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54/64 Unit 1 > HTN, PVD, PAD > Flashcards

HTN, PVD, PAD Flashcards

1
Q

The largest artery in the body

A

Aortic artery

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2
Q

Factors that affect blood pressure

A

Peripheral resistance, vessel elasticity, blood volume, cardiac output

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3
Q

The volume of blood pumped by each side (ventricle) of the heart in one minute

A

Cardiac output

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4
Q

Resistance of blood vessels to blood flow

A

Peripheral resistance

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5
Q

The total amount of blood in the circulatory system

A

Blood volume

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6
Q

Components of the blood

A

Nutrients and oxygen

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7
Q

Decreased blood volume causes __________, while elevated blood volume causes _________

A

Dehydration & hypotension; hypertension

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8
Q

Peripheral vascular disease (PVD) most commonly affects the

A

Extremities; particularly the lower extremities

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9
Q

Volume of blood pumped by each ventricle in one contraction (heartbeat)

A

Stroke volume (SV)

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10
Q

How much blood is pumped out of the left ventricle with each heartbeat?

A

~ 70 mL

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11
Q

Typical heart rate

A

75 bpm

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12
Q

Ways to increase cardiac output

A

Increase SV, increase HR, or increase both

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13
Q

Cardiac output equation

A

CO = SV x HR

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14
Q

Blood pressure equation

A

Blood pressure (P) = Cardiac output (Q) x vascular resistance (R)

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15
Q

Which two factors are interconnected through the hemodynamic regulation of blood pressure?

A

Cardiac output and hypertension

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16
Q

Hypertension that is developed over time

A

Primary or essential

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17
Q

Risk factors for primary/essential hypertension

A

Genetics, smoking, obesity, high salt intake, high alcohol consumption, stress, lack of exercise, aging

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18
Q

Hypertension that occurs quickly and more severely

A

Secondary

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19
Q

risk factors for secondary hypertension

A

Obstructive sleep apnea, heart defects, kidney disease, medications or illegal drugs, adrenal/thyroid conditions

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20
Q

Hormone that is released when the body senses that BP and/or blood volume is low

A

Renin

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21
Q

Renin triggers

A

Angiotensin

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22
Q

Angiotensin signals __________ to retain sodium and water when BP is low, or release sodium and water when BP is high

A

Aldosterone

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23
Q

Electrolyte imbalance associated with ACE inhibitors

A

Hyperkalemia (release of sodium and water, retention of potassium)

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24
Q

Cardiac complications of HTN

A

Coronary artery disease —> angina or MI, left ventricular hypertrophy, HF

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25
Q

Brain complications of HTN

A

TIA, stroke, cognitive impairment, vascular dementia

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26
Q

Kidney complications of HTN

A

Chronic kidney disease (CKD), end-stage renal disease (ESRD)

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27
Q

Eye complications of HTN

A

Hypertensive retinopathy —> damage to retinal blood vessels, vision impairment, blindness

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28
Q

Blood vessel complications of HTN

A

Atherosclerosis, PAD, increased risk of aneurysms and vascular complications

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29
Q

Nervous system complications of HTN

A

Peripheral neuropathy (particularly in individuals with poorly controlled HTN)

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30
Q

Atherosclerosis/PVD/PAD risk factors

A

Aging, genetics, gender, hyperlipidemia, HTN, smoking, DM, lack of exercise, stress, obesity

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31
Q

Chronic inflammatory disorder that causes build up of cholesterol plaques on medium and large arteries

A

Atherosclerosis

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32
Q

Loss of arterial elasticity through the hardening and thickening of arterial walls

A

Arteriosclerosis

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33
Q

Most common cause of PAD

A

Atherosclerosis

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34
Q

Most common arteries affected by atherosclerosis

A

Abdominal aorta, coronary, popliteal, carotid

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35
Q

PAD pathophysiology

A

Hardening of fatty deposits in arteries narrow the opening and block effective blood flow

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36
Q

An umbrella term for disorders affecting blood vessels outside the heart and brain

A

Peripheral vascular disease (PVD)

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37
Q

A specific type of PVD where plaque buildup occurs in arteries carrying blood to extremities, especially the legs

A

Peripheral artery disease (PAD)

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38
Q

S/S of PVD

A

Pain or discomfort in legs, cramping, numbness, weakness, skin color/temp changes

39
Q

S/S of PAD

A

Intermittent claudication, cold feet, reduced hair growth on legs

40
Q

PAD can progress to

A

Critical limb ischemia

41
Q

Diagnosis for PVD and PAD

A

Medical history, physical, and imaging tests such as ultrasound and angiography

42
Q

PVD/PAD treatment

A

Lifestyle changes, medications (to control risk factors), possible procedures such as angioplasty and surgery

43
Q

First diagnostic test for PAD

A

Ankle brachial index (ABI) test

44
Q

Recommendation for mild to moderate PAD

A

Lifestyle modifications

45
Q

Normal/no PAD as determined by ABI

A

> 0.9

46
Q

Mild PAD as determined by ABI

A

0.8-0.9

47
Q

Moderate PAD as determined by ABI

A

0.3-0.7

48
Q

Critical PAD as determined by ABI

A

<0.3

49
Q

A arterial condition affecting blood flow to certain parts of the body, often fingers and toes

A

Raynaud’s Disease

50
Q

Rare disease affecting small and medium sized arteries and veins in the arms and legs

A

Buerger’s Disease

51
Q

Cause of Raynaud’s

A

Cold or stress triggers episodes, causing small artery narrowing

52
Q

Cause of Buerger’s

A

Strongly associated with tobacco use

53
Q

S/S of Raynaud’s

A

Episodic color changes (white, blue, red), numbness, tingling during episodes

54
Q

S/S of Buerger’s

A

Pain, tenderness, skin changes, ulcers, potential progression to gangrene

55
Q

Age and gender risk factors for Raynaud’s

A

Can affect anyone, more common in women and people in colder climates

56
Q

Age and gender risk factors for Buerger’s

A

Affects young males more

57
Q

Raynaud’s management

A

Lifestyle changes, avoiding triggers, medications

58
Q

Buerger’s management

A

Smoking cessation, medications for vasodilation, surgical interventions (severe cases)

59
Q

Raynaud’s prognosis

A

Generally manageable with lifestyle changes and medications

60
Q

Buerger’s management

A

Severity can lead to amputation; smoking cessation critical!!

61
Q

Arterial narrowing or occlusion (arteriosclerosis) which causes decreased O2 and nutrients to the lower extremities

A

PAD

62
Q

Pooling of blood in the extremities due to the inability to bring blood back to the heart (vascular insufficiency)

A

Peripheral venous disease

63
Q

S/S of PAD

A

1) Sharp pain, 2) absent pulse, 3) skin: cool to touch, pale, shiny, absent hair, thin, dry, scaly, no edema, 4) Lesions: red sores on toes and feet with punched out appearance, 5) gangrene (death of tissues)

64
Q

S/S of peripheral venous disease

A

1) dull, achy pain, 2) presence of strong pulse, 3) skin: edema, warm legs, yellow/brown ankles, 4) irregular shaped sores/lesions, 5) no gangrene

65
Q

Patient positioning for PAD

A

Hang/dangle the patients legs (remember: an “A” shape for PAD)

66
Q

Patient positioning for peripheral venous disease

A

Elevate patients legs (remember: v shape for PVD)

67
Q

Pathogenesis of PAD

A

Endothelial dysfunction (impairment of arterial lining d/t HTN or DM), inflammatory response, plaque formation, plaque rupture (risk for clot formation), ischemia and tissue damage, thrombosis and embolism, collateralization

68
Q

Attempted compensation by developing new blood vessels

A

Collateralization

69
Q

PAD lifestyle modifications

A

Healthier diet, smoking cessation, exercise, lose weight

70
Q

Anti-platelet agents to reduce the risk of blood clots in PAD

A

Aspirin, clopidogrel (Plavix)

71
Q

Cholesterol lowering agents to control and slow progression of atherosclerosis in PAD

A

-statins (atorvastatin)

72
Q

PAD medications to reduce cardiovascular risk

A

Antihypertensives

73
Q

PAD medication for improving claudication symptoms and walking distance

A

Cilostazol

74
Q

Pain management medications for PAD

A

Acetaminophen or NSAIDs

75
Q

PAD endovascular surgical intervention used to dilate narrowed arteries and improve blood flow

A

Ballon angioplasty

76
Q

PAD endovascular surgical intervention that provides structural support to the treated artery and prevents re-narrowing

A

Stent placement

77
Q

PAD endovascular surgical intervention that removes plaque from arterial walls

A

Atherectomy

78
Q

PAD surgical revascularization that reroutes blood flow around blocked arteries, using autologous grafts or synthetic material

A

Bypass surgery

79
Q

PAD surgical revascularization that removes atherosclerotic plaque from the inner lining of the artery to restore blood flow

A

Endarterectomy

80
Q

PAD surgical intervention for severe cases with tissue necrosis or non-healing ulcers

A

Amputation

81
Q

Nursing assessment for PAD

A

Vascular assessment — peripheral pulses, skin color, temperature, capillary refill time; assess for pain, claudication, and ulceration

82
Q

PAD patient education regarding foot care

A

Regular inspection and moisturization

83
Q

PAD nursing wound care

A

Cleaning, debridement, dressing changes, monitor for s/s of infection

84
Q

How to correctly take BP

A

Choose correct cuff size for patient’s arm circumference, support arm at heart level with cuff at the same level as the heart, take multiple readings and use an average for accuracy

85
Q

Factors that can cause an elevated blood pressure reading

A

Not allowing the patient to rest for at least 5 minutes before measurement, speaking or moving during the measurement

86
Q

At what rate should the nurse deflate the cuff when measuring blood pressure?

A

2-3 mmHg per second

87
Q

Elevated blood pressure due to anxiety in a medical setting

A

White coat hypertension

88
Q

How to prevent inaccurate BP measurements in a patient with A.fib or irregular heartbeat

A

Use automated monitors that account for irregular heart rhythms or average multiple measurements

89
Q

Improving blood flow to tissues and organs

A

Revascularization

90
Q

Procedure commonly performed on carotid arteries to reduce stroke risk

A

Endarterectomy

91
Q

Surgical removal of blood clot and atherosclerotic material to restore blood flow, typically performed in cases of acute arterial occlusion

A

Thromboendarterectomy

92
Q

Patient education for warfarin (Coumadin)

A

Regular blood work, goal INR: 2.5 (2.0-3.0), s/s of toxicity include easy bruising and bleeding

93
Q

First sign of sepsis

A

Tachycardia

94
Q

Sepsis interventions

A

Establish IV access (18 gauge), fluid resuscitation, antibiotics

54/64 Unit 1 (9 decks)

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