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Chapter 35 - Cardiac
Cardiac and Vascular Disorders
| Question | Answer |
|---|---|
| Slow heart rate, usually defined as fewer than 60 bpm | Bradycardia |
| Rapid heart rate, usually defined as greater than 100 bpm | Tachycardia |
| Abnormal thickening and hardening of the arterial walls caused by fat and fibrin deposits | Atherosclerosis |
| Obstruction of a blood vessel with a blood clot transported through the bloodstream | Thromboembolism |
| A sound heard on ausculation of the heart that usually indicates turbulent blood flow across heart valves | Murmur |
| Abnormal thickening, hardening, and loss of elasticity of the arterial walls | Artheriosclerosis |
| The amount of blood in a ventricle at the end of diastole; the pressure generated at the end of diastole | Preload |
| Disturbances of rhythm; arryhythmia | Dysrhythmia |
| Study of the movement of blood and the forces that affect it | Hemodynamics |
| A heartbeat that is strong, rapid, or irregular enough that the person is aware of it | Palpatation |
| Fainting | Syncope |
| The amount of resistance the ventricles must overcome to eject the blod volume | Afterload |
| Backward flow | Regurgitation |
| Death of myocardial tissue caused by prolonged lack of blood and oxygen supply | Myocardial Infarction |
| Passage of blood through the vessels of an organ | Perfusion |
| The delivery of synchronized electric shock to the myocardium to restore normal sinus rhythm | Cardioversion |
| Place where electrical impulse is initiated in the heart | SA Node/Pacemaker |
| Terminal ends of bundle branches that cause ventricles to contract | Purkinje Fibers |
| The amount of blood ejected by each ventricle per minute | Cardiac Output |
| Adaptations made by the heart and circulation to maintain normal cardiac output | Compensation |
| The ability of a cell to regenerate an impulse without external stimulation | Automaticity |
| The ability of cardiac muscle to shorten and contract | Contractility |
| Enlargement of existing cells, resulting in increased size of an organ or tissue | Hypertrophy |
| A wall that divides a body cavity | Septum |
| Termination of fibrillation, usually by electric shock | Defibrillation |
| Contraction phase of the cardiac cycle | Systole |
| The ability of the cell to transmit electrical impulses rapidly and efficiently to distant regions of the heart | Conductivity |
| Formation of a blood clot | Thrombosis |
| Relaxation phase of the cardiac cycle | Diastole |
| Increased: HR Speed of conduction through the AV node Force of contractions | Cardiac Functions by the Sympathetic Nervous System |
| Decreased: HR Speed of conduction through the AV node Force of contractions | Cardiac functions by the parasympathetic nervous system |
| Factors that increase preload | Increase venous return to the heart Overhydration |
| Factors that decrease preload | Venous vasodilation dehydration hemorrhage |
| Age-Related Changes: Density of heart muscle connective tissue ____________________. | Increases |
| Age-Related Changes: Elasticity of myocardium __________________. | decreases |
| Age-Related Changes: Cardiac contractility _____________________. | declines |
| Age-Related Changes: Valves ____________________. | Thickens and stiffen |
| Age-Related Changes: Emptying of chambers __________________. | Incomplete |
| Age-Related Changes: Number of pacemaker cells in the SA node _____________. | decreases |
| Age-Related Changes: Number of nerve fibers in ventricle ______________. | decreases |
| Age-Related Changes: Cardiac response to stress __________________. | takes longer to respond |
| Age-Related Changes to blood vessels: Elastic fibers __________________. | becomes stiffer |
| Age-Related Changes to blood vessels: Systolic blood pressure _______________. | increases |
| Age-Related Changes to blood vessels: Pulse pressure _________________. | generally increases |
| Age-Related Changes to blood vessels: Veins _________________________. | stretch and dilate leading to venous stasis & impaired venous return |
| Indicates the body's ability to defend itself against infection and inflammation; elevated with acute myocardial infarction | WBC |
| Determines ability of the blood to carry oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lung | RBC |
| Percentage of packed RBCs in the total sample of whole blood | Hematocrit |
| Measurement of main component of the RBCs whose function is to transport oxygen to the cells | Hemoglobin |
| Measurement of formed elements in the blood needed for coagulation | Platelet |
| Indicates damage to myocardial cells. Protein found in cardiac muscle | Myoglobin |
| Determination of body's ability to maintain acid-base balance | ABGs |
| Arms, Back, Neck or Jaw | List three areas to which pain of the heart may radiate: |
| Decreases fluid retention | Diuretics |
| Relieves pain | Antianginals |
| Prevents strokes | Antiplatelets |
| Increases cardiac output | Cardiac glycosides |
| Dissolves clots | Thrombolytics |
| Drugs used to treat angina | Nitrates Beta-adrenergic blockers Antiplatelets Calcium channel blockers |
| Descriptors for anginal pain | Burning Squeezing Vise-like Smothering |
| Observations made in patients with mitral stenosis | Tachypnea Decreasing pulse pressure Jugular vein distention Rumbling, low-pitched murmur sounds |
| Contains the highest pressure in the heart | Left Ventricle |
| Cone-shaped, has the thickest muscle mass of the four chambers | Left ventricle |
| Receives blood through the tricuspid valve | Right ventricle |
| Receives blood saturated with oxygen from the four pulmonary veins | Left Atrium |
| Receives blood from the inferior and superior vena cava | Right Atrium |
| Dehydration, hemorrhage and venous dilation ___________ preload | decreases |
| Increased venous return to the heart and overhydration _______________ preload | increases |
| Vasodilation _______________ afterload | decreases |
| Hypertension, vasoconstriction, and aortic stenosis _____________ afterload | increases |
| An ambulatory ECG that provides continous monitoring | Holter monitor |
| A transducer is used that picks up sound waves and converts them to electrical impulses | Echocardiogram |
| A high-resolution, three dimensional image of the heart; cardiac tissue is images without lung or bone interference | MRI |
| An exercise tolerance test that is a recording of an individual's caridiovascular response during measured exercise challenge | Stress test |
| study of electrical activity of the heart | ECG |
| A procedure in which a catheter is advanced into the heart chambers or coronary arteries under fluoroscopy | Cardiac catherterization |
| Images of the heart obtained with a probe in the esophagus | Transesophageal echocardiogram |
| Test that may determine pressures in the RA, RV, and pulmonary artery | Cardiac catherterization |
| Electrodes placed on the surface of the skin pick up the electrical impulses of the heart | ECG |
| Patient ambulates on a treadmill or a stationary bicycle while connected to a monitor | Stress test |
| Heart sonogram that is a visualization and recording of the size, shape, position, and behavior of the heart's internal structures | MRI |
| Injection of technrtium 99m that concentrates in necrotic myocardial tissue to measure ventricular failure | Multiple-gated acquisition scan (MUGA) |
| Noninvasive measurement of oxygen saturation | Pulse oximetry |
| Evaluates patency of coronary artery bypass grafts | Thallium imaging |
| Use of catheters with multiple electrodes inserted through the femoral vein to record the heart's electrical activity | Electrophysiology study (EPS) |
| Fast form of imagin technology that allows for high-quality images of the heart as it contracts and relaxes | Ultrafast computed tomography |
| Disturbances in heart rhythm | Dysrhythmias |
| When the injured left ventricle is unable to meet the body's circulatory demands | Heart failure |
| The most frequent cause of death after an AMI; marked by hypotension and decreasing alertness | Cardiogenic shock |
| When clots form in the injured heart chambers, they may break loose and travel to the lung | Thromboembolism |
| A fatal complication in which weakened areas of the ventricular wall bulge and burst | Ventricular aneurysm/rupture |
| The narrowing of the opening in the valve that impedes blood flow from the left atrium into the left ventricle is called _______________. | Mitral stenosis |
| The leading cause of mitral stenosis is _________________. | Rheumatic heart disease |
| In patients with mitral stenosis, the chamber of the heart that dilates to accommodate the amount of blood not ejected is the ________________. | Left atrium |
| Excision of parts of the leaflets of the mitral valce to enlarge the opening is called _____________________. | Commissurotomy |
| When collecting data for the assessment of the patient with mitral stenosis, the nurse takes the vital signs and auscultates for _________________________________. | Heart murmur |
| Nitroglycerin | Antianginals |
| Aspirin, dipyridamole (Persantine) and clopidogrel (Plavix) | Antiplatelet agents |
| Heparin and warfarin (Coumadine) | Anticoagulants |
| Morphine and meperidine hydrochloride (demoral) | Analgesics |
| Furosemide (Lasix) and hydrochlorithiazide (Esidrix, HCTZ, and Oretic) | Diuretics |
| Streptokinase, sotalol hydrochloride (Betapace), and tissue plasminogen activator | Fibrinolytics (antithrombolytics) |
| Digoxin (Lanoxin) and digitoxin | Cardiac glycosides |
| Ineffective thermoregulations relates to _________________________. | cooling during surgery |
| Decreased cardiac surgery related to __________________________. | Fluid loss or decreased fluid intake |
| Risk for infection related to ____________________. | altered skin integrity |
| The t wave is inverted | Ischemia |
| There is ST segment elevation | Injury |
| A significant Q wave is present; the Q wave is greater than one-third the height of the R wave | Infarction |
| Signs and Symptoms of Right Sided Heart Failure | Dependent Edema Increased central venous pressure Jugular vein distention Abdominal engorgement Pulmonary edema Decreased urinary output |
| Signs and symptoms of left sides heart failure | Decreased BP reading Anxious, pale, and tachycardiac Crackles, wheezes, dyspnea and cough |
| Improves pump finction by increasing contractility and decreasing heart rate | Cardiac glycosides (digoxin) |
| Decrease anxiety, dilates vasculature and reduces myocardial consumption in the acute stage | Morphine |
| The pressure is highest in which heart chamber? | Left ventricle |
| Afterload is decreased by ________________. | vasodilation |
| The first branches of the systemic circulation are the ____________________. | coronary arteries |
| The ventricles contract when the electrical impulse reaches the ___________________. | purkinje fibers |
| Stroke volume, the amount of blood ejected with each ventricular contraction, depends on myocardial _________________. | contractility |
| If the valves of the heart so not close properly, the patient is said to have _____________. | murmur |
| Ways to increase oxygen supply to the myocardium are to administer supplemental oxygen and increase coronary blood flow by: ________________. | coronary artery vasodilation |
| Thrombophlebitis and varicosities are more common in ___________________. | older people |
| ________________ is more likely to occur in older adults as the cardiovascular system adapts more slowly to changes in position. | Postural hypotension |
| In asking cardiac patients about their diets, the nurse should especially record information about which two areas of intake? | Salt and fat |
| A noninvasive measure of cardiacoutput is ____________________. | pulse pressure |
| The sound produced by turbulent blood flow across the valves is called an _____________. | heart murmur |
| A common diagnostic test that measures the electrical activity of the heart is ________. | ECG |
| A normal ECG finding is documented as a normal ____________________. | sinus rhythm |
| The stress test must be stopped immediately if which of the following symptoms occur? | Angina and falling blood pressure |
| The normal cardiac output is ____________. | 4-8 liters/min |
| Patients with AMI often exhibit ___________. | elevated cholesterol levels |
| A noninvasive measurement of arterial oxygen saturation is _____________________. | pulse oximetry |
| What type of diet is generally recommended for cardiac patients? | low-fat and high-fiber |
| If fluid retention accompanies the cardiac problem, the physician may order restriction of ______________________. | sodium |
| Diuretics, such as furosemide, may cause a deficiency of ________________. | potassium |
| The purpose of temporary and permanent pacemakers is to improve cardiac output and tissue perfusion by restoring regular __________________. | impulse conduction |
| The delivery of a synchronized shock to terminate atrial or ventricular tachyarrhytmias is called ______________. | cardioversion |
| During oprn-heart surgery, the patient's core temperature is reduced to decrease the body's need for ____________________. | oxygen |
| Smoking, high blood pressure and abesity are risk factors for _______________________. | atheroslerosis |
| The most frequent symptom of coronary artery disease, which represents lack of oxygen to tissues, is _________________. | pain |
| The substernal pain resulting from lack of oxygen to the myocardium is called _____________________. | angina pectoris |
| Modifiable risk factors for AMI include hypertehsion, obesity and _________________. | smoking |
| What drugs are used to prevent angina in patients with CAD? | analgesics |
| Nurses should be alert to complaints of decreased exercise tolerance and dyspnea in African-American males because they are at risk for _______________________. | cardiomyopathy |
| Cardiogenic shock is marked by hypotension, cool moist skin, olguria and ______________. | decreased alertness |
| Which drug is administered to dilate coronary arteries and increase blood flow to the damages area of a patient with AMI? | Nitroglycerin |
| Veins generally used in coronary artery bypass surgery as grafts to the coronary arteries include the internal mammary and __________. | saphenous |
| In order to decrease cardiac workload and increase oxygenation to the myocardium, the recommended position for patients with HF is ___________________________. | semi-fowlers of high-fowlers |
| The most adverse effects of diuretic theraphy for patients with HF are __________________. | fluid and electrolyte imbalances |
| A common finding in patients with right sided heart is ______________________. | dependent edema |
| Drugs that may be given to patients with HF include diuretics, vasodilators and ___________________. | inotropics |
| The most common site for organisms to accumulate in patients with infective endocartitis is the _________________. | mitral valve |
| Symptoms of endocartitis include weight loss, malaise, chills & fatigue and ____________. | fever |
| The hallmark symptom of pericarditis is ________________. | chest pain |
| The patient with pericarditis is treated with analgesics, anti-inflammatory agents, antibiotics and ___________________. | antipyretics |
| A procedure in which a periherally inserted catherther is bassed into an occluded artery and a balloon inflated to dilate the artery is ___________________. | intracoronary stent placement |
| Disease od the heart muscle that generally has an unknown cause and leads to heart failure is called ___________________. | cardiomyopathy |
| Which type of cardiomyopathy is associated with a high incidence of sudden death? | Hypertropic |
| Lifelong medications that must be given to patients with heart transplants include ______________. | immunosuppressives (prevents body from rejecting heart) |
| Two major valve problems of the heart are _____________ and __________________. | stensis regurgitation |
| Heparin dosage for the patients with cardiac disorder is adjusted according to the ___________________. | partial thromboplastin time (ptt) |
| Diuretics such as furosemide and hydrochlorothiazide are used with cardiac conditions to treat _________________. | fluid retention |
| Before each dose of digitalis, the apical pulse is counted for 1 full minute; the drug is withheld and the physician notified if the pulse is below _____________________/ | 60bpm |
| Older people are more susceptible to adverse effects because they _____________________. | excrete drugs more slowly |
| Patients taking immunosuppressive drugs to prevent rejected transplanted tissue have reduced ___________. | resistance to infection |
| antidysrhythmic drugs work by slowing impulse conduction, increasing resistance to premature contraction or ____________________. | depressing automaticity |
| A major part of treatment for people with heart disease is the reduction of dietary fat and ________________. | cholesterol |
| An sutomatic implanted cardioverter defibrilator is used to ____________________________________. | decrease the risk of sudden caridac death in people with recurrent life-threatening dysrhyhmias |
| The internal cardia defibrillator is used to treat patients with life-threatening recurrent ______________________. | ventricular fibrillation |
| A Swan-Ganz catheter is inserted into the pulmonary artery to measure ________________________. | right-sided heart pressure |
| Measurements below normal from a central venous cathether threaded into the right atrium indicates ________________. | hypovolemia |
| Pulse that is easily obliterated by slight finger pressure is considered _________________. | weak or thready |
| Pulse that is absent is considered _________________. | absent |
| Pulse that is forceful, not easily obliterated by finger pressure is considered _________________. | bounding |
| Which heart sound is normal in children and young adults but is pathologic if it is heard after the age of 30? | S4, atrial gallop |
| What type of drug theraphy is used after an AMI to prevent strokes? | antiplatelets |
| Calcium channel blockers, vasodilators and beta=adrenergic blockers are used to treat ________________. | angina |
| Drugs that slow down the rate of impulse conduction in the heart and also depresses automaticity or increase resistance to premature stimulation are _________________. | antidysrhythmics |
| The dosage of heparin is based on measurements of the patient's __________________. | aPTT |
| When the pericardium is inflamed, a sound heard along the left sternal border is the ___________________________. | friction rub |
| The most widely used drugs in the treatment of HF are ____________________________. | cardiac glycosides |
| The first medication given to patients with chs pain is _______________. | aspirin |
| Which herb taken to lower plasma lipids may increase the effects of anticoagulants and insulin? | garlic |
| Chambers paced, chambers sensed and mode of response are three settings for a ___________________. | pacemaker |
| Patient teaching for permanent pacemakers include _______________________. | how to count their pulse for 1 full minute daily |
| The leading cause of mitral stenosis is ________________________. | Rheumatic Heart disease |
| As left atrial pressure increases in mitral stenosis, this leads to: | Increased workload and right ventricular hypertrophy |
| If dietary control does not reduce cholesterol sufficiently, treatment may inclue ___________________. | lipid-lowering agents |
| Questran, Lopid and niacing are drugs classidied as ___________________________. | lipid-lowering drugs |
| sudden obstruction of an artery by a floating clot or foreign material | embolism |
| An abnormal sensation | Paresthesia |
| concentration of the blood | hemoconcentration |
| development of a clot in the presence of venous inflammation | Phlebothrombosis |
| deficient blood flow due to obstruction or constriction of blood vessels | Ischemia |
| increase in blood vessel diameter | vasodilation |
| deevelopment of venous thrombi without venous inflammation | thrombophlebitis |
| decrease in blood vessel diameter | vadocontriction |
| coolness in an area of the body due to decreased blood flow | poikilothermy |
| thickness in the blood | viscosity |
| development or presence of a thrombus | thrombosis |
| dilated segment of an artery caused by weakness and stretching of the vessel wall | aneurysm |
| murmur detected by auscultation | bruit |
| vessels that return blood from the heart | veins |
| two main trunks of these vessels are the thoracic duct and the right lumphatic duct | lymph vessels |
| thick-walled, elastic structures | veins |
| equipped with valves that aid in the transportation of blood against gravity | lymph nodes |
| formed by a single layer of endothelial cells | leaflets |
| vessels that carry blood away from the heart | arteries |
| transfer of oxygen and nutrients between the blood and the tissue cells occur here | capillaries |
| thin-walled vessels that collect and drain fluid from the peripheral tissues and transports the fluid to the venous system | lymph vessels |
| decreased temperature at tn ischemic site | poililothermy |
| paleness apparent over an area of reduced blood supply | pallor |
| associated with intermittent claudication | pain |
| detected by palpating the affected and surrounding areas | pain |
| determined by paplating peripheral pulses for rate, rhythm and quality | pulselessness |
| abnormal sensation such as numbness, tingling or crawling sensation | paresthesia |
| impairment of motor function | paralysis |
| characterized by pins and needles sensation | paresthesia |
| describes by patients as tenderness, heaviness or fullness in the extremity | pain |
| a test to evaluate the pain response in the calf area to determine venous thrombosis is called _____________________. | bruits |
| a test used to determine the patency of the ulnar and radial artery is called ____________________. | allen's test |
| when blood flowing through the arteries sound like turbulent, fast moving fluid, these sounds are called ________________. | bruits |
| Brown pigmentation sites with flaky skin over the edematous areas of the ankles are described as ____________________. | statis dermatitis |
| a noninvasive, inexpensive diagnostic tool in which sound waves are directed toward the artery or vein being tested is __________________. | doppler ultrasound |
| a noninvasive examination that measures the blood volume and graph changes in the flow of blood and is often used for patients too ill to undergo arteriography is ________________. | plethysmography |
| the segmental limb pressure test and pulse volume measurement test are examples of ____________________. | pressure measurement |
| an invasive procedure that requires the injection of dye into the vascular system is called __________________________. | angiography |
| a test that measures pulse volumes before and after exercise is _____________________. | treadmill test |
| a test that evaluates blood flow by providing a two-dimensional image of blood vessels and blood flow is ________________. | doppler ultrasound |
| the injection of a chemical that irritates the venous endothelium for patients with varicose veins | sclerotheraphy |
| a procedure that is done to relieve arterial stenosis in people who are poor surgical risks | percutaneous transluminal angioplasty |
| procedure used to rmove vairose veins | vein ligation and stripping |
| an incision into the obstructed vessel to stop awau emboli and atheroslcerotic plaque followed by surgical closure of the vessel | endarterectomy |
| the excision of the sumpathetic ganglia; used for patients with intermittent claudication | sympathectomy |
| the removal of a blood clot located in a large vessel | embolectomy |
| protein levels increase in cardiac disease as well as in skeletal muscle disorder | myoglobin |
| protein is elevated in serum inflammation. Elevated levels with cardia disease | C-reactive protein (CRP) |
| helps differentiate dypnea related to cardiac problems from noncardiac related dyspnea. Elevated in heart failure | C-type natriuretic peptide (BNP) |
| measures the protein released after myocardial injury | troponin |
| the affected extremity appears in deep vein thrombosis is ____________________. | Edematous, warm and tender |
| superficial veins appears ________________ in deep vein thrombosis | warm and tender |
| The affected area of compromise may be __________________ deep vein thrombosis is | warm and tender |
| Homan's sign is _____________ positive sign for deep vein thrombosis | positve |
| Risk factors for the development of deep vein thrombosis are : | prescribed foot rest obesity malnourishment use of oral contraceptives surgery under general anesthesia |
| Treatments for deep vein thrombosis are: | frequent ambulation elevate extremity apply warm compress anticoagulant theraphy |
| Factors (aka Virchow's triad) contribute to venous thrombos formation are: | stasis of the blood damage to the vessel walls hypercoagulability |
| Symptoms of a deep vein thrombosis in the lower leg are: | edematous area area is tender to the touch |
| percentage of patients with deep vein thrombosis that have no visible signs or symptoms is __________. | 50% |
| The most serious complicatino of deep vein thrombosis is ________________. | pulmonary embolism |
| Care must be taken when using heat on patients with peripheral vascular disease because ___________. | they may have impaired sensation and results of tissue ischmia |
| Drugs that are used in the general management of peripheral vascular disease to improve peripheral circulation are: | antocoagulants thrombolytics vasodilators hemorrheologic agent |
| Drugs that are used to treat Raynaud's disease are: | calcium channel blockers bosentan sildenafil transdermal nitroglycerin IV protaglandins |
| Oral anticoagulants and antidote | heparin and LMWH - protamine sulfate |
| Parenteral anticoagulant and antidote | Warafin sodium - vitamin K |
| when are anticoagulants and thrombolytic drugs contraindicated? | active bleeding patients on bed rest |
| What are complications of aneurysms? | emboli rupture thrombus forms obstructing blood flow pressure on surrounding structures |
| Factors that contribute to varicosities | hereditary weakness aging pregnancy obesity occupations |
| characterized by deep vein obstruction | secondary varicose vein |
| oonly superficial veins are affected | promary varicose vein |
| common sites for varicosities | esophageal veins hemorrhoidal veins |
| primary diagnostic examination used to detect venoud thrombi | duplex ultrasonography |
| Any interruption of the blood flow to the distal regions of the body, as occurs in peripheral vascular disease, results in ___________. | hypoxia |
| The primary result of aging on the peripheral vessels is __________________________. | stiffening of vessel walls |
| Aging in the vascular system causes a slowing of the heart rate and a decrease in the stroke volume, resulting in decreased ______________________. | cardiac output |
| the transportation of oxygen is compromised in the aging patient by decreased ______________. | hemoglobin |
| PVD is a common complication of ______________. | myocardial infarction |
| If PVD caused limb-threatening ischemia, amputation of a limb may be necessary because of the development of _______________. | tissue necrosis |
| Skin themperature is palpated in patients with PVD to determine the existence of _____________. | ischemia |
| In the ecaluation of edema, when the thumb is depressed in the area for 5 seconds and the depression of the thumb remains in the edematous area, the edema is said to be _____________. | pitting |
| If pain or severe skin color changes occur during exercises with PVD patients, the nurse should ______________________. | stop the exercise immediately |
| It is important for patients with PVD to stop smoking because smoking causes ________________. | vasoconstriction |
| The primary function of intermittent pneumatic compression devices is to prevent __________________. | deep vein thrombosis |
| Which position should be avoided by patients with PVD? | lowering extremities below the level of the heart |
| Which works as a vasodilator that promotes arterial flow to the peripheral tissues? | Heat |
| Elevation of the extremity following surgery for patients with PVD aids in the prevention of __________________. | edema |
| Disapperance of a peripheral pulse during postoperative care of patients with PVD alerts the nurse to the development of __________________. | thrombotic occlusion |
| The main adverse action of anticoagulants is ________________________. | bleeding |
| Thrombolytic theraphy is employed to ________________________. | dissolve an existing clot |
| The use of vasodilators results in increased blood flow by relaxing the vascular smooth muscle and causing ______________________. | decreased resistance in vessels |
| A grave risk with a diagnosis of deep vein thrombosis is the development of ____________________. | pulmonary embolus |
| Three participating factors (called Virchow's triad) for a thrombus to form include hypercoagulabilitym damage to the vessel walls and ____________________. | statis of the blood |
| The primary diagnostic examinations used in the detection of thrombus formation are plethysmography, Doppler ultrasound and ___________________. | venography |
| Patients with thrombosis should not be massaged or rubbed because of the possible development of ____________________. | pulmonary emboli |
| The placement of antiembolism hose on patients with thrombosis is done to improve circulation and to prevent _______________. | stasis |
| A life-threatening event that requires immediate attention is _____________________. | arterial embolism |
| The absence of a peripheral pulse below the occlusive area is a clinical manisfestation of ___________________________. | peripheral arterial occlusive disease |
| During repair of an abdominal aneurysm, the aorta is clamped for a period of time. This poses a risk of __________________. | renal failure |
| Varicose veins develop as a result of faulty _____________. | valves |
| Chronic venous insufficiency may develop form ____________________. | varicose veins |
| Signs of chronic venous sufficiency include edema of lower legs and __________________. | stais dermatitis |
| The medical management of lymphangitis necessaties the administration of _____________________. | antimicrobial agents |
| Elastic support hose are utilized for several following an acute attack of lymphangitis to prevent the formation of __________________. | lymphedema |
| The primary age-related change in peripheral vessels is _______________________. | arteriosclerosis |
| Aging in the vascular system causes __________________________. | decreased cardiac output |
| A patient complains of severe aching pain in his left foot after lying quietly in bed. This type of pain is a symptom of ____________. | PVD |
| A priority in caring for patients with PVD is _____________________. | pain management |
| When intermittent claudication occurs, the patient should __________________. | stop exercise |
| Intermittent pneumatic compression is used for patients ______________________. | on bed rest following surgery |
| Which medications intensify anticoagulant effects? | NSAIDS Antibiotics Mineral Oil Tolbutamine |
| Which herbal remedy decreases the effectiveness of warfarin? | St. John's wort. |
| Patients taking vasodilators for PVD must be monitored for __________________. | hypotension |
| Intermittent claudication is the classic sign of ___________________. | PVD |
| Beurger's disease (thromboangitis obliterans) is uncommon in people living in _________________. | the United States |
| Beurger's disease is common in people in ____________, _____________, and ____________. | India Korea Japan |
| Chronically cold hands, tingling, pallor, and numbness are symptoms of _________________. | Raynaud's disease |
| An alternate theraphy for vasopastic episodes of Raynaud's disease is _______________. | biofeedback |
| Occupations requiring prolonged standing and the aging process increase the risk for _________________. | varicosities |
| Foods that should be avoided in patients with PVD are: | MSG Ham processed meals salted foods pre-packaged food canned food |
| What is the "related to" term in the ineffective tissue perfusion nursing diagnosis for patient with Raynaud's disease? | vasoconstriction |
| Characteristics of venous insufficiency in the legs are: | lower leg edema bronze-brown pigmentation cool skin dull ache, heaviness in calf or thigh |
| Groups that experience an increased incidence of Raynaud's disease are: | women people who live in cold climates |
| Normally, the impulse that stimulates a myocardial contraction begins in the ______________. | SA node |
| When cardiac output falls, compensatory mechanisms include _____________________. | enlargement of the ventricular myocardiam |
| The exchange of oxygen and nutrients occurs at the level of the _________________-. | capillary |
| Thickening and hardening of the intima put the older adult at risk for __________________. | Emboli |
| A patient complains of pain and cramping in the legs that occur when walking and is relieved by rest. This complaint is typical of ______________. | intermittent claudication |
| When inspecting a patient's leg, you press your thumb into a edematous area around the ankles. When you remove your thumb, a depression 1/4 inch remains on both ankles. You would document: _______________ | 2+ edema, both ankles |
| For the patient with PVD, the common purpose of exercise, elastic stockings and elevation of extremities is to: ____________. | improve venous return |
| The dosage of low-molecular weight heparin is based on ______________. | fixed recommended dosage |
| Discharge teaching for the patient with peripheral arterial occlusive disease affecting both legs includes: | promptly report anyinjury to the feet or legs |
| After repair of an abdominal aneurysm, it is especially important to monitor _____________. | I |
| The most seious complication of venous thrombosis is ____________. | pulmonary embolism |
| Low HDL levels can be raised by being physically active at least 30 minutes every day, by not smoking, and by losing weight. | |
| Heparine dosage is adjusted based on the patient's _______________. | activated partial thromboplastin time (aptt) |
| Warafin dosage is adjusted based on the patient's ______________and ________________. | prothrombin time (pt) international normalized ratio (INR) |
| _________ and ___________ agents prevent formation of new clots | anticoagulants antiplatelet agents |
| ________ destroy clots that have already formed. | fibrinolytic agents |
| American Indians and African Americans develop CAD at an earlier age than other Americans. | |
| The incidence of CAD is highest among middle-aged Caucasian males. | |
| Drugs that help some people who are trying to quit smoking are _________ and _____________. | nicotine bupropin |
| When patients are taking diuretics, monitor for signs and symptoms of hypokalemia; cardiac dysrhytmias, muscle weakness and diminished bowel sounds | . |
| Monitor people with diabetes for low blood glucose if they are taking beta-blockers | . |
| Asians respond better to beta-blockers than whites do. | , |
| Whites respond better than African americans to beta-blockers and ACE inhibitors | . |
| Advise patients not to discontinue antihypertensive theraphy simply because they feel well. Blood pressure can be very high with no symptoms | . |
| A consistent blood pressure of 144/100 is considered ______________. | stage 2 hypertension |
| Individuals at greatest risk for severe complications of HTN are ___________________. | african-american males |
| The cause of primary HTN is ______________. | unknown |
| complications associated with prolonged HTN include the following _____________. | chronic renal failure |
| a patient who is taking hydrochlorothiazide for HTN complains of weakness, feeling grouchy, and loss of appetite. You should suspect ______________. | hypokalemia |
| beta-blockers lower blood pressure by _____________. | inhibiting cardiac stimulation |
| the initial measurement of blood pressure should include ____________________. | having the patient rest supine for at least 10 min before taking BP |
| a patient on antihypertensive drugs complains of feeling dizzy when first getting up. What should you advise the patient to do when this occurs? | change position slowly and exercise the legs beefore standing |
| sudden drop in systolic blood pressure when changing from a lying or sitting position to a standing position | orthostatic hypotension |
| stationary blood clot | thrombus |
| nosebleed | epistaxis |
| persistent elevation of arterial blood pressure of 140/90 mm Hg or greater | hypertension |
| fainting | syncope |
| enlargement | hypertrophy |
| abnormal amounts of lipids or lipoproteins in the blood | dyslipidemia |
| epinephrine constricts blood vessels and increases blood pressure, causing the heart rate to _________. | increase |
| when body position is altered from supine to standin, the diastolic blood pressure normally _______________. | increases |
| in response to decreased ability of the aorta to distend, pulse pressure ___________. | widens |
| in response to increased peropheral vascular resistance, the systolic pressure ___________. | increases |
| epinephrine constricts blood vessels and increases the force of cardiac contraction, causing blood pressure to ________________. | increase |
| when there is narrowing of the arteries and arterioles, peripheral vascular resistance ___________. | increases |
| retention of fluid contributes to hypertension | . |
| stimulants that may contribute to HTN are: | caffiene nicotine amphetamines |
| symptoms of HTN crisis | nausea restlessness blurred vision severe headache confusion |
| Lifesyle Modifications: reduces water in the body, decreasing the circulating blood volume | sodium reduction |
| Lifesyle Modifications: decreases blood glucose and cholesterol levels, increasing sense of well-being | exercise |
| Lifesyle Modifications: eliminates vasoconstriction caused by nicotine | smoking cessation |
| Lifesyle Modifications: reduces stress and lowers blood pressure | relaxation theraphy or biofeedback |
| Lifesyle Modifications: improves cardiac efficiency by increasing cardiac output and decreasing peripheral vascular resistance | exercise |
| reduces blood pressure by reducing the workload of the heart | weight reduction |
| Drug theraphy: block alpha receptor effects, lowering blood pressure by reducing peripheral resistance | alpha-adrenergic receptor blockers |
| Drug theraphy: decrease fluid retention by decreasing production of aldosterone | ACE inhibitors |
| Drug theraphy: reduce blood pressure by blocking the beta effects of catecholamines | beta-adrenergic receptor blockers |
| Drug theraphy: inhibut impulses from the casomotor center in the brain, reducing peripheral resistance and lowering blood pressure | central-adrenergic blockers |
| Drug theraphy: block receptors for angiotensin II and reduce aldosterone secretion | ACE inhibitors |
| Drug theraphy: reduce blood volume through promostion of renal excretion of sodium and water | diuretics |
| Drug theraphy: block the movement of calcium into cardiac and vascular smooth muscle cells, reducing heart rate, decreasing force of cardiac contraction, and dilating peripheral blood vessels | calcium channel blockers |
| Drug theraphy: relax arteriolar smooth muscle | direct vasodilators |
| Drug theraphy: prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, decreasing peripheral resistance | ACE inhibitors |
| Side effects or caution: Palpitations, dizziness, headache, drowsiness | alpha-adrenergic receptor blockers |
| Side effects or caution: hypoglycemia | beta blockers |
| Side effects or caution: hypovolmia and hypokalemia | diuretics |
| Side effects or caution: flushing, dizziness, headache | calcium channel blockers |
| Side effects or caution: skin rase, cough | ACE inhibitors |
| Side effects or caution: use cautiously in patients with asthma, diabetes, and COPD | beta-blockers |
| Side effects or caution: fluid & electrolyte imbalance | diuretics |
| Side effects or caution: dry mouth, weakness | centrally acting drugs |
| As blood pressure rises, what are complications that occur? | HF Heart Attack Blindness Kidney disease stroke |
| What are long term effects of hypertension in the eyes? | Retinal hemorrhages Papilledema Narrowing of retinal arterioles |
| What are long term effects of hypertension on the heart? | angina myocardial infarction CAD CHF |
| What are long term effects of hypertension on the brain? | Transient isdhemic attack Strokes |
| At what age do complications of hypertension increase? | 50 yrs |
| What is the leading cause of death in people with hypertension? | stroke |
| How does aging affect blood pressure? | decreased cardiac output increased PVD Pulse pressure widens |
| The most common cardiovascular problem in the US today is ___________________. | HTN |
| The cause of primary HTN is ______________. | unknown |
| HTN is usually detected in which age group? | 30-50 yrs old |
| A blood pressure of 135/87 is considered to be: _______________ | prehypertension |
| In which risk group is a HTN patient who smokes half a pack of cigarettes a day and who has no heart disease or heart damage, classified? | Risk B |
| Isolated systolic blood pressure elevations of 160 mm Hg in older adults are most often due to ____________. | adrenal hormone glands |
| Patients with systolic pressure between 120 and 139 and with diastolic pressures between 80 and 89 are said to have ________________. | prehypertension |
| An older patient taking furosemide (Lasix) for HTN compplains of muscle weakness, confusion, and irritability. Which patient teaching is correct for this patient? | Increase potassium in the diet |
| Beta blockers are contraindicated in patients with _____________. | asthma |
| When people with diabetes are taking beta blockers for HTN, the only sign of hypoglycemia may be __________________. | diaphoresis |
| Older patients taking beta blockers are at greater risk than younger people for _______________. | bradycardia & hypotension |
| Which group of patients responds better to diuretics as treatment for HTN? | African-Americans |
| Older patients taking antihypertensives are more susceptible to orthostatic hypotension, increasing their risk for ______________. | falls |
| When body position is changed from supine to standing, the systolic pressure normally ___________________. | rises about 10 mm Hg |
| If patient's diastolic pressure is 120 mm Hg, the nurse should _____________. | notify the physician |
| What is the danger of suddenly stopping antihypertensive drugs? | rebound hypertension myocardial infarction CVA |
| People with increased blood pressure should not take over the counter ____________________. | cold remedies |
| A common side effect of many antihypertensives is ___________________. | sexual dysfunction sedation depression |
| Without appropriate treatment, the patient with hypertensive crisis may develop ______________________. | cerebrovascular accident malignant HTN hypertensive encephelopathy eclampsia preochromocytoma |
| What percentage of people with HTN do not know they have it? | 30% |
| Althougt 59% of people with HTN are being treated, in what % of people is HTN controlled? | 34% |
| what is the medical treatment goal for patients with diabetes or renal disease? | 130/80 |
| Which drug is recommended for initial theraphy for HTN, according to JNC-7? | Thiazisde-type diuretic |
| How does a blood pressre cuff which is too small affect the blood pressure reading? | false high reading |
| Patients taking antihypertensive medications are encouraged to rise slowly from lying or sitting position in order to prevent ________________. | orthostatic hypotension |
| What may occur is antihypertensive drugs are stopped abruptly? | rebound HTN myocardial infarction CVA |
| What is the percentage of people with HTN who have primary or essential HTN? | 90-95% |
| Which blood strudies are usually ordered for people with HTN? | hematocrit glucose potassium calcium creatine Lipid profile |
| Which of the following are teaching points for patients with orthostatic hypotension? | avoid hot baths and showers rise slowly |
| What are causes of secondary HTN? | renal disease narrowing of the aorta increased intracranial pressure excess secretion of adrenal hormones |
| What is the category for a person with BP of 150/95? | stage 1 HTN |
| What is the category for a person with BP of 122/84? | preHTN |
| What is the category for a person with BP of 118/78? | normal |
| What is the category for a person with BP of 180/110? | stage 2 HTN |
| The average systolic BP reduction range for a person who walks briskly 30 min per day, most of the week is ___________________. | 4-9 mm Hg |
| What is the average systolic BP reduction range for a person who adopts the DASH eating plan? | 8-14 mm Hg |
| what is the average systolic BP reduction range for a person who maintains body weight with a BMI between 18.5-24.9 kg/mm? | 5-20 mmHg |
Created by:
jleycomiller
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