Week 1 Cardiac Hypertension and PAD

Question 1

Hypertension

Answer 1

• anything above 130/80

Question 2

Risk factors for hypertension

Answer 2

-Race
- Age
-Family History
- Obesity
-Smoking and Alcohol
- A lot of Sodium and fat diet
- Not enough exercise
-Stress
-Chronic Conditions

Question 3

Hypertension symptoms

Answer 3

-Most patients are asymptomatic
- Symptomatic: severe headaches, nosebleeds, fatigue, vision problems, chest pain, difficulty breathing, irregular heartbeat, blood in urine, and pounding in the chest, neck, or ears

Question 4

What are the two types of hypertension?

Answer 4

-Essential (primary) Hypertension
-Secondary Hypertension

Question 5

Essential Primary Hypertension

Answer 5

• No identifiable causes; tends to develop gradually over years
  -Results in damage to vital organs
  -Causes medial hyperplasia (thickening) of arterioles
  -Risk Factors: Obesity, Smoking, Stress, and Family History

Question 6

Secondary Hypertension

Answer 6

• Common Causes: Obstructive Sleep Apnea, Renal Disease, Primary Aldosteronism ( hormonal disorder), Pheochromocytoma (adrenal tumor), cushing’s syndrome, Medications (birth control, over the counter pain relievers, decongestants, and illegal drugs ( cocaine and amphetamines)

Question 7

JNC 8 Goals (Eighth Joint National Committee Guidelines)

Answer 7

-People over 60: Below 150/90
-People younger 60: Below 140/90

Question 8

Blood Pressure Stages:

Answer 8

Normal: Below 120/80
Elevated Blood Pressure: Systolic 120 to 139 and Diastolic below 80
Stage 1: Systolic 130 to 139 and Diastolic 80 to 89
Stage 2: Systolic above 140 and Diastolic of 90 or above

Question 9

Drug Therapy

Answer 9

• Beta-adrenergic Blockers
  -Renin Inhibitors
  -Central alpha agonists
  -Alpha-adrenergic Agonists
  -Thiazide Diuretics
  -Calcium Channel Blockers
  -ACE inhibitors
  -Angiotensin 2 receptor Antagonsists
  -Aldosterone Receptor Antagonists

Question 10

Nursing Care Planning Goals

Answer 10

-Focus on lowering/controlling Blood Pressure
-Lifestyle Modifications and preventions

Question 11

Atherosclerosis

Answer 11

Usually has no symptoms until the narrowed coronary arteries severely restrict blood flow to the heart. At this point, you may feel chest pain because not enough blood is reaching your heart, especially while you are exerting yourself or are under stress

Question 12

Arteriosclerosis vs Atherosclerosis

Answer 12

-Arteriosclerosis: Thickening or hardening of arterial wall and often associated with aging
-Atherosclerosis: Type of Arteriosclerosis involving formation of plaque within arterial wall

Question 13

Arteriosclerosis and Atherosclerosis Interventions

Answer 13

-Assess Labs (Cholesterol, HDL, LDL, and Homocysteine levels)
-Nutrition Therapy
-Drug Therapy
-Smoking Cessation
-Exercise
-Complementary and Alternative Therapies

Question 14

Arteriosclerosis and Atherosclerosis

Answer 14

-HMG-CoA reductase inhibitors (statins)
-Fibrinic Acids
-Ezetimibe (Zetia)
-PCSK9 inhibitors including Alirocumbab (Praluent) and Evolocumbab (Repatha)

Question 15

High Blood Pressure Atherosclerosis and Peripheral Arterial Disease (PAD)

Answer 15

• Alters natural flow of blood through arteries and veins of peripheral circulation
• Results of systemic atherosclerosis

Question 16

PAD Assessment

Answer 16

-Intermittent Claudication
-Pain that occurs even while at rest; numbness and burning
-Inflow Disease: Discomfort in lower back, buttocks, and thighs.
-Outflow Disease: Burning or cramping in calves, ankles, feet, and toes
-Hair loss and dry, scaly, pale, or mottled skin, and thickened toenails
- Severe arterial Disease: Extremity is cold and gray-blue or darkened, Pallor may occur with Extremity Elevation, Dependent Rubor, Muscle Atrophy

Question 17

PAD Diagnostics

Answer 17

-Imaging assessment
-Ankle-Brachial Index (ABI): Normal is 1.0-1.4
-Exercise Tolerance Testing
-Plethysmography

Question 18

Six P’s of Arterial Occlusion

Answer 18

Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia (cooling)

Question 19

Types of Aneurysms of Central Arteries

Answer 19

-Fusiform
-Saccular
-Dissecting (Aortic Dissection)

Question 20

Abdominal Aortic

Answer 20

-Pain related to AAA is usually steady with a gnawing quality, unaffected by movement, may last for hours or days
-Pain in abdomen, flank, and back
-Abdominal mass is pulsative

Question 21

Thoracic Aortic

Answer 21

-Back pain
-Assess for shortness of breath
-Hoarseness
-Difficulty swallowing
-Mass may be visible above suprasternal notch
-Sudden excruciating back or chest pain symptomatic of thoracic rupture
-Surgical Treatment: Thoracic aortic aneurysm repair

Question 22

Diagnostics for Aneurysms of Central Arteries

Answer 22

• X-ray “eggshell” appearance
  -CT
  -Aortic Arteriography
  -Ultrasonography

Question 23

Aneurysms of the Peripheral Arteries

Answer 23

-Symptoms: Limb ischemia, Diminished or absent pulses, cool to cold skin, or pain
-Treatment: Surgery and monitoring for pain