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NUS111 test 3 > Module 2B > Flashcards

Module 2B Flashcards

1
Q

Normal BP

A

<80

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2
Q

What is prehypertension?

A

120-139/80-89

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3
Q

What is stage 1 hypertension?

A

> 140-159/90-99

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4
Q

What is stage 2 hypertension?

A

> 160/>100

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5
Q

What is the diagnosis of hypertension?

A

140 or >/ 90 or >

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6
Q

What are the risk factors of hypertension?

A

coronary, cerebral, renal, peripheral vascular disease, ISH( isolated systolic HTN)

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7
Q

Why are the risk factors a silent killer?

A

They don’t know they have it until there is already organ damage

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8
Q

What are the risk factors for essential or primary hypertension?

A

modifiable factors: 2g Na+, increased body weight, physical inactivity, diet, smoking, ETOH, genetics, age, ethnicity

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9
Q

What are the risk for secondary hypertension?

A

disease process: renal disease, brain tumor, pregnancy, steroids, endocrine disorders

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10
Q

Causes of 2nd HTN

A

coarctation of aorta, renal disease, endocrine disorders, neurologic disorders, medications

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11
Q

What are the clinical manifestations of 2nd HTN?

A

asymptomatic= silent killer, headache, dizziness or fainting, nosebleeds, tachycardia, sweating, pallor

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12
Q

What are compelling factors of 2nd HTN?

A

ischemic heart disease, heart failure, diabetic HTN, chronic kidney disease, cerebrovascular disease

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13
Q

What are nursing interventions for 2nd HTN?

A

sodium restriction (2g Na+ daily), weight reduction, ETOH intake, exercise promoted, relaxation techniques, and tobacco avoidance

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14
Q

What are the drug therapy for hypertension?

A

oral & written info, diuretics, adrenergic inhibitors, direct vasodilators, ganglionic blockers, angiotensin inhibitors, and calcium channel blockers

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15
Q

What do you never do with hypertension medications?

A

DO NOT STOP ABRUPTLY

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16
Q

What are the sign of pre-eclampsia?

A

develops after 20 weeks gestation, decreased placental perfusion, fetal growth retardation, fetal hypoxia = arteries not wide enough to carry oxygen to baby, BP beings to rise after 20 week gestation, loss of vasodilation

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17
Q

What does the loss of vasodilation result in?

A

decreased placental perfusion, decreased maternal perfusion, pathology in other systems

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18
Q

What are the clinical manifestations of SEVERE PRE-ECLAMPSIA?

A

may develop suddenly, generalized edema, BP >160/110, albuminuria, frontal headaches, blurred vision & spots before eyes, nausea & vomiting, epigastic pain, decreased urine output

19
Q

What does HELLP syndrome stand for?

A

Hemolysis, Elevated Liver function test, Low Platelet count

20
Q

What does the HELLP syndrome mean?

A

decreased maternal perfusion, RBC’s fragmented, multiple organ failure-> increased maternal &fetal morbidity & mortality, associated with SEVERE pre-eclampsia

21
Q

What are the signs and symptoms of HELLP syndrome?

A

RUQ pain & epigastric pain

22
Q

What are therapeutic nursing interventions for HELLP syndrome?

A

prenatal visits for detection, monitor BP weight edema urine and reflexes, diet education, daily weights

23
Q

What are therapeutic nursing interventions for MILD HELLP syndrome?

A

hospitalization, monitoring: maternal & fetal, nonstress test & fetal monitoring, stimuli, medications, impending labor, emotional support and activities

24
Q

What are therapeutic nursing interventions for Eclampsia?

A

patent airway, suction, crash cart

25
Q

What do you assess when administering MgSO4?

A

weight, BP, RR, breath sounds, deep tendon reflexes (knee jerk), urinary output, LOC

26
Q

What do you keep at the bedside when giving MgSO4?

A

calcium gluconate

27
Q

What are the signs of recovery after giving MgSO4?

A

urinary output, decreased proteinuria, BP returns to normal

28
Q

What is claudication?

A

cramp like ischemic pain/ burning in the extremities; what brings patient into the hospital

29
Q

PAD: Pain

A

intermittent claudication, > lactic acid present in muscles, > 75% occluded, < pain with rest

30
Q

PAD: Skin

A

cool, pale, rubor, cyanosis, hair loss, edema, ulcers, pallor when legs elevated

31
Q

Therapeutic Nursing Interventions to increase arterial blood supply

A

exercise, walking -> gradually and increase slowly walking promotes blood flow & collateral circulation, pain as guide, positioning -> elevate feet don’t encourage elevation above heart can put one leg on floor,

32
Q

What are the “NO’s” for increasing arterial blood supply

A

crossing legs, cold temperatures, constrictive clothing, smoking

33
Q

What are drug therapies for increasing arterial blood supply

A

walking 30-40 minutes/day, claudication, trental= blood flow extremities, ACE inhibitors, antiplatelet, aspirin

34
Q

What is Virchow’s triad?

A
  1. venous stasis -> not moving
  2. endothelial damage -> vena puncture; clot?
  3. hypercoagulability of blood -> increased RBC’s
35
Q

What are the signs and symptoms of VTE?

A

superficial, pain warmth redness tenderness swelling infection, DVT-> unilateral swelling slight temperature calf or groin pain increased circumference of limb warmth and edema

36
Q

What labs do you check with VTE or PE?

A

platelet, bleeding time, PTT & INR

37
Q

What are preventive measures for VTE?

A

pharmacologic agents -> aspirin & Coumadin = prevent venous statis; early ambulation; TEDS; intermittent compression devices -> prior to VTE; ROM on bedrest patients

38
Q

What are surgical management for VTE?

A

thrombectomy -> removal of clots, only done no response to medical treatment; inferior vena cava interruption -> greenfield filters= like sink drain but with high infection rate

39
Q

What are anticoagulant therapy for VTE?

A

delay clotting time, prevent formation, prevent extension, DOESNT DISSOLVE THROMBUS

40
Q

What is thrombolytic therapy?

A

clot busters streptokinase TPA not VTE; MI or stroke; NOT ANTICOAGULANTS

41
Q

What are nursing concerns for anticoagulant therapy?

A

check dosage to be administered, monitor for S/S of bleeding, monitor VS, have antidotes available, monitor aPTT, PT and INR, pressure to sites, patient teaching, injections sub q not IM

42
Q

Key features of lower extremity ulcers ARTERIAL

A

peripheral pulses, capillary refill -> greater than 3 seconds, other assessment findings, collaborative care

43
Q

Key features of lower extremity ulcers VENOUS

A

peripheral pulses -> difficult to palpate, capillary refill -> less than 3 seconds brisk, other assessment findings

NUS111 test 3 (1 decks)

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