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basic 130 > week 12 alterations in cardiac function > Flashcards

week 12 alterations in cardiac function Flashcards

1
Q

atherosclerosis

A

the abnormal accumulation of lipids and fibrous tissue in vessels

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2
Q

coronary atherosclerosis

A

blockages and narrowing of coronary vessels reduce blood flow to the myocardium
CAD is caused by myocardial ischemia

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3
Q

leading cause of death in US

A

heart disease

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4
Q

most prevalent cardiovascular disease

A

CAD

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5
Q

CAD s/s

A

angina pectoris
epigastric distress
radiating pain to jaw or left arm

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6
Q

CAD risk factors

A 
DM
peripheral arterial disease
HTN
smoking
elevated LDL
AAA
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7
Q

CAD prevention

A 
diet to control cholesterol, fat
exercise
smoking cessation
medication
disease mgmt (DM, HTN)
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8
Q

cholesterol med groups

A 
-statins
fibrates
resins (chole or cole)
absorption inhibitors (Zetia)
omega 3 (fish oil caps)
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9
Q

angina pectoris

A

syndrome characterized by episodes of intense pain or pressure in anterior chest

caused by insufficient coronary blood flow
worsened by emotional stress or physical exertion

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10
Q

stable angina

A

predictable, consistent
occurs with exertion
relieved by rest, NTG

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11
Q

unstable angina

A

frequency and severity of sx increased

may not be relieved with rest, NTG

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12
Q

intractable/refractory angina

A

severe incapacitating pain

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13
Q

variant angina

A

pain at rest with reversible ST-segment elevation

caused by coronary artery vasospasm

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14
Q

silent ischemia

A

objective evidence of ischemia but patient reports no pain

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15
Q

angina assessment

A 
tightness, choking, heavy sensation
frequently retrosternal, may radiate to neck, jaw, shoulders, back, arms (usually left)
anxiety accompanies pain
other sx: dyspnea, dizziness, n/v
subsides with rest, NTG
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16
Q

angina medication

A 
nitrates (ntg)
beta blockers (-olol)
calcium channel blockers (norvasc, cardizem)
antiplatelets: plavix
anticoags
17
Q

most common chronic disease among US adults

A

hypertension (HTN)

18
Q

hypertension increases risk for

A

premature death, disability
MI, CHF
stroke
CKD

19
Q

hypertension definition

A

systolic BP > 140
diastolic BP >90

based on 2+ accurate measurements taken 1-4 weeks apart

20
Q

primary/essential HTN

A

95% of HTN pts

no identifiable cause

21
Q

secondary HTN

A

5% of pts

associated with renal disease, sleep apnea, pregnancy

22
Q

symptoms of HTN

A

often asymptomatic (“silent killer”)

retinal/eye changes
renal damage
MI
cardiac hypertrophy
stroke
23
Q

HTN risk factors

A 
smoking
obesity, sedentary lifestyle
DM
age
microalbuminuria or GFR < 60
24
Q

HTN assessment

A

retinal exam
12 lead EKG
labs

25
Q

HTN medical mgmt

A

maintain BP < 140/90

in older adults BP < 150/90

26
Q

HTN lifestyle modifications

A

weight reduction
DASH diet
decrease sodium intake

27
Q

goals of HTN pharm therapy

A

decrease peripheral resistance
decrease blood volume
decrease rate/strength of myocardial contraction

28
Q

stage 1 HTN medication

A

african-americans, pts > 60 receive calcium channel blocker or thiazide diuretic

non african-americans and pts < 60 get ACE-1 or ARB

29
Q

HTN gerontologic considerations

A

educate pt and family on medication routine, since it may be complex

medication may be expensive

try to treat with a single drug

30
Q

hypertensive emergency

A

BP > 180/120

must be lowered immediately to prevent damage to target organs

31
Q

hypertensive urgency

A

BP elevated but no evidence of immediate or progressive target organ damage

32
Q

hypertensive emergency treatment

A

reduce BP 20-25% in first hour
reduce to 160/100 within 6 hrs
gradual reduction to normal within days
IV vasodilators (sodium nitroprusside, enalaprilat, nitroglycerin)

33
Q

hypertensive urgency treatment

A

oral agents to normalize BP over 24-48 hrs
beta blocker (labetalol)
ACE inhibitor (captopril)
alpha 2 agonist (clonidine)

34
Q

left sided heart failure

A

left side of the heart must work harder to pump the same amount of blood; failure to properly pump out blood to the body; often reduced ejection fraction

35
Q

right sided heart failure

A

when the left ventricle fails, increased fluid pressure is transferred back through the lungs, ultimately damaging the heart’s right side
the right side loses pumping power, blood backs up in the body’s veins causing peripheral edema

36
Q

ejection fraction

A

percentage of how much blood the left ventricle pumps out with each contraction

between 50-70% is normal
measured by echocardiogram or MUGA

37
Q

The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema?

A

decreased left ventricular pumping

when the demand on the heart increases, there is resistance to left ventricular filling and blood backs up into the pulmonary circulation; pulmonary edema quickly develops

basic 130 (12 decks)

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