E-TEST 1

Question 1

What is orthostatic (postural) hypotension?

Answer 1

An atypical drop in blood pressure when a person stands up from sitting or lying

Question 2

What is the physiology behind orthostatic hypotension?

Answer 2

Gravity causes arterial blood pressure to drop -> ineffective reflexes or low blood volume leads to less oxygen to the brain

Question 3

What is orthostatic hypotension characterised by?

Answer 3

Dizziness, syncope (fainting) and increased risk of falling

Question 4

What is the baroreceptor reflex?

Answer 4

Compensates standing
Located in the vessels of the chest and carotid
They sense a decrease in blood pressure that leads to an increase in vasoconstriction and increase in HR to bring BP up
There are also increased levels of epinephrine and antidiuretic hormone in the blood to help maintain BP while standing

Question 5

What are the signs/symptoms of orthostatic hypertension?

Answer 5

Drop in systolic BP/MAP, increased HR and weak pulse, sweating, tremor, nausea, feeling faint, light headed (beware of the patient who goes quiet)

Question 6

How does prolonged bed rest effect blood distribution?

Answer 6

Reduced baroreceptor function, peripheral vasodilation and increased redistribution of the blood to the periphery

Question 7

Describe the change in blood distribution when going from lying to standing

Answer 7

700mL blood shift from the thorax, decreased stroke volume and cardiac output = compensatory increase in HR

Question 8

What are some precautions to be aware of when doing a blood pressure assessment?

Answer 8

Wounds, cannula or line, aterio-venous fistula and lymphedema

Question 9

What are some factors that can make a pulse oximeter assessment inaccurate?

Answer 9

Heavily pigmented skin, cardiac arrhythmia, sickle cell anaemia, hypothermia (vasoconstriction) and finger movements

Question 10

What is mean arterial pressure?

Answer 10

Systolic/diastolic
MAP = SBP + 2x(DBP)/3
MAP should be maintained above 65 mmHg to maintain organ perfusion

Question 11

What is systolic pressure?

Answer 11

Arterial pressure when the heart contracts (ventricles)

Question 12

What is diastolic pressure?

Answer 12

Arterial pressure when the heart relaxes

Question 13

What is tachycardia and bradycardia?

Answer 13

Tachycardia = >100bpm
Bradycardia = <60bpm

Question 14

What is blood pressure?

Answer 14

The pressure of blood on the walls of the arteries as the heart pumps blood around the body

Question 15

What are the effects of surgery on blood pressure?

Answer 15

Blood loss = decreased haemoglobin
Diuresis = hypovolaemia and decreased stroke volume and cardiac output
Surgical patients that have an inability to weight bear through lower limbs will have decreased muscle pumps