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321 Geri > Exam2 > Flashcards

Exam2 Flashcards

1
Q

Arterial Disease position to alleviate pain

A

dangling, elevation makes it worse

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2
Q

Venous disease position to alleviate pain

A

elevation, dangling legs/standing makes it worse

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3
Q

arterial disease explanation of pain

A

sharp, worse at night
“rest pain”
intermittent claudication-pain from activity

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4
Q

venous disease explanation of pain

A

heavy, dull throbbing, aching

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5
Q

aterial disease skin of lower extremity

A

cool to touch
thin/dry/scaly
hairless
thick toe nails

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6
Q

venous disease skin of lower extremities

A

thick, touch skin
brownish color

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7
Q

arterial disease strength of pulse

A

very poor/absent

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8
Q

venous disease strength of pulse

A

present/typically normal

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9
Q

arterial disease, is there edema

A

not common

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10
Q

venous disease, is there edema

A

yes-tends to be worse by the end of the day

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11
Q

arterial disease lesions

A

on feet/ankles
little drainage (no blood flow)
pale/light pink
“punched out” appearance

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12
Q

venous disease lesions

A

medial parts of lower leg
swollen w/drainage
deep pink/red
irregular edges
shallow

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13
Q

overview of cardiac changes with aging

A

goes unnoticed
aorta dilation (hyperlipidemia)
stiffening of heart vessels
loss of arterial elasticity
veins thicken & loose elasticity

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14
Q

baroreceptors (tells vessels to constrict) less efficient with age which leads to risk for…

A

orthostatic hypotension

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15
Q

other age-related changes

A

-myocardial hypertrophy
-arteriosclerosis (aging)
-atherosclerosis (plague build up)
-thickening of the left ventricular wall
-myocardial musculature less efficient
-decrease in pacemaker cells

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16
Q

True/False: elevation in BP is a normal sign of aging

A

False

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17
Q

cardiac output formula

A

Stroke volume (vm) x Heart rate (HR)

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18
Q

afterload

A

resistance to ejection of blood from the ventricle

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19
Q

contractility is increased by what drugs

A

digoxin (Lanoxin)
dopamine
dobutamine
catecholamines

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20
Q

contractility is decreased by what drugs

A

beta-adrenergic blocking agents (metoprolol) [Lopressor]

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21
Q

preload

A

degree of stretch of the ventricular cardiac muscle fibers at the end of diastole

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22
Q

ejection fraction

A

% of the end-diastolic blood volume that is ejected with each heartbeat.
-normal left ventricle is 55-65%. lower than 40 requires treatment of HF

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23
Q

1 cause of disability in US

A

hypertension

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24
Q

hypertension

A

-arterial walls hypertrophy
-narrow vessels
-unable to support vasodilation
-increase rate of atherosclerosis
-left ventricular hypertrophy (increase risk for CAD)
-damage vessels to all other organs
risk for MI or CVA

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25
Q

what system usually regulates hypertension

A

renal system

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26
Q

blood pressure is determined by

A

blood volume, cardiac output, peripheral resistance

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27
Q

papilledema

A

swelling of the optic nerve

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28
Q

1 sign of hypertensive heart disease

A

angina/dyspnea (SOB)

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29
Q

goal of hypertension treatment

A

maintain acceptable BP

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30
Q

ACE inhibitors s/e

A

cough

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31
Q

CAD (coronary artery disease)

A

blood is unable to flow through the coronary arteries

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32
Q

CAD can result in

A

ischemia or infarction

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33
Q

CAD diagnostics

A

-cardiac stress
-c-reactive protein
-invasive perfusion techniques

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34
Q

CAD management

A

antiplatelet agents
control chronic diseases

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35
Q

CABG

A

Coronary Artery Bypass graft surgery
-most common cardiac surgery
-CA are bypassed by the PTs venous or arterial blood vessels

36
Q

agina

A

caused by imbalance between O2 supply and demand

37
Q

women’s unusual angina symptoms

A

nausea
fatigue
dizziness

38
Q

Define Heart Failure

A

decreased contractility of the heart=inability of the heart to pump sufficient blood

39
Q

cardiac output is

A

amount of blood pumped out of the left ventricle each minute.
should be 4-8L/min at rest

40
Q

stroke volume

A

amount of blood pumped per contraction (65-70mL)

41
Q

left sided heart failure

A

-impaired blood to aorta
-causes congestion of blood in pulmonary vessels
-back up in lungs

42
Q

right sided heart failure

A

-cannot empty completely
-major cause is Left-sided HF
-peripheral edema
-systemic

43
Q

LS-HF signs

A

-pulmonary congestion
-nocturnal dyspnea
-restlessness
-confusion
-tachycardia
-fatigue
-cyanosis
-cool extremities
-S3/S4 heart sounds

44
Q

RS-HF signs

A

-fatigue
-ascites
-enlarged liver & spleen
-distended jugular veins
-anorexia/GI distress
-weight gain
-dependent edema

45
Q

how does human B-type naturetic peptide (BNP) work

A

excreting NA+ and H2O through vasodilation
BNP 100-300 PG/mL suggestive of HF

46
Q

management of HF

A

-reduce heart’s workload & improve cardiac output
-conserve energy
-prevent fatigue
-dietary mod

47
Q

HF drug therapy

A

digoxin (inotropic)
toxicity= fatigue, weakness, confusion, anorexia, halos

diuretic therapy
loop& thiazide

vasodilators
ACE inhibitors

48
Q

HF education

A

lifestyle changes
control symptoms
monitor for signs
daily weights- 2lbs/day
5lbs/week

49
Q

signs of MI (heart attack)

A

-pain radiating down left arm
-mental status change
-agitation
-falls

50
Q

MI nursing management

A

-bed rest/limit activity
-assess for chest pain
-permanent smoking cessation

51
Q

what is meant by afib

A

several areas in the right atrium initiate impulse resulting in a disorganized, rapid activity of the atria
blood pools and can form clots

52
Q

implanted pacemaker facts

A

used for 2nd/3rd degree heart block
battery life= 5-10 yrs
battery power monitored frequently.
hiccupping is a sign of failure

53
Q

GI changes with aging

A

-tongue atrophies (decreased taste)
-xerostomia (dry mouth)
-saliva production decreases
-swallowing becomes more difficult

54
Q

more GI changes

A

-weakening of esophageal sphincter
-diminished gastric motility (increases risk for indigestion & aspiration)
-decreased elasticity of stomach
-diminished capacity of gastric mucosa to resist damage

55
Q

last of GI changes

A

-decreased in intestinal absorption, motility, blood flow
-pancreas decreases in size
-liver size/blood flow decreases
-decreased thirst and hunger drive
-decreased mucosal immune function

56
Q

most common esophageal disorder in older people

A

dysphagia- could be indicative of another problem.

57
Q

oropharyngeal dysphagia

A

difficulty moving from the mouth into the pharynx (more common with neuro disorders)

58
Q

esophageal dysphagia

A

difficulty moving food down the esophagus

59
Q

Gastroesophageal reflux disease (GERD)

A

gastric contents flow upward into the esophagus

60
Q

GERD symptoms

A

-pyrosis (burning sensation in esophagus)
-dyspepsia (indigestion)
-belching
-sour mouth
-hypersalivation

61
Q

GERD diagnostics

A

Barium swallow
upper endoscopy
esophageal manometry
esophageal pH monitoring

62
Q

GERD treatments

A

antacids
H2 antagonists (decrease production of acid)
PPI (decrease release, can increase risk for bone issues)

63
Q

Gastritis

A

men/women equal effected
inflammation or stomach lining
erosive vs non

64
Q

non erosive gastritis

A

H. pylori

65
Q

Peptic Ulcer Disease s/s

A

dull/gnawing/burning pain in back
heartburn
nausea
vomiting
constipation
diarrhea
bleeding

66
Q

gastric vs duodenal PUD

A

Gastric
-pain after eating
dudenal
-pain 2-3 hrs after eating, increases at night

67
Q

diverticular diease

A

saclike mucosal projections- trap feces-> infection/inflammation. greater risk in men
Risk Factors: obesity
chronic constipation
hernia
atrophy or intestinal wall

68
Q

diverticular disease s/s

A

pain (LLQ)
nausea/vomiting
constipation
diarrhea
low grade fever
blood/mucous in stool

69
Q

foods to avoid with diverticulitis

A

corn, popcorn, nuts, strawberries, foods containing seeds

70
Q

what is a small bowel obstruction

A

blockage that prevents the contents of the intestines from passing normally through the digestive tract
common causes: adhesions, hernia, tumors

71
Q

Nursing mgmt for bowel obstruction

A

NG tube- decompress the stomach, allow the bowel to rest
lower intermittent sucking
checking placement
admin meds

72
Q

chronic constipation defined as

A

two or fewer stools per week

73
Q

nutrition in aging

A

-decrease in needed calories
-decrease in body fluids
2/7L/day men
3.7L/day women

74
Q

BMI measurement

A

<22 undernutrition (higher mortality)
>25 overweight (risk for morbidity)

75
Q

osteoblasts

A

bone forming

76
Q

osteocytes

A

maintaining bone

77
Q

osteoclasts

A

bone cells that reabsorb bone during repair and growth

78
Q

changes of aging musculoskeletal Type 1

A

menopausal bone loss. 5-10 yrs after menopause

79
Q

changes of aging musculoskeletal Type 2

A

senescent bone loss-affects both sexes

80
Q

musculoskeletal changes

A

-bones become stiff, weak, brittle and porous
-lose 1-2cm every 2 decades in ht
-erosion of hyaline cartilage
-vitamin D

81
Q

which extremities atrophy earlier

A

lower

82
Q

sarcopenia is

A

a loss of muscle tissue as a natural part of the aging process

83
Q

leading cause of accidental death

A

falls. 1:3 people >65 sustain serious fall

84
Q

exercise benefits: weight bearing, balance, swimming

A

wt bearing- bones
balance- falls
swimming- joints

85
Q

osteoarthritis vs rheumatoid arthritis to do with inflammation

A

OA isn’t inflammatory
RA is inflammatory disease

321 Geri (2 decks)

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