Exam 3 Flashcards
Cardiac Output = ? x ?
CO= HR x SV
What is Cardiac Output?
The amount of blood pumped by each ventricle in one minute.
What is Stroke Volume?
The amount of blood ejected from the ventricle with each cardiac cycle
What is ejection fraction?
the measurement of the percentage of blood leaving your heart each time it contracts (how much blood is actually leaving the heart. is calculated by dividing the stroke volume by the end diastolic volume)
What are some labs for the diagnosis of hypertension?
BP Urinalysis BUN and serum creatinine Creatinine clearance Serum electrolytes and glucose Serum lipid profile (cholesterol) Uric acid levels ECG (electrical current of heart) Echocardiogram (look at flow of blood in heart)
Hypertension complications: what organs can hypertension affect/damage?
Heart Brain Vasculature (peripheral vascular disease) Kidney Eyes
What are some ways to control/reverse hypertension?
Weight reduction DASH eating plan Dietary sodium reduction Limit alcohol intake Physical activity Avoidance of tobacco products
Furosemide
- What is it?
- Complications?
- Contraindications?
- What to monitor?
- When to administer?
- Loop Diuretic, diuresis for 8 hours
- Complications: hypotension, dizziness, dehydration, electrolyte imbalance, hypokalemia, hypoglycemia (think insulin and K+), urinary frequency
- Contraindications: ototoxic meds, h/o CV disease, diabetes, lithium, digoxin, other antihypertensives (risk of hypotension)
- Monitor: BP (always take BP before administering a BP med), daily weight (water loss/gain), lung sounds, glucose levels, electrolyte levels. Make sure patient supplements with potassium-rich foods
- Administer in morning to avoid nocturia.
What is something you should always educate the patient on with antihypertensive medicines?
Orthostatic hypotension. High risk from laying to sitting and from sitting to standing.
Beta Blockers
- List some examples
- What do they do?
- Complications?
- Nursing Implications/Monitor?
- What is special about Carvedilol?
- Metoprolol; Carvedilol
- Beta blockers reduce blood pressure by blocking epinephrine which causes the heart to beat more slowly/with less force. This lowers the BP.
- Complications: bradycardia, hypotension, decreased heart contractility
- Monitor: BP, HR, cardiac rhythm, orthostatic hypotension.
- Carvedilol offers cerebral protection and protects the vasculature in the brain.
ACE Inhibitors
- Example
- What do they do? How do they work?
- Risks?
- Monitor?
- What is a common side effect?
- Lisinopril
- Vasodilation. ACE inhibitors blocks ACE in the body (ACE causes the blood vessels to tighten), and as a result, the blood vessels tighten. This lowers the blood pressure and increases the supply of blood and O2 to the heart. It can also be used to treat heart failure
- Risks: dry cough, hypotension, hyperkalemia (RAAS system effects), angioedema
- Monitor: BP, HR, Cough, Labs
Vasodilators
- Example?
- What do they do and how?
- Risks?
- Monitor?
- Hydralazine
- Reduces the circulating blood volume and improves coronary artery circulation by causing arteriolar dilation in smooth muscle.
- Risks: dizziness, weakness, hypotension
- Monitor: BP and mental status
Digoxin/Digitalis
- What is it? What does it do and how?
- Positive inotrope. Increases heart contraction, alters electrical activity and neurohormonal systems.
Morphine
What does it do and how?
Reduces pulmonary congestion and anxiety by vasodilating and decreasing the chemoreceptor response to hypoxia.
What is a hypertensive crisis?
Systolic > 180 mmHg
and/or
Diastolic > 110 mmHg
Can be greater than 220/140.
What is the normal ejection fraction?
60%
Right sided HF
What is it?
S/S?
blood backs up into venous system (body)
Peripheral edema, sudden weight gain, abdominal distension
Left-sided heart failure
What is it?
S/S?
Blood backs up into lungs
This is the most common HF!!! Left almost always fails first because it pumps blood out of the heart and it is bigger so it needs more muscle.
S/S: pulmonary edema (crackles/wheezing, abnormal S3 or S4, frothy blood-tinged sputum), use of accessory muscles, anxiety, cool/clammy skin, dyspnea, orthopnea, tachypnea, cough.
Chronic Heart Failure.
FACES
F: fatigue A: limitation of Activities C: Chest congestion/Cough E: Edema (3rd spacing) S: Shortness of breath
What is the P wave?
Visual representation of the electrical impulse over the Atria
How many seconds should the P wave be?
How many boxes?
What should the shape of the P wave be?
Less than .12 seconds.
Less than 3 small boxes
Small, round
What is the PR interval?
Normal PR interval time?
Time between the start of the P wave and the start of the QRS complex
Normal time: .12-.20 seconds (3 to 5 small boxes)