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Med-Surg ch 18
| Question | Answer |
|---|---|
| HYPERTENSION | persistently high blood pressure >140/90 |
| PREHYPERTENSION | >120-139/80-89 |
| ideal plood pressure? | 115/75 |
| essential hypertension | 90% of cases are this, primary or idiopathic related to age; race; obesity; Na intake |
| Secondary hypertension | causes by diseases like-atherosclerosis of renal arteries, dysfunction of adrenal cortex and medulla |
| what things increase the blood pressure levels? | nicotine(causes vasoconstriction), caffine , sodium |
| which groug of people have higher incidence of hypertenstion and have more complications? | African americans |
| causes of high blood pressure? | blood vessels becoming smaller, excess of renin secreted by the kidneys. |
| Arteriosclerosis | natural part of aging that causes rigitity of blood vessels in the elderly |
| why is hypertension called the silent killer? | Because it will affect the kidneys, brain, aorta, and heart before the person knows they have the disease |
| malignant hypertension | rapidly progressive moderate hypertension that is difficult to control (diastolic=140-170) |
| Hypertensive crisis | pt has severe headaches, blurred vision, nausea, and confusion. pt may be given IV nitroprusside,nitroglycerin or oral Procardia to lower BP |
| what can be examined to check for the degree of damage that is done from hypertension? | The vessel of the retina |
| these test can determine whether any damage has been done to the coronary arteries or heart muscle? | ECG and Cardiac stress test |
| how to treat high BP? | stop smoking, <Na 2300/day, low-fat diet, stress control, <alcohol, exercise for 30-45min 3-5 days a week. |
| which drug are used alone or in combinatio to treat hypertension? | angiotension-converting enzymes ACE-inhibitors,beta-blockers,Ca channel blockers,adrenergic inhibitors or vasodilator |
| Patients taking these meds need to > their K intake and have their electrolyte values monitored? | Potassium wasting Diuretics |
| diuretics do what? | <Circulating blood volume |
| which drugs <cardiac output and peripheral resistance? | Beta-adrenergic inhibitors- beta blockers & Ca channel blockers |
| when is the best time to take BP of the elderly? | between meals because right after meals BP is usually elevated. |
| Arteriosclerosis | hardening of the arteries, due to calcium build up,and elsasicity loss which causes slowing of blood flow. |
| this type of Arteriosclerosis is caused by lipids being deposited along vessel walls, plaques are formed | Atherosclerosis |
| This disease speeds up the process of Arteriosclerosis & Atherosclerosis | Diabetes mellitus |
| PAD Peripheral arterial disease, arterial insufficiency is mainly caused by what? | Atherosclerosis(it leads to a loss of blood flow to the extremities |
| intermitten claudication | this is a sign of arterial insufficiency, it is pain while walking that stops at rest. |
| what are the 5 p's that occur when there is occulsion in the pheripherial system? | pain, pallor, pulselessness, paralysis, and parathesia. BP in the affected limb in usually lower |
| what is the best treatment for arterial occlusive disease? | regular exercise(walking 20 2x a day promotes collateral circulation and< claducation) |
| most common drug used for antiplatelet purposes? | aspirin |
| these agents are injected directly into the vessel to destroy clots that have accumulated along the vessel walls | thrombbolytics ex:reteplase, cilostanzol |
| whar is the purpose of surgical treatment of pheripherial arterial insufficiency? | it is to help relieve pain, avoid amputation, and add years to patients life. it does not cure the disease! |
| Laser angioplasty, & Cryothearpy does what? | it opens clogged arteries |
| Aortoiliac bypass or a Femoropopiteal bypass is perfomed to correct what? | arterial occlusionof the leg to prevent the need for amputation. |
| Hyoerbaruc oxygen chambers are used for what? | they are used on patients with severly compromised circulation to a lower extremity to increase tissue oxygen and avoid amputation |
| How often should patients with arterial insufficience be checked or assessed? | at least every 4 hours or as required by facility.check for warmth paresthesia and pulses |
| what measures can the nurse take to encourage blood flow? | keep patient & enviroment warm, keep lower extremities lower than the heart level, encourage exercise |
| this condition causes inflammation , thickening of the arterial walls and occlusion of the vessels in the hand and the feet | Thromboangiitis obliterans or Buerger's diseasesymptoms:numbness and tingling of the toes or fingers in cold weatherstop smoking is most important factor to improivenment |
| Raynaud's Disease | spasms of the arteries, body has exaggerated response to the cold; can be a primary diseas or a seconday due to lupus, rheumatoid arthritis, trauma, or scleroderma.ganfrene results from ishemia |
| Aneurysms | occur in weakend area of a blood vessel, usually results from plaque formation, genetic predisposition or hypertenstion. |
| 2 factors that contribute to the formation of aneurysms? | Diabetes Mellitus and Hyperlipidemia |
| Where do aneurysms occur? | along artery walls, its a outpouching of the wall due to the structural defect in the arterial wall. blood flow stops and thrombosis or embolis forms |
| Bruit | purring sound heard with a stethoscope, when there is narrowing of the cartoid artery from atherosclerosis |
| Varicose Veins | enlarged and tortous veins that are distorted in shape by accumulation of pooled blood, cause is unknown |
| scleropathy | injecting an agent into varisose veins, that will sclerose the vessel and cause a thrombosis and thereby preventing blood from filling the area |
| ulcers on the lower extremities are caused by what? | chronic venous insufficiency |
| which patients are subceptibile to forming ulcers on the lower extremities? | Diabetic patients |
| what type of dressing can be used on and inflammed skin area to help protect it from ulcer formation? | OpSite or Tegaderm |
| Thrombophlebitis | inflammation of a superficial vein caused by a blood clot. occurs from inactivity, trauma to vein, infection from IV, and contaminated needle use. |
| thrombosis | formation of a clump of blood elements that form a blood clot and diminish or completely obstruct blood flow |
| Thromboectomy | surgical removal of a thrombus |
| What is used to dissolve a clot over a 36-72 hour peroid when a patien has a arterial thrombosis? | Urokinase or Streptokinase. Heparin is also give to prevent clotting |
| DVT | deep vein thrombosis, occurs because of immobility, trauma, dehydration, obesity, cancer, hormone thearpy, or any condition that causes a slowing of venous flow. |
| Embolism | when a piece of a DVT breaks off and travels to the lungs, heart, or brain. |
Created by:
VRoberts
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