Exam 3 (Cardio-1) Flashcards
PVR
peripheral vascular resistance
preload, afterload, contractility
CO x PVR = ?
CO x PVR = BP
BP of 139/82 , what is the plan, what is the stage
start with hydrochlorothiazide (diuretic) as the first line anti HTN medication
STAGE 1
Drug therapy and lifestyle modifications combined can control BP in most patients with chronic hypertension
True
which 2 medications primarily work for the hypertensive patient by decreasing HR and contractility
Beta Blockers (beta 1), Calcium Channel Blockers
in the patient with hypertension and _______, decreasing contractility must be approached with great caution
!heart failure!
we dont want to lose more contractility
would the nurse recommend the use of a beta blocker for a person with hyperthyroidism or hypothyroidism?
hyperthyroidism
would the nurse recommend the use of a beta blocker for a person with an AV block?
no
how do beta blockers mask hypoglycemia?
they block the classic signs, like an increased heart rate
how do diuretics work?
decrease the reabsorption of sodium and chloride
(solutes stay IN the nephron, this allows water to follow and increase flow of urine)
which type of diuretic places the patient at greatest risk for hypokalemia?
loop diuretic, because we are disrupting the sodium potassium pump
by decreasing the reabsorption of sodium and chloride, it puts the patients at risk for
hyponatremia, hypovolemia, hypokalemia, dehydration, hyperuricemia (uric acid), hyperglycemia
why are we causes with people with unstable glucose levels?
at risk for hyperglycemia
in GM patients, it inhibits the release of insulin, so glucose goes up
a patient with HTN will start HCTZ what labwork will the nurse check prior to starting the medication
renal function labs
which of these lab results would cause the nurse to hold the furosemide ?
A) glucose 109
B) Na+ 135
C) K+ of 3.1
D) Ca+ 6.9
the potassium, should be 3.5-5
The patient on a beta blocker and a loop diuretic reports a change in balance and hearing. these changes are because of which medication?
the loop diuretic
what are the two main results of the the RAAS?
increased volume in blood pressure &
vasoconstriction
What are three indications for Aldosterone Receptor Blockers? What are three ADRs for ARBs?
indications: Heart Failure, MI, Stroke, Diabetic Nephropathy
ADR: dizziness, headache, fatigue, angio edema (swelling of the airway), fetal danger, renal failure, orthostatic hypotension
what are four indications for ACE inhibitors? What are three ADRs for ACE inhibitors?
indications: HTN, Heart Failure, M.I., Diabetic and non-diabetic Nephropathy
ADRs: orthostatic HTN, angio edema (swelling of the airway), hyperkalemia, persistent dry cough, kidney failure, fetal danger
what is the role of aldosterone in normal situations and with RAAS agents?
it reabsorbs sodium which leads to water reabsorption
(with too much aldosterone we have a decreased potassium reabsorption)
how is renal stenosis related to ace inhibitors?
you wouldnt want to give an ace inhibitor to someone with renal stenosis because kidney failure is an ADR
who is more at risk for hyperkalemia, someone on ACE or ARBs?
ACE
what are signs of hyperkalemia? what can we teach our patient about avoiding hyperkalemia?
muscle weakness, nausea and vomiting,
*avoid salt substitutes (which contain potassium)
when do we use nitroprusside? how does it work? how long can we keep the drip going?
in a hypertensive crisis, so diastolic over 110
it relaxes arteries and the veins
it decreases preload and afterload
not more than 72 hrs because of toxicity
