Midterm Review Flashcards
1
Q
Define Hemostasis
A
A sequence of responses that stops bleeding
2
Q
Increased tendency toward blood clotting (coagulation)
A
Hypercoagulability
3
Q
Associated with conditions that produce turbulent blood flow and platelet adherence.
A
Arterial Thrombosis
4
Q
Associated with conditions that cause stasis of blood flow. Composed of platelet aggregates and fibrin complexes (resulting from increased concentrations of clotting factors)
A
Venous Thrombosis
5
Q
Pinpoint purplish-red spots
A
Petechiae
6
Q
Purple areas of bruising
A
Purpura
7
Q
Decrease in number of circulating platelets
A
Thrombocytopenia
8
Q
Abnormally low number of circulating red blood cells or level of hemoglobin, resulting in diminished oxygen carrying capacity
A
Anemia
9
Q
Decrease in number of white blood cells, most often affects neutrophil
A
Leukopenia
10
Q
Excessive or inappropriate activation of immune system
A
Hypersensitivity Disorder
11
Q
Acquired Immunodeficiency Syndrome, caused by HIV
A
AIDS
12
Q
Retrovirus that attacks CD4 lymphocytes (immune cells responsible for coordinating the immune response to infection)
A
HIV
13
Q
What are the 2 conditions that can lead to hypercoagulability? Explain each condition and give examples
A
1) Increased Platelet Function:
- Platelet adhesion, formation of platelet clots and disruption of blood flow
- Atherosclerosis
- Diabetes Mellitus
- Smoking
- Elevated Blood Lipid (Cholesterol)
- Increased Platelet Levels
2) Increased Clotting Activity:
- Thrombus formation because of activation of coagulation system can result from primary (genetic) or secondary disorders affecting coagulation compents of blood clotting
- Pregnancy
- Birth Control
- Post Surgical Site
- Immobility
- Congestive Heart Failure
- Malignant Disease
14
Q
What can cause a bleeding disorder?
A
1) Platelet # or Function
2) Coagulation Factors
3) Blood Vessel Integrity
15
Q
Describe Hemophilia A
A
- Clotting Factor VIII (8) deficiency
- X-linked recessive disorder primarily affects males
- 90% diagnosed produce insufficient factor, 10% produce defective
16
Q
List the 4 primary causes of anemia:
A
1) Excessive loss of red blood cells from bleeding
2) Destruction (Hemolysis) of RBC
3) defective RBC production
4) inadequate RBC production b/c of bone marrow failure
17
Q
What is Sickle Cell Anemia?
A
Inherited disorder in which abnormal hemoglobin (S) leads to chronic hemolytic anemia, pain and organ failure
18
Q
Sickle Cell Anemia Contributing Factors
A
Cold Stress Physical exertion Infection Illnesses causing hypoxia, dehydration, acidosis
19
Q
Complications of Sickle Cell Anemia
A
- Severe sudden pain in the body (abdomen, chest, bones, joints)
- Infarctions in liver, spleen, heart, kidneys, retina
- Acute chest syndrome
- Growth retardation, osteomyelitis, infarction in marrow
- Damage to spleen
20
Q
What is the most common type of anemia?
A
Iron Deficiency Anemia
21
Q
What are the possible causes of Iron Deficiency anemia? Briefly describe each cause.
A
1) Dietary Deficiency
Iron used repeatedly, RBC break down iron is released and reused to produce more RBC
2) Loss of Iron through Bleeding
Chronic blood loss (peptic ulcers, hemorrhoids, cancer)
3) Increase Demands
Pregnancy, increase growth demand (children)
22
Q
What are the signs and symptoms associated with iron deficiency anemia?
A
1) Fatigue, Palpitations, Dyspnea, Angina, Tachycardia
2) Epithelial Atrophy (brittle nails/hair, smooth tongue, etc)
3) Pica
4) In Kids: neurological manifestation; stroke, cranial nerve palsies
23
Q
Eating disorder, eating non-nutritious items (soils, chalk, etc)
A
Pica
24
Q
What happens to the RBCs when there is a deficiency of vitamin B12?
A
- Nuclear maturation and cell division fail to occur
- RBC are larger and oval (short life span)
25
B12 deficiency and Folic Acid deficiency have similar manifestations – what is the biggest difference between the two deficiencies?
NO neurological manifestation with Folic Acid deficiency
26
Describe Aplastic Anemia and its causes
- Primary condition of bone marrow stem cells that result in reduction of all 3 hematopoietic blood lines (RBC, WBC, platelets)
- Bone marrow replaced with fatty tissue
Causes:
Radiation
Chemicals
Toxins
27
Chemotherapy can suppress bone marrow function – what is a common condition that results from this?
Neutropenia
28
What are the signs and symptoms associated with Infectious Mononucleosis?
Fever, Generalized Lymphadenopathy, Sore throat, Appearance in blood of atypical lymphocytes and several antibodies
29
Which virus causes Infectious Mononucleosis?
Epstein-Barr (herpes family, mono)
29
Which virus causes Infectious Mononucleosis?
Epstein-Barr (herpes family, mono)
30
Compare the difference between Hodgkins and Non-Hodgkins lymphoma:
1) Non-Hodgkins:
- Lymphoma from B-Cell, T-Cell, NK-Cell
- Alterations in development process of these can lead to any subtype of lymphoid neoplasm
- Spreads to various tissue in the body and bone marrow
2) Hodgkins:
- Specialized form of lymphoma, presence of abnormal cell “Reed-Sternberg”
- Begins as malignancy in single lymph node and spread to contiguous lymph nodes
31
Bone marrow stem cells are replaced by malignant neoplasms
Leukemia
32
Signs and symptoms of Leukemia
- Fatigue
- Pallor
- Weight loss
- Repeated infections
- Easy bruising
- Nosebleeds
- Appear sudden in children
33
Explain the 4 types of hypersensitivity disorders
a. Type I: Immediate Hypersensitivity Disorder
IgE mediated immune response leads to release of inflammatory mediators (Allergic reactions)
b. Type II: Antibody Mediated Disorder
IgG or IgM antibodies directed against target antigens on surface of cells or other tissue components
Mismatch blood type, Hemolytic Disease, Drug reactions
c. Type III: Immune Complex-Mediated Disorder
IgG or IgM, formation of antigen-antibody immune complex in blood stream, later deposit in vascular epithelium tissues
Autoimmune disease
d. Type IV: Cell-mediated Hypersensitivity Disorder
T-lymphocytes, response to variety of microorganisms including intracellular pathogens (virus) or extracell (fungi)
Hepatitis, Allergic contact dermatitis, Exposure to inhaled dust
34
What causes AIDS?
HIV
35
a retrovirus that attacks the CD4 T lymphocytes (immune cells responsible for coordinating the immune response to infection)
HIV
36
How is HIV transmitted?
1) Exchange of blood/fluids
2) Sexual contact
3) Contaminated blood through needles
4) Infected mother to newborn
5) Infectious with no symptoms present
37
What is the pathogenesis of HIV?
- In the process of taking over the CD4 T cell, the virus attaches to its receptors, fuses to and enters the cell, incorporates its RNA into the cell’s
- DNA to reproduce large amounts of HIV, which is released into the blood. 60-70% develop AIDS 10-11 years after infection
38
List and explain each phase of an HIV infection:
Primary Infection Phase:
Fever, fatigue, myalgia, sore throat, night sweats, GI problems, rash, headache, oral ulcers
Latency (Chronic asymptomatic):
No sx & sx
Overt AIDS:
CD4 cells count falls to low levels, signs of opportunistic infections and other disease manifestations develop
39
Decrease in arterial flow that is not sufficient to meet the oxygen demands of the tissues
Ischemia
40
Harding of the arteries, formation of fibrofatty lesions in the intimal lining of the large and medium sized arteries such as the aorta and its branches, the coronary arteries, and the cerebral arteries that supply the brain
Atherosclerosis
41
a condition where arterial wall thickens. Larger the arteries
Arteriosclerosis
42
Major risk factor for Atherosclerosis. Serum marker for systemic inflammation
CRP
43
Disorder causing inflammatory injury and necrosis of the blood vessel wall
Vasculitis
44
Dilation of a blood vessel due to stretching of BV walls (weakening)
Aneurysm
45
Elevation in systolic and/or diastolic blood pressure
Hypertension
46
List the 3 disorders of arterial circulation:
1) Narrowing of blood vessels
2) Thrombus formation
3) Weakening of vessel walls
47
What are the primary risk factors associated with Atherosclerosis?
1) Increasing age
2) Gender (male) ~ estrogen decrease risk
3) Family history
48
What lifestyle changes can be made to lessen the risk of developing atherosclerosis?
1) Stop smoking
2) Diet
3) Hypertension
4) Hyperlipidemia
5) Cholesterol
6) Type 2 Diabetes
49
Describe a fatty streak that can develop with atherosclerosis:
Thin, flat, yellow discoloration that progressively enlarge, becoming thicker, and slightly elevated as they grow in length.
50
Describe a fibrous atheromatous plaque that can develop with atherosclerosis:
- Basic lesions of atherosclerosis
- Characterized by the buildup of intracellular and extracellular lipids, proliferation of vascular smooth muscle cells, formation of scar tissue, and calcification
51
Which vessels can be affected by vasculitis?
Arteries, Veins, Capillaries
52
What are the signs and symptoms associated with vasculitis?
Fever, Myalgia, Arthralgia, Malaise
53
Sudden event that interrupts arterial flow to affected tissue and organs
acute arterial occlusion
54
How does arterial occlusion develop?
Most result in embolus or thrombus
55
What are the clinical manifestations associated with AAC? (list the 7 Ps)
1) Pistol Shot (Acute onset)
2) Pallor
3) Polar (cold)
4) Pulselessness
5) Pain
6) Paresthesia
7) Paralysis
56
Compare how a thrombus and embolus cause AAC:
Thrombus:
Erosion/rupture of fibrous cap of ateriosclerotic plaque (promotes blood clotting)
Embolus:
Arise from heart, caused by conditions that cause blood clot formation of walls of heart chamber/valve
57
Which type of atherosclerosis is seen most commonly in the lower extremities?
Arteriosclerosis Obliterans
58
Which two arteries are most commonly affected atherosclerosis?
Superficial Femoral & Popliteal
59
List the manifestations associated with atherosclerosis
1) Gradual onset
2) Intermittent Claudication
3) Signs of ischemia (atrophic change, thin skin, decreased leg mm, cool foot, popliteal pulse absent, limb color blanch)
4) Blood flow reduced doesn’t meet min needs of resting mm and nerves (ischemic pain at rest, ulceration, gangrene)
60
What is ischemic pain?
-Pain causing pressure and compression
61
What can result from the blood flow demands of the tissue not being met?
Ischemic pain, gangrene, tissue/skin breakdown, ulceration
62
What is Buerger’s Disease?
- Thromboangitis Obliterans
| - Inflammatory arterial disorder causing thrombus formation
63
Which arteries are most commonly affected Buerger’s Disease?
Medium sized arteries, hands and feet
64
What are the risk factors of Buerger’s disease?
- Heavy smoking
| - Men, but becoming common in young female smokers
65
List the signs and symptoms associated with Buerger’s Disease:
Pain, Increased sensitivity to Cold, Decreased Peripheral Pulse, Change of color Extremity, Lack of Blood Flow, Chronic Ischemia, Ulceration, Gangrene
66
Which disease is caused by intense vasospasm of the arteries and fingers?
Raynaud’s Disease
67
Compare Type 1 and Type 2 of Raynauds
Type 1: Raynaud's Disease (Primary)
- Occurs without cause
- Exposure to cold or strong emotion
- Limited to fingers
- Unknown cause
Type 2: Raynaud’s Phenomenon:
- Associated with other disease of known vasospasm
- Previous vessel injury (frostbite, vibrating tools, hot/cold temps)
68
What are the signs and symptoms associated with Raynauds
1) Ischemia (change in color, temp, sensory)
2) After episode, redness, throbbing, pain
3) Usually fingers affected sometimes feet
4) Trophic change can develop, brittle nails, skin becomes thick
69
Where is the most common location for an aneurysm?
Arteries/Veins most common in Aorta
70
What are some common causes for an aneurysm?
1) Congenital defects
2) Trauma
3) Infections
4) Atherosclerosis
71
How can a ruptured aneurysm be dangerous?
Severe bleeding
72
How can an unruptured aneurysm be dangerous?
Cause damage by pressure on surrounding structures, interrupting blood flow
73
Describe a berry aneurysm:
Small, sphere dilation of vessel at bifurcation
74
Describe a fusiform aneurysm:
Entire circumference of vessel
75
Describe a saccular aneurysm:
Extends over part of circumference of the vessel
76
Describe a dissecting aneurysm:
False aneurysm, from treat in intimal layer of vessel, blood to enter between layers, causing blood filled cavity
77
What is the only type of aneurysm that is considered a “false” aneurysm?
Dissecting Aneurysm
78
What can result from disorders of the venous circulatory system?
Produce congestion of the affected tissues and predispose to clot formation (b/c of stagnation of blood flow and activation of the clotting system)
79
What is a varicose vein?
Dilated and tortuous veins
80
How do varicose veins develop?
Prolonged standing, Increased intra-abdominal pressure (Pregnancy, heavy lifting, obesity)
81
What are the signs and symptoms of varicose veins?
1) Superficial appearance
2) Aching in lower limbs
3) Edema
82
How can varicose veins be treated?
- Little can be done to restore, prevention is key.
| - Avoid long periods of standing, proper lifting, support stocking
83
Describe the two possible ways that chronic venous insufficiency can develop?
- Deep vein thrombosis (DVT)- causes deformity of the valve leaflets, so they cannot close properly
- Valvular incompetence- without proper closing of the valves unidirectional blood flow and emptying of the deep veins cannot occur. Muscle pump is ineffective (blood flows backwards)
84
What is venous thrombosis?
The presence of thrombus in a vein and accompanying inflammatory response in the vessel wall
85
What are the risk factors of venous thrombosis?
1) Venous stasis
2) Hyperactivity of blood coagulation
3) Vascular Trauma
86
What are the signs and symptoms associated with venous thrombosis?
1) Asymptomatic
2) Inflammation (Pain, swelling)
3) Other ind. Inflammation (fever, malaise, elevated WBC)
4) Tenderness/pain along the vein
5) Swelling
87
How is venous thrombosis treated?
Anticoagulants
88
What is compartment syndrome?
A condition of increased pressure in an anatomic space that cannot expand
89
What are its causes compartment syndrome
- Decreased Compartment Size
- Constrictive dressings and casts
- Infiltration of intravenous fluids
- Thermal injury/ frostbite
- Surgical closure of fascial defects
- Increased Compartment Volume
- Fractures and orthopedic surgery
- Trauma and bleeding
- Post-ischemic Injury
- Severe exercise
- Prolonged immobilization with limb compression
90
How is compartment syndrome treated
- Reducing compartmental pressures
- Limb elevation is not recommended
- Fasciotomy: fascia is cut longitudinally and separated to relieve pressure and reestablish blood flow (last resort)
91
What is a pressure ulcer?
Ischemic lesions of the skin and underlying structures caused by external pressure that impairs blood/lymph flow
92
What are two other names for a pressure ulcer?
Decubitus Ulcers and Bedsores
93
How do pressure ulcer develop
External pressure compress blood vessel, Friction forces
94
How are pressure ulcer treated?
Prevention of further damage, frequent turning, moist dressing, promote healing
95
Which steps can be taken to prevent pressure ulcer?
Frequent position change, skin care, observation is key
96
Compare primary hypertension to secondary hypertension
Primary Hypertension:
Chronic high blood pressure without other disease
Secondary Hypertension:
High blood pressure resulting from other disorder
97
What is considered “Normal” blood pressure?
Less than 120/80
98
b. Which risk factors of hypertension can NOT be changed?
Family history, Race, Age, Insulin Resistance
99
Which risk factors of hypertension CAN be changed?
Salt intake, Obesity, Alcohol, Potassium, Cal, Magn, Birth Control, Stress
100
What are the signs and symptoms associated with hypertension?
- Asymptomatic
- When symptoms occur:
- Kidneys
- Heart
- Left ventricular hypertrophy
- Angina
- Heart failure
- Eyes
101
How is hypertension treated?
- Lifestyle changes
- Weight reduction
- Diet rich in nutrients and reduced saturated fat
- Dietary sodium reduction
- Physical activity
- Moderation of alcohol consumption
- Stop smoking (increases risk for heart disease)
- Drugs
102
What other diseases/disorders/problems can result from hypertension?
Atherosclerosis, Heart failure, stroke, Coronary Artery Disease
103
What is orthostatic hypotension?
Abnormal decrease in BP on assumption of the upright position
104
What are the signs and symptoms of orthostatic hypotension?
Decrease in cerebral blood supply; feeling light-headed, dizzy, fainting
105
What can cause orthostatic hypotension?
- Decrease vascular volume (dehydration)
- Impaired mm pump function (bed rest, spinal cord injury)
- Cardiovascular Reflex (med that decrease heart rate)
106
What is the term for fluid accumulating in the pericardial cavity?
Pericardial Effusion
107
How does pericardial effusion affect the heart?
Depends on the amount of fluid, how fast it accumulates and elasticity of pericardium
108
What other problem can occur as a result of pericardial effusion?
Cardiac Tramponade
109
What can cause pericardial effusion?
Injury, Inflammation, Altered Capillary Filtration Pressure
110
What is cardiac tamponade?
Slow/rapid compression on heart due to accumulation of fluid, blood or pus in pericardial sac (Life threatening)
111
What are the causes cardiac tamponade
Trauma, Cardiac Surgery, Cancer, Uremia, Cardiac Rupture
112
How does cardiac tamponade affect the heart function?
- Increasing intracardiac pressure
- Progressively limits ventricular diastolic filling
- Reduces stroke volume/cardiac output
113
What are the symptoms of Rapid accumulation
- Elevation of central venous pressure
- Jugular venous distention
- Decline in venous return of the heart
- Decrease in cardiac output despite an increase in heart rate
- Fall in systolic BP
- Signs of circulatory shock
- Heart sounds may be hard to hear
114
What are the symptoms of Slow development
acutely ill, but not to the same degree as rapid accumulation. Dyspnea is common
115
What is pericarditis?
Inflammation process of pericardium
116
What are the causes pericarditis
Infection, Trauma, 2ndry to other systemic/cardiac Disease
117
What will result from pericarditis? (hint: clinical manifestation)
Evoke acute inflammatory process
118
What are the signs and symptoms of acute pericarditis
Fever, Malaise, Flu-like symptoms
119
What is exudate?
Fluid that seeps out of blood vessels
120
How long can pericarditis last?
- Last 2-6 weeks in Acute
| - Chronic can last for years
121
Where will the pain be felt pericarditis
- Abrupt onset
- Precordial area (over/below heart)
- Sharp pain
- Radiate to neck, back, abdomen, side
- Worse with deep breath, coughing, swallowing
122
What are the clinical manifestations of chronic pericarditis?
Minimal (through xray), accumulation of fluid compress
123
What are the signs and symptoms of constrictive pericarditis?
- Ascites (accumulation in abdomen of fluid, swelling)
- Pedal edema
- Dyspnea on exertion
- Fatigue
- Jugular vein distension
124
What causes constrictive pericarditis?
Fibrous scar tissue formation between layers of the serous pericardium
125
What is coronary artery disease?
Heart disease caused by imparied coronary blood flow
126
What can result from coronary artery disease?
- Angina
- Myocardial Infarction
- Cardiac arrhythmias
- Conductions defects
- Heart failure
- Sudden death
127
What is the most common cause of CAD?
Atherosclerosis
128
What are the two types of CAD? Describe each.
1) Acute coronary syndrome
| 2) Chronic ischemic heart disease
129
What are the two types of atherosclerotic plaques?
1) Stable artherosclerotic plaque
| 2) Unstable artherosclerotic plaque
130
What is the effect of Aspirin?
- Anticoagulant used to prevent aggregation at the site of plaque
- Targets pathway formation of fibrin clot
- Irreversible, last for lifetime of platelet (8-10 days)
131
How long to the effects of aspirin last on the platelets that were in the body at the time the medication was administered?
8-10 days, lifetime of the platelet
132
What is Angina?
Chest pain “to choke”
133
What are the 3 types of anginas?
1) Angina Pectoris
Sudden chest pain associated with transient myocardial ischemia
2) Chronic Stable Angina
Fixed coronary obstruction that prevents heart from getting sufficient blood flow to meet its metabolic demands
```
3) Unstable Angina
Pain is more persistent and severe course
Caused by:
Artherscleortic plaque disruption
Platelet aggregation
Secondary hemostasis
```
134
What is a heart attack?
- Myocardial Infarction
| - Ischemic death of myocardial tissue
135
What are the manifestations of MI
- Abrupt onset
- Severe crushing pain, radiating to left arm, neck/jaw
- GI complaints
- Complaints of fatigue/weakness
- Tachycardia, anxiety, restlessness, feelings of doom
- Pale, cool and moist skin
- Sudden death
136
What is myocarditis?
Inflammation of heart muscle and conduction system without evidence of myocardial infarction
137
What are the manifestations myocarditis
- Range from asymptomatic to profound heart failure or sudden death
- In children/young adults is often asymptomatic
- Acute symptomatic myocarditis flu-like symptoms
- Upper respiratory tract/GI tract infection
138
How does myocarditis resolve
- Transient, symptoms subside within 1-2 months
- Heart failure/life-threatening arrhythmias occur
- Progression to subacute and chronic disease
139
What is the most common cause myocarditis
Viral infection
140
Group of disorders that affect the heart muscle
Cardiomyopathy
141
What are the 2 types of cardiomyopathies?
1) Dilated Cardiomyopathies
Progressive cardiac hypertrophy/dilation and imparied pumping ability of one or more ventricles
Wall thinning and hypertrophy
2) Hypertrophic Cardiomyopathies
Abnormality that involves excessive ventricular growth (hypertrophy)
Common young adults, and cause of sudden death in young
142
Bacterial Infection of the endocardial surface of the heart, including valves.
infective endocarditis
143
What are the manifestations of endocarditis
Fever and signs of systemic infection (malaise, anorexia, lethargy)
144
Compare Valve Stenosis to Valve Regurgitation
1) Valve Stenosis
| 2) Valve Regurgitation
145
Ductus arteriosus remains open beyond 3 months in full term infant
Patent Ductus Arteriosus
146
Persistent opening that allows shunting of blood across atrial septum from left to right
Atrial Septal Defect
147
Opening in ventricular septum that results from incomplete separation of ventricles during early fetal development
Ventricular Septal Defect
148
Most common cyanotic heart defect
Tetralogy of Fallot
149
Aorta arises from right ventricle and pulmonary artery arises from left ventricle
Transposition of the great vessels
150
localized narrowing of aorta prox to distal or opposite the entry of ductus arteriosus
Coarctation of the aorta
151
localized narrowing of aorta prox to distal or opposite the entry of ductus arteriosus
Coarctation of the aorta
152
What is the function of the heart?
Move deoxygenated blood from venous system through the right heart, and move oxygenated blood from pulmonary circulation through the left heart into arterial system
153
What is heart failure?
Inability of heart to keep up with demand on it and failure of heart to pump blood with normal efficiency
154
How is cardiac output regulated?
- The amount of blood the heart pumps each minute
- Regulated by balance between activity of the sympathetic nervous system (increase heart rate) and parasympathetic nervous system (slow heart rate)
155
What is the equation used to calculate cardiac output?
Heart rate x Stroke volume
156
What is stroke volume?
How much blood the heart pumps each beat
157
Shortness of breath
Dyspnea
158
Shortness of breath with lying down
Orthopnea
159
Sensation of shortness of breath that awakens
Paroxysmal nocturnal dyspnea
160
Periodic breathing
Cheyne-stokes respiration
161
Extreme tiredness progress with activity during the day, diminished blood output from heart, mental confusion, disturbed behavior
Cardiac Fatigue
162
Bluish discolored of skin/mucous
Cyanosis
163
What is the Frank-Starling Mechanism?
- Increases stroke volume by increasing ventricular end-diastolic volume
- Increase filling causes increased stretching of fibers ~ increase next contraction
164
What are the causes of Heart Failure?
Congestion of body tissues. After initial compensatory period
165
Compare Systolic and Diastolic dysfunction
Systolic:
Impaired ejection of blood from heart during systole
Decrease cardiac contractility and ejection fraction
```
Diastolic:
Due to impaired filling resulting in congestion
Smaller ventricular chamber size
Ventricular hypertrophy
Poor ventricular compliance
```
166
Define left side heart failure
- Failure of left heart to move blood from pulmonary circulation and systemic circulation
- Blood back up into pulmonary circulation (impairs gas exchange)
167
What tissues are affected left side heart failure?
```
Pulmonary edema (cough with frothy sputum, orthopnea)
Usually at night
```
168
What are the causes left side heart failure
- Acute myocardial infarction
- Cardiomyopathy
- Stenosis/regurgitation of aortic/mitral valves
- Rapid infusion of intravenous fluid/blood transfusion
169
Define right side heart failure
- Failure of the right heart to pump deoxygenated blood forward into pulmonary circulation
- Blood backs up into systemic circulation
170
What tissues are affected right side heart failure
- Lower extremity (Swelling)
- Liver (Congestion)
- Spleen (Ascites)
- GI Tract (Congestion, anorexia)
- Jugular veins (Distension)
171
What are the causes right side heart failure
Conditions that restrict blood flow into lung (stenosis of tricuspid valves, right ventricular infarction, cardiomyopathy)
172
What is congestive heart failure?
Heart muscle is weakened and can’t pump as well as it usually does
173
What are the signs and symptoms of heart failure
- Fluid retention/edema
- Respiratory manifestations
- Fatigue and limited exercise tolerance
- Cachexia malnutrition
- Cyanosis
174
How is CHF treated?
- Correction of reversible causes
- Surgical repair of ventricular defect or an improperly functioning valve
- Pharmacologic control of afterload stress
- Modification of activity/lifestyle consistent with functional limitations of reduce cardiac reserve
- Use of medications to improve cardiac function
- Mechanical Aids (Resynchronization, Implantable cardioverter defibrillators, Assist devices, Heart transplant
175
What is acute pulmonary edema?
Capillary fluid moves into alveoli, causes lung stiffness, makes lung expansion more difficult and impairs the gas exchange function of the lung
176
What can result from pulmonary edema?
- Shortness of breath
- Rapid pulse
- Moist/cool skin
- Cyanosis
177
What is circulatory failure/Shock?
Acute failure of circulatory system to supply the peripheral tissues and organs of the body with adequate blood supply resulting in cellular hypoxia
178
What can cause circulatory failure?
- Decrease in blood volume
- Obstruction of blood flow
- Vasodilation with redistribution of blood flow
179
What are the 4 types of shock? Describe each.
1) Cardiogenic
Failure of the heart to pump blood adequately
2) Hypovolemic
Diminished blood volume in that there is inadequate filing of the vascular compartment
3) Obstructive
Circulatory shock that results from mechanical obstruction of flow of blood through the central circulation (great veins, heart, lung)
4) Distributive
Loss of blood vessel tone, enlargement of vascular compartment, displacement of vascular volume away from the heart and central circulation
180
What is the clinical course of hypovolemic shock? Describe each stage.
1) Initial Stage
Circulatory blood volume is decrease, not enough to cause effects
2) Second (Compensatory) Stage
Blood volume reduce, are able to maintain BP and tissue perfusion enough to prevent tissue damage
3) Third (Progressive) Stage
BP falls, blood flow to brain is impaired, capillary permeability, fluids leaves capillaries, blood flow sluggish
4) Forth (Final) Stage
Irreversible, blood volume may be restored the vital signs stabilized, death ensure eventually
181
What are the 3 types of distributive shock? Include their cause and symptoms.
1) Neurogenic
Brain injury, Depressant action of drugs, General anesthesia, Hypoxia, Lack of Glucose
Sx: Heart rate is slower than normal, skin dry/warm
2) Anaphylactic
Immunological reactions
Sx: Sudden dvlp, apprehension, burning sensation, itching, hives, coughing, Drop in BP
3) Septic
Gram-negative Bacterium
Early Sx: Fever, Vasodilation, Warm skin, Mild hyperventilation, Respiratory alkalosis
Late Sx: Hypovolemia (B/c arterial/venous dilation and leakage of plasma into interstitial space)
182
What are the complications of shock?
1) Acute respiratory distress syndrome
2) Acute renal failure
3) GI complications
4) Disseminated intravascular coagulation
5) Multiple organ dysfunction syndrome
