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341 > Exam 2- SYSTEMS > Flashcards

Exam 2- SYSTEMS Flashcards

1
Q

hypertension

A

the force exerted by the blood against the walls of the blood pressure

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2
Q

cardiac output

A

the total blood flow through the systemic or pulmonic circulation per minute

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3
Q

stroke volume

A

amount of blood put out by the left ventricle of the heart in one contraction; 70 ml/minute

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4
Q

how do you find cardiac output?

A

CO= SV * HR

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5
Q

systemic vascular resistance

A

amount of force that the left atrium and ventricle need to overcome to push the blood out; force opposing the movement of blood within blood vessels

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6
Q

what’s affected from SVR?

A

radius of arteries and arterioles
sympathetic nervous system activity

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7
Q

vasodilation

A

arteries DIALATE, resistance to blood flow DECREASES

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8
Q

vasoconstriction

A

blood vessels NARROW, resistance to blood flow INCREASES

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9
Q

normal blood pressure

A

<120/
<80

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10
Q

elevated

A

120-129/
<80

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11
Q

stage I blood pressure

A

130-139/
80-89

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12
Q

stage II blood pressure

A

> 140/
90

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13
Q

hypertensive crisis

A

> 180/
120`

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14
Q

what factors from cardiac output contribute to blood pressure?

A

heart rate
contractility
conductivity
renal fluid volume control

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15
Q

what factors from SVR contribute to blood pressure?

A

sympathetic nervous system
vasodilators
vasoconstrictor

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16
Q

what medications help the heat contract and work harder?

A

digoxin
positive isotropic

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17
Q

where and how fast does the SA node work?

A

right atrium; 60-100 BPM

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18
Q

where and how fast does the AV node work?

A

between atria and ventricle (backup); 40-60 BPM

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19
Q

where and how fast does the bundle of HIS work?

A

aorta; 20-40 BPM

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20
Q

where and how fast does the punkinje fibers work?

A

left ventricle; 20-0 BPM

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21
Q

which populations are most affected for hypertension?

A

african americans: less response to renin inhibiting meds, better with calcium channel blockers and diuretics
hispanics: less likely receive treatment, lack of awareness
women: increased chances due to oral contraceptives, preeclampsia, and after menopause

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22
Q

what are the risk factors for primary hypertension?

A

unknown cause

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23
Q

what are the risk factors from secondary hypertension?

A

specific cause

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24
Q

what are some clinical manifestations for hypertension?

A

silent killer, fatigue, dizziness, palpations, angina, and dyspnea

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25
Q

what are hypertension patients at risk for?

A

myocardial infraction, heart failure, stroke, renal disease, retinopathy, death, peripheral vascular disease (aortic aneurysm, aortic dissection)

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26
Q

what are hypertension patients at risk for in the cardiovascular system?

A

coronary artery disease, atherosclerosis, left ventricular hypertrophy (left ventricle trying to overcome SVR), heart failure

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27
Q

what are hypertension patients at risk for in the brain?

A

cerebrovascular disease, hypertensive encephalopathy, changes in auto regulation

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28
Q

what are hypertension patients at risk for in the kidney?

A

nephrosclerosis leads to chronic kidney disease

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29
Q

what are hypertension patients at risk for in the eyes?

A

damaged retinal vessels indicate concurrent damage to vessels in heart, brain, and kidney

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30
Q

what are diagnostic studies you can do?

A

take BP wherever; teach the patient; cardiac and peripheral pulses assessment; echo; ambulatory BP monitoring (consistent BP randomly for 24 hours)

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31
Q

what are the overall goals for hypertension

A

achieve and maintain goal Bp; lifestyle modifications

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32
Q

what are the AHA’s life’s simple 7?

A
  1. manage and monitor BP
  2. control cholesterol- dec choles and saturated fats
  3. reduce blood sugar
  4. get active
  5. eat better- restrict salt, eat potassium and calcium
  6. lose weight
  7. stop smoking
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33
Q

what are some lifestyle modification for patients diagnosed with hypertension

A

weight reduction; dietary approaches; dietary sodium reduction; dash diet; moderations of alcohol; physical activity; avoid tobacco products; management of risk factors

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34
Q

what is the drug therapy for patients diagnosed with hypertension?

A

primary actions- decrease circulating blood volume and reduce SVR; centrally acting alpha-agonist hypotensive agents; alpha adrenergic blocker; beta adrenergic blocker; diuretics

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35
Q

centrally acting alpha-agonist hypotensive agent

A

hypertension; decreases heart rate and relaxes blood vessels so that blood can flow more easily through the body
side effects: dry mouth

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36
Q

alpha adrenergic blocker

A

hypertension; relaxes blood vessels so blood can flow more easily
side effects: orthostatic hypotension

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37
Q

beta adrenergic blocker

A

blocks the action of certain natural chemicals in the body such as epinephrine, on the heart and blood vessels. this effect lowers the heart rate, BP, and strain on the heart
side effects: dizziness, lightheadedness, tiredness

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38
Q

diuretics

A

hypertension; help rid the body of sodium and water. the sodium takes with it water from your blood, decreasing the amount of fluid flowing through veins and arteries
side effects: dizziness, headaches, frequent voiding, loss of potassium, orthostatic hypotension

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39
Q

what is one important piece of information for patient and caregiver education?

A

need to continue adherence to therapy. Don’t double skip or stop abruptly. Know the patient’s medications

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40
Q

what are common side effects for those diagnosed with hypertension?

A

orthostatic hypotension, frequent voiding, hypotension

41
Q

what is resistant hypertension?

A

failure to reach goal blood pressure which increases the risk of stroke or myocardial infraction

42
Q

what are the causes of resistant hypertension?

A

improper BP measurement; volume overload; inadequate or inappropriate drug dose/therapy; poor adherence; white coat syndrome; secondary hypertension

43
Q

what are priority problems with those diagnosed with hypertension?

A

altered BP; ineffective tissue perfusion; impaired sexual function; stroke; MI

44
Q

what are gerontologic consideration for those diagnosed with hypertension?

A

increased incidence with age; more likely to have white coat syndrome; age-related physical changes; altered drug absorption, metabolism, and excretion; often a wide auscultatory gap

45
Q

what are the age-related physical changes for the older population with hypertension?

A

loss of elasticity in arteries; stiffness in myocardium; increased PVR; decreased renal function

46
Q

hypertension crisis

A

> 180/>120; target organ damage (kidney, brain, heart); requires hospitalization

47
Q

hypertension urgency

A

no evidence of target organ disease

48
Q

what are hypertension crisis clinical manifestations?

A

increase BP; hypertensive encephalopathy; renal insufficiency/failure; cardiac decompensation; aortic dissection

49
Q

what are hypertension crisis interprofessional care actions?

A

hospitalization; monitor cardiac function; renal function; neurologic checks; bedrest if on IV drugs; determine cause; education to avoid crisis; hypertension urgency is outpatient

50
Q

what is the primary purpose of the respiratory system?

A

transfer O2 and CO2 between atomsphere and blood

51
Q

what is in the upper respiratory system?

A

nose, mouth, pharynx, epiglottis, larynx, and trachea

52
Q

what is in the lower respiratory system?

A

bronchi, bronchioles, alveolar ducts, alveoli

53
Q

how many lobes are in the right and left lung?

A

right has three
left has two

54
Q

what is the structure of trachea and bronchi?

A

anatomic dead space; no gas exchange

55
Q

what is the structure of the bronchioles?

A

smooth muscle that constricts and dilates

56
Q

what is the structure of alveoli?

A

terminal part of the respiratory tract; gas exchange

57
Q

alveoli

A

primary site for gas exchange with pulmonary capillaries

58
Q

pores of kohn

A

interconnections between alveoli; allows air/bacteria to pass

59
Q

surfactant

A

lipoprotein secreted by alveoli when stretched; reduces surface tension to make alveoli less likely to collapse

60
Q

atelectasis

A

collapsed alveoli

61
Q

what are the two blood supplies of the respiratory system?

A

pulmonary circulation and bronchial circulation

62
Q

pulmonary circulation

A

artery: deoxygenated blood from right ventricle
capillaries: exchange gases at alveoli
veins: return oxygenated blood to left atrium

63
Q

bronchial circulation

A

arteries: oxygen to bronchi and lung tissues
azygos vein: deoxygenated blood to superior vena cava

64
Q

what are the parts of the chest wall?

A

ribs and sternum; mediastinum; pleura; diaphragm

65
Q

oxygenation

A

O2 dissolved in plasma results in pressure of O2 in arterial blood (PaCO2); normal 80-100 mmHg
O2 bound to hemoglobin results in arterial O2 saturation (SaO2); normal >95%

66
Q

diffusion

A

O2 and CO exchange at alveolar capillary membrane;
high to low concentration till equal

67
Q

venitilation

A

inspiration and expiration occur due to intrathoracic pressure changes and muscle action

68
Q

elastic recoil

A

lungs return to original size after expansion

69
Q

compliance

A

measures ease of lung expansion and elastic recoil
decreased: hard to inflate
increased: hard to recoil

70
Q

resistance

A

airflow impeded during inspiration and/or expiration; altered airway diameter

71
Q

medulla

A

respiratory center in brainstem; responds to chemical and mechanical signals; sends impulses from spinal cord and phrenic nerve to respiratory muscles

72
Q

chemoreceptors

A

respond to changes in PaCO2 and pH in surrounding fluid; in the medulla

73
Q

mechanical recpetors

A

located conducting upper airways, chest wall, disphragm, and alveolar capillaries

74
Q

what are the three types of stimuli mechanical receptors respond to?

A

irritant; stretch; j-receptors

75
Q

what are the respiratory defense mechanisms?

A

protect lungs; filtration of air; mucociliary clearance; system-escalator; cough reflex; reflex bronchoconstriction; alveolar macrophages

76
Q

what are the diagnostic studies of the respiratory system?

A

pulse oximetry; arterial blood gases; CO2 monitoring; mixed venous blood gases; sputum studies; skin tests; bronchoscopy; lung biopsy; thoracentesis; pulmonary function tests; radiology

77
Q

what is the structure of the GI?

A

mucosal lining; submucosa connective tissue; muscle; serosa

78
Q

autonomic nervous system

A

innervates and affects ENS

79
Q

parasympathetic

A

excitatory

80
Q

sympathetic

A

inhibitory

81
Q

enteric nervous system

A

can work independently of CNS; regulates motility and secretion along entire GI tract

82
Q

circulation of the GI system

A

celiac artery; superior mesenteric artery; inferior mesenteric artery

83
Q

peritoneum

A

parietal layer lines the abdominal cavity wall
visceral layer covers abdominal organs

84
Q

peritoneal cavity

A

potential space between 2 layers

85
Q

function of GI system

A

supply nutrients to body cells through ingestion, digestion, and absorption

86
Q

ingestion and propulsion of food

A

controlled by appetite center in hypothalamus and hormone ghrelin
mouth, pharynx, and esophagus

87
Q

digestion and absorption

A

stomach
small intestine
physiology of digestion

88
Q

gastric secretions

A

chief cells secrete pepsinogen; parietal cells secrete hydrochloric acid, water, and intrinsic factor

89
Q

physiology of digestion

A

physical and chemical breakdown of food into absorbable substances; starts with saliva in mouth; protein is broken down by pepsin in the stomach; carbs, fats, and protein are broken down into the small intestine

90
Q

absorption

A

transfer of the end products of digestion across the intestinal wall into circulation; most occurs in small intestine

91
Q

digestion and absorption

A

small intestine- pylorus to ileocecal wall, duodenum, jejunum, ileum, villi, and microvilli

92
Q

elimination

A

large intestine- cecum, colon, rectum, and anus
absorption of water and electrolytes; produces vitamin K and some B vitamins; forms and stores fecal mass; secretes mucus

93
Q

liver

A

largest internal organ; contains right and left lobes; functional unit is the lobule (hepatocytes, kupffer cells, capillaries)

94
Q

biliary tract

A

bile needed for fat emulsification

95
Q

gallbladder

A

collects bile from lives and collects/ concentrates it

96
Q

common bile duct

A

delivers bile to the duodenum at the ampulla of vater

97
Q

pancreas

A

head, body, and tail; lobes and lobules; pancreatic duct enters the duodenum through the common bile duct at ampulla of vater; exocrine and endocrine functions

98
Q

what are the diagnostic studies of the GI tract?

A

radiologic studies; endoscopy; liver biopsy; liver function studies

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