Vascular disorder Flashcards
what is blood pressure?
the product of CO x PVR
CO=SV x HR
what is HTN?
BP = > 120/80
_____ HTN is not caused by a pre-existing condition _______ is caused by a condition
essential htn= no pre condition
secondary= co morbitiy
who is at risk for essential HTN
- genetics
- african americans
- hyperlipidemia
- overweight or obese
- alcoholism
-stress
who is at risk for secondary hypertension
- kidney dx
- cushing’s dx
- coarctation of the aorta
- brain tumor
- encephalitis
- pregnancy
- medications (HRT, steroids)
- pheochromocytoma
pathophysiology of hypertension
continuous BP elevation causes Medial hyperplasia (thickening) of the arterioles; increase thickening causes decreased perfusion = end organ damage (heart, brain, kidneys)
abnormal organ system complications from hypertension
- MI, CVA, PVD, RF
what type of hypertension is indicated by
- managed outpatient
- managed with oral medications
- acute or chronic
hypertension urgency
a patient with symptoms of end organ damage like MI, ARF/ARI, chest pain, stroke this is most likely what type of hypertension
hypertension emergency
what will the nurse expect for a patient who is in HTN emergency
- expect ICU admission
- IV medications
- tx evolving symptoms
Long term Heart failure treatment includes
- BNP MONITORING
- daily weight
- low fat, low Na diet (2g)
- diuretics, ACE, ARB, CCB, BB, maybe Digoxin
arteriosclerosis
-> thickening/hardening of arterial walls
what is atherosclerosis?
thickening of the arterial walls by plaque formation on vessel walls that obstructs normal blood flow
who is at risk for atherosclerosis
low HDL & high LDL
genetics
AA or hispanics
obesity
stress
smoking
which type of atherosclerosis is less likely to rupture why?
stable is less likely to rupture because the plaque builds up over time, if it does then thrombosis causes inadequate perfusion.
assessment for atherosclerosis
- BP in both arms
- palpate all major pulses
- temperature of extremities
- bilateral cap refill
- bruits
peripheral arterial disease is the _________ type of PVD, and is a ________ result of systemic _______
- most common type
- chronic result
- systemic atherosclerosis
manifestations of PAD
- hair loss on lower legs/ foot
- dry, scaly, dusky, pale , mottled
- thickened toenails
- cold, cyanotic, or darkened severed PAD
- clean approximated edges not draining ulcers
- pallor with leg elevation
where can you assess for color changes in darker-skinned patients
soles of the feet, palms, nails bed – whole foot might turn a grayish color
inflow obstruction is ________ to the aorta and __________ arteries, but above _________ arteries.
inflow obstruction is distal to the aorta and common internal external iliac arteries and above the inguinal ligament arteries.
outflow obstruction includes which arteries
arteries distal to the superficial femoral artery:
femoral, popliteal, tibial
signs to recognize outflow PAD
- burning/ cramping in legs, feet, toes, ankles, calves
pain is coming from ischemia (no o2) to the tissues
STAGES OF PAD
I- asymptomatic
II claudication
III rest pain
IV gangrene/necrosis
Stage II : Claudication
claudication = ischemia pain when walking
- relieved at rest
if a dependent position like hanging foot off bed relieves the pain of PAD while at rest this is stage
stage III
