unit 5

46 cards·by deb2910

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how is hypertension diagnosed

by averaging 2 or more accurate BP measurements taken during 2 or more contacts with provider

what is the treatment/management of HTN trying to do

aims to decrease peripheral resistance, blood volume, or the strength, force, and rate of myocardial contraction

how do you define pre-hypertension

SBP 120-139; DBP 80-89

returns unoxygenated blood to the heart

veins

occurs when metabolic requirements increase (stress, illness, exercise,heat applied)

vasodilation

pulmonary system circulation comes from which side of the heart

right side

uncomplicated HTN is treated by what first

thiazide diuretic

a HTN patient with what two comorbidities would require 2 or more HTN meds

diabetes and chronic kidney disease

what are the two classifications of HTN and what are the SBP/DBP ranges

stage 1: SBP 140-159; DBP 90-99. stage 2: 160/90

what is the treatment for pre-hypertension

lifestyle modification

peripheral vascular resistance

r/t diameter of blood vessel and viscosity of blood

what is pulse pressure

difference between systolic and diastolic pressure

what does pulse pressure indicate/measure

how well the body is maintaining cardiac output

how is cardiac output determined

stroke volume x heart rate

what influences stroke volume

preload/after load/contractility

what is preload

pressure ventricles at the end of diastole

what is afterload

amount of resistance to ejection of blood from ventricles

what measurement is used to gauge severity of CHF

ejection fraction

what is ejection fraction

the percentage of blood that is ejected from the ventricles with each heartbeat

what age related cardiovascular changes affect afterload

walla thicken, calcification and stiffening of blood vessels, thickening/increased rigidity of cardiac valves

what age related cardiovascular changes affect contractility

myocardial muscle shrinks, decreased elasticity

what is normal ejection fraction

50-70%

why is systemic pressure greater than pulmonary pressure

because the blood being pumped to the body needs to overcome resistance and get blood to periphery

what is the advantage of veins being easily distended

it allows for large volumes of blood to flow

what does vasodilation do to the blood pressure

decreases pressure

what are the three main coronary arteries

1. right coronary. 2. circumflex 3. left anterior descending

what does vasoconstriction do to the blood pressure

increases pressure

how does blood get back to the heart after picking up oxygen

via the pulmonary veins

what happens to the blood vessel s when metabolic demand is low (rest, cooling of body, cold application)

vessels constrict

how does deoxygenated blood from the body enter the heart

superior and inferior vena cava

which is the largest chamber of the heart

left ventricle

what are 4 non modifiable risk factors for cardiovascular disease

1. older age 2. male 3. heredity 4. race

what are the three main diagnostic labs used to confirm cardiac issues

1. creatine kinase. 2. myoglobin 3. troponin T and I

what does BNP do

act as diuretic and vasodilator

what is BNP used to diagnose

heart failure

when are beta blockers recommended

cardiovascular disease and heart failure

what is am important nurse instruction when a patient is perscribed calcium channel blocker

no grapefruit juice

which pharmacologic therapy decreases the work load of the heart

calcium channel blockers

which pharmacological therapy would be prescribed if a patient had DM, heart failure or CVD and why

ace inhibitor or arbs, to protect vascular endothelium and preserve renal function

what is the best diagnostic tool for chest pain

12 lead EKG

what are the five early, distinct symptoms of acute coronary syndrome

1. unusual fatigue 2. shortness of breath 3. sleep disturbances 4. anxiety 5. chest discomfort that comes and goes

where are the alternative locations for pain associated with acute coronary syndrome

1. upper back 2. shoulders 3. arms 4. neck/jaw 5. epigastric burning 6. shortness of breath

what may prevent a patient from experiencing pain

1. neuropathy in elderly and pts with diabetes

what are the teaching interventions for hypertension

1. medication info. 2. lifestyle changes (diet and exercise), self monitoring blood pressure

what are the complications of hypertension

1. blood vessel damage (heart, kidneys, brain, eyes) 2. MI 3. heart failure 4. left ventricular hypertrophy 5. renal failure 6. stroke impai

major side effect of ace inhibitor

persistent cough