CV TEST ONE: HYPERTENSION

Question 1

Hydrochlorothiazide

Answer 1

Diuretic HTN Med, potassium wasting (no potassium) potassium rich diet suggested

Question 2

Peripheral resistance

Answer 2

Arteries’ resistance to blood flow, arteries constrict=increased resistance , arteries dilate= decreased resistance

Question 3

Modifiable/non modifiable HTN factors

Answer 3

•Modifiable—diet, lifestyle, exercise
•non modifiable—race, gender, heredity, age, pre existing conditions

Question 4

BP categories

Answer 4

*normal–less than 120/80 mmHg
*elevated–120-129/<80 mmHg
*stage 1–130-139/80-89 mmHg, poss. Med. intervention, lifestyle change
*stage 2–BP < 140/< or = 90 mmHg, meds (ANTIHYPERTENSIVES) lifestyle change
*urgent–180/120 or <, immediate reduction of BO to prevent organ damage, PT resting while 911 contacted

Question 5

HTN diagnosis includes:

Answer 5

Confirmed >2 occasions of hypertensive measurements, risk factors, presence/absence of symptoms, history of heart/kidney disease, current meds used

Question 6

HTN S/S

Answer 6

Headache, bloody nose, anxiety, SOB

Question 7

Cardiac catheterization

Answer 7

•Studies heart’s anatomy/physiology, assesses pressure in coronary arteries/chambers/great vessels, assesses C.O./O2 saturation
•dye injected into catheter>inserted into femoral vein

Question 8

Pre & post cardiac catheter

Answer 8

•pre– consent, assess for iodine/dye allergies, NPO/conscious sedation
•post–monitor for bleeding, pressure device at site, bedrest, no flexion of extremity for hrs, V.S. Taken, peripheral pulses taken

Question 9

PTs radial pulse is different than their apical. What should nurse proceed to do and why

Answer 9

Report pulse deficit to doctor, could indicate arrhythmia/cardiac dysfunction

Question 10

Trans esophageal Echocardiogram (TEE Test)

Answer 10

•Clearer picture, transducer probe in esophagus (doesn’t cross lung/rib tissue), sedation/local anesthetic in oropharynx, NPO 6 hrs pre-test
•complications—esophageal perforation, throat bleeding, hypoxia, dysthymias

Question 11

Pre/Post TEE

Answer 11

•Pre TEE—assess allergy hx/sedation reactions/local & general anesthesia
•post TEE–asses VS, monitor bleeding, MONITOR GAG REFLEX!, keep suction & resuscitation equipment available

Question 12

Pericardial rub

Answer 12

Heard in inflammatory processes (pericarditis), sounds like rubbing tissue papers, can be heard closely if PT sitting up & leaning forward

Question 13

S3 & S4 sounds

Answer 13

•S3—ventricular gallop or LUBB DUBB DUBB
•S4— atrial gallop or LUBB LUBB DUBB

Question 14

3 membranes of heart

Answer 14

•fibrous pericardium– outermost layer, forms sac around heart
•parietal pericardium–middle layer
•visceral pericardium aka epicardium– innermost layer

Question 15

Where does blood start at in the heart ?

Answer 15

Superior and inferior vena cava

Question 16

If a PT is struggling financially to pay for care costs they should be redirected to:

Answer 16

The financial dept within the clinical setting

Question 17

The left ventricle pumps __x times more force because _____

Answer 17

5, accommodate systemic circulation

Question 18

Cardiac pathway

Answer 18

AV node>SA node>Bundle of His>purkinje

Question 19

SA node

Answer 19

Pacemaker of the heart, where cardiac impulse is first carried out, heartbeat initiation, located in R.A.’s wall, gives normal rhythm

Question 20

Cardiac cycle

Answer 20

One heartbeat, 0.8 seconds

Question 21

During cardiac cycle, both atrias and ventricles contract and relax, known as

Answer 21

•systole–contraction(emptying occurs)
•diastole–relaxation phase

Question 22

Cardiac output

Answer 22

•amount of blood ejected from left ventricle in a minute
•calculation –stoke volume X heart rate

Question 23

Too much or too little potassium can cause

Answer 23

Dysrhythmia

Question 24

ANP (Atrial natriuetic) is secreted in response to

Answer 24

Vessels stretching from increased volume

Question 25

Uretic

Answer 25

Sodium and water loss, BP increased

Question 26

If there’s a different reading on the PTs arms go with

Answer 26

The higher reading for ongoing use

Question 27

Complications of HTN

Answer 27

CAD, atherosclerosis, M.I., H.F., stroke, kidney damage, eye damage, L.V. hypertrophy

Question 28

Meds to lower Bp (diuretics)

Answer 28

•K-sparing: Spironolactone (Aldactone)
•k-wasting: thiazide (hydrochlorothiazide) (chlorothiazide)
•Loop: furosemide (lasix), torsemide (demadex)
•oldest most studied antiHTN med
•PTs should swing legs on bed’s edge for some minute before standing to avoid syncope

Question 29

most common heart disease manifestation

Answer 29

chest pain (angina)

Question 30

Dyspnea may be a sign of

Answer 30

LV failure or transient CHF

Question 31

Heart sounds produced by closing valves start at

Answer 31

the aortic

Question 32

murmur

Answer 32

turbulent blood flow through heart/vessels, prolonged sound>narrowed valve closing

Question 33

cardiac enzyme elevated values

Answer 33

CPK and troponin

Question 34

C.O., blood viscosity, blood volume, PVR

Answer 34

factors determining BP

Question 35

What is HTN? what could it cause?

Answer 35

Increase in blood pressure against vessel walls…

coronary heart disease, CHF, stroke, M.I., eye damage, LV hypertrophy

Question 36

can a clot be caused by HTN

Answer 36

Yes due to blood being forced thru narrow vessels

Question 37

Increased C.O., PVR, blood viscosity, blood volume, hormone imbalances, kidney dysfunction

Answer 37

pathophysiologic changes of HTN

Question 38

Lifestyle mods. should be done ______ drug therapy unless PT is at high risk

Answer 38

before….

Question 39

PTs at risk for urgent HTN

Answer 39

untreated HTN, non compliant with med, using nitroprusside as its a vasodilation

Question 40

beta 1

Answer 40

beta 1 antagonist: iontropic, chronotropic effects
beta 1 blocker: decreased contractility, HR, decreased C.O.

Question 41

BETA 2

Answer 41

agonist: bronchodilation
blocker: bronchoconstriction

Question 42

alpha 1

Answer 42

agonist: vasoconstriction
blocker: vasodilation

Question 43

secreted by adrenal medulla, sympathomimetic response

Answer 43

epinephrine

Question 44

produced by adrenal cortex, regulates Na & K levels

Answer 44

aldosterone

Question 45

ANP

Answer 45

secreted by atria, increases Na excretion