASE
Propanolol
Opioid analgesic for BUERGER’S DISEASE
Clue: M. S
morphine sulfate
Complications of BUERGER’S DISEASE
If patient is unmanaged: may cause U and G
Ulcer and Gangrene
NURSING INTERVENTIONS BUERGER’S DISEASE
● Ineffective Tissue Perfusion
○ Smoking cessation (mainstay Tx)
○ Beurger-Allen exercises
○ Amputation = surgical removal of feet OR hand
■ BELOW KNEE
■ ABOVE KNEE
○ Articulation
○ Sympathectomy (for vasospasm)
known as the surgical removal of toe
Articulation
Medication for BUERGER’S DISEASE for vasodilation and circulation
Nifedipine
Intermittent painful/spasm/ construction of arteries in fingers and toes
RAYNAUD’S DISEASE
involuntary muscular contraction is AKA
SPASM
RAYNAUD’S DISEASE is common in _____ during what season?
Americans; cold weather/ season
Main 3 causes of RAYNAUD’S DISEASE
MAIN CAUSE: UNKNOWN
○ Cold (water, weather, works in an ice factory etc.)
○ Stress (always gumagalaw yung kamay like dentist)
○ Caffeine
Clinical Signs RAYNAUD’S DISEASE
○ Pale
○ Pallor (white)
○ Cyanotic blue
○ Cold
○ Redness
○ Tingling
○ Numb
○ Throbbing aching pain finger
Diagnostic Tests RAYNAUD’S DISEASE
Cold challenge test
hand x-ray
Digital BP
plethysmography
NURSING INTERVENTIONS RAYNAUD’S DISEASE
● Ineffective Tissue Perfusion
○ Warm water, lukewarm, bath, warm clothes, wear mittens,
woolen gloves, warming device, relaxation stress technique
NURSING INTERVENTIONS RAYNAUD’S DISEASE
● Ineffective Tissue Perfusion
AVOID THIS:
Colds, coffee, extreme temp, repetitive hand movements
first line drug therapy FOR RAYNAUD’S DISEASE
CLUE: -dipine
Calcium Channel Blockers
Arterial insufficiency of extremities (legs) is called
Clue: PAOD
PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
Causes of PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
○ Men
○ Advance age
○ Elderly
○ Family history
○ Smoking
○ DM
○ HPN
○ Hyperlipidemia
○ Obesity
○ Stress
○ Sedentary lifestyles
Diagnosis of PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
Doppler, ankle-brachial indices, duplex ultrasound
Hallmark Signs of PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
Aching, cramps, fatigue, weakness or intermittent claudication
Clinical Signs of PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
Difficulty walking, cold & pale (feet elevated), ruddy & cyanotic (dependent), numbness (affected extremities), bruit
NURSING THERAPEUTICS of PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
● Impaired Circulation
○ Feet exercises
○ Leg elevation
○ Exercise program
○ Avoid cross legs & prolong feet dependency (to prevent thrombosis)
○ Elastic compression stockings
○ Adequate hydration
○ Weight reduction
○ Smoking cessation
○ Endarterectomy/vascular graft (treatment of choice)
Medications of PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
This reduces blood viscosity
Pentoxifylline
Medications of PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
This is to prevent blood clot
Clue: Antiplatelet
C
A
C
Antiplatelet (Cilostazol, Aspirin, Clopidogrel)
This disease causes blood clot formation due to virchow triad
DEEP VEIN THROMBOSIS
3 components of virchow triad
E
V
H
endovascular damage
venous stasis
hypercoagulation
hypercoagulation (kulang OR sobra ang tubig)?
kulang
Venous stasis happens kapag
hindi ginagalaw ang px
Endovascular damage happens kapag may damage sa
intema arterial wall
Causes of DEEP VEIN THROMBOSIS
○ Prolong sit
○ Bed Rest
○ Prolonged Standing
■ Sales lady
○ Cross Sit
○ Immobility
○ Prolonged Travel
○ Trip
○ Smoking
○ Surgery (Hip, Knee)
○ Obesity
○ Pregnancy
■ Increasing intra-abdominal pressure due to the increasing fetal growth can cause occlusion
○ Pills
○ Restrictive Clothes
Clinical Signs of DEEP VEIN THROMBOSIS
○ Positive homans signs (pain during feet dorsiflexion)
■ Alternative: instruct patient to walk
○ Leg edema
○ Swelling
○ Tenderness
○ Pain
○ hot/warmth
○ Redness
○ Discomfort
○ Monitor Respiratory Rate
Positive homans signs means
pain during feet dorsiflexion
How to manage + homans sign
instruct patient to walk
most serious Complication of DEEP VEIN THROMBOSIS
Reports for severe dyspnea and chest pain
Clue: P. E
Pulmonary embolism
Medical Interventions of DEEP VEIN THROMBOSIS
○ for blood clot
Anticoagulants
Medical Interventions of DEEP VEIN THROMBOSIS
○ report immediately for bleeding
Thrombolytic therapy
Medical Interventions of DEEP VEIN THROMBOSIS
○ remove thrombus in veins and the procedure of choice
Venous thrombectomy
NURSING THERAPEUTICS for DEEP VEIN THROMBOSIS
● Impaired Circulation
○ Increased Oral fluid intake, hydration, prevent dehydration - to
avoid hypercoagulation
○ turning every 2 hrs
○ Antiembolic elastic compression stockings, leg exercise
■ ROM
■ Wearing of Antiembolic elastic compression legs stockings,
avoid cross legging, avoid standing
○ Avoid prolonged sitting/standing
most cost efficient NURSING THERAPEUTICS for DEEP VEIN THROMBOSIS
Early ambulation/mobilization
NURSING THERAPEUTICS for DEEP VEIN THROMBOSIS
● Altered Comfort
○ Mild analgesic NSAID, ASA (for leg discomfort)
○ Bed rest
○ Warm compress
○ Walking
○ Bed exercises
○ Elevate legs above heart level
○ Ambulation
Limb swelling associated with bacterial infection is known as
CELLULITIS
causes of CELLULITIS
○ Leg cracks,fissures, contusions, abrasions, ulcerations
○ Ingrown toenails
○ hangnails
Clinical Signs of CELLULITIS
○ Swelling
○ Localized redness
○ Pain affected legs
○ Febrile signs (fever, chills, sweating, palpable lymph nodes)
NURSING THERAPEUTICS for CELLULITIS
● Infection
Antibiotic therapy
NURSING THERAPEUTICS for CELLULITIS
● Acute Pain
○ Elevate affected legs
○ Apply warm moist pack
○ Analgesics
Dilated, weak, incompetent, defective, distending, bulging, protruded, prominent, visible, tortuous veins in legs
VARICOSE VEINS
Confirmatory Diagnosis for VARICOSE VEINS
Duplex ultrasound
Causes of VARICOSE VEINS
○ Prolong sitting, standing, cross sitting
○ Obesity
○ Pregnancy
○ Cardiovascular Diseases
○ Constrictive cloth
○ High impact exercises
○ Heavy physical activities
○ Thrombophlebitis
Most common Clinical Sign of VARICOSE VEINS
Heavy ache leg pain
Other Clinical Signs of VARICOSE VEINS
○ Spider vein (teleangiectasis)
○ Burning pain
○ Paresthesia
○ Leg fullness
○ Pruritus
○ Leg cramps
Complications of VARICOSE VEINS
○ Deep vein thrombosis
○ SVD (most common)
NURSING THERAPEUTICS for VARICOSE VEINS
● Impaired Circulation
○ Turning q2h, frequent position change
○ Anti-embolic elastic compression stockings
○ Ankle- flexion-leg exercise, feet elevation
○ Warm compress
○ Prepare patient for surgical ligation (Procedure of choice),
sclerotherapy, radiation ablation
DOC for VARICOSE VEINS (for blood clot)
Anticoagulants
DOC for VARICOSE VEINS (for leg discomfort)
ASA (Aspirin)
5 components of Atherosclerosis
Looking For Phineas and Ferb
lipid
fat deposit
plaques
atheroma
fibrous tissue
Rheumatic endocarditis main points
S
P
C
P
Sore throat
Pharyngitis
Carditis
Polyarthritis
What drug for rheumatic endocarditis causes immunosuppression that is why it should be used with caution
Corticosteroids
Where do we see staphylococcus aureus? (Infective Endocarditis)
Skin
4 examples of Cardiac enzymes
Serioactive protein
Troponin I
Troponin T
CKMB
2 examples of Kidney enzymes
BUN
Creatinine
4 examples of Liver enzymes
SGPT
SGOT
ALT
AST
AKA blood clot formation
Thrombus/ Thrombi
Myocarditis can lead to _________ formation
Thrombus
Localized blood clot formation
Thrombus
A circulating thrombus, dislodged from other body parts (e.g. Legs) then became a travelling blood clot then may cause MI
Embolus
Myocarditis patients is possible prone to
VT and MT
Venous thrombosis and mural thrombi
Prevent the formation of DVT in the legs
Anti embolic stockings
Other nursing interventions to prevent blood clot formation (what bed mattress and position)?
Egg crater bed mattress
Change position q2h
Antibiotic group of Penicillin
Beta- lactam
Amoxicillin antibiotics belong to what antibiotic group?
Penicillin group
What antibiotic class does Co-trimoxazole belong?
Sulfonamides
Antibiotic class of Ciprofloxacin
Fluoroquinolones
What immunologic class of drugs do
-cillin belong?
Penicillin group of antibacterial drugs
What class does -floxacin belong?
Fluoroquinolones
What class does sulfa- belong?
Ex: sulfamethoxazole (Co-trimoxazole), sulfasalazine
Sulfonamide antibacterial drugs
what class does Ce- belong?
Ex: Cefuroxime, ceftazidime
Cephalosphorin group
What drug is a 2nd generation cephalosphorin that inhibits cell wall synthesis which is bacteriocidal (antibiotic drugs)?
Clue: This is its mechanism of action
Cefuroxime
what class of drugs do -mycin belong?
Ex: Clindamycin
Aminoglycosides/ macrolide antibiotics
All antibiotics has a main/ common side effect of?
Allergic reaction (Hypertensitivity)
Most common sign of allergic (hypersensitivity) reaction
Rashes (maculo-papular)
What do you call if a person is allergic to the same medications with the same class?
Ex. Penicillin group
Cross-sensitivity reaction
Pain, weakness, tenderness in the calf muscle of the legs. Generalized form of atherosclerosis (entire body is with fatry deposits) is called?
Intermittent claudication
It is called as the middle layer of the blood vessel
Tunica media
Duplex UTZ is used for
Arteries are with fatty deposits/ atheroma deposits
Stimulating environment should be avoided for px with aneurysm
T or F
True
Room for aneurysm patients
ICU
Why? Aneurysm px should avoid private room, semi private, near nurses station, or wards
Standard treatment for aneurysm
Clue: S
Surgery
Avoid activities that will stimulate valsalva maneuver for px with aneurysm,
Ex: coughing, pooping, bearing down, palpating the mass
T or F
True
Promotes cardiac stimulation
Normal pulse rate
60-100 bpm
Normal blood sugar
80 over 120
3 blood thinning products
Aspirin (antiplatelet), heparin (anticoagulant), thrombolytic
This drugs prevents platelet aggregation, thus prevent blood clot formation. Also promotes collateral circulation.
Antiplatelet (aspirin)
Side effect of antiplatelet (aspirin)
Bleeding tendencies, blood thinning episodes
Ex: Nose bleeding, gum bleeding, blood in the vomit, hematuria (blood in urine), bruises, black starry stool (Upper GI bleeding)
Will you give anticoagulant therapy to a px with embolism?
Yes or No
No. Because it will rupture lalo
Why is it hard for a physician to prescribe thrombolytic therapy to Arterial embolism & thrombosis px?
Masyado na siyang malala = increased chance of hemorrhage (excess bleeding)
Most common side effect of thrombolytic therapy
Intracerebral hemorrhage
Mainstay treatment of beurger’s disease
Smoking cessation
Surgical remova of feet or hand
Amputation
2 types of amputation
AK
BK
Above knee
Below knee
Colors of fingers (raynaud’s disease)
Yellow
Blue
White
Purple
Dark blue
