Unit 3 Study Guid Flashcards
what anemia has these manifestations?
Lhermittes sign
Numbness, tingling, burning in hands or feet
Altered mood status (confused, dementia)
Depression/confusion
Mood swings
Coordination and balance
Impaired balance/taste, stinging sensation on the tong
Verbal disturbances
B12
What anemia has these medications
injections
Oral supplementation
B12
what anemia has these manifestations?
Glossitis ( smooth, shiny toung)
Koilonychia (spoon shaped nails)
Iron dificiency anemia
what anemia has these manifestations?
Mood changes
Increased bleeding risk
Neural tube defects in infants
folic acid
what anemia has these manifestations?
Frequent infections
Bruising
Nosebleeds
Gum bleeding
Aplastic anemia
what anemia has these manifestations?
Jaundice
Dark urine
Splenomegaly
G6PD
what anemia has these manifestations?
Pruritis
Facial flushing
Splenomegaly
Vison problems
Weight loss
Nose bleed
Bleeding gums
Hypertension
thromboembolism
Polycythemia
WHAT FOOD CONTAINS IRON?
BEATS
BEANS; LIMA, LAGUNES
CLAMS
DATES
DARK GREEN VEGETABLES
DRIED NUTS
ENRICHED AND WHOLE GRAIN CEREALS
FORTIFIED BREADS AND CERIALS
MEAT
Heart
Liver
OYSTERS
SPINIACH
WHAT FOOD CONTAINS VITAMIN B 12
MEAT
EGGS
DAIRY PRODUCTS
SEAFOOD
WHAT FOOD CONTAINS FOLIC ACID
DARK GREEN VEGETABLES
DRIED BEANS, LEGUMES
FORTIFIED CERIAL
NUTS
BRAN
YEAST
labs to confirm anemia
Woman
Hematocrit
Hemoglobin
Hematocrit= 36%-48%
Hemoglobin= 11.7-15.5
labs to confirm anemia
Men
Hematocrit
Hemoglobin
Hematocrit= 42%-52%
Hemoglobin 14-17.3
what anemia has these manifestations?
Dietary sources of folate/ folic acid
Immediately report any clinical manifestations of fatigue, shortness of breath, dizziness, and confusion
Prenatal teaching
Need for supplementation
…
what anemia has this epidemiology?
Inadequate dietary intake
folic acid
what anemia has this epidemiology?
Develops due to
- bone marrow depression or damage or damage
- Acquired secondary to infetions like hepatitis & HIV
- High dose radiation (chemotherapy)
- Inherited bone marrow dysfunction
aplastic anemia
what anemia has this Management/Treatment
Blood transfusion- primary treatment
Bone marrow transplant from an HLA- matched sibling doner
Stimulating bone marrow production with neupogen,epogen
Over 60yrs immunosuppressive therapy is preferred
aplastic anemia
what anemia has these complications?
70% mortality rate
Hemorrhage & infection due to decreased platelets and WBC
Risk of GVD due to bone marrow transplant
aplastic anemia
what anemia has this PERFERED treatment
Bone Marrow Transplant is the PERFERD treatment
From a HLA-matching doner
aplastic anemia
what anemia has this diagnosis?
Heinz bodys blood smear
(Accumulation of deragated Hbg in RBCs)
G6PD
what anemia has this epidemiology?
Occurs in response to the body’s hypoxic state
Occurs from high altitudes and heavy smoke
WBC/platelet counts remain normal in the presence of the increased RBC production
secondary polycythemia vera
whiach anmeia has this medical managment?
Reduce hyperviscosity and prevent hemorrhage
Therapeutic phlebotomy to remove blood and reduce viscosity
polycythemia vera
what is the purpose of radiation in polycythemia vera?
to suppress bone marrow production
which anemia has this management?
Obtain routine CBCs
Increase fluid intake
Ensure adequate rest
Elevate lower extremities when sitting
Modify cardiovascular risk factors
polycythemia vera
what can the treatment of therapeutic phlebotomy cause?
iron deficiency
which anemia has decreased production of plates by the bone marrow increased platelet destruction ?
Thrombocytopenia
which anemia has these manifestations?
Ecchymosis
Brusing
Petechiae
Bleeding from nose, gums, GI tract, brain
Thrombocytopenia
which anemia has these complications?
Risk of hemorage
Spontanious bleeding
Thrombocytopenia
which anemia has this action
mplement bleeding precautions
Minimize blood loss from lacerations or venepunture
Avoid intramuscular injections
Avoid rectal temperatures, enemas, suppositories, douches
Provide a safe nvironment
Unse minimal inflation when assesing blood presure
Minimize blood draws
Thrombocytopenia
what anemia has this etiology
Group of bleeding disorders in which, although thrombocytopenia may be present, clotting factors VIII and IX are inadaquate.
hemophilia
what anemia has this manifestations?
Spontanious bleeding
Bleeding in muscles and joints
…
What happens to the older client’s PTT, RBCs as they age?
Bonemarrow ages and fewer blood cells are produced
of RBC, Hgb, Hct levels are reduced wich contributes to fatgue
Body water decreases= less fluids in the blood stream with decreased fluid volume lower levels of plasma proteins
Female Values
RBC Hematocrit Hemoglobin WBC Neutrophils
RBC= 3.61 - 5.11
Hematocrit= 36-48%
Hemoglobin= 11.7-15.5
WBC
Neutrophils
Male Values
RBC Hematocrit Hemoglobin WBC Neutrophils
RBC= 4.21-5.81
Hematocrit= 42-52%
Hemoglobin= 14-17.3
WBC= 4.5-11.1 (4,500-11,000)
Neutrophils= 59%, bands 3%, segs 56%
What evaluates the effectiveness of Warfarin (coumadin)
PT/INR
What are the ranges of
PT
INR
PT= 10-13 seconds
INR=
What does aPTT monitor?
it monitors the response to thrombin inhibitor therapy
Where is folic acid absorbed
Jejunum
What is a coenzyme in the DNA Synthesis & RBC
Vit b 12
What anemia has this as a diagnostic test
Serum ferrin levels
IDA
Where is Iron absorbed
Duodenum
What is necessary for all maturation and replication of cells
fOlic acid
how does unstable angina present its self?
may present with nonspecific or transient ST segmant depresions or elevations
what does a ST segment depression indicate?
ischema
what does a ST segment elevation indicate?
injury
what does a Q wave idicate?
its a diagnostic for MI
Normal value for
choleterol
less than 200 mg
Normal value for
low density lipopanels
less than 100
Normal value for
highdensity lipoprotiens
grater than 40-60 mg
Normal value for
triglycerides
less than 150 mg
Normal value for
glucose
65-99
Normal value for
homocysteine
4.4-10.8 mm
Normal value for
platelets
150,000-400,000
Normal value for
fibrinogen levels
200-400mg
Normal value for
prothrombin levels PT
10-13 seconds
Normal value for
partial thromboplastin PTT
25-23 seconds
Normal value for
international normalized ration INR
more than 2.0
Normal value for
ck-mb
0-3 ng
Normal value for
troponin
less than 0.4ng
Normal value for
myoglobin
0-85 ng
Normal value for
brain natriuretic peptide BNP
less than 100pg
what are
lisinopril (Zestril),
losartan (Cozaar)
ACE inhibitors
what are
nifedipine (Adalat, Procardia),
Calcium channel Blockers
what are
atorvastatin (Lipitor),
simvastatin (Zocor)
statins,
what drug is
reduce total cholesterol when used for an extended period. Statins reduce cholesterol synthesis in the liver and increase clearance of LDL from the blood.
This group of medications is contraindicated in patients with active liver disease or during pregnancy because of the possibility of causing muscle myopathies and marked decreases in liver function.
Statins
Examples:
atorvastatin (Lipitor),
simvastatin (Zocor)
what drug is
Used when patients cannot tolerate beta blockers or in patients with HF Lowers blood pressure and increases blood flow through the coronaries Also prevents coronary artery spasms in Prinzmetal’s/variant angina
Calcium channel blockers
Examples:
nifedipine (Adalat, Procardia),
what drug is
Reduces blood pressure, which decreases workload and oxygen demands Particularly beneficial in patient with HTN, diabetes, renal disease, and heart failure
ACE inhibitors and ARBs- after load
Examples:
lisinopril (Zestril),
losartan (Cozaar)
what drug
control sympatheric nervous system responce. help with work load.
beta blockers
what drug
dioxin
aldosterone antagonist diuretics- aldectone-not for renal -hyperkalemia-
lupe diaretics- lasiks- hypokelemia
perosomide
preload stretch of the heart after diastole
ace inhibitors- end in prill- dry cough
angiotipten receptor blockers ARB-
vasodilators-varsartan
vasiodialator. isophril
calcium chanel blockers
after load- resistance with in the vasculature
what looks at streching of the heart in hart faiulure
BNP
what kind of angina is
Chest pain or discomfort associated with physical activity
Liked to fixed plaque formation as is predictable
Symptoms alleviated with rest/ medications
Nitrate= nitroglycerin, dilate the artery
stable angina
what kind of angina
Chest pain that occurs at rest
Is the initial phase of Acute coronary syndrome (ACS)
Caused by acute decrees in blood flow through the coronaries to the myocardial tissue.
Precursor to MI
unstable angina
what medications serve this disease?
Nitrates- vasodilators
Nitroglycerin (tridil, nitrostat) = dilate the coronary arteries, improving oxygen-rich blood flow to the heart
Can be given to reduce afterload
Asprine
Morphine
Betablockers/calcium channel blockers
Satin medicaton- reduce cholesterol and plaque
angina
what kind of disease has this managment?
Stop and rest
Nitroglycerin tabs
Put under tongue
Do not exceed more than 3 doses 5 minutes apart
angina
what kind of disease has this description?
variation of unstable angina
Blockage caused by coronary artery spasm not plaque formation
prinzmetal’s angina
what disease is this?
Plaque within the lumen of the vessels, is the principal cause of obstruction to blood flow
begins with an injury to the endothelium that causes an inflammatory response
atherosclerosis
what disease has this teaching SATA
Medication regimen
Angina management
Bleeding precautions
Risk factor reduction
When to call emergency services
Encourage cardiac rehabilitation
CAD
what disease has this managment/
Administer oxygento keep saturation grater than 93%
Obtain ECG with the occurance of chest pain
Administer nitroglycern as ordered
Administer asprin as ordered
Administer morphine as ordered if nitroglycerin dos not relieve pain
Administer beta blockers/ calcium blokers
CAD
what disease has this risk factor?
Modifiable
Non modifiable
Higher in Caucasian men
Hispanic woman
Posmenopausal woman
CAD
what disease has this purpose
Supplemental oxygen optimizes oxygen delivery to the myocardium
Cardiac dysrhytmias, especialy tachycardia, and anxiety increse myocardial oxygen consuption
CAD
what deasease has this teaching?
Medication regimen
Angina management
If angina occurs stop activity. Take nitroglyceryn tabs. Do not exceed 3 doses 5 min apat.
Bleeding precautions if on anticoagulants
Risk factor reduction strategies: physical activity, blood pressure management, healthy diet/weight loss, smoking cessation, decreased alcohol consumption, control of glucose
When to call providers or emergency services
Encourage participation in cardiac rehabilitation for ACS patients after PCI or CABG.
CAD
what kind of risk are these?
Cigarette smoking
High total cholesterol, high LDL level, low HDL levels, and high triglycerides
Hypertension
Diabetes
Obesity, particularly central obesity
Sedentary lifestyle/physical inactivity
Stress
excessive alcohol consumption
modifiable
what kind of risk are these?
Gender
Race
Age older than 45 for men
Genetics/family history
Being postmenopausal
non modifiable
what drug is this?
Losartan (cozaar)
Reduces blood presure, wich decresed work load and oxygen demands
Particularly benificial in patient with HTN, diabetes, renal disease and heart failure
ACE inhibitors
what drug is this?
Nifedipine (adalt,procardia)
Amlodipine (norvasc)
Used when patient cannot tolorate beta blockers or in patietns with HF
Lowers blood presure and increased blood flow through the coronaies
Also prevents coronary artery spasims in prinzmetal’s variant angina
Clacium channel blockers
what drug is this?
Atrovanstain (lipitor)
Simvanstain (zocor)
Reduce total cholesterol when used for an extended epriod of time
They reduce cholesterol synthesis in the liver and increse clearance of LDL from blood
Statins
what disease has this teaching?
green leafy vegetables contain Vitamin K wich is the antidote for warfarin.
when achieving therapeutic range for the INR, a change in the consuption of green leafy vegetables will change the anticoagulation effects in the body
deep vain thrombosis
what medication had this as a goal?
before the annitiation, it is drawn and then repeated every 4-6 hrs to monitor therapy.
The therapeutic goal is 1.5-2.5 tomes the normal value, or 40 to 90 seconds
id the aditional medication is less than designated therapeutic level, and additional bolus may be given along with an increase in the rate of inusion
herapin therapy.
therapeutic goal of aPTT
what disease has this epidimology? SATA
65 years or older
African american
Overweight
The development of
CAD
Hypertension
Diabetes millitus
Metabolic syndrome
Obesity
Smoking high sodium diatery intake
Heart failure
what disease has this epidimology?
Heart is unable to pump effectively
Heart failure
what disease is
Progressive disease charecterised by myocardial cell dysfunction, resulting in th eability of the heart to pump enough cardiac output to meat the demands of the body
S3 sound means heart failure is getting worse
heart failure
CBC
Serum electrolytes, urine analysis, glucose level, fasting lipid profile, liver function testing, renal function testing
Cardiac biomarkers
heart failure
what are these called?
Troponin I/T- used to rule out acute ischemic event
BNP, N-terminal, are increased because of overstretching of the heart
cardiac biomarkers
what disease has this medication?
Beta blockers
-Used to control the sympathetic nervous system in hf to decrees cardiac workload
Aldosterone antagonist diuretics
-Decrease preload in patients with fluid retention
A C E inhibitors
-Used to control RAAS compensatory response and reduce after load
Calcium channel blockers
-Should be avoided
Digoxin
-Used to increase cardiac contractability and reduce heart rate
heart failure
what disease has this managment?
Symptom monitoring
Medication adherence
Lifestyle changes
Daily weight taken to monitor fluid retention
Sodium restricted diet
heart disease
what disease has these actions?
Oxygen therapy
Elevate head of bed
Administer medication as ordered
Fluid and sodium restriction
heart disease
what diease has these manifestations?
- Sudden onsent of symptoms that require immidiate attention
- Stable with treatment and management
Acute heart failure
Chronic heart failure
in what side of the heart does biventricular failure occure?
both sides
in what side does this back flow of blood cause
Shortness of breath or dyspnea or orthopnea
Crackles on auscultation
Pale color, weak pulses, cool temperature in extremities
Fatigue, weakness
left
in what side does this back flow of blood cause
Jugular vein distention
Dependent edema
Hepatomegaly
ascites
right
what desease has this teaching?
- no smoking of cigarrettes or other tobacco products
- maintain normal body weight
Excesise for at least 150 min with moderate intensity activity, or 75 min of vigorus- intensity activity or a combination per week
Eat a healthy diet that follows the curret american heart assosiation recommendations
Mailtain cholesterol levels less than 200mg/dl
Keep BP less than 120/79
Keep fasting glucose less than 100mg/dL
Mayo cardinal infraction
what are the AHA SIMPLE 7
- no smoking of
- maintain weight
Excesise 150-70 min per week
Eat a healthy diet that follows the curret american heart assosiation recommendations
Mailtain cholesterol levels less than 200mg/dl
Keep BP less than 120/79
Keep fasting glucose less than 100mg/dL
what disease has this list of medications?
MONA
Morphine
Oxygen
Nitriate
Asprin
Mayocardial infarction
what disease has this medication?
Oxygen- pation with less than 90% SPo
Sublingual nitroglycerine (SL)-dialate coronary arteries, if in 3 doses it does not work you must then start and IV nitroglycerine
Asprin- prevent blood clots
Morphine sulfate- for pain
Additional medication;
- Beta blockers would not be used in a patient with right coronary MI
- Herapin- to prevent clot formation
mayocardial infraction
what disease has this medication?
IV nitroglycerin
Morphine sulfate
β-adrenergic blockers
Angiotensin-converting enzyme inhibitors
Antidysrhythmia drugs
Cholesterol-lowering drugs
Stool softeners
mayocadial infraction
what disease has this medication and what is this medication?
protiens expresed in the heart- marker of cadiac damage. Can stay elevated form 4hrs to 10 days
Troponin T/I-
what disease has this medication and what is this medication?
general marker of cellular injury, it asses muscle damage, 3-36 hrs
Creatine kinase (CK)
what disease has this medication and what is this medication?
isoenzyme marker specific to cardiac tissue- asses mayocardial damage
CK-MB-
what disease has this characteristics?
No elevation in cardiac markers
Maypresent with nonspecific or transient ST segment depresions or elevations
Unstable angina
what disease has this characteristics?
ST depresions (0.5mm at least) or T wave inversions (1.0) mm at least) without Q waves in 2 contiguous leads with prominent R waves or R/S ratio>1
Non-ST Elevation Myocardial Infraction
what disease has this characteristics?
Elevated cardiac markers
ST elevations
ST Elevation Myocardial Infraction
what blood pressure is
systolic Less than 120 mm Hg
diastolic and less than 80 mm Hg
normal
what blood pressure is
systolic 120–129 mm Hg
diastolic and less than 80 mm Hg
elevated
what blood pressure is
systolic 130–139 mm Hg
diastolic or 80–89 mm Hg
stage 1 hypertensive
what blood pressure is
140 mm Hg or higher
or 90 mm Hg or higher
stage 2 hypertensive
what blood pressure is
systolic Higher than 180 mm Hg
diastolic
and/or higher than 120 mm Hg
hypertensive crisis
what kind of diet has this food
grain and grain prducs fruits vegetables low fat non dary foods lean meats, fish poultry nuts,seeds, legumes
hypertensive dash diet
what disease has a bruits sound?
hypertension
what high levels indicate an increased risk for atherosclerosis.
target level is is less than 100
LDL
what low levels
indicate an increased risk for atherosclerosis.
HDL
