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NURS216A > Perfusion 5 > Flashcards

Perfusion 5 Flashcards

1
Q

side effects of Green Tea

A

has caffeine but labelled as not having

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2
Q

HIbiscus tea

A

lower BP, a potent diuretic and ACE inhibitor

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3
Q

Licorice

A

Increases BP, interferes at the renal level of neg feedback of cortisone (cortisone needs to be converted to its inactive form to not interfere with BP) licorice stops this conversion

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4
Q

Coconut Oil

A

is a saturated fat, advertised as not

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5
Q

Garlic

A

is an anti-inflammatory

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6
Q

Ginger

A

anti-platelet

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7
Q

Vit K rich foods would counter the ____ (which drug?)

A

warfarin

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8
Q

Clotting antidotes

A

for heparins: ise protamin sulfate

coumadin - use vit k or FFP

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9
Q

effect of diuretics

A

decrease preload, heart can pump more efficiently

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10
Q

tx of A-fib

A

calcium channel blockers, beta blockers and anti coagulant/platelet

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11
Q

tx of angina

A

nitro:
if it responds its stable angina.
unstable angina may end in MI

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12
Q

tx of HF

A

ACE inhibitors. or ARBs which are less potent. likely will also be on diuretics or beta 1 blockers (atenolol)

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13
Q

drugs to decrease HR

A

Calcium channel blockers, beta blockers.

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14
Q

How soon can we give a thrombolytic for an MI?

A

within 6 hours.

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15
Q

How soon can we give a thrombolytic for a stroke?

A

3 hours

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16
Q

SE of Thrombolytics

A

risk of bleeding as it is plasminogen.

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17
Q

When a atherosclerotic plaque begins to travel it is called a what?

A

a thrombus

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18
Q

Risk factors for a thrombus/thromboembolism

A
  • blood stasis
  • high estrogen
  • smoking
  • blood clotting disorders
  • injury to the vessel or embolus (why we treat prophylactically with warfarin during surgery)
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19
Q

DVT

A

diagnosis made with ultrasound.
- pain in the affected area, redness, swelling and edema.
Always assess for symmetry

place pt on thrombolytics or anticoagulants.

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20
Q

PE

A

Caused by DVT
S&S: low o2, compensatory mechanisms, chest pain

diagnosis made with a CT scan

tx: prevention: early mobilication post sx, anticoagulation pre/post/during sx (heparin, LMWH)
- thrombolytics - break the clot before it goes cerebral

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21
Q

injury in the brain is a risk of

A

cerebral edema, increased ICP and brain damage

22
Q

Earliest symptom of increased ICP

A

LOC changes, can be as subtle as a headache or confusion

23
Q

Cushings Triad

A
  • increased BP
  • Decreased HR
  • irregular BP

widening pulse pressure in resp to intracranial pressure increasing

24
Q

Vasogenic cerebral edema

A

BBB compromise

head injury, hematoma, hemorrhage, CNS infection leads to inflammation and increased permeability

25
Q

Cytotoxic cerebral edema

A

increased intracellular fluid shift, hypoosmotic states, ischemia leading to increased h20 shift into cells. increased ICP

26
Q

tx of cerebral edema

A

treat the underlying cause ex. fever, dehydration, do they need electrolytes

27
Q

Hypo-osmotic situation

A

someone sweating but only replacing with water. The blood will be high in water but not electrolytes. The cells will be high in electrolytes but the blood won’t. water will move into the cells to balance causing intracellular fluid shift. When this happens in the brain this caused increased ICP.

28
Q

CVA: CT to confirm ischemic vs hemorrhagic

A

ischemic: 80% of all CVAs

29
Q

Risk factors for CVA

A

risk factors: htn, artherosclerosis, smoking, dyslipidemia, stenosis, diabetes, atrial fib, meds, age…..

30
Q

TIA

A

angina of the brain, often a warning sign of CVA risk.

often seen as a brief LOC change, may trip and fall w/o remembering

31
Q

FAST acronym for stroke

A

Facial Droop
Arm Drift
Speech slurring
Time (call for help)

32
Q

Dysarrythria

A

weal muscle control (slurred speech)

33
Q

Aphasia

A

impairment of language (production or comprehension. wernickes or brocas area affected)

34
Q

tx of CVA

A
  • Sx
  • antiplatelets, anticoagulants
  • tx htn, dyslipidemia
35
Q

Carotid endarterectomy

A

cut into carotid and take out the clot

36
Q

Endovascular tx.

A

following angiogram, the clot is then removed.

37
Q

Area most often affected by CVA

A

middle cerebral artery, upper limbs and face are the area supplied by this vessel. often affects motor and broca’s area.

38
Q

hemorrhagic CVA

A

more often fatal.
risks include htn, meds, age, arterial deficits, bleeding disorders.
sudden onset of headache, vomiting.
tx: stabilize and reverse anticoagulation. osmotic diuretics, hypertonic NS,

39
Q

Lab work for the CVA pt often includes…

A

Thrombocytopenia (low platlet count)

40
Q

Osmosis for tx

A 
hypertonic NS (3% NaCl IV solution)
osmotic diuretic: mannitol

the solution has so much solute in it that it will draw water out of the cell. make sure we do this slow or we kill the cells

41
Q

AVM: arteriovenous malformation

A

congenital defect: a bundle or arteries and veins lacking capillary network and lacking normal wall structure.

  • high pressure arterial flow enters veins with no capillaries and the vessels rupture.

AVM will steal blood flow from surrounding area, causes slow onset neuro deficits, headaches and seizures.

42
Q

Sx tx of AVM

A

surgical removal or clipping of AVM, gamma knife radiation, embolization

43
Q

Aneurysms

A

80% of cerebral aneurysms are in the circle of willis which is an area of high pressure in the brain

AAA (aortic abdominal aneurysm) causes systemic bleed. NEEDS SURGERY ASAP

44
Q

Risk factors for aneurysms

A

congentially malformed vessels, htn, atherosclerosis, age

45
Q

sx tx of aneurysms

A

coiling or flow diversion (similar to angioplasty but in the brain)

46
Q

meds for aneurysms

A

often started 3 months pre sx and continues 3 months post sx.

  • ASA, Clopidogrel (plavix)
  • if the pt is high risk for clotting then heparin immediately post and antiplatelets. MRI followup
47
Q

Why is aortic aneurysm more common in elderly

A

elastin is not synthesized in the elderly. after menopause with estrogen deficiency comes decreased elastin and collagen (vessels are less strong and flexible)

48
Q

Cardiac Tamponade

A

Blood in the heart muscle builds up and puts pressure on the heart. decreased CO, heart failure.
tx” pericardiocentesis

49
Q

Intracerebral hemorrhage

A

can be caused by a ruptures aneurysm, AVM, stroke. if this is epidural burrholes may be appropriate.

50
Q

Epidural hematoma

A

caused by skull fx injury

51
Q

Subdural hematoma

A

Most common with accel/decel injuries leading to venous tearing.

NURS216A (15 decks)

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