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Med Surg Ch. 22
Understanding the CV System
| Question | Answer |
|---|---|
| What is a normal BP? | Less than 120/80 |
| How often should a pt with a normal BP follow up with their doctor? | Every 2 years |
| What BP indicates pre-hypertension? | 120-139/80-89 |
| How often should a pt with pre-hypertension follow up with their doctor? | Every year |
| What BP indicates stage 1 hypertension? | 140-159/90-99 |
| How often should a pt with stage 1 hypertension follow up with their doctor? | Every 2 months |
| What drugs are prescribed for stage 1 hypertension? | Thiazide-type diuretics. ACE inhibitors are considered |
| What BP indicates stage 2 hypertension? | Over 160/100 |
| How often should a patient with stage 2 hypertension follow up with their doctor? | Every month |
| What drugs are prescribed for stage 2 hypertension? | A two drug combination. Usually thiazide-type diuretics with an ACE inhibitor, ARD, BB or CCB |
| What determines BP? | CO, PVR, viscosity of blood and amount of circulating blood volume |
| What processes influence BP? | Nervous system regulation, aterial baroreceptors and chemorecceptors, the renin-angiotensin-aldosterone mechanism and the balance of body fluids |
| Cytomegalovirus may cause what? | High BP |
| What is the cause of primary HTN? | The cause is unknown |
| What is the cause of secondary HTN? | A kidney abnormality, a tumor of the adrenal gland or congenital defect of the aorta |
| What is isolated systolic hypertension? | A systolic pressure of 140 mm Hg or greater and diastolic pressure of 90 mm Hg or less |
| In what age group does isolated systolic hypertension occur most often? | The elderly |
| How is isolated systolic hypertension treated? | With lifestyle modifications. If that is not successful antihypertensives are used |
| Because HTN lacks symptoms it is refered to as...? | The silent killer |
| What symptoms are occasionally seen with HTN? | Headache, bloody nose, severe anxiety or shortness of breath |
| How is HTN diagnosed? | By considering a pts risk factors, a previous diagnosis of HTN, presence of s&s. hx of kidney or heart disease and current meds |
| How many occasions must your BP be measured to be diagnosed with HTN? | Two or more |
| What diagnostic tests are used to determine kidney damage? | Urinalysis, electrolytes, uric acid, BUN, creatinine, blood glucose |
| What diagnostic tests are used to determine heart damage? | ECG, CBC, lipid profile |
| What are modifiable risk factors for HTN? | Blood glucose level, activity level, smoking, salt and alcohol intake, insufficient sleep (less than 5 hours/day) |
| What are nonmodifiable risk factors for HTN? | Family history, age, ethnicity, diabetes mellitus |
| How much Na+ per day is allowed with the DASH diet? | Less than 2,400mg |
| If a pt has severe HTN, increased risk factors or target organ disease what should their therapy begin with? | Drug therapy and lifestyle modifications |
| If a pt has low risk of HTN what should their therapy begin with? | Lifestyle modifications |
| What is the goal of therapeutic intervention of HTN? | BP lower than 140/90 mm Hg; 130/80 mm Hg for pt with diabetes, chronic kidney disease or proteinuria |
| How long must hypertensive medications be continued usually? | The rest of the pt's life |
| What side effect causes many men to become reluctant of taking their meds? | Erectile dysfunction/impotence |
| What's the nursing dx for HTN? | Deficient knowledge |
| What are common complications of HTN? | Coronary artery disease, atherosclerosis, MI, HF, stroke and kidney or eye damage |
| What is target organ disease? | When the BP increases dmaging the small vessels of the heart, brain, kidneys and retina |
| What patients are at higher risk for stroke, MI, HF, kidney failure and pulmonary and cerebral edema? | Hypertensive |
| What is a hypertensive emergency/crisis? | When the BP is greater than 180/120 |
| Should pts with hypertensive crisis go to the hospital? | Yes, they should be admitted to the critical care unit |
| What med may be given IV to decrease BP during crisis? | Nipride (nitroprusside) |
| Are pts in crisis at risk for progressive target organ dysfunction? | Yes |
| Are pts with hypertensive urgency at risk for progression of target organ dysfunction? | No |
| What are symptoms of hypertensive urgency? | Severe headaches, nosebleeds, shortness of breath and severe anxiety |
| How is hypertensive urgency treated? | With combination oral meds and a follow up visit within several days |
| What is the most common cause of ESRD? | Nephrosclerosis |
| What are the different thiazide diuretics? | Hydrochlorothiazide (Hydrodiuril); Chlorothiazide (Diuril) |
| What are the different thiazide-like diuretics? | Chlorthalidone(Hygroton); Indapamide (Lozol); Torsemide (Demadex) |
| What do thiazide diuretics do? | Increases urine output by promoting Na+, Cl- and water excretion |
| What electrolytes are lost during thiazide diuretic use? | Na+, K+ and Mg+ |
| What are side effects of thiazide diuretics? | Dizziness, fatigue, weakness, hypercalcemia, n&v, anorexia, hyperglycemia, photosensitivity |
| What drug should be given cautiously to pt on thiazide diuretics? | Digoxin |
| What are the different loop diuretics? | Bumetanide (Bumex); Furosemide (Lasix); Torsemide (Demadex) |
| What do loop diuretics do? | They act on the ascending loop of henle to cause Na+ and water loss |
| What electrolytes are lost during loop diuretic use? | K+, Mg+ and Ca+ |
| What are side effects of loop diuretics? | Nausea, hypoglycemia, tinnitus, increased uric acid levels, photosensitivity |
| In what pt are loop diuretics contraindicated? | Pt allergic to sulfonamides |
| What are the different K+ sparing diuretics? | Amiloride (Midamor); Spironolactone (Aldactone) |
| What do K+ sparing diuretics do? | Promote Na+ and water excretion and K+ retention by the kidney |
| What are side effects of K+ sparing diuretics? | Headache, n&v, anorexia, diarrhea |
| What foods should be avoided with K+ sparing diuretics? | Food rich in K+; oranges, bananas, salt substitutes and dried fruits |
| What do beta blockers end in? | -lol |
| What do beta blockers do? | Decrease sympathetic nervous system response which decreases BP, HR, contractility, CO and renin activity |
| What are side effects of beta blockers? | Ortho hypo, diarrhea, n&v, blood dyscrasias, HF |
| What beta blocker is not cardiac specific? | Propanolol (Inderal) |
| To which pt should Inderal not be given? | Asthmatic; causes bronchospasm=wheezing |
| What do ACE inhibitors end in? | -pril |
| What do ACE inhibitors do? | Blocks production of angiotensin II |
| What are side effects of ACE inhibitors? | Hypotension, increased HR, dyspnea, cough, angioedema, photosensitivity |
| What do ARBs end in? | -tan |
| What do ARBs do? | Block angiotensin II receptors causing vasodilation and reduction in BP |
| What are side effects of ARBs? | Dizziness, insomnia, diarrhea, cough, photosensitivity |
| What are the different Ca+ channel blockers? | Amlodipine (Norvasc); Ditiazem (Cardizem); Felodipine (Plendil); Isradipine (DynaCirc); Nicardipine HCL (Cardene); Nifedipine (Procardia); Nisoldipine (Sular); Verapamil (Calan) |
| What do Ca+ channel blockers do? | Prevent movement of extracellular Ca+ into the cell which vasodilates |
| What are side effects of Ca+ channel blockers? | Dysrhythmias, edema, headache, fatigue, drowsiness, flushing |
| What drug may Ca+ channel blockers increase the level of? | Digoxin |
| What are the different anticoagulants? | Enoxaparin (Lovenox); Heparin; Warfarin (Coumadin) |
| What do anticoagulants do? | Decrease the clotting ability of blood |
| What is the antidote for anticoagulants? | Vitamin K |
| What are the different antiplatelets? | Aspirin; Clopidogrel (Plavix) |
| What do antiplatelets do? | Prevent blood platelets from sticking together so clots do not form |
| What are vasodilators? | Nitrates |
| What do vasodilators do? | Relax blood vessels and increase the supply of blood and oxygen to the heart while reducing the workload |
| What does Digoxin do? | Increases the force of the heart's contractions |
| What do statins do? | Lower LDL and triglycerides and raise HDL |
Created by:
maxxinekj
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