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Medical Surgical II 229 > Week 07 > Flashcards

Week 07 Flashcards

Cardiac Dysfunction/ CVAD

1
Q

what is a central venous access device (CVAD) used for and where is it inserted

A
  • administration of medications, IV fluids, and blood products
  • inserted into large veins
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2
Q

where does the tip of the CVAD sit

A

in the superior or inferior vena cava

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3
Q

what veins are used for CVAD

A
  • internal jugular vein (IJ)
  • subclavian vein
  • femoral vein
  • bronchial vein
  • planted under the skin
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4
Q

after insertion of the CVAD it is very imperative that the location of the tip of the catheter be verified/ confirmed by what
what is the only exception to this rule

A
  • chest x-ray
  • if the CVAD was placed under fluoroscopy or using 3CG technology with PICC lines
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5
Q

depending on the type, how long may central line catheters remain in place for

A

several weeks to months

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6
Q

avoid flushing or giving medications with a syringe smaller than

A

10 mL

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7
Q

why should a 10 mL syringe be used

A

smaller syringes may result in too much pressure and rupture the catheter

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8
Q

who are some candidates for a CVAD

A

infection, dialysis, TPN

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9
Q

who are not candidates for a CVAD

A

IV drug users

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10
Q

how do you make sure line is not to short or to long

A

x-ray

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11
Q

what are indications for a CVAD

A
  • TPN
  • chemotherapy
  • vesicant/ irritating solutions
  • blood products
  • antibiotics
  • limited peripheral access
  • central venous pressure (CVP) monitoring
  • hemodialysis
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12
Q

what are single lumen CVADS used for

A

TPN

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13
Q

why can single lumen CVAD not be used to transfuse blood

A

blood cells tend to adhere to tubing, impeding the flow of the TPN

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14
Q

multi lumen CVAD can have up to how many lumens

A

5

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15
Q

each lumen has a what associated with it

A

port

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16
Q

what are the types of CVAD catheters

A
  • short peripheral
  • midline
  • peripherally inserted central (PICC)
  • non-tunneled
  • tunneled
  • percutaneous
  • central venous (CVC)
  • hemodialysis
  • implanted port
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17
Q

where are short peripheral catheters placed

A
  • superficial veins
  • forearm veins
  • jugular if situation is emergent
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18
Q

when should short peripheral catheters be assessed
what about vulnerable patients

A
  • every 2 hours
  • every 1-2 hours
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19
Q

what size IV needles is best practice

A

16 G and 18 G

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20
Q

where are midline catheters inserted and what are they used for

A
  • through the vein in the upper arm
  • hydration and drug therapy
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21
Q

what is the duration of a midline catheter

A

longer than 6 days up to 14 day

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22
Q

should you use a midline catheter to draw blood

A

no

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23
Q

*where should peripherally inserted central catheters (PICC) be inserted
which is preferred

A

basilic vein (preferred) or cephalic vein through the arm

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24
Q

where does the end of the PICC catheter rest

A

in the superior vena cava just above the right atrium (cavo atrial junction)

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25
Q
  • how is PICC placement verified
  • whats the golden standard and what rhythm does the patients heart have to be in
A
  • CXR
  • golden standard is 3CG technology if the patient is in normal sinus rhythm (NSR)
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26
Q

what are considerations for a PICC line

A
  • patients requiring IV treatments at home
  • no BP, blood draws, or injections in extremity with PICC
  • greatest risk to patient is DVT
  • indicated for IV fluids, medications, blood products, blood sampling
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27
Q

what can happen with drawing blood from a PICC line

A

DVT and infection

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28
Q

what can happen to PICC line if blood pressure is taken in that arm

A

dislodge or break line

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29
Q

where are non tunneling central venous catheters inserted

A

through the subclavian vein in the upper chest or jugular veins in the neck, can insert in femoral vein as well

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30
Q

with femoral vein inserted non tunneling central venous catheters what is the greatest risk

A

infection

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31
Q

where does the tip of a non tunneling central venous catheter reside

A

superior vena cava

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32
Q

what is the duration of use for a non tunneling central venous catheter

A

short term use

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33
Q

where does a portion of a tunneled central venous catheter lie

A

in subcutaneous tunnel

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34
Q

describe a tunneled central venous catheter tube

A

soft, hallow, tube made of silicone

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35
Q

what does a tunneled central venous catheter have to help reduce infection

A

cuff of antibiotic containing material

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36
Q

what are other names for tunneled central venous catheters depending on location

A

Broviac, Hickman, Groshongs

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37
Q

what is special about a Groshongs catheter

A

it can be tunneled or non tunneled

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38
Q

what environment are tunneled central venous catheters inserted

A

OR

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39
Q

what is a implanted port (port-a-cath)

A

placed under the skin without any part exiting the skin, may be single or double injection port

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40
Q

with a implanted port what does the catheter connect to

A

the port

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41
Q

with a implanted port what does the reservoir connect to
which one

A
  • a central vein
  • superior vena cava typically
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42
Q

what are implanted ports used for

A

administering medications, IV fluids, chemotherapy, draw blood

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43
Q

what do you use to ALWAYS assess a implanted port

A

non-coring, non-barred Huber needle

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44
Q

how long may a implanted port be accessed with the same needle,
what about when not accessed

A
  • 7 days
  • monthly flushing is sufficient
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45
Q

what should you do after accessing and prior to each use for a implanted port

A
  • aspirate for blood return
  • flush with 10 mL NS
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46
Q

what should you do prior to de-accessing or removing the huber needle

A

lock with a heparin solution per hospital protocol or flush with normal saline

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47
Q

why do hemodialysis catheters have such large lines

A

they are pushing and pulling large volumes

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48
Q

are hemodialysis catheters tunneling or non tunneling

A

they can be either

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49
Q

what is the most common complications of a hemodialysis catheter

A

CLABSI and vein thrombosis

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50
Q

when should sterile dressing changes be done for hemodialysis catheters

A
  • every 48 hours
  • with dialysis treatments
  • when soiled
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51
Q

what are the common causes for a CLABSI (microorganism wise)

A
  • staphylococcus aureus
  • yeast
  • fungi
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52
Q

what should you monitor for with a CLABSI

A

fever, redness, swelling, drainage at site, pain, chills

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53
Q

how to prevent a CLABSI

A

proper technique, hand hygiene, dressing changes, assess necessity daily, notice early signs of infection

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54
Q

what is a pneumothorax r/t CVADs

A

ling collapsed due to needle puncturing the lung during insertion

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55
Q

CVAD pneumothorax interventions

A
  • immediate CXR
  • oxygen therapy
  • monitor condition
  • surgical intervention
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56
Q

what is thrombosis r/t CVADs

A

blood clots form around the catheter, potentially blocking blood flow

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57
Q

CVAD thrombosis interventions

A
  • anticoagulation therapy
  • catheter removal
  • thrombolytic therapy
  • mechanical thrombectomy
    -monitoring and follow up
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58
Q

what is catheter malposition

A

the catheter may be incorrectly positioned which can affect function

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59
Q

catheter malposition interventions

A
  • remove and reposition
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60
Q

what is mechanical complications r/t CVADs

A

catheter malfunction, central vein stenosis, thrombosis

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61
Q

mechanical complication interventions

A
  • reposition
  • replace
  • flush
  • thrombolytic
  • repair
  • securement devices
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62
Q

what is central vein stenosis

A

a narrowing of the large veins that carry blood from the arms, head, and chest back to the heart

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63
Q

*signs and symptoms of a central catheter infection

A

redness, swelling, pain, drainage, fever

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64
Q

*nursing interventions to prevent CLABSI

A
  • preform hand hygiene
  • proper sterile draping, sterile gloves, gown, and mask
  • prepare the insertion site with greater than 0.5% chlorhexidine and alcohol
  • scrub the access port with an appropriate antiseptic before each use
  • assess daily for the need for the CVAD
  • change huber administration set at least every 7 days, but no more than every 4 days
  • follow facility policy for the frequency of site care
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65
Q

*what should you prepare the insertion site with

A

greater than 0.5% chlorhexidine and alcohol

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66
Q

*when should you change the huber administration set

A

at least every 7 days but no more than every 4 days

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67
Q

*what should you assess daily for with CVADs

A

the need for them

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68
Q

what is best practice for central line insertion

A
  • patient assessment
  • hand hygiene
  • maximal barrier protection
  • site selection
  • skin antisepsis
  • ultrasund guidance
  • insertion technique
  • securement and dressing
  • daily review
  • documentation
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69
Q

*what are the 8 sterile dressing change steps in order

A
  1. prepare your work area
  2. hand hygiene
  3. wear protective gear
  4. remove the old dressing
  5. inspect the site
  6. clean the site
  7. apply a new dressing
  8. document the procedure
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70
Q

*what should you do/ gather for a sterile dressing change

A
  • clean and prepare your work area
  • gather all necessary supplies
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71
Q

*why should you measure the length of the catheter

A

to ensure it hasn’t moved

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72
Q

*what supplies are needed for a sterile dressing change

A
  • sterile gloves
  • clean gloves
  • mask
  • chlorohexidine or antiseptic solution
  • sterile gauze
  • transparent dressing
  • tape or securement device
  • sterile field drape
  • hand sanatizer
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73
Q

*steps for central line discontinuation

A
  • prepare the patient and environment
  • hand hygiene and protective gear
  • stop infusion
  • remove dressing and sutures
  • catheter removal
  • apply pressure to the dressing
  • monitor and document
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74
Q
  • what position should the patient be in for central line discontinuation and why
A
  • supine for easy access
  • prevent air embolism
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75
Q

*what is the Valsalva Maneuver and why is it important

A
  • hold breath and bear down
  • to prevent air from entering the blood stream
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76
Q

other than the Valsalva Maneuver what can the patient do

A

hum continuously

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77
Q

what should you do to achieve hemostasis when removing a central line catheter

A

immediately apply pressure to the site

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78
Q

what should be documented after removing a central line catheter

A

the condition of the site and any patient reactions

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79
Q

what are air embolism managements

A
  • close the tubing
  • *turn the patient on left side trendelenburg, with head down
  • check tubing for leaks
  • administer oxygen 100%
  • notify medical direction
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80
Q
  • what are signs and symptoms of a air embolism
A
  • A: anxiety- the patient may feel anxouis and restless
  • I: increased heart rate- tachycardia is common
  • R: respiratory distress- SOA or difficulty breathing
  • S: sudden chest pain- sharp, sudden chest pain
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81
Q

*what are complications of IV infusion
which 3 are the most common

A
  • infection, hematoma, air embolism
  • phlebitis, infiltration, extravasation
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82
Q

*infection symptoms of IV infusion

A
  • local: pain, warmth, edema, induration, malodorous drainage
  • systemic: fever, chills, malaise, elevated WBC
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83
Q

*IV complication: what is phlebitis

A

occurs when the cannula is too large for the vein or if it improperly secured

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84
Q

*IV complications of phlebitis

A

erythema, edema, warmth, pain, vein may be indurated, red streak that follows superficial vein

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85
Q

*IV complication: what is infiltration

A

when IV fluids or medications leak out of the vein and into the surrounding tissue

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86
Q

*IV complications of infiltration

A

swelling, damp site, cold to the touch, pain, slowed rate of IV infusion, fluid may leak from the IV site

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87
Q

*IV complication: what is extravastion

A

another type of infiltration, occur when a vesicant agent in the IV leaks into surrounding tissues and causes serious damage

88
Q

*IV complications of extravastion

A

pain, edema, burning, erythema, formation of blisters, necrotic tissue, slough, eschar

89
Q

*IV complication: what is hematoma

A

occurs when the IV angiocatheter passes through more than one wall of a vein or if pressure is not applied to the site where the catheter is not removed

90
Q

*IV complications of hematoma

A

swelling, pain, ecchymosis

91
Q

*IV complication: what is air embolism

A

occurs when air enters the venous system from the IV catheter and circulates

92
Q

*IV complications of air embolism

A

hypotension, tachycardia, difficulty breathing, cyanosis

93
Q

what is erythema

A

redness of the skin

94
Q

what is slough

A

soft, yellow or white, moist, stringy material composed of dead cells and debris that accumulates on the surface of a wound

95
Q

what is eschar

A

crusty, brown or black layer of dead tissue that forms over a wound or burn

96
Q

what is ecchymosis

97
Q

*what are interventions for infiltration and extravastion

A
  • stop infusion
  • discontinue IV
  • thoroughly assess
  • warm, moist or cool compress
  • restart IV in opposite arm
  • follow unit protocol
  • notify doctor
  • fill out drug report form
  • monitor closely
98
Q

what are ways to prevent IV complications

A
  • hand hygiene
  • monitor site every 2 hours minimum
  • careful vein selection
  • assess site for color, swelling, drainage, blood return
  • clean all injection ports prior to use
  • apply CHG caps to ports
  • make sure IV is current according to facility policy
  • when in doubt, change IV out
99
Q

what is a arrhythmia

A

irregular heartbeats caused by issues with the hearts electrical conduction system

100
Q

examples of arrhythmias

A
  • arterial fibrillation
  • ventricular tachycardia
  • ventricular bradycardia
101
Q

what is a heart block

A

occurs when the electrical signals are partially or completely blocked between the atria and ventricles, leading to a slower heart rate and reduced cardiac output

102
Q

what is long QT syndrome

A

a condition that affects the hearts electrical activity, leading to prolonged repolarization and increasing the risk of sudden cardiac arrest

103
Q

what is heart failure

A

a condition that occurs when the heart muscle is unable to pump blood effectively, leading the inadequate perfusion of tissues

104
Q

what is valvular heart disease

A

dysfunction of the heart valves that can impair blood flow through the heart, leading to reduced cardiac output and perfusion

105
Q

what are examples of valvular heart disease

A
  • stenosis
  • regurgitation
106
Q

what is cardiomyopathy

A

disease of the heart muscle that affects it ability to contract and pump blood, leading to heart failure and poor perfusion

107
Q

what is the function of the right atrium

A

receives deoxygenated blood

108
Q

what is the function of the right ventricle

A

pumps deoxygenated blood to the lungs via the pulmonary arteries

109
Q

what is the function of the left atrium

A

receives oxygenated blood from the lungs via the pulmonary veins

110
Q

what is the function of the left ventricle

A

pumps oxygenated blood through the aorta

111
Q

what are the three layers the heart is composed of

A

endocardium, myocardium, epicardium

112
Q

what layer is the endocardium

A

inner layer

113
Q

what layer is the myocardium and its function

A

middle layer, muscular and responsible for contractions

114
Q

what layer is the epicardium and its function

A

outer layer, protective

115
Q

*where is the tricuspid valve located and its function

A
  • between the right atrium
  • prevents back flow of blood into the right atrium
116
Q

*where is the mitral valve located and its function

A
  • between the left atrium and left ventricle
  • prevents back flow into the left atrium
117
Q

*where is the pulmonary valve located and its function

A
  • between the right ventricle and pulmonary artery
  • prevents back flow into the right ventricle
118
Q

*where is the aortic valve located and its function

A
  • between the left ventricle and aorta
  • prevents back flow of blood into the left ventricle
119
Q

what does arteries do

A

carry oxygenated blood away from the heart to body’s tissues

120
Q

what does veins do

A

returns deoxygenated blood back to the heart

121
Q

what does capillaries do

A

tiny blood vessels where oxygen, nutrients, and waste are exchanged

122
Q

*what is the function of the SA node

A

hearts natural pace maker, generates electrical impulse that initiates the heartbeat

123
Q

*where is the SA node located

A

located in the upper wall of the right atrium

124
Q
  • what is the function of the AV node
A

receives electrical impulses from the SA node

125
Q

*where is the AV node located

A

in the lower part of the right atrium near the septum

126
Q

*what is the bundle of HIS function

A

transmits electrical impulses from the AV node to the ventricles, splits into right and left bundle branches

127
Q

*where is the bundle of HIS located

A

throughout the ventricles

128
Q

*what does systole indicate and its action

A
  • contraction of the heart muscle
  • ejection of blood from the ventricles
129
Q

*what does diastole indicate and its action

A

-relaxation of the hearts muscle
- filling of the ventricles occurs

130
Q

*what is stroke volume

A

the amount of blood ejected by a ventricle in one contraction

131
Q

*what is cardiac output

A

the amount of blood pumped by each ventricle in one minute

132
Q

*what does a high systole number indicate

A

the heart is working harder

133
Q

*what happens when the heart fills with more blood during diastole

A

it contracts harder and pumps out more blood during systole

134
Q

*what system controls heartrate

A

the autonomic nervous system

135
Q

*what does increased work load of the heart lead to

A

increased oxygen demand

136
Q

*what is preload

A
  • stretching of the ventricles at the end of diastole
  • volume of blood in ventricles at end of diastole
  • the end of diastolic pressure
137
Q

*what is afterload

A
  • peripheral resistance against which the left ventricle must pump
  • resistance left ventricles must overcome to circulate blood
138
Q

*what can increase preload

A
  • hypervolemia
  • regurgitation of cardiac valves
  • heart failure
139
Q

*what can increase afterload

A
  • hypertension
  • vasoconstriction
140
Q

what does increased after afterload do to cardiac workload

A

increased cardiac workload

141
Q

*where is the left coronary artery (LCA) located and its function

A
  • runs down the front of the heart
  • supplies blood front to bottom of the left ventricle and front of the septum
142
Q

*where is the left circumflex (LCX) located and its function

A
  • circles the left side of the heart
  • supplies blood to the left atrium and the side/back of the left ventricle
143
Q

*where is the right coronary artery (RCA) function

A
  • supplies blood to the right atrium and right ventricle, bottom of both ventricles, back of the septum, and SV/AV nodes
144
Q
  • where is the posterior descending artery (PDA) located and its function
A
  • runs down the back of the heart
  • supplies the bottom of the left ventricle and back of the septum
145
Q

what is the location and function of the great cardiac vein

A

runs alongside the LAD artery and drains the front of the heart

146
Q

what is the location and function of the middle cardiac vein

A

runs alongside the PDA and drains the back of the heart

147
Q

what is the function of the small cardiac vein

A

drains the right atrium and right ventricle

148
Q

what is the location and function of the coronary sinus

A

a large vein on the hearts posterior surface that collects blood from the coronary veins and empties into the right atrium

149
Q

*what is blood pressure

A

the force of blood against the walls of the arteries

150
Q

*what does blood pressure indicate

A

the health of the cardiovascular system

151
Q

true or false: high cholesterol means you have a bad heart

152
Q

*what does a wide pulse pressure indicate

A

increased cardiovascular risk

153
Q

*what does a narrow pulse pressure indicate

A

poor cardiac output

154
Q

*what is systemic vascular resistance (SVR) and what is it a crucial factor in determining

A
  • the force opposing blood flow in the arteries and arterioles
  • blood pressure and cardiac output
155
Q

*what is mean arterial pressure (MAP)

A

the average pressure in the arteries

156
Q

*what number does MAP have to be greater than and why

A
  • 60, unless the kidneys are already bad, if not this will hurt them if it drops under
  • for organ perfusion
157
Q

short term mechanisms in blood pressure regulation

A
  • sympathetic nervous system (SNS)
  • parasympathetic nervous system (PNS)
  • baroreceptors
  • vascular endothelium
158
Q

what happens if short term mechanisms for blood pressure begin to fail

A

long term kicks in

159
Q

what are long term mechanisms in blood pressure regulation

A
  • the renal system
  • sodium retention
  • renin angiotensin
  • aldosterone system and endocrine system
  • epinephrine
  • beta 2 adrenergic receptors
160
Q

what does long term hypertension lead to

A

heart failure

161
Q

what are the four types of BP

A
  • primary
  • secondary
  • orthostatic
  • malignant
162
Q

*primary BP diagnosis

A

no specific cause for 90%-95% of all cases

163
Q

*primary BP risk factors

A
  • obesity
  • smoking
  • stress
  • family history
  • increased age
  • excessive sodium intake
164
Q

*primary BP management

A
  • regular exercise
  • smoking cessation
  • avoid drugs and alcohol
  • good sleep habits
  • heart healthy, low sodium diet
165
Q

*what is secondary BP

A

an underlying medical condition

166
Q

*secondary BP diagnosis

A

cause that can be identified and corrected

167
Q

*secondary BP risk factors

A
  • renal disease
  • primary aldosteronism
  • pheochromocytoma
  • cushing’s syndrome
  • medications
168
Q

*secondary BP management

A
  • thiazide diuretics
  • ACE inhibitors
  • beta blockers
  • angiotensin II
  • calcium channel blockers
  • renin inhibitors
169
Q

*what is orthostatic hypertension

A

significant elevation in BP with position changes

170
Q

*orthostatic BP diagnosis

A

increase in HR by 20 mmHg and decrease in SBP by 20 mmHg

171
Q

*orthostatic BP risk factors

A
  • advanced age
  • antihypertensives
  • cardiac failure
  • kidney disease
172
Q

*orthostatic hypertension management

A
  • increased sodium intake
  • compression stockings
  • getting up slowly
  • plenty of fluids
  • exercise
173
Q

*what is malignant BP

A

severe sudden elevation of BP that causes organ damage

174
Q

*malignant BP diagnosis

A

severe hypertension that rapidly progresses BP greater than 180/120

175
Q

*malignant BP risk factors

A
  • uncontrolled hypertension
  • pre-eclampsia
  • kidney/renal failure
  • RAS
  • glomerulonephritis
176
Q

*malignant BP management

A
  • IV nipride
  • target organ damage
  • requires hospitalization
  • head bleed
  • heart attack
  • renal failure
  • dissecting aneurysm
177
Q

*primary hypertension key aspects, think GENETICS

A
  • G: genetics
  • E: excessive salt intake
  • N: no identifiable cause
  • E: exercise lack
  • T: tobacco use
  • I: increased age
  • C: chronic stress
  • S: sodium sensitivity
178
Q

*orthostatic hypertension key aspects, think STANDUP

A
  • S: slow position changes to avoid sudden drop in BP
  • T: thirst (increased fluid intake
  • A: avoid prolonged bedrest
  • N: neurological disorders (parkinsons disease)
  • D: dehydration (common cause)
  • U: use compression stockings
  • P: pharmacological management
179
Q

*secondary hypertension key aspects, think KIDNEY

A

-K: kidney disease
- I: intake of certain medications (birth control, decongestants)
- D: disorders of the adrenal galnds (cushing’s syndrome, pheochromocytoma)
- N: neurological disorders (sleep apnea)
- E: endocrine disorders (thyroid isses, hyperparathyroidism)
- Y: young age (secondary hypertension is more common in younger individuals compared to primary)

180
Q

*malignant hypertension key aspects, think SEVERE

A
  • S: systolic BP greater than 180 mmHg
  • E: emergency (requires immediate medical attention
  • V: very high diastolic BP greater than 120 mmHg
  • E: end organ damage (kidneys, heart, brain)
  • R: rapid onset
  • E: IV antihypertensives
181
Q

what are some diagnostic tools for establishing a treatment plan for hypertension

A
  • *BP managements (correct cuff, level of heart)
  • no caffeine, smoking, or exercise 30 minutes before checking BP
  • history and physical
  • fasting blood glucose
  • routine urinalysis
  • CBC
  • BMP
  • lipid panel
  • uric acid, magnesium, calcium
  • 12 lead ECG
182
Q

what are managements of hypertension

A
  • home monitoring
  • HCP every 3-6 months once hypertension is stabilized
  • *restrict sodium, cholesterol, and saturated fats
  • maintain adequate K+ and Ca+ intake
  • weight management
  • *regular physical activity
  • tobacco cessation
  • moderate alcohol consumption
  • stress management
  • antihypertensive medications
  • patient and caregiver teaching
183
Q

what are sympatholytic medications

A

antihypertensives to treat anxiety by reducing sympathetic nerve

184
Q

what are diuretic medicaitons

A

known as water pills, helps the kidneys remove the salts and water from the body via urination

185
Q

what are vasodilator medications

A

work in the muscles of the arteries and veins, preventing the muscles from tightening

186
Q

what are angiotensin inhibitor medication

A

relaxes the blood vessels to ease the heart to pump blood properly

187
Q

what are the first line drug therapies for hypertension

A
  • ACE inhibitors
  • ARBs
  • calcium channel blockers
  • diuretic thiazides
  • loop diuretics
188
Q

examples of ACE inhibitors

A

lisinopril, captopril, enalapril

189
Q

examples of diuretic thiazides

A

HCTZ, chlorothiazide, metazolone

190
Q

examples of ARBs

A

candesartan, valsartan, losartan

191
Q

examples of loop diuretics

A

bumetanide, furosemide, torsemide

192
Q

examples of calcium channel blockers

A

diltiazem, verapamil, amlodipine, nicardipine

193
Q

what are the second line drug therapies for hypertension

A
  • beta blockers
  • potassium sparing diuretics
  • direct vasodilators
  • adrenergic inhibiting agents
194
Q

examples of cardiac selective beta blockers

A

metoprolol, bisoprolol, esmolol IV

195
Q

examples of non cardiac selective beta blockers

A

propranolol

196
Q

examples of mixed cardiac selective beat blockers

A

carvedilol, labetalol

197
Q

examples of potassium sparing diuretics

A

spironolactone, eplerenone, triamterene

198
Q

examples of direct vasodilators

A

hydralazine, nitroglycerin, sodium nitroprusside

199
Q

examples of adrenergic inhibiting agents

A

clonidine (last resort)

200
Q

main classes of hypertensive medications, think ABCD

A

A: ace inhibitors
B: beta blockers
C: calcium channel blockers
D: diuretics

201
Q

how does ace inhibitors work
ends in

A
  • helps relax blood vessels by blocking the formation of a natural chemical that narrows the blood vessels
  • pril
202
Q

how does beta blockers work
ends in

A
  • reduce your heart rate and the force of your heartbeats, which lowers blood pressure
  • olol
203
Q

how does calcium channel blockers work
ends in

A
  • prevent calcium from entering the cells of the heart and blood vessel walls, resulting in lower BP
  • pine
204
Q

how does diuretics work

A
  • help your body get rid of excess sodium and water, reducing blood volume
205
Q

what are the five C’s of hypertension complications

A
  • coronary artery disease
  • chronic renal failure
  • congestive heart failure
  • cardiac arrest
  • cerebrovascular accident
206
Q

what does coronary artery disease do

A

narrow the blood vessels, increasing the risk of heart attack

207
Q

what does chronic renal failure do

A

damage the kidneys, impairing their function

208
Q

what does congestive heart failure do

A

the heart becomes to weak to pump blood effectively (enlarged left heart)

209
Q

what is cardiac arrest

A

sudden loss of heart function

210
Q

what is cerebrovascular accident

211
Q

what raises the risk of heart attack and heart failure

A

a thickened and enlarged left ventricle

212
Q

nursing interventions of hypertension

A
  • blood pressure monitoring
  • medication administration
  • lifestyle modifications
  • patient education
  • stress management
  • dietary counseling (dash diet)
  • physical activity promotion
  • monitor for complications
  • support and follow up
213
Q

normal BP range

214
Q

elevated BP range

A

120-129/<80

215
Q

stage 1 BP range

A

130-139/80-89

216
Q

stage 2 BP range

A

140-159/90-99

217
Q

stage 3 BP range

A

> 160/>100

Medical Surgical II 229 (9 decks)

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