PVD and HTN

Question 1

Peripheral Vascular resistance (PVR)

Answer 1

pressure the heart has to work against in the periphery (with HTN, arteries harden–>more pressure–>increased PVR)

Question 2

use of diuretics and BP

Answer 2

diuretics decrease body fluid–>decreased BP

Question 3

HTN and dementia

Answer 3

the microscopic arteries in brain can hemorrhage–>brain cells die

Question 4

effects of beta blockers

Answer 4

slow HR, lower BP, increase preload (so it ADDS fill time to the heart. this will reduce the workload of the heart bc it gets a good fill)

Question 5

CO x PVR =

Answer 5

BP

Question 6

why should we “start low, go slow” with older adults and HTN meds?

Answer 6

older adults have less circulating albumin (less protein for binding) so more meds stay available to hit receptor sites which exacerbates the response from the meds

Older adults are more sensitive to volume depletion

Question 7

DASH diet

Answer 7

diet low in sodium and fat to lower BP (effect is seen one week after starting diet)

Question 8

JNC 8 HTN guidelines

Answer 8

for 60 years and older: start treatment at 150/90 or above

for younger than 60: start treatment at 140/90 or above

Question 9

what’s the #1 reason PTs stop taking their BP meds?

Answer 9

they reach their BP target

Question 10

Buerger’s disease

Answer 10

Claudication in feet and lower extremities worse at night; causes ischemia and fibrosis of vessels in extremities with increased sensitivity to cold. Ulcerations and gangrene occur on digits. Cause unknown but is associated with smoking.

Question 11

Raynaud’s disease

Answer 11

Painful vasospasms of arteries and arterioles in extremities, especially digits; causes red-white-blue skin color changes on exposure to cold or stress; cause unknown, occurs more in women, and may be autoimmune because it is associated with many rheumatic diseases like systemic lupus erythematosus

Question 12

nursing care for Raynaud’s and Buerger’s

Answer 12

Teach patient about smoking cessation, avoid cold by wearing gloves and warm clothes, manage stress, avoid caffeine; teach patient taking nifedipine to avoid grapefruit and grapefruit juice to prevent severe adverse effects, including possible death; teach patients on vasodilators about side effects such as facial flushing, hypotension, headaches.

Question 13

MONA

Answer 13

mneumonic for heart attacks: morphine (to reduce anxiety), oxygen, nitro, aspirin

But give in this order: ONAM

Question 14

1 ounce =

Answer 14

30 mL

Question 15

1 tablespoon=

Answer 15

15 mL

Question 16

what is the MOST SERIOUS complication of chronic venous insufficiency?

Answer 16

venous ulcerations

Question 17

varicose veins are most common in what population?

Answer 17

white females in occupations that involve prolonged standing (aka nurses!)

Question 18

what are the 6 P’s

Answer 18

pallor, pulselessness, pain, poikilothermia, parathesia, paralysis