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Nur 333 fundamentals 2 > WK 2: HTN and HLD > Flashcards

WK 2: HTN and HLD Flashcards

1
Q

Afterload

A

pressure ventricles must work against to open the semilunar valves to pump blood out of the heart to the lungs/body

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2
Q

Preload

A

amount the ventricles stretch at end of of diastole
-the relaxation / filling phase of ventricles

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3
Q

myocardial contractility

A

strength of cardiac cells to contract or shorten

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4
Q

cardiac output

A

the amount of blood that the heart pumps out in one minute
CO= HR x SV
it maintains tissue perfusion

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5
Q

Ejection fraction
What is it?
what is a normal ejecton fraction?

A

% of blood pumped out of the left ventricle with EACH contraction
NML= >50%
heart failure = <40%

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6
Q

infarction

A

blocking of blood flow to a certain area, causing tissue death

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7
Q

ischemia

A

tissue perfusion has decreased but is not totally cut off, resulting in hypoxia

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8
Q

stroke volume

A

amount of blood pumped by a ventricle with each beat
stroke volume is affected by: contractility, preload and afterload

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9
Q

pulsus alternans

A

an arterial pulse with alternating strong and weak beats

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10
Q

venous thromboembolism

A

obstruction of a blood vessel by a a clot that has been dislodged from another site
commonly starts in legs and moves to lungs (PE)

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11
Q

perfusion

A

passage of fluid through the circulatory system to tissue, oxygenating the tissue

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12
Q

perfusion

A

passage of fluid through the circulatory system to tissue, oxygenating the tissue

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13
Q

what is the formula for cardiac output ?

A

CO= HR x SV

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14
Q

What can alter a persons cardiac output?

A

HR
SV
myocardial contractility

EX. medications, Dz processes, activity

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15
Q

What is pulse pressure?

A

the difference between systolic and diastolic BP
NML= 1/3 of SBP

Ex: BP of 120/80
120-80= a pulse pressure of 40, this is normal

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16
Q

what is peripheral vascular resistance?

A

the amount of effort that the heart has to overcome in order to get the blood out of the heart and into the periphery

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17
Q

HTN

A

pressure in your arteries is higher than it should be
-causes adverse effects to arterial walls
-changes in arterial walls leads to PVR, leading to decreased peripheral perfusion over time

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18
Q

What is an elevated BP range

A

systolic: 120-129
Diastolic: less than 80

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19
Q

What is the range for stage 1 HTN

A

systolic: 130-139
diastolic: 80-89

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20
Q

what is the range for stage 2 HTN

A

systolic: 140 or higher
diastolic: 90 or higher

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21
Q

what is the range for a hypertensive crisis

A

systolic: higher than 180
diastolic: higher than 120

22
Q

What are some modifiable factors that influence blood pressure?

A

DM, elevated lipid serum lipids, excess sodium intake, obesity, sedentary lifestyle, stress, tobacco use, alcohol use

23
Q

what are some non-modifiable risk factors that influence blood pressure?

A

genetics, family hx, race/ethnicity, increasing age, gender, chronic kidney Dz, obstructive sleep apnea

24
Q

complications of HTN

A

cardiovascular Dz
MI
HF
stroke
PVD
renal Dz
retinal Dz

25
Q

nursing care of HTN

A

-determine risk factors and assist with changing
-promote heart healthy nutrition
-weight reduction if needed
-encourage balance of rest & activity
-smoking cessation
-medication management
-BP monitoring
-collaboration
-patient education

26
Q

What symptoms indicate that you are having a hypertensive crisis and should see a physician ?

A

BP >180/110
severe HA
dyspnea or CP
Dizziness, numbness, and weakness
loss of vision
difficulty speaking
nosebleed/ epistaxis
severe anxiety
unresponsive

27
Q

what is the difference between a hypertensive emergency and hypertensive crisis

A

HTN emergency: develops in hours-days, BP>220/140, targets organ diseases
HTN urgency: develops over days to weeks, BP>180/110, NO target organ disease.

EMERGENCY requires fast reversal wile URGENCY requires slow reversal

28
Q

what are some causes of hypertensive crises?

A

medication non-compliance
drug abuse
head injury
preeclampsia/eclampsia
phenochromocytoma
Acute aortic dissection

29
Q

lifestyle modifications of HTN

A

manage BP
control cholesterol
reduce BG if a diabetic
eat better (DASH diet)
loose weight
stop smoking
limit alcohol
stress modifications

30
Q

What is hypotension?
why do we care if a patient is hypotensive?

A

systolic BP is less than 90
we care d/t concerns about the patients tissues getting perfused

-before reacting, check patients baseline BP and see if they are symptomatic

31
Q

Sx of hypotension

A

pallor/ skin mottling/ clamminess
decreased brain perfusion -> LH/dizzy/syncope/confusion
burred vision
CP
increased HR
decreased urine output
N/V

32
Q

nursing implementations of hypotension

A

monitor VS frequently
assess symptoms
treat cause
consider adding salt to diet
increased fluid intake
compression stockings
medications

33
Q

what kind of patients typically get orthostatic hypotension?

A

elderly
bed rest pt
pregnant pt
pt w/o high blood volume

34
Q

How do you diagnose someone with orthostatic hypotension?

A

-measure BP lying down/sitting/standing
-measurements done within 3 minutes of position change
SBP-decreases by 20
DBP- decreases by 10

35
Q

nursing care for a patient with orthostatic hypotension

A

-slow position changes
-don’t cross legs
-early ambulation
-balance rest and activity
-isometric exercises before standing
-compression stockings
-don’t stand for long periods of time
-risk factor for falls

36
Q

why do we care if a patient has high cholesterol levels?

A

it can lead to atherosclerosis which overtime can lead to poor perfusion, CAD, peripheral artery Dz and MI’s

37
Q

When should a person get tested for HLD?

A

test at 20 y/o, then test evert 4-6 years

38
Q

how long does a person need to fast prior to their cholesterol testing?

A

9-12 hours

39
Q

What should a patients levels be for cholesterol?

overall cholesterol
LDL
HDL

A

cholesterol <200
LDL <130
HDL
males should be >45
females should be >55

40
Q

HLD Nursing Care

A

-check, change, control
-maintain healthy weight
-be active
-limit smoking and alcohol
-dietary modifications
-lipid-lowering drug therapy

41
Q

what diet modifications should be enacted for a patient with HLD?

A

-reduce saturated and trans fats
-increased complex carbs (whole grains, fruits, veggies)
-limit major sources of cholesterol (yolk, whole milk)
-limit alcohol and simple sugars
-eat fatty fish weekly
-eat foods high in omega 3 (soybean oils, canola, walnuts, flax seed)

42
Q

what diet modifications should be enacted for a patient with HLD?

A

-reduce saturated and trans fats
-increased complex carbs (whole grains, fruits, veggies)
-limit major sources of cholesterol (yolk, whole milk)
-limit alcohol and simple sugars
-eat fatty fish weekly
-eat foods high in omega 3 (soybean oils, canola, walnuts, flax seed)

43
Q

who is at risk for a venous thromboembolism

A

pt wit venous stasis (bed rest)
pt with hyper-coagulability(thick blood)
pt with endothelial damage

44
Q

S/Sx of VTE (venous thromboembolism)

A

localized redness, tenderness, and swelling
warmth, tenderness, firmness over muscle calf
calf pain w/ ambulation
unilateral size of legs

45
Q

how would one diagnose of VTE?

A

obtain Hx
physical assessment
vascular US

46
Q

nursing care to prevent VTE

A

assess symptoms
measure calf
check for calf tenderness/phlebitis
early ambulation/ activity
TED stockings
SCD’s
calf pumping

47
Q

VTE treatment

A

prevention is key
anticoagulation
thrombolytic
IVC filter

48
Q

diagnostics related to cardiovascular system

A
  1. CBC
    Hgb: iron containing pigment needed for O2 to travel
    females should be 12-16, males should be 14-18
    Hct: % of total volume of blood that is made up of RBC. women should be 37-47% men should be 42-52%
  2. fasting lipid panel
    LDL, HDL, triglycerides
  3. CXR
  4. EKG: conduction of the heart
49
Q

What are some cardiovascular nursing problems?

A

risk for unstable BP
activity intolerance
decreased cardiac output
ineffective tissue perfusion
fatigue
impaired gas exchange
ineffective airway clearance
fluid volume issues
risk for injury

50
Q

S4

A

atrial gallop
“TEN-nes-see”

51
Q

S3

A

ventricular gallop
“ken-TUCK-y”

Nur 333 fundamentals 2 (7 decks)

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