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Chapter 35 - Cardiac

Cardiac and Vascular Disorders

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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