Care of patients with vascular problems Flashcards
Arteriosclerosis
thickening or hardening of ARTERIAL wall
Atherosclerosis
formation of plaque within arterial wall.
*leading contributor to CV disease & usually affects larger arteries.
Stable plaque rupture
thrombosis & constriction obstructs vessel lumen, causes decreased perfusion & oxygenation
Unstable plaque rupture
More severe - after rupture, exposed underlying tissue causes platelet adhesion & thrombus formation. May suddenly block a blood vessel causing ischemia or infarction.
Causes of arterial injury
Elevated LDL
Decreased HDL
Chemical damage from smoking and other toxins
Weakened vessel wall from HTN or aging
Familial hyperlipidemia
Microvascular damage from diabetes mellitus
Hypertension definition
SBP >140
DBP >90
Pre-HTN: 120-139 systolic, 80-89 diastolic
Vessel constriction and dilation maintained by
ANS & circulating hormones such as norepinephrine & epinephrine.
Blood pressure formula
Cardiac Output x Peripheral Vascular Resistance (PVR)
Auscultatory Gap
Period which Korotkoff sounds indicating true systolic pressure fade away and reappear at a lower pressure point.
Responsible for errors made in recording falsely low SBP, especially in HTN patients, of up to 25mmHg.
Avoided by pumping the cuff 30 mmHg beyond palpable systolic pressure.
Four control systems that maintain blood pressure
- Arterial baroreceptors
- Changes in fluid volume
- Club RAAS
- Kidneys
Most common hypertension
Primary
Secondary hypertension etiologies
~Kidney disease ~Primary aldosteronism ~Brain tumors ~Estrogen (oral contraceptives) ~Glucocorticoids
What is isolated hypertension?
SBP >140, DBP <90
What is malignant hypertension?
SPB >200, DBP >150.
NEEDS EMERGENCY TREATMENT to prevent renal failure, left ventricular failure, and stroke.
MOST SEVERE AND PROGRESSES RAPIDLY
Signs/symptoms of malignant hypertension
Morning headache
Blurred vision
Dyspnea
