Disorders of Circulatory System

Question 1

Whats is hypertension?

Answer 1

Systolic blood pressure of 140 or greater, and a diastolic blood pressure of 90 or greater

Question 2

What would stage 1 hypertension be?

Answer 2

140-160/90-100

Question 3

What would stage 2 hypertension be?

Answer 3

> 160/ >100

Question 4

What is hypertensive crisis?

Answer 4

When blood pressure rises rapidly; threat of immediate vascular necrosis and target organ damage (heart, kidneys, brain); blood pressure is usually greater than 180/120

Question 5

What are the risk factors of primary hypertension?

Answer 5

Immediate family history, race (african american, hispanic, native american), stress, obesity, diet high in sodium, smoking, contraceptive use, sedentary life, and age

Question 6

What are the signs and symptoms of hypertension?

Answer 6

Usually asymptomatic unless end organ damage is present or hypertensive crisis is occurring

Question 7

How can hypertension affect the brain?

Answer 7

occipital headache, blurred vision, and dizziness

Question 8

How can hypertension affect the heart?

Answer 8

chest pain, palpitations, dyspnea, and/or signs of heart failure

Question 9

What are the signs of a hypertensive crisis?

Answer 9

hypertensive encephalopathy, severe headache, nausea, vomiting, seizures, confusion, coma, papilledema, angina, pulmonary edema, and renal insufficiency

Question 10

How do you diagnose hypertension?

Answer 10

hypertension is diagnosed based on the average of three or more blood pressure readings, 2 minutes apart, and 3 or more visits.

Question 11

How do you manage hypertension?

Answer 11

weight reduction, regular physical activity, limit sodium, alcohol in moderation, smoking cessation, stress reduction

Question 12

What pharmacological agents are used to manage hypertension?

Answer 12

Diuretics, beta-adrenergic blocking agent, ACE inhibitors,

Question 13

How do you treat a hypertensive crisis?

Answer 13

Intensive care required for rapid reduction of blood pressure by use of vasodilators

Question 14

What is the goal of treatment for a patient with hypertension?

Answer 14

BP of 135/80 or less

Question 15

What is the client and family teaching for a patient with hypertension?

Answer 15

self-monitoring BP, record BP readings, routine schedule for taking antihypertensive meds, avoid decongestants (raise BP), optimize body weight, moderate alcohol consumption, limit sodium, manage stress

Question 16

What are some alternative medicine options for a patient with hypertension?

Answer 16

garlic, ginseng root, hawthorn, omega-3-fatty acid, amino acid L-arginine,

Question 17

Patients with hypertension should avoid which two things?

Answer 17

Licorice and ephedra (weight loss drug)

Question 18

What are the nursing interventions for a patient with hypertensive crisis?

Answer 18

monitor for end organ damage, monitor urine output, assess level of consciousness, monitor labs (BUN, creatinine, ABG’s, urinalysis), continuous cardiac monitoring, monitor vitals every 5-30 minutes

Question 19

What is coronary artery disease?

Answer 19

fatty deposits in the coronary arteries narrow the artery (by 75% or more) reducing the flow of blood and oxygen to the heart muscle

Question 20

What is the most common cause of CAD?

Answer 20

atherosclerosis

Question 21

Who is mostly affected by CAD?

Answer 21

Western people; men in their 60’s or older

Question 22

What are the risk factors for CAD?

Answer 22

white males over age 40, diabetes, family history of CAD, high HDL, smoking, obesity, physical inactivity, stressed life style

Question 23

What are the symptoms of CAD?

Answer 23

early stages are asymptomatic, anginal chest discomfort, dyspnea, lightheadedness, and GI complaints

Question 24

What labs are used to diagnose CAD?

Answer 24

C-reactive protein, high LDL cholesterol, low HDL, triglycerides

Question 25

What tests are used to diagnose CAD?

Answer 25

Cardiac stress test (elevated ST levels), nuclear perfusion scanning (poor perfusion), cardiac catheterization and coronary angiography (shows areas of narrowing* gold standard for diagnosis)

Question 26

What medications are given to manage CAD?

Answer 26

Nitrates (vasodilator), beta-blockers (reduce workload of heart), anti platelet agents (aspirin- reduces chance of thrombolytic agent), and ant-lipidemics ("statin" drug- reduces hyperlipidemia)

Question 27

How do you manage CAD?

Answer 27

oxygen (during anginal events), well balanced diet (low in fat & cholesterol), stopping smoking, stress reduction techniques, surgical revascularization, coronary angioplasty, coronary artery bypass graft (CABG)

Question 28

What is a coronary artery bypass graft?

Answer 28

A healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the coronary artery. This creates a new path for oxygen-rich blood to flow to the heart muscle.

Question 29

What is the post cardiac catheterization nursing care

Answer 29

Maintain heparin (reduce risk of clot), observe for bleeding, monitor for chest pain & hypotension, keep the affected leg straight and immobile for 6-12hours, check for distal pulses, keep IV fluids going, assess potassium levels & monitor for arrhythmias, monitor serum creatinine

Question 30

What should a patient with CAD avoid?

Answer 30

physical activities for two hours after a meal, very cold or hot weather, alcohol and caffeine, and stimulants (diet pills)

Question 31

What tablets should CAD patient carry at all times and when should they take it?

Answer 31

nitroglycerin tablets, 1 tablet every five minutes up to three times, if no relief call 911

Question 32

What is hyperlipidemia?

Answer 32

An elevation of lipids in the blood stream

Question 33

What is the cause of hyperlipidemia?

Answer 33

dietary and hereditary

Question 34

What is the pathophysiology of hyperlipidemia?

Answer 34

increased lipids and cholesterol leads to atherosclerosis , which leads to CAD

Question 35

How do you diagnose hyperlipidemia?

Answer 35

increased total cholesterol, increased LDL, decreased HDL, increased triglycerides

Question 36

How do you manage hyperlipidemia?

Answer 36

Eliminate trans fats, limit cholesterol, eat whole grains, eat foods rich in omega 3 fatty acids, exercise, medication

Question 37

What medication is used to manage hyperlipidemia?

Answer 37

Statins (atorvastin, simvastatin), bile acid sequelstrants, niacin