WEEK 2 HTN & CAD Flashcards
What is the formula used to determine cardiac output?
Stroke volume x heart rate
What is the average cardiac output?
5 L/min
What is the formula used to determine blood pressure?
Cardiac output (SV x HR) x peripheral vascular resistance
What blood pressure reading is considered hypertension?
Above 140/90 (130/80 if pt has comorbidities)
What kind of hypertension makes up 90% of cases, and has no known trigger?
Essential/primary hypertension
What kind of hypertension is caused by a pre-existing condition in the patient?
Secondary hypertension
What kind of hypertension is considered a hypertensive emergency, and what blood pressure value would it be?
Malignant hypertension, above 180/120
Name 3 organs that hypertension will cause end organ damage in
- Heart/vasculature
- Kidneys
- Brain
Name 5 non-modifiable risk factors for hypertension
- Gender: male
- Age: >55 M, >65 F
- Ethnicity: SE Asian
- Family history
- Chronic diseases
Name 6 modifiable risk factors for hypertension
- Sedentary lifestyle
- High alcohol consumption
- Obesity
- Hyperlipidemia
- Excessive sodium intake
- Smoking
How much exercise per week should adults get?
150 min/week (30-60 min, 4-7 days per week)
What is the normal BMI range?
18.5-24.5
What are 4 things nurses must educate patients about in regards to hypertension management?
- Disease pathology and trajectory
- Role of medication
- Medication side effects
- Lifestyle modification
Briefly explain the pathophysiology of CAD
Lipid deposition of plaques from blood to damaged coronary arteries, causing hardening and narrowing
What are the 4 stages of atherosclerosis development?
- Endothelial damage
- Inflammation: macrophages, platelets, “fatty streak”
- Thrombosis
- Scar tissue
What is the difference between monounsaturated and polyunsaturated fats?
Polyunsaturated fats can accommodate less cholesterol than monounsaturated
What are the 5 levels in a lipid panel?
- Total cholesterol
- Low-density lipoprotein (LDL) cholesterol
- Very low-density lipoprotein (VLDL) cholesterol
- High-density lipoprotein cholesterol
- Triglycerides
Which type of cholesterol takes fat from cells and delivers it to the liver to be eliminated?
HDL
Which type of cholesterol carries fat to cells of the body?
LDL
Which type of cholesterol carries triglycerides to fat and muscle cells, and is usually present in low amounts?
VLDL
What are triglycerides?
Fat from food we eat, composed of glycerol and fatty acids.
What is the term for an imbalance of any part of the lipid profile?
Dyslipidemia
What kind of foods decrease LDL while increasing HDL?
Foods high in fiber and unsaturated fats
What vitamin raises HDL and lowers LDL?
Niacin (Vitamin B3)
Which diagnostic test looks for ischemia related changes on ECG and symptoms such as chest pain while increasing oxygen demand on the heart?
Exercise stress test
Which diagnostic test increases heart rate through exercise or persantine, then tracks distribution of radioactive dye to note areas of ischemia?
MIBI nuclea scan
Which diagnostic test uses ultrasound to measure the size of the heart chambers, valves, and ejection fraction?
Echocardiogram
Which diagnostic test is a 24-hour ECG where the patient keeps a diary of activity and symptoms during certain times?
Holter monitor
Which diagnostic test is the “gold standard” for diagnosing coronary artery disease, but is invasive and expensive?
Angiogram
What are 3 points to include in patient teaching for stable angina?
- Rest frequently
- Avoid overeating, smoking, excess caffeine
- Wait 2 hours after eating to exercise
What are 3 BP regulating mechanisms that can result in the development of HTN if defective?
- Release of norepinephrine
- Stimulation of the sympathetic nervous system
- Activation of the RAA system
What is a major consideration in the mgmt of an older person with hypertension?
Use careful technique in assessing BP because of the possible presence of an auscultatory gap
What are 3 management strategies for a patient in a hypertensive emergency?
- Measure hourly urine output
- Continuous BP monitoring with an intra-arterial line
- Assessing pt for signs of heart failure and changes in mental status
If a client with hypertension still has elevated blood pressure after 12 months of lifestyle modifications, what is the next step in treatment?
Medications
What is the main reason that hypertension leads to organ damage?
It promotes atherosclerosis
