Erstellt von Brenna Gailinas
vor mehr als 4 Jahre
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Frage | Antworten |
Pathophysiology of HF | heart muscle unable to pump effectively |
Expected Findings for Left-Sided HF | Dyspnea Displaced apical pulse S3 (gallop) Pulmonary congestion Frothy pink-tinged sputum |
Expected Findings for Right-Sided HF | Jugular vein distention Ascending edema Ascites Weight gain Liver enlargement |
Disease Prevention for HF | Exercise program Low-sodium diet Fluid restrictions Smoking cessation Consistent med-schedule |
Meds for HF | Diuretics After-load reducing agents (ACE/ARB/Ca+ channel blocker) Digoxin Beta blockers |
Pathophysiology for Angina | Blood flow to heart is compromised causing ischemia |
Expected Findings for Angina | "Impending doom" feeling Chest pain Dizziness Pallor/clammy skin Tachycardia, tachypnea, heart palpations |
Disease Prevention for Angina | Regular exercise Check BP & cholesterol checked regularly Low-sodium, low-fat diet Smoking cessation |
Meds for Angina | Vasodilators Analgesics Beta blockers Thrombolytic agents Antiplatelet agents Anticoagulants Nitro |
4 Ways Body Regulates BP | 1. Arterial baroreceptor system 2. Regulation of fluid volume 3. RAAS 4. Vascular auto regulation |
Expected Findings for Atherosclerosis | Cool extremities Prolonged cap. refill Asymmetric pulse strengths Bruit |
Treatment for Atherosclerosis | Diet Exercise Cholesterol-lowering meds (statins most common) |
Expected Findings for Venous PVD | Edema Stasis dermatitis Stasis ulcers |
Expected Findings for Arterial PVD | Intermittent claudication Numbness (at night) Loss of hair on legs Dry, scaly, pale skin Thickened toenails Pain |
Meds for PVD | Anti-hypertensives Vasodilators Antiplatelet Analgesics Anti-lipidemics |
Heart Beat Explanation (P QRS T) | P: atrial contraction QRS: contraction of the ventricles T: relaxation of ventricles |
Expected Findings for A Fib | Fatigue Weakness Shortness of breath Dizziness Anxiety Palpitation Hypotension |
Purpose of Meds for A Fib | Slow & regulate heart rate NOT to correct rhythm |
Meds for A Fib | Beta blockers Ca+ channel blockers Digoxin Anticoagulants |
Systolic Left-Sided HF | Heart cannot contract forcefully enough during systole to eject enough blood into circulation |
Diastolic Left-Sided HF | Left ventricle cannot not relax enough during diastole (cannot fill properly) |
Valvular Stenosis | Stiffening/thickening of valve causing narrow opening and obstructing flow |
Valvular Regurgitation | Backward flow through the valve |
Valvular Prolapse | Displacement of valve leaflets during systole |
Drug Therapy for Valvular Disease | Diuretics Beta blockers ACE inhibitors Digoxin O2 |
Cholesterol | Used for insulation Major component in bile Stored in liver |
HMG-CoA Reductase | Produces LDL and VLDL |
MoA of HMG-CoA Reductase Inhibitor | Inhibits production of LDL and VLDL |
Suffix for HMG-CoA Reductase Inhibitors | -statin |
Side Effects of HMG-CoA Reductase Inhibitors | Myopathy Rhabdomyolysis Hepatotoxicity over time |
Rhabdomyolysis | Inflammation of the sheath that surrounds the muscle |
Nursing Considerations for HMG-CoA Reductase Inhibitors | Annual lipid/liver panels Assess for muscle pain Avoid grapefruit juice Teratogenic Take in PM (chol. produced in PM) Contraindicated w/ Ca channel blockers |
HMG-CoA Reductase Inhibitor Medication | atorvastatin (Lipitor) |
MoA of Fibrates Acid Derivatives | Reduces production of triglycerides |
Side Effects of Fibrates Acid Derivatives | GI discomfort Flatulence |
Nursing Considerations for Fibrates Acid Derivatives | Monitor for GI discomfort Panel annually Notify provider if going to be pregnant |
Fibrates Acid Derivation Medication | gemfibrozil (Lopid) |
MoA for Cholesterol Absorption Inhibitors | inhibits absorption of cholesterol in the small intestine |
Side Effects of Cholesterol Absorption Inhibitors | Cholecystitis (inflammation of gallbladder) |
Nursing Considerations for Cholesterol Absorption Inhibitors | Teratogenic Used in combination w/diet and exercise |
Cholesterol Absorption Inhibitor Medication | ezetimibe (Zetia) |
MoA for Inotropic Med | Slows HR to beat more forcefully; ions shift in the heart to enhance contractility |
Side Effects for Inotropic Meds | Bradycardia Arrhythmias Toxicity Hypokalemic pt more @ risk for toxicity Weakness |
Signs of Digtoxicity | Yellow halos Bradycardia Vomiting |
Nursing Considerations for Inotropic Meds | Apical pulse! Therapeutic lab draw Same time everyday Antidote is Digibind Educate on toxicity |
Therapeutic Level in Blood for Digoxin | 0.5 - 2.0 ng/dL |
Inotropic Med | digoxin (Lanoxine) |
MoA of Nitrates | Dilates coronary arteries (smaller vessels) to increase blood supply |
Side Effects of Nitrates | Headaches Orthostatic hypotension Reflexive tachycardia Dizziness |
Nursing Considerations for Nitrates | Fall risk Need rest for 30 mins after admin Change positions slowly Assess pain Avoid w/ erectile dys meds Educate pt not to carry in pocket |
Nitrate Medication | nitroglycerin (Nitrostat) |
MoA for ACE Inhibitors | ACE blocks the conversion of angiotensin I to angiotensin II which helps to decrease BP, decrease blood volume, and decrease uptake of Na+ |
Suffix for ACE Inhibitors | -pril |
Side Effects of ACE Inhibitors | Hypotension Cough |
Nursing Considerations for ACE Inhibitors | Monitor BP Change positions slowly Fall risk Angioedema Monitor for cough Teratogenic |
ACE Inhibitor Medication | captopril, lisinopril |
MoA of ARB Inhibitor | Blocks angiotensin II receptor from binging to the smooth muscles which decreases BP, decreases BV, and decreases uptake of Na+ |
Suffix of ARB Inhibitors | -sartan |
Side Effects of ARB Inhibitors | Hypotension Angioedema |
Nursing Considerations for ARB Inhibitors | Monitor BP Change positions slowly Don't give to pt w/hypokalemia Teratogenic |
ARB Inhibitor Medication | losartan (Cozaar) |
MoA for Calcium Channel Blockers | Blocks calcium from binding to channels in smooth muscle of blood vessels, decreasing BP |
Side Effects of Calcium Channel Blockers | Hypotension Peripheral edema |
Nursing Considerations for Calcium Channel Blockers | Monitor BP & HR Change positions slowly Edema: monitor weight & I/O, sock lines Avoid grapefruit juice Photosensitivity |
Calcium Channel Blocker Medication | nifedipine (Adatta, Procardia) |
Purpose of Alpha in Body | Contraction of smooth muscle |
MoA for Alpha I Blockers | Vasodilates smooth muscle of SMALLER vessels; helps decreases BP & benign prostatic hyperplasia (BPH) |
Side Effects of Alpha I Blockers | Dizziness Hypotension Headaches |
Nursing Considerations for Alpha I Blockers | Monitor BP Report headaches Change positions slowly Take @ bedtime |
Alpha I Blocker Medication | doxazosin (Cardura) |
MoA of Beta Blockers | Blocks beta receptors in the heart to decrease HR and blocks epinephrine |
Suffix for Beta Blockers | -olol |
Side Effects for Beta Blockers | Hyperglycemia Bradycardia Hypotension Erectile dysfunction Fatigue |
Nursing Considerations for Beta Blockers | Monitor HP & BP Change positions slowly Monitor glucose levels |
Beta Blocker Medications | metoprolol (Lopressor) atenolol (Tenormin) |
MoA of Centrally-Acting Alpha Antagonists | Activates Alpha receptors in the CNS to reduce BP & HR; Long-term use med |
Side Effects of Centrally-Acting Alpha Antagonist | Reflexive tachycardia Drowsiness Dry mouth Weight gain Hypotension |
Nursing Considerations for Centrally-Acting Alpha Antagonists | Avoid alcohol Avoid other CNS depressants Taper off slowly Avoid machinery Slows metabolism |
Centrally-Acting Alpha Antagonist Medication | clonidine (Catapres) |
MoA of Arterial Vasodilators | Vasodilators arterioles for restrictive blood flow |
Side Effects of Arterial Vasodilators | Hypotension Reflex tachycardia Headaches |
Nursing Considerations for Arterial Vasodilators | Monitor BP & HR Change positions slowly |
Arterial Vasodilator Medication | hydralazine (Apresoline) |
Pathophysiology of Aortic Regurgitation | Aortic valve cannot close properly so blood flows back into left ventricle |
Disease Prevention for Aortic Regurgitation | Diet low in sodium Control chronic illnesses Regular exercise |
Expected Findings for Aortic Regurgitation | Increased pulmonary artery pressure LV hypertrophy Orthopnea Fatigue Palpitations |
Medications for Aortic Regurgitation | Diuretics Afterload-reducing agents (ACE/ARB/Ca+ Channel blockers) Inotropic agents (digoxin) |
Infective Endocarditis | Microbial infection of the endocardium (most common microbe is S.aureus or S.viridians) |
Expected Findings for Infective Endocarditis | Fever: chills, night sweats, fatigue Anorexia/weight loss New cardiac murmur Development of HF Petechiae Systemic embolization |
Examples of Primary Hypertension | Family hx of HTN African-American Hyperlipidemia Smoking > 60yo or postmenopausal Excessive sodium/caffeine intake Overweight/Obesity Physical inactivity |
Examples of Secondary Hypertension | Kidney disease Primary aldosteronism Cushing's Disease Brain tumors Encephalitis Pregnancy Drugs |
Aneurysm | Permanent localized dilation of an artery; arterial wall is weakened by congenital or acquired problems |
Common Anatomic Sites of Arterial Aneurysms | |
Stasis Dermatitis | Reddish-brown discoloration along the ankles extending up the calf |
What Symptoms Activate the RAAS? (4) | 1. Decreased BP 2. Decreased Na+ 3. Decreased O2 4. Decreased fluid volume |
Ways BP Medications Affects Organs (3) | 1. Decreases glomerular filtration 2. Vasoconstriction 3. Adrenal cortex releases aldosterone |
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