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adult health > EXAM 4 > Flashcards

EXAM 4 Flashcards

1
Q

HTN is greater in

A

african americans

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2
Q

what is considered HTN

A 
Systolic blood pressure ≥140 mm Hg
 OR
   Diastolic blood pressure ≥90 mm Hg 
OR
Current use of antihypertensive medication(s)
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3
Q

pre HTN definition

A

Systolic BP: 120 to 139 mm Hg

			OR

Diastolic BP: 80 to 89 mm Hg

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4
Q

STAGE 1 HTN

A

systolic: 140-159
diastolic: 90-99

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5
Q

STAGE 2 HTN

A

systolic: >160
diastolic: >100

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6
Q

5 factors that influence HTN

A

insulin resistance
Increased sympathetic nervous system activity
Increased reabsorption of sodium, chloride and water by the kidneys
Increased activity of the renin-angiotensin system
Decreased vasodilatation

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7
Q

5 symptoms of severe htn

A 
Fatigue
Dizziness
Palpitations
Angina
Dyspnea
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8
Q

htn target organ disease

A 
Heart
Brain
Peripheral vascular disease 
Kidney
Eyes
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9
Q

serum creatinine

A

0.6-1.2

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10
Q

Noninvasive, fully automated system that measures BP at preset intervals over 24-hour period

A

Ambulatory blood pressure monitoring (ABPM)

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11
Q

Fruits, vegetables, fat-free or low-fat milk, whole grains, fish, poultry, beans, seeds, and nuts

A

dash eating plan

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12
Q

why are beta blockers a black box warning

A

due to bronchospasms and hyperactive airway

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13
Q

what to check before giving betablocker

A

bp and hr

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14
Q

tell the patient to report what 4 things if they are taking a HTN med

A

Orthostatic hypotension
Sexual dysfunction
Dry mouth
Frequent urination

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15
Q

Most common form of hypertension in individuals age >50

A

isolated systolic hypertension

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16
Q

hypertensive emergency

A

Occurs over hours to days

BP >220/140 with target organ disease

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17
Q

hypertensive urgency

A

Occurs over days to weeks

BP >180/110 with no clinical evidence of target organ disease

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18
Q

-pril

A

ace inhibitors

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19
Q

a syndrome whereby a patient’s feeling of anxiety in a medical environment results in an abnormally high reading when their blood pressure is measured.

A

white coat hypertension

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20
Q

bp goal for diabetes

A

130/80

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21
Q

can prevent adequate bp

A

NSAIDS

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22
Q

depolarization of the atria

A

p wave

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23
Q

depolarization of the ventricles

A

qrs

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24
Q

repolarization of the ventricles

A

t wave

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25
Q

if present may represent repolarization of the perkingie fibers

A

u wave

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26
Q

what equals blood pressure

A

systemic vascular resistance x cardiac output = blood pressure

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27
Q

relaxing and refilling

A

diastolic

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28
Q

contractions

A

systolic

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29
Q

blood pressure

A

measures arterial pressure

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30
Q

what to do for a person with white coat pnomenom

A

ambulatory blood pressure monitoring

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31
Q

first line treatment for hypertension

A

hydrochlorothiazide- diuretic

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32
Q

what teaching do we want to tell them about hydrochlorothiazide.

A

change positions slowly due to orthostatic hypotension; decreasing sodium

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33
Q

all diuretics cause

A

orthostatic hypotension

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34
Q

3 things to do before giving diuretics

A

check bp, creatinine, and electrolytes

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35
Q

nitroglycerin is given

A

for chest pain

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36
Q

sob

A

orthopnea

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37
Q

calcium channel blocker

A

can cause prolonged QT syndrome; slow conduction due to HR going down

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38
Q

slow heart rate =

A

slow conduction ; abnormal heart block

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39
Q

angina indicates

A

ischemia of the coronary artery

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40
Q

dyspnea on exertion/ sob is the first sign of

A

heart failure

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41
Q

why do you have shortness of breath

A

blood isnt moving like its suppose to and it backs up

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42
Q

if cuff is too big

A

bp will be low

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43
Q

If cuff is too small

A

bp will be high

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44
Q

bp with orthostatic hypotension

A

bp and pulse supine then sitting then standing, if they can tolerate to stand ; 1-2 minutes between position changes

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45
Q

what is considered positive orthostatic hypotension

A

↓ of 20 mm Hg or more in SBP, ↓10 mm Hg or more in DBP, or ↑ 20 beats/minute or more in heart rate

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46
Q

what helps with orthostatic hypotension

A

HYDRATION

47
Q

Most common form of hypertension in individuals age >50

A

isolated systolic htn

48
Q

postprandial hypotension

A

seen in older adults

49
Q

hypertensive emergency

A

onset is hours to days

with target organ damage

50
Q

hypertension urgency

A

onset is days to weeks

no target organ damage

51
Q

htn and then rapidly drop their bp

A

blood dumps and the can cause damage

52
Q

how is iv drug therapy managed

A

any meds a pt needs in a hypertensive crisis will get it through an iv. the meds are titrated (adjusting meds based on parameters) to MAP

53
Q

what is blood pressure

A

cardiac output x peripheral resistance

54
Q

risk factors of atherosclerosis

A

htn, tobacco use, diabetes, infections, toxins, hyperlipidemia, hyperhomocysteinemia

55
Q

stable angina

A

they have the pain then it goes away, have it then goes

56
Q

why does stable angina go away

A

because the plaque build up in the artery is stable

57
Q

unstable angina

A

unstable lesion

58
Q

pain not going away, increasing in intensity, increasing in severity; not relieved

A

lesion is complicated and is unstable

59
Q

Thickening/hardening/narrowing or coronary arteries that result from risk factors like HTN

A

atherosclerosis

60
Q

Arterial anastomoses (or connections) within the coronary circulation

A

collateral circulation

61
Q

things you can change to improve your health

A

modifiable risk factors

62
Q

chronic stress; chronic inflammation

A

CPR; NOT MODIFIABLE

63
Q

CAD gender risk

A

younger men and older women

64
Q

unsaturated fats

A

are good!! HDL ; protective for cardiovascular disease

65
Q

gerontologic 2 risk factors

A

reducing their lipids and treating their blood pressure

66
Q

clinical manifestation of ischemia

A

angina/chest pain

67
Q

is ischemia reversible?

A

yes!

68
Q

what to give a patient with angina

A

nitroglycerin to dilate arteries and oxygen. the pain goes away because the rbc are now getting oxygen

69
Q

ischemia results from

A

narrowed and thick arteries

70
Q

when do you get ischemia

A

when arteries are blocked 75% or more

you will get hypoxic within 10 seconds of occlusion

71
Q

heart cells can stand HOW long without blood flow

A

20 minutes; after 20 minutes the blood vessels are irreversibly damaged

72
Q

by product of anaerobic metabolism

A

lactic acid

73
Q

what is the cardiac pain that patients feel

A

lactic acid build up

74
Q

start when youre increasing demand for oxygen
chest pain that has a precipitating factor such as stress, activity, position changes
predictable

A

stable angina

75
Q

5-15 minutes

A

stable angina

76
Q

control with drugs; nitrates/oxygen

A

stable angina

77
Q

ST segment depression and/or T-wave inversion

A

unstable and stable angina

78
Q

unstable angina is more likely to progress to

A

an MI

79
Q

nitroglycerin

A

acute nitrate so it works quickly and is why its given at the hospital

80
Q

wont treat the chest pain

A

aspirin ; for platelets

81
Q

nitroglycerin give sublingual why

A

It works faster; acute. dont chew or drink water ; short acting for people to take while at home

82
Q

vasodilates

A

nitroglycerin

83
Q

how many doses for how long -nitroglycerin

A

3 doses every 5 minutes and after the third dose if they are still having chest pain they need to call 911

84
Q

if patient knows they are about to exert themselves in a certain activity what can they do

A

take nitroglycerin prophylactically 5-10 minutes before activity; sex

85
Q

prevents the occurrences of angina

A

long acting nitrates

86
Q

side effects of long acting nitrates

A

orthostatic hypotension, headache (to help w headache give acetaminophen )

87
Q

oral long acting nitrate

A

isosorbide, -trates

88
Q

1 reason to hold nitroglycerin

A

hypotension because its bringing down their bp

89
Q

completed occluded

A

stemi

st elevation myocardial infarction

90
Q

partial occlusion of a coronary artery

A

non stemi

91
Q

complete occlusion of coronary artery

A

stemi

92
Q

how to tell if its a stemi or non

A

ekg

93
Q

complete occlusion means

A

reperfuse

94
Q

mi symptoms in women

A

fatigue followed by abdominal pain

95
Q

ask about chest pain that is likely myocardial

A

nausea, vomiting, sob, diaphoresis

96
Q

initially for an MI HR and BP

A

go up

97
Q

what do you expect to hr and bp after awhile with a mi

A

hr goes down patient is about to code

98
Q

3 evidence to acute heart failure

A

crackles, jvd, abnormal heart sounds

99
Q

fluid volume overload

A

s3 heart sound

100
Q

troponin elevation

A

positive is 0.01

101
Q

cardiac enzymes

A

troponin
CK-MB
myoglobin

102
Q

most significant enzyme

A

troponin

103
Q

what is morphine for

A

vasodilator and decreases oxygen consumption

104
Q

why do you want to give someone a stool softener for acute coronary syndrome

A

avoid vasovagal stimulation which can lead to bradycardia which can lead to dysrhythmia

105
Q

hallmark sign of pericarditis

A

pericardial friction rub

106
Q

potassium wasting

A

hydrochlorohiazide

107
Q

potassium sparing

A

Spironolactone

108
Q

increased heart rate and is used for sinus brady patients

A

atropine

109
Q

potassium wasting that is best for heart failure patients

A

lasix

110
Q

what med treats a flutter and a fib

A

adenosine

111
Q

increases cardiac out put

A

Dobutamine

112
Q

normal ejection fraction

A

> 55%

113
Q

SOB, crackles, orthopnea, dyspnea on exertion, paroxysmal nocturnal dyspnea, oliguria

A

left sided heart failure

114
Q

JVD, peripheral edema, hepatomegaly, peripheral congestion, pitting edema, ascites

A

right sided heart failure

adult health (10 decks)

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