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Med Surg 1 > Ch 27 > Flashcards

Ch 27 Flashcards

1
Q

The forced produced by the volume of blood in the arterial

A

BP

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2
Q

Older adults are at increased risk for development of ___ from __ drugs

A

Hypokalemia
Potassium-waisting diuretic

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3
Q

The ___,___ & ___ regulate arterial pressure

A

Autonomic nervous system
Kidneys
Various endocrine glands

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4
Q

Determined by the force & volume of blood that the LEFT VENTRICLE ejects during systole and the ability of the arterial system to distend at the time of ventricular contraction

A

Systolic BP

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5
Q

Reflects arterial pressure during ventricular relaxation. It depends on the resistance of the arterioles and the diastolic filling times

A

Diastolic BP

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6
Q

Central aortic systolic pressure (CASP), the pressure of blood at the ____ as blood is pumped from the left ventricle, can be lowered by as much as 30 mm hg than the corresponding ___ systolic pressure

A

Root of the aorta
Brachial arm

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7
Q

Pre hypertension

A

Systolic 120-139
Diastolic 80-89

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8
Q

When elevated BP causes cardiac abnormalities

A

Hypertensive heart disease

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9
Q

When vascular damage is present without heart involvement

A

Hypertensive vascular disease

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10
Q

Sustained elevated BP with no known cause .. about 95% of cases

A

Essential hypertension

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11
Q

Elevated BP that results from or is secondary to some other disorder

A

Secondary hypertension

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12
Q

____ (elevated serum sodium level) increases blood volume which raises BP

A

Hypernatremia

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13
Q

A low serum potassium level may cause ___ as the kidneys try to maintain a balanced number of cations in body fluid

A

Sodium retention

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14
Q

Defects in BP regulation may result from impairment in the __

A

Renin-angiotensin-aldosterone system

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15
Q

A chemical that kidneys release to raise BP
And increase vascular fluid volume in response to renal HYPOperfusion

A

Renin

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16
Q

Normal BP

A

Systolic less than 120
Diastolic less than 80

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17
Q

Elevated BP

A

Systolic 120-129
Diastolic less than 80 (bc systolic is still elevated)

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18
Q

For people with a ___ response, hypertension may be correlated with a higher than usual release of ___ such as __ and ___ which elevate BP

A

Heightened stress
Catecholamines
Epinephrine
Norepinephrine

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19
Q

Secondary hypertension may accompany any primary condition that affects ___ or __ or causes ___

A

Fluid volume
Renal function
Arterial vasoconstriction

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20
Q

Predisposing conditions of secondary hypertension
SATA ( 9)

A

-Kidney disease
-Pheochromocytoma (benign tumor of adrenal medulla)
-Hyperaldosteronism(increased secretion of mineralocorticoid by adrenal cortex)
-Atherosclerosis
-Use of cocaine
-Use of cardiac stimulants
*Weight control drugs
*Caffeine
-Use of oral contraceptives

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21
Q

Hypertension causes the heart to __

A

Work harder to pump against the increased resistance

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22
Q

The size of the heart muscle ___

A

Increases

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23
Q

When the heart can no longer pump adequately to meet the body’s metabolic needs ___ occurs

A

HF

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24
Q

The extra work and the greater mass increases the hearts need for __

A

Oxygen

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25
In addition to its direct effects on the heart, high BP damages the __ system
Arterial vascular system
26
The increased resistance of the Arterioles to the flow of blood causes serious complications in other body organs including ___,___,___, & ___
Eyes Brain Heart Kidneys
27
Hemorrhage of tiny arteries in the retina may cause ___
Marked visual disturbances or blindness
28
A CVA accident may result from
Hemorrhage or occlusion of blood vessels in the brain
29
MI may result from occlusion of a
Branch of a coronary artery
30
Impaired circulation to the kidneys may result in
Renal failure
31
The onset of hypertension is considered
“The silent killer”
32
As the BP becomes elevated, clients may identify sympathetic such as a ___ or ___, ___,___,____,____,___ &___ (8)
Throbbing or pounding Headache Dizziness Fatigue Nose bleeds (epistaxis) Blurred vision Confusion
33
An___ exam may reveal vascular changes in the eyes, retinal hemorrhages or edema of the optic nerves knows as ___
Ophthalmic Papilledema
34
3 tests that may reveal an enlarged LEFT ventricle
Electrocardiography Echocardiography Chest radiography
35
A test that detects how well or inefficiently the heart pumps, can detect HF that may be associated with hypertension
MUGA (multiple gated acquisition) scan
36
An ophthalmologic test using IV dye, often reveals leaking retinal blood vessels
Flourescein angiography
37
If the causes is related to dysfunction of the adrenal gland, a ___ detects elevated Catecholamines
24- hour collected urine specimen
38
The primary objective of therapy for hypertension is to
Lower the BP & prevent major complications
39
Items that contain significant sodium SATA(10)
Pickles Green olives Sauerkraut Mustard Catsup Bbq sauce Pizza sauce Canned soup Packaged mixes Cheese
40
Believed that in persons older than __ reducing the __ below __ is more important than that decreasing the ___
60 Systolic pressure 150 mm Hg Diastolic BP
41
Clients who require drug therapy may be treated initially with one drug, usually a___. However, most people with hypertension will need two or more antihypertensives meds to reduce their BP to target level
Thiazide diuretic (potassium waisting)
42
Secondary hypertension often resolves by
Treating it’s cause
43
All drugs used to reduce BP can produce __ & __ when rising to a sitting or standing position. Teach clients how to reduce symptoms of ___ as they adjust to their meds
Dizziness and syncope Hypotension
44
___ may cause a persistent cough until the med is D/C
ACE inhibitors (-prils)
45
Intended use of calcium channel blockers
Relieve angina by DILATING arteries, improving myocardium blood supply and reduces myocardial oxygen demand
46
Calcium channel blockers 1-1trade
Nifedipine (Procardia)
47
Safety warnings for nurses with beta blockers
Drug is held if HR is less than 60 or above 120 *count apical 1 full minute
48
Risk for decreased cardiac output, nursing process
-encourage adherence to treatment with salt/sodium restrictions (doing so decreases blood volume and improves the potential for greater CO) -administer prescribed antihypertensives (they use various mechanisms to control BP, including INCREASING URINE ELEMINATION, blocking production of angiotensin, & dilating blood vessels)
49
Injury risk related to syncope & dizziness secondary to side effect of antihypertensive drugs
Monitor postural changes in BP by assessing client while lying sitting & standing Orthostatic hypotension - ortho vitals - lie down- call Dr
50
More serious forms of elevated BP that can develop in clients with either essential or secondary hypertension
Accelerated and malignant hypertension
51
Considered a hypertensive crisis
Accelerated hypertension
52
Accelerated hypertension is manifested by ___ accompanied by __ and ___
Markedly elevated BP Hemorrhages and exudates in the eyes
53
If untreated accelerated hypertension may progress to
Malignant hypertension
54
Malignant hypertension is ___ accompanied by ___
Dangerously elevated BP Papilledema
55
Malignant hypertension is ___ unless BP is quickly reduced
Fatal
56
Even with intensive treatment of malignant hypertension the ___,___ and __ may be ___
Kidneys, brain & heart Permanently damaged
57
Consequences are life threatening when the BP in the ___ system becomes extremely elevated. Some ___ already may have ruptured or will soon
Vascular Arterial blood vessels
58
Retinal hemorrhages can lead to
Blindness
59
A stroke occurs if__ in the ___ rupture & bleed
Vessels Brain
60
If a __ has developed in the __ from ___ it may burst and cause __ & ___
Aneurysm Aorta Chronic hypertension Hemorrhage Shock
61
The onset of sudden ___ accompanied by ___ indicates that an aortic ___ is ___ or has __
Severe back pain Hypotension Aneurysm Dissecting Ruptured
62
In true hypertensive emergencies the goal is to lower the BP within __ to ___ hrs by using ___
1 to 2 hours Potent IV drugs

Med Surg 1 (19 decks)

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