Cardiovascular system

Question 1

angina

Answer 1

any disease in which spasmodic and painful suffocation or spasms occur.

Question 2

Angina Pectoris

Answer 2

pain about the heart

Question 3

arrhythmia

Answer 3

irregular or loss of the rhythm of the heart

Question 4

arteriosclerosis

Answer 4

thickening and hardening of arterial walls caused by calcium build-up that interference with blood circulation

Question 5

atherosclerosis

Answer 5

a deposit of degenerative accumulation of cholesterol and lipoid material in the arteries

Question 6

Bradycardia

Answer 6

slow heartbeat; less than 60 beats per minute.

Question 7

Cerebrovascular Accident (CVA)

Answer 7

sudden impairment of circulation in one or more of the blood vessels supplying the brain.

Question 8

Congestive Heart Failure (CHF)

Answer 8

heart muscles weakness causing fluid to back up and cause edema in the tissues.

Question 9

Electrolytes

Answer 9

chemical elements in the blood and body that are important for muscle function

Question 10

hematemesis

Answer 10

vomiting blood

Question 11

hemoptysis

Answer 11

coughing blood

Question 12

hypertension

Answer 12

high blood pressure

Question 13

hypotension

Answer 13

low blood pressure

Question 14

ischemia

Answer 14

temporary decrease in the amount of blood being delivered to a part of the body; mainly due to the contractions of the supplying blood vessels.

Question 15

phlebitis

Answer 15

inflammation of a vein

Question 16

syncope

Answer 16

a brief loss of consciousness

Question 17

Tachycardia

Answer 17

excessively rapid heartbeat; usually applied to a pulse rate above 100 beats per minute

Question 18

thrombosis

Answer 18

the formation of a blood clot

Question 19

thrombophleditis

Answer 19

inflammation of a vien that results in the formation of a clot.

Question 20

Trendelenburg position

Answer 20

lying on the back with the pelvis higher than the head; inclined at a 45 degree angle.

Question 21

Cardiotonics

Answer 21

action: slows and strengthens the heart action. use: as maintenance therapy in congestive heart failure, atrial fibrillation, atrial flutter. increases force of contraction thus decreases heart rate. Example: digoxin (Lanoxin and Lanoxicap). Adverse effects: fatigue, loss of appetite, dizziness, agitation, excessive slowing of heartbeat or irregular heartbeat. confusion, weakness, visual blurring, or yellow-green halos around visual images. nursing condiserations: check pulse BEFORE giving. should be 60 beats per minute or more or as physician determines. PRECAUTION: notify licensed nurse before giving medication if pulse is below 60 or other signs of toxicity are present. drug levels are rountinely drawn to ensure the dosage is within a therapeutic range.

Question 22

Antiarrhythmics

Answer 22

Action: slows conduction to regulate heart rate and rhythm. use: angina and arrhythiams. Examples: propranolol (Inderal), quinidine (Quinidex, Cin-Quin), procainamide HCL (Pronestyl), amiodarone (Pacerone, Cordarone)- may cause dizziness. residents must stay out of the sun. When exposed to sun, be sure resident uses sunscreen. sun will cause residents skin to turn blue/gray, disopyramide phosphate (Norpace) propafenone hydrochloride (Rythmol). Adverse effects: slow pulse rate- even normal impulses do not cause heart to beat, postural hypotension, dizziness- slowed heart action may lower blood pressure, quinidine may cause GI upset, ringing in the ears and other symptoms. Nursing Consideration: adiminister 1 hour before or two hours after meals with a full glass of water, administer at prescribed times, check pulse routinely, report any postural hypotension, slow pulse rate or low blood pressure to the licensed nurse promptly, if quinidine causes GI upset, administer with food.

Question 23

antihypertensives: Adrenergic blockers

Answer 23

Action: decrease blood pressure by having an effect on the nervous system and dilating blood vessels. Use: to treat blood pressure that remains elevated (hypertension). If untreated, hypertension can damage blood vessels in the brain, kidneys, or the heart. Examples: methyldopa (Aldomet), clonidine HCL (Catapres), prazosin (Minipress). Adverse effects: dizziness, weakness, nausea and vomiting, hypotension, drowsiness. nursing consideration: check blood pressure at least weekly.

Question 24

Antihypertensive: Calcium Channel blockers

Answer 24

Action: reduce constriction of heart muscles and increase blood supply to correct arrhythmias. Use: to treat angina and arrhythmias. Examples: verapamill HCL (Calan, Isoptin), nifedipine (Procardia), diltiazem (Cardizem): if systolic blood pressure is less than 90 mm HG or heart rate is less than 60, hold dose and notify nurse. adverse effects: dizziness, slow pulse, hypotension, chest pain, constipation. nursing consideration: give only at prescribed times, monitor the resident’s blood pressure prior to administering.

Question 25

Antihypertensive: Angiotensin Converting Enzymes Inhibitors (ACE inhibitors)

Answer 25

Action: a potent vasoconstricter that stimulates the secretion of aldosterone thus reducing sodium and water retention and lowering blood pressure. use: treat hypertension. Example: captopril (Capoten), enalapril (Vasotec), lisinopril (Zestril)(Prinivil), olmesartan medoxomil (Benicar). Adverse effect: hypotension, persistent, dry, tickling, nonproductive cough, nausea and vomiting. nursing consideration: elderly residents may be more sensitive to the medication’s hypotensive effects. monitor residents pulse rate and blood pressure frequently.

Question 26

Antihypertensive: Beta Blockers

Answer 26

Action: decrease cardiac output, peripheral resistance and cardiac oxygen consumption. use: arrhythmias, angina and migraine headaches. Examples: propranolol (Inderal), metoprolol (Lopressor, Toprol-XL), atenolol(Tenormin), nadolol ( Corgard). Adverse effects: fatigue, lethargy, hypotension, bradycardia, bronchospasm, heart failure. nursing consideration: check apical pulse before administering medication. medication can mask common signs of shock or hypoglycemia. report any unusual findings to the licensed nurse promptly.

Question 27

when hypertension is not releived by the use of these medications, a combination of two or more medications may be ordered

Answer 27

examples: lisinopril and hydrochlorothiazide (Zestoretic), enalapril and hydrochlorothiazide (Vaseretic), Aldactone and hydrochlorothiazide (Aldactazide)

Question 28

Antihypertensive: Vasodilators

Answer 28

Action: dilate blood vessles and improve blood supply to the heart. use: to treat angina pectoris and decrease circulation to the brain and extremities. Example: nitroglycerin (A) Nitro-Bid (ointment), Nitrostat, NitroQuick (sublingual), Nitrolingual Translingual Spray (Spray), Nitrodisc, Nitro-Dur, Transderm-Nitro (transdermal). Adverse effect: hypotension, tachycardia, flushing, palpitation. nursing consideration: elderly residents may be more sensitive to medication’s effect. sublingual tablets are placed under the tongue when pain begins. The physicians order wil usually allow the medication to be repeated every five minutes until relief occurs, taking no more than three tablets in fifteen mintues. This is a PRN medication, QMA must seek approval of the licensed nurse.

Question 29

Antihypertensive: Anticoagulants

Answer 29

Action: inhibits clotting of blood. Use: to prevent formation of clots which may cause damage to the brain, heart, or lungs. Examples: asprin (ASA), heparin, enoxaparin (Lovenox)- given per injection by a licensed nurse, warfarin (Coumadin). Adverse effects: hemorrhage, gastrointestinal bleeding, bleeding gums, mouth ulcerations, hemoptysis. nursing condiseration: observe for signs of bleeding from gums, bruising, blood in urine or stools. protect form injury (e.g., shave resident with an electric razor), sudden extreme headaches should be reported immediately to licensed nurse. consider compatibility with other ordered medications (avoid aspirin or aspirin contaning products) lab studies are conducted routinely to ensure the dosage remains in therapeutic range.

Question 30

Miscellaneous medications that help prevent blood from clotting: Platelet Aggregation Inhibitors

Answer 30

Example: clopidogrel (Plavix), ticlopidine (Ticlid)-Used often after MI or stroke, residents may have increased bleeding tendencies.

Question 31

Hemorrheologic agents

Answer 31

examples: pentoxifylline (Trental), decreases blood viscosity, increased blood flow by increasing flexibility of reb blood cells