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Test 1 -Adult Health 1 - Cher > Vascular Disease > Flashcards

Vascular Disease Flashcards

1
Q

Prevention of HTN

A
  • Limit sodium to 2400 mg/ day (1500 is better)
  • Diet of fruits, veggies and whole grains
  • limit sweets
  • low fat dairy products, poultry, fish, legumes
  • physical activity 3-4 times a week for 40 min
  • limit alcohol consumption
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2
Q

Management of HTN

A

Lifestyle modifications:

  • Diet
  • Low sodium, low fat diet.
  • Lower cholesterol levels to
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3
Q

Medication for HTN

A
  1. Diuretics
    -Thiazide diuretics first choice for uncomplicated HTN.
  2. Calcium channel blockers
    -Verapamil, amlodipine
  3. ACE inhibitors
    -captopril, lisinopril, enalapril
  4. Beta-adrenergic blockers
    atenolol, metoprolol
  5. Angiotensin II receptor antagonists (ARB)
    -valsartan, losartan
  6. Central alpha agonists
    -clonidine
  7. Alpha-adrenergic agonists
    -prazosin, terazosin
  8. Aldosterone receptor antagonists
    -Eplerenone
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4
Q

Education for HTN

A 
Teach Patient to:
-Monitoring BP at home
---Goal of 140/90 or lower
---Keep a record and bring to visits with provider
-Watch for Warning signs:
---MI, CVA, PAD, Kidney disease
Take Medications
Teach What meds are for and the side effects
Teach Adherence to medication regimen
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5
Q

Symptoms of Peripheral Artery Disease

A

-Intermittent claudication
pain at rest, numbness and burning.
-Lower back or buttocks discomfort if inflow
-burning or cramping in calves, ankles feet or toes if outflow
-hair loss and dry scaly, pale or mottled skin, thick toenails

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6
Q

Treatment of Peripheral Artery Disease

A

Non-surgical:
exercise, positioning, promoting vasodilation, drug therapy, and invasive nonsurgical procedures to increase arterial flow in affected leg.

Surgical:
Arterial revascularization
Surgical bypassing occlusions

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7
Q

Education for Peripheral Artery Disease

A

Avoid crossing legs and avoid restrictive clothing which interfere with blood flow.
Check Feet daily for color or other changes.

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8
Q

VTE symptoms

A
  • calf or groin tenderness
  • pain and sudden onset of unilateral swelling of the leg
  • pain in the calf on dorsiflexion of the foot
  • palpate for induration, redness and warmth
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9
Q

Initial Treatment of VTE

A

-first focus is preventing complications such as PE, prevent further thrombus formation and prevent the one you have enlarging

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10
Q

Management of VTE

A
  • drug therapy and rest

- Anticoagulants

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11
Q

What is Peripheral Artery Disease

A

Alters natural flow of blood through arteries and veins of peripheral circulation

Result of systemic atherosclerosis

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12
Q

What is Peripheral Venous Disease

A

-VTE basically

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13
Q

What is HTN

A

High blood pressure
150/90 if you are over 60
140/90 if you are under 60
This excludes pts w diabetes mellitus.

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14
Q

What is buergers disease

A

-thromboanginitis obliterans—relatively uncommon occlusive disease of arteries and veins in distal portion of upper and lower extremities

Often identified with tobacco smoking
Familial or genetic predisposition and autoimmune etiologic factors also possible

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15
Q

What are symptoms of buergers disease

A 
-Claudication
Aching pain
Sensitivity to cold
Diminished pulses
Cool, red, or cyanotic extremities
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16
Q

What is management of buergers disease

A

-Treatment focuses on prevention of disease progression
abstinence of tobacco in all forms
Avoid exposure to cold
Medications for vasodilation

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17
Q

What is aortic disease?

A

-

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18
Q

Abdominal aneurysm symptoms

A

-

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19
Q

Thoracic Aneurysm symptoms

A

–

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20
Q

Repair of aneurysm

A

-

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21
Q

Management of Aneurysm

A

-

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22
Q

What is raynaud’s phenomenon?

A

-Caused by vasospasm of arterioles and arteries of upper and lower extremities

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23
Q

What are symptoms of raynauds phenomenon?

A

-

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24
Q

How is Raynaud’s phenomenon managed?

A

-Drug therapy—nifedipine, cyclandelate, phenoxybenzamine

Lumbar sympathectomy

Restrict cold exposure

Reinforce patient education

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25
Q

What is VTE?

A 
-Thrombus—a blood clot
Thrombophlebitis
Deep vein thrombosis (DVT)
Pulmonary embolism
Virchow’s triad
-1.Stasis of blood flow
-2.Endothelial injury
-3,Hypercoagulability
Phlebitis
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26
Q

What is the etiology of VTE?

A

-

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27
Q

How is VTE managed?

A 
-Early ambulation
Adequate hydration
Compression stockings
Intermittent pneumatic compression (SCDs)
Venous flexus foot pump
Anticoagulation
28
Q

Severe Peripheral artery disease symptoms

A
  • extremity is cold and gray-blue or darkened;
  • pallor may occur with extremity elevation; -dependent rubor;
  • and/or muscle atrophy
29
Q

Statin education

A
  • take it at night

- see physician regularly

30
Q

Drugs for arteriosclerosis

A

lovastatin
simvastatin

gemfibrozil

ezetimibe

31
Q

What to monitor with statins

A

liver enzymes

32
Q

Diabetes pt normal BP

A

140/90

33
Q

Go read slide 12 on the doc

A

Go read slide 12 on the doc

34
Q

1st step of medication at the beginning with HTN =

A

thiazide diuretic

35
Q

what is “end organ damage”

A

High BP for so long it damages other organs

36
Q

Be able to asociate the name with the class of these drugs

A 
Diuretics
Thiazide diuretics first choice for uncomplicated HTN
Calcium channel blockers
Verapamil, amlodipine
ACE inhibitors
captopril, lisinopril, enalapril
Beta-adrenergic blockers
atenolol, metoprolol, 
Renin inhibitors
aliskiren
Angiotensin II receptor antagonists
valsartan, losartan
Central alpha agonists
clonidine
Alpha-adrenergic agonists
prazosin, terazosin
Aldosterone receptor antagonists
Eplerenone
37
Q

In crisis how quickly do we lower BP?

A

We titrate so it drops slowly
Reduce by no more than 25% in first 2-6 hours
If stroke lower slowly 15-20%

38
Q

Know what nitrates do:

A

-causes vasodilation (widening of blood vessels) by donation of nitric oxide (NO), and is mostly used for the treatment and prevention of angina pectoris.

39
Q

Know nursing interventions for nitrates/ nitroprusside drip

A
  • Tell them to stay in bed
  • Teach them to call if they get up
  • they can have headaches
  • check BP q15 if no hemdynamic
  • document the numbers
40
Q

Know nicardipine drip and why we pick it

A

-nicardipine is neuroprotective

41
Q

Ankle brachial index (ABI)

A

take the blood pressure in the brachial area and the ankle

42
Q

compartment syndrome

A

A painful and dangerous condition caused by pressure buildup from internal bleeding or swelling of tissues.

43
Q

6 P’s of arterial insufficiency

A 
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia (coolness)
44
Q

aortic aneurysm (fusiform)

A

protruding on both sides

45
Q

aortic aneurysm (sacular)

A

one side

46
Q

false aneurysm

A

due to trauma or vessel injury

47
Q

true aneurysm

A

weakened from congenital problems

48
Q

aneurysm symptoms

A

limb ischemia, diminished or absent pulses, cool to cold skin, pain

49
Q

abdominal aortic aneurysm

A

usually steady with a gnawing quality, unaffected by movement, may last for hours or days

Pain in abdomen, flank, back

bruit

50
Q

rupture of AAA

signs of hypovolemic shock

A

-Sudden ripping, tearing, stabbing abdominal or back pain and legs.

-Diaphoresis, faintness, N&V, apprehension
Hypotension, tachycardia

51
Q

symptoms of thoracic A

A 
THINK HOARSENESS
-coughing and wheezing
Horner's syndrome (drooping eyelid, constricted pupil and dry skin on one side of the face)
Hoarse voice
Difficulty swallowing

Back pain

Mass may be visible above suprasternal notch

52
Q

rupture of thoracic A

A

-Sudden excruciating back or chest pain symptomatic of thoracic rupture. Pain can travel into arms, abdomen and lower back

53
Q

Management of Raynaud’s disease

A

Drug therapy
Restrict cold exposure
Reinforce patient edu

54
Q

what is virchow’s triad

A
  • 1.Stasis of blood flow
  • 2.Endothelial injury
  • 3,Hypercoagulability
55
Q

Who is at risk for VTE?

A 
Hip surgery
Total knee replacement
Open prostate surgery
Ulcerative colitis
Heart failure
Cancer
Oral contraceptives
Immobility
Obesity
Age > 60
56
Q

D Dimer

A

a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two crosslinked D fragments of the fibrin protein.

57
Q

VTE nonsurgical management

A

Unfractionated heparin
Low–molecular weight heparin
Warfarin
Thrombolytics

58
Q

unfractionated heparin drip

A

titrate based on labs

-ptt

59
Q

understand overlap of heparin drip and warfarin

A

DVT - for immediate coagulation start heparin

Warfarin takes longer (if i start warfarin today i wont go home tomorrow)
2-5 days = theraputic

60
Q

VTE pathology

A

When a thrombus develops, inflammation occurs around the clot. thickening the vein wall and leading to the formation of an embolus (pulmonary embolus being the most common).

61
Q

unfractionated heparin therapy

A

inhibition of fibrin formation

for pts with a confirmed dx of clot

62
Q

management of thoracic aneurysm

A

non-surgical:
Monitor aneurysm growth

Maintain BP at normal level to decrease risk of rupture

63
Q

aortic dissection:

  • caused by
  • creates
  • pain described as
A

Caused by: sudden tear in aortic intima, opening way for blood to enter aortic wall

Creates a false lumen

Pain described as tearing, ripping, stabbing

64
Q

What is Raynaud’s

A

Caused by vasospasm of arterioles and arteries of upper and lower extremities

65
Q

drugs for raynauds

A

nifedipine, cyclandelate, phenoxybenzamine

66
Q

saccular aortic aneurysm

A

an outpouching only affecting a portion of the artery

Test 1 -Adult Health 1 - Cher (8 decks)

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