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Nursing 323: med surg > Perfusion > Flashcards

Perfusion Flashcards

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1
Q

CAD results in impaired blood flow to ________

a. veins
b. brain
c. myocardium
d. toes

A

c. myocardium

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2
Q

what is the formula used to determine Blood pressure

A

cardiac output x systemic vascular resistance = blood pressure

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3
Q

define cardiac output

A

the amount of blood pumped by the heart in 1 minute

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4
Q

define blood pressure

A

force exerted by the blood against the walls of the blood vessels

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5
Q

how do you determine cardiac output?

A

heart rate (HR) x stoke volume (SV)

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6
Q

define stroke volume

A

the volume of blood ejected everytime the heart beats (ml per beat)

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7
Q

define systemic vascular resistance (SVR)

A

force opposing the movement of blood in the vessels

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8
Q

what determines SVR?

A

Determined by the radius of arteries and arterioles
* Arteries narrow= SVR
* Arteries dilate=SVR

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9
Q

Regulation of BP is a complex process involving both _________ and _______mechanisms.

A

short term and long term

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10
Q

short term mechanisms include: SELECT ALL THAT APPLY

a. sympathetic nervous system
b. vascular endothelium
c. renal processes
d. hormonal processes

A

A and B

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11
Q

the long-term mechanisms include: SELECT ALL THAT APPLY

a. sympathetic nervous system
b. renal processes
c. vascular endothelium
d. hormonal processes

A

b and d

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12
Q

the renal and hormonal processes regulate ____ resistance and ______

a. venous; blood volume
b. arteriolar; blood volume
c. arteriolar; blood vescocity
d. venous; blood thickness

A

b

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13
Q

how does angiotensin II act on the heart and blood vessels?

A

Causes vasoconstriction and tissue growth –> remodeling of vessel walls=primary HTN and atherosclerosis

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14
Q

how do changes in blood volume affect blood pressure?

A

the higher the blood volume, the greater work is needed for the heart to pump blood through the circulatory system

increased blood volume = increased blood pressure

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15
Q

how does overall compliance affect blood pressure?

A

the elastic characteristics of the vessels contribute to the overall pressure in the vessels. The more elastic the blood vessels are, the lower the blood pressure.

increased blood vessel elasticity = decreased blood pressure

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16
Q

how does cardiac output affect blood pressure?

A

related to heart rate and stroke volume

increased HR + Stroke Volume = increased cardiac output = increased BP

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17
Q

how does peripheral resistance affect blood pressure?

A

the resistance of the arteries is related to the overall compliance characteristics

increased peripheral resistance = decreased overall compliance = increased arterial blood pressure

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18
Q

Normal blood pressure range

A

systolic: less than 120
and
diastolic: less than 80

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19
Q

elevated blood pressure range

A

systolic: 120-129
and
diastolic: less than 80

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20
Q

high blood pressure (hypertension) stage 1 range

A

systolic: 130-139
or
diastolic: 80-89

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21
Q

high blood pressure (hypertension) stage 2 range

A

systolic: 140 or higher
or
diastolic: 90 or higher

22
Q

hypertensive crisis (consult doctor immediately)

A

systolic: higher than 180
and/or
diastolic: higher than 120

23
Q

define primary hypertension (essential or idiopathic)

A

elevated BP without an identified cause

24
Q

define secondary hypertension

A

elevated BP with a specific cause that often can be identified and corrected. can cause cardiovascular complications if left untreated

25
Q

what are some common causes of secondary hypertension?

A
  • Cirrhosis
  • Coarctation or congenital narrowing of the aorta
  • Drug-related: estrogen replacement therapy, oral contraceptives, corticosteroids, nonsteroidal anti-inflammatory drugs (e.g., cyclooxygenase-2 inhibitors), SNS stimulants (e.g., cocaine, monoamine oxidase)
  • Endocrine disorders (e.g., pheochromocytoma, Cushing syndrome, thyroid disease)
  • Neurologic disorders (e.g., brain tumors, quadriplegia, traumatic brain injury)
  • Pregnancy-induced hypertension
  • Renal disease (e.g., renal artery stenosis, glomerulonephritis)
  • Sleep apnea
26
Q

What are some risk factors for primary hypertension?

A
  • age
  • Alcohol
  • Diabetes
  • elevated serum lipids
  • ethnicity
  • excess dietary sodium
  • family history
  • Gender
  • Obesity
  • sedentary lifestyle
  • socioeconomic status
  • stress tobacco use
27
Q

patients are frequently asymptomatic until the target organ disease occurs

True or False

A

True

28
Q

what are some signs and symptoms of hypertension?

A
  • Fatigue, Reduced activity
    tolerance
  • Dizziness
  • Palpitations, angina
  • Dyspnea
  • Vision changes
  • Nocturia
29
Q

What are some complications of hypertension?

A
  • coronary artery disease
  • left ventricle hypertrophy
  • heart failure
  • retinopathy
  • peripheral vascular disease
  • renal disease
  • stroke cognition
30
Q

list the diagnostics for hypertension

A
  • history and physical exam
    • ophthalmic
  • labs
    • urinalysis (UA)
    • fasting glucose
    • BMP, CBC, and lipid profile
    • Ca + and Mg+
  • tests
    • 12 ECG
    • echocardiogram
31
Q

hypertension treatments

A
  • lifestyle changes
  • pharmacological
  • nursing/collaborative
    • focus on individual, modifiable risk factors that contribute to HTN
    • develop a realistic health maintenance plan for the patient and their family
    • promote treatment adherence
32
Q

which of the following medications are used to treat hypertension? SELECT ALL THAT APPLY

a. Diuretics
b. Adrenergic-inhibiting agents
c. Direct vasodilators
d. Angiotensin inhibitors
e. Calcium channel blockers

A

all of the above

33
Q

how does hydrochlorothiazide work?

A

inhibits NaCl reabsorption in distal convoluted tubule

34
Q

how does furosemide work to treat hypertension?

A

inhibits NaCl reabsorption in the loop of Henle

35
Q

how does spironolactone work to treat hypertension?

A

inhibits Na+ retaining and K+ excreting effect of aldosterone in the distal and collecting tubules

*CHECK POTASSIUM LEVELS. DON’T WANT PATIENT TO BECOME HYPERKALEMIC

36
Q

How does clonidine work to regulate BP?

A

reduces sympathetic outflow from CNS = peripheral vasodilation, decrease SVR

37
Q

how does Doxazosin work to regulate BP?

A

blocks alpha-adrenergic effects = peripheral vasodilation, decreased SVR

38
Q

how does metoprolol work to regulate BP?

A

block beta 1 adrenergic receptors; reduce sympathetic vasoconstrictor tone, decrease renin secretion by kidneys

39
Q

how does propranolol work to reduce BP?

A

blocks beta 1 and bet 2 adrenergic receptors

40
Q

how does carvedilol work to regulate BP?

A

peripheral vasodilation and HR reduction

41
Q

how do hydralazines regulate BP?

A

direct arterial vasodilation, reduces SVR

42
Q

how does nitroglycerin regulate BP?

A

reduces pre load and SVR

  • low dose: venous dilation
    *high dose: arterial dilation
43
Q

how does sodium nitroprusside regulate BP?

A

direct arterial vasodilation, reduces SVR

44
Q

how do ACE inhibitors (-pril) regulate BP?

A

reduce conversion of angiotensin 1 to angiotensin II (prevents vasoconstriction)

45
Q

how do ARBs (-sartan) regulate BP?

A

prevents action of angiotensin II and produces vasodilation and increased NA+ and water excretion

46
Q

how does diltiazem regulate BP?

A

inhibits movement of calcium across cell membrane = vasodilation

47
Q

how does amlodipine regulate BP?

A

relaxes vascular smooth muscle = decreases SVR and arterial BP

48
Q

what are some causes of hypertensive emergencies?

A

preeclampsia, eclampsia, stimulant drugs, head injury

49
Q

what are some symptoms of hypertensive emergencies

A

-Hypertensive encephalopathy
* Cerebral edema
- Renal insufficiency
* Acute Kidney Injury→ renal failure
- Cardiac decompensation
* Unstable angina, MI, pulmonary edema

50
Q

hypertensive emergency treatments

A
  • Hospitalization
  • Hemodynamic monitoring
    • Arterial line: direct measure
      of arterial pressures
  • IV Anti-hypertensive
    medications
    • Direct vasodilators or
      adrenergic inhibitors
    • Treat MAP (mean arterial
      pressure)
    • Slowly decrease pressure to
      stabilize

Nursing 323: med surg (6 decks)

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