exam 2 Flashcards
What is cardiac output
-stroke volume x heart rate
-normal ab 5 L/min
What is the systemic vascular resistance (SVR)
-force opposing flow
-radius of small arteries & arterioles
factors influencing blood pressure
cardiac
-heart rate, contractility, conductivity
sympathetic nervous system
-vasoconstriction, vasodilation
renal fluid volume control
-renin-angiotension-aldosterone system, natriuretic peptides
neurohormonal
-vasoconstrictors (angiotension & norepinephrine)
local regulation
-vasodilators (prostaglandins, nitric oxide)
-constrictors ( endothelin)
What are the biological differences between men and women?
more common before 55 yrs old for men and after 55 for women. For women estrogen decrease, overproduction of pituitary hormone, & weight gain. for men myocardial infarction more likely than CVA
Health disparities rt hypertension for black people
-highest prevalence worldwide
-females> males
-increase end-organ damage
-increase mortality
-less responsive to ACEI
Health disparities rt hypertension for hispanics
-decreased awareness
-less likely to receive treatment
- lower rates of control
facts rt hypertension in older adults
-over age 55=90% chance of developing hypertension
-physiologic changes contribute to HTN
-increased sensitivity to BP changes
-orthostatic hypotension common
primary hypertension
-increased BP with no identifiable cause
-essential or idiopathic
- 90-95% of adult cases
secondary hypertension
-increase BP due to specific underlying cause
- 5-10% of adult cases
patho rt primary hypertension
-sustained increased systemic vascualr resistance (SVR)
-or increase cardiac output (CO)
-heredity, water & sodium retention, altered renin-angiotension mechanism
-stress: psychologial and physiologic, insulin resistance, endothelial cell dysfunction
Symptoms rt secondary hypertension (if not asymptomatic)
-fatigue
-decreased activity tolerance
-dizziness
-palpitations
-dyspnea
target organs rt to hypertension
cardiac
cerebrovascular
peripheral vascular
renal
retinopathy
diagnostic studies rt hypertension
history & physical
blood pressure
urinalysis
BUN and creatine, GFR
serum electrolytes
serum lipid profile
ECG
invasive method for blood pressure measurement
arterial catheter provides direct measurement
Common diuretics?
thiazide, loop, potassium-sparing, adlosterone, receptor blockers
what are inflammatory diseases of the heart
endocarditis, pericarditis, myocarditis, rheumatic fever, rheumatic heart disease
What is infective endocarditis?
infection of endocardium and valves
what causes endocarditis
staphlyloccus aureus and streptoccus virdians, other bacteria, fungi, and viruses
Risk factors for endocarditis
prior endocarditis, prosthetic valves, valve disease, cardiac lesions, IVDA, intravascular devices, other procedures
What are vegetations for infective endocarditis
firbrinm leukocytes, platelets, and microbes, adhere to endocardium and/or valves
What are the systemic embolization for endocarditis
lesions on right-lungs, lesions on left-brain, kidney, spleen
clinical manifestations rt endocarditis
“from jane”
fever, roth spots, osler nodes, murmur, janeway lesions, anemia, nail-bed hemorrhage, emboli
interprofessional care for endocarditis
antibiotic prophlaxis
long-term IV antibotics
acetaminophen or ibuprofen
valve replacement
complications rt endocarditis
cerebral emboli, pulmonary edema, heart failure
