CV Flashcards
What causes hypertension
increased cardiac output or vasoconstriction
what is primary hypertension?
hypertension with no identifiable cause
what is secondary hypertension?
hypertension caused by another disease process
what is complicated hypertension?
sustained hypertension that effects other body systems
what does continued hypertension do to the blood vessels?
Hypertrophy and Hyperplasia, decrease in the diameter of vessels
Most common symptom with hypertension
asymptomatic or headache
What is the most important evaluation to do for someone with hypertension?
lifestyle
what tests will be run for hypertension?
Urinalysis, blood, and EKG, however, none can diagnose, they’re used to see if there is damage anywhere else
Options for treatment
-lifestyle modifications
-DASH diet
-moderate alcohol consumption
The amount of blood pumped in one minute
cardiac output
what is the primary diagnosis in the United States?
Hypertension
Which part of the heart pushes blood out to the rest of the body?
Left ventricle
What is the diet called for hypertension?
DASH diet
You need to monitor potassium with this medication?
Lasix
What is a diuretic that is primarily used to treat hypertension?
hydrochlorothiazide
What is orthostatic hypotension?
decrease in blood pressure upon standing
What is the biggest nursing intervention with orthostatic hypotension?
safety– huge fall risk
who is more likely to have orthostatic hypotension
Men, Elderly
What is atherosclerosis?
Accumulation of lipids in vessel walls causing narrowing or occluding of vessel
What is myocardial ischemia?
Pathological mechanisms that interfere with blood flow through the coronary arteries
What does myocardial ischemia cause?
lack of oxygen getting distributed into the cells
Causes of myocardial ischemia
-atherosclerosis
-thrombus formation
-vasoconstriction
because of myocardial ischemia you either have-
-decrease supply of blood flow (oxygen)
-increase demand of blood flow (oxygen)
what part of the heart is the blood most oxygen rich
right ventricle
what is angina?
chest pain caused by myocardial ischemia
Predictable pain on exertion that stops at rest
stable angina
unpredictable pain caused by vasospasm usually at rest
prinzmetal angina
Silent ischemia angina
EKG changes (ST depression) but no symptoms
chest pain occurs at rest or during minimal activity and is not relieved with rest
unstable angina
Angina goal of treatment
reduce myocardial oxygen consumption
what do you do immediately if someone complains of chest pain? (3 things)
- put on o2
- get a 12 lead EKG
- assume it is cardiac
Medications for angina
nitrates, beta blockers, calcium channel blockers, anticoagulants
What does ST depression represent?
ischemia
what does ST elevation represent?
injury or infarction
umbrella term for unstable angina and myocardial infarction
acute coronary syndrome
what lab looks specifically at cardiac muscle injury or damage
troponin
What lab looks specifically at heart failure
BNP
what drugs for ACS
lipid lowering drugs
- statins
-niacin
-fibrates
What does myocardial infarction lead to?
dead muscle tissue
cardiac output is directly related to-
urinary output
Nursing care for myocardial infarction
-bed rest
-education
-stool softener
Medications for myocardial infarction
-morphine
-oxygen
-nitrates
-aspirin
-ace inhibitors
-beta blockers
What is a PTCA
looks for blockages and uses a balloon to push atherosclerosis to the side to open up the vessels
what is a stent
tiny metal spring-like device that they place into the vessel at the site of a blockage to hold it open.
What is a CCCA
visualize blockage and diagnose CAD
Pre-op for CCCA
-NPO for 8-12 hours
-Prepare the patient for expectations
Post-op for CCCA
-PV assessment
-monitor for dysrhythmias
-assess catheter site
-bed rest for 2-6 hours
-keep affected extremity straight
-HOB less than 30 degrees
-encourage fluids to flush out dye
-safety/fall risk
What to check for post-op CCCA
bleeding or hematoma or blood pulling or pop
what is a CABG
surgery where a blood vessel from another part of the body is grafted to the occluded coronary artery
best place to get a vessel for CABG
internal mammory
how much urinary output is expected every hour
30 mls
Mitral valve prolapse
leaflets of the mitral valve billow upward into the atrium
S/S of mitral valve prolapse
often asymptomatic
Cause of mitral valve prolapse
?
Stenosis
valve becomes stiff and doesn’t open completely
What does stenosis cause
blood not able to flow through, causes extra fluid
what is regurgitation
leaflets fail to completely shut and blood is able to leak into chamber
Medications for valve disorders
-diuretics
-beta blockers
-cardiac glycosides
-prophylactic antibiotics
valve replacement or repair
-replace with prosthesis
-mechanical valves
-tissue valves
what does someone with a mechanical valve have to take for the rest of their lives?
Anticoagulants
what is heart failure?
The inability of the heart to pump sufficient blood to meet the needs of the body for oxygen and nutrition
Causes of heart failure
-CAD
-HTN
-Valve disorder
-Infection
Left heart failure
pulmonary congestion and pulmonary edema
Right heart failure
systemic symptoms, JVD, dependent edema
Most important nursing managements with CHF
-I&O
-daily weight
