Deck 07_Cardiovascular - kayrene Flashcards
What are the signs and symptoms of HTN?
Primary- Rarely Produces symptoms
Secondary- is characterized by elevations in blood pressure due to a specific cause.
Identify complications of HTN.
- Hypertensive urgency: severely elevated BP (diastolic greater than or equal to 120 mm Hg) with no obvious, acute TOD
- Hypertension emergency: evidence TOD
- Hypertensive crisis = umbrella term
- Stroke and Aneurysm
- Damage to the heart, brain, and kidneys before symptoms become apparent.
What are the signs, symptoms, and resources for the treatment of peripheral artery disease (PAD)?
-
Signs
- blockage in the peripheral artery
-
Symptoms
- asymptomatic
- intermittent claudication (muscle pain–ache, cramp—classsic in the calf muscle, numbness, that occurs during exercise and is relieved by a short period of rest)
- severe chronic leg ischemia
-
Resources for the treatment of PAD
-
non-surgical
- Exercise
- Position extremity below the position of the heart
- Keep extremities warm but no direct heat.
- Avoid vasoconstricting substance
- percutaneous transluminal angioplasty: laser probe advanced through a cannula that is inserted into or above an occluded artery
-
surgical
- bypass blockage with artery graft thing
-
non-surgical
What are the signs, symptoms, and treatment goals for patients with thrombophlebitis and DVT?
- Thrombophlebitis
- Signs: redness, swelling (bilateral), warmth @ IV site
- Symptoms: tenderness/pain at IV site
- Tx goals: stop infusion, prevent inflammation from progressing
- DVT
- Signs: Homan’s sign (kind of), one leg looks all swollen and purpley and angry
- Symptoms: cramping/calf pain, pulmonary Embolism, Increased RR, Drop in 02 Sat, Asymptomatic, Calf or groin tenderness, Unilateral leg swelling, Redness
-
Tx goals (Early Ambulation, Leg Excercises, Hydration, DO NOT MASSAGE LEG):
- prevent clot from getting bigger and preventing it from breaking loose and causing a pulmonary embolism.
- Use anticoagulant therapy/Heparin. After clot dissolves, you’re focused on keeping it from happening again
What are signs and symptoms of angina?
- Signs
- vessel has narrowed 60-70%
- Symptoms
- stable/unstable angina: unstable happens at any time.
- intermittent chest pain pretty much (pressure)
Stable angina
Chest pain or discomfort that is associated with physical activity
Unstable angina: refers to chest pain that can occur at rest
Atypical Angina
- From women
- Epigastric pain
- Back pain
- Overall fatigue
- Flu-like symptoms
What are the clinical manifestations of (and treatment for) an acute myocardial infarction (MI)?
-
Clinical manifestations
- Intermittent chest pain
- Tropin T and Tropin I markers
- hella bad CP that isn’t resolved by 3x NTG administration
- Nausea/vomiting/other GI symptoms may present more commonly in women
- hella bad CP that isn’t resolved by 3x NTG administration
-
Treatment
- MONA/OANM
- Oxygen for 02 saturations less than 94%
- Aspirin “baby”
- Nitroglycerin
- Morphine Sulfate
- Position of comfort; semi-Fowler’s position
- Quiet and calm environment
- fibrinolytics can dissolve thrombi in coronary arteries, heparin prevents further clots from forming
- Cardiac catheterization to det if blockage, if hella bad blockage → CABG (coronary artery bypass graft)
- PTCA (percutaneous transluminal coronary angioplasty)
- snake a catheter from the groin → heart to bust the clot
What patient teaching is provided for the patient with heart failure?
- weigh same time each day in the AM after bowel movement (for fluid not calories)
- report weight gain of more than 2 pounds in a day
- decrease sodium intake
- MAWDS
- Medications: avoid NSAIDs, take medications as prescribed and do not run out. Know the purpose/side effects of drugs
- Activity: do your low-key exercise stuff: stay active but do not overdo! Know your limits
- Weigh yourself, same time each day in the AM after bowel movement on the same scale
- Diet: decrease sodium intake, follow heart healthy diet (less saturated fat, less cholesterol, less sodium, less yummy stuff), limit fluid intake to 2 liters
- Symptoms: identify new or worsening symptoms and notify healthcare provider
What is the difference between stenosis and regurgitation of heart valves?
- stenosis: stiffening and thickening of heart valves/arterial walls. Increased fibrosis of heart chambers also.
- regurgitation: incomplete closure of valve; allows backflow
Ms. Ard
Mitral
Stenosis
Aortic
Regurgitation
Diastolic
Mr. Ass
Mitral Regurgitation
Aortic
Stenosis
Systolic
What is the difference between endocarditis and pericarditis?
- Endocarditis: inflammation of valves usually
- Pericarditis: inflammation of the pericardial sac/pericardium
Endocardidtis
- Dx: blood culture
- S/S: Splinter hemorrhage in nail bed, Janeway lesions
- Tx: Abx
Pericarditis
- *S/S:** Friction rub, Orthopnea, EKG changes, Pericardial Effusion
- *Tx:**
- NSAIDs
- Pain can be alleviated by leaning over, like leaning over a pillow in bed
What is the rationale for treating strep throat?
- Strep throat is generally AF (atrial fibrillation). Here are reasons why:
- can cause infective endocarditis (microbial infection involving the endocardium). You can super die
- it can cause MF-ing meningitis
- You can get an embolus and straight up die from the microemboli/blood clot that strep creates.
- We give meds to prevent from additional complications and prevent renal failure (kidney)
- Post-streptococcal Glomerulonephritis. Rheumatic fever
What are the clinical manifestations of (and treatment for) severe aortic artery disease?
- Asymptomatic until a complication (dissection or rupture) occurs
- May have a palpable pulsatile abdominal mass -- but avoid palpating the mass to avoid rupture!
- Treatment: MAINTAIN NORMOTENSION (NORMAL BP)
- too low? they might have already started bleeding (no bueno)
- too high? it’ll blow!!!
Signs and Symptoms of HF (right and lefit-sides)
Right Sided HF :
- Edema
- Asites
- JVD
Left Sided HF:
- Crackles
- Tachypnea
- Dyspnea
- Fatigue
- Breathlessness
What are the different classifications of blood pressures measurements?
Normal <120, <80
Elevated 120-129, <80
HTN 1 130-139, 80-89
HTN 2 >140, >90
Hypertensive Crisis >180, >120
What are complications of Immobility?
- OH
- DVT
- Constipation
- UTI
- Depression
