NUR 106

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NUR 106
2012-08-26 16:10:41

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  1. How is hypertension defined by the American Heart Association?
    • Systolic >140 and diastolic >90
    • Patient is taking medications for HTN
    • Doctor prescribed HTN medications
  2. Cholesterol
    used to estimate risk of developing heart disease.  High blood cholesterol a  cholesterol greater than or equal to 240 mg/dL 
  3. Triglycerides
    Test for hypertension/CAD:  A form of fat in the blood stream; the storage form of food used for energy.  A desirable triglyceride level is <100
  4. HDL
    Test for Hypertension/CAD:  The carrier of cholesterol; the “good” cholesterol. HDL’s transport cholesterol back to the liver for processing and excretion.  A desirable HDL level is >35 mg/dL.
  5. LDL
    Test for hypertension/CAD:  The carrier of cholesterol; the “bad” cholesterol.  This cholesterol may get deposited in the lining of vessels of the vascular system.  A desirable LDL level is <100 mg/dL. 
  6. How does hypertension develop
    • Overactive Renin-Aldosterone problems (vasoconstriction)
    • Overactive SNS firing continously
    • Peripheral vascular resistence
    • Insulin resistence/Diabetes
  7. Primary Hypertension
    • 90 - 95% of the population
    • Lifestyle 
    • Genetics
    • Family History
  8. Secondary Hypertension
    • Kidney disease
    • Taking stimulants or drugs
    • Pregnancy Induced
  9. What is normal BP range and different stages of hypertension
    • Normal range 120/80
    • Pre-hypertension–need lifestyle
    • changes: systolic 120-139 diastolic 80-89

    Stage I & II:  Requires meds and lifestyle changes
  10. What are some early symptoms of hypertension
    • Vague headache
    • Occasional dizziness
  11. What are some S/S of advanced hypertension
    • Morning Headache
    • Blurred vision
    • Nocturia
    • Unsteadiness
    • Depression
  12. What are some common medications given for hypertension and CAD
    • Diuretics - decrease blood volume + plaque = decrease BP
    • Beta - Blockers - SNS inhibitory mechanisms
    • Direct vasodilators - relax blood vessles
    • ACE Inhibitors - blocks angio I from becoming angio II
    • Angiotesnsin inhibitor - blocks vasocontriction from angio II
    • Calcium Channel Blockers - depolorization slowing
    • HMG-CoA Reductase Inhibior - lower cholesterol levels
  13. S/S of coronary artery disease (CAD)
    • Typically asymptomatic until reaching advanced state
    • JVD
    • Edema in the lower extremeties
  14. Pre procedure Cardiac catheterization
    • Physical Assessment
    • Vital sings
    • Pedal pulses
  15. Post procedure Cardiac catheterization
    • Bed rest 4 – 8 hrs.
    • Patient must lay flat
    • Assess site for Vasoseal/Femstop
    • Vitals
    • Pedal pulses
  16. Angina
    • Transient substernal chest pain brought on by exercise, strees, extreme temperature changes, eating a heavy meal.
    • Less than 15 minutes that is relieved with nitroglycerin and/or rest is considered angina.
  17. Nitrates
    • Nitroglycerin can be given 1 pill every 5 minutes for angina
    • Nitroglycerin will decrease BP
    • Nitroglycerin is a vasodilator with a side effect of light-headedness
  18. What signs and symptoms will a woman display while having an MI
    back and epigastric pain
  19. Myocardial Infarction
    • Plaque ruptures and clogs the coronary arteries of
    • the heart can cause heart muscle death distal to the region of blockage
  20. What is the initial treatment for a patient with an MI.
    • 1.  12-lead EKG
    • 2.  Morphine
    • 3.  Nitroglycerin
    • 4.  Order a Troponin
  21. Why would an opiod analgesic be used for an acute MI
    Relieve anxiety, pain, distress, and reduce myocardial oxygen demand by causing vasodilation
  22. When is an EKG performed
    • Tracing of the electrical activity of the heart.
    • First test to be performed before medications are given for angina, MI, or CHF
  23. What is the treatment for a patient who is having an MI within the 1rst 6 hours
    Fibrinolytic, aspirin, antidysrythmic
  24. Troponin
    Blood test to differentiate between unstable angina and MI in patients with chest pain.  A troponin level > 0.1 ng/mL is reflective of a possible MI.  Normal level should be <0.03
  25. Fibrinolytic
    • Used in the event of a heart attack.
    • Special drugs that work to break up clots that are blocking an artery.
    • Sometimes called clot busters.
  26. Antidysrhymics
    • used in the case of an MI.
    • Reduce ventricular conduction
  27. What are the different diagnositic studies for CHF/CAD
    • CBC
    • CRP
    • Lipid Panel
    • H&H
    • Myoglobin
    • BNP
    • Fasting Blood Sugar
  28. BNP
    • Typically used for CHF
    • B-Type natiuretic peptied is released from the ventricles in response to stress.
    • A level of < 100 pg/mL is good
  29. CRP
    • C-reactive protien is a blood test marker for inflammation in the body; which can cause artherosclerosis.
    • You are at high risk for cardiovascular disease if your CRP level is higher than 3.0 mg/L
  30. Holter Monitoring
    Machine that is worn for 24 - 48 hours that measres heart rhythms.
  31. Echocardiogram
    Test that uses sound waves to create a moving picture of the heart without using radiation. This test can detect back flow and cross flow
  32. Exercise Stress Test
    Electrodes are attached to an ECG monitor while the patient exercises on a treadmill.  If the patient develops chest pain or angina then this is a concern
  33. Cardiac Computed Tomography
    Multiple X-rays taken of the heart without using IV or contrast dye.  A negative test indicates low risk but does not absolutely rule out a future MI
  34. CT angiography
    Uses a CT scanner in which contrast dye is injectced in the catheter vein in the arm to detect for artherosclerosis in the coronary arteries of the heart
  35. Cardiac catheterization
    Passing a thin flexible cardiac catheter into the right or lef side of the heart either from the groin or the arm in which ballon angioplasty can be performed if there is blockage in the coronary artery.
  36. Antiplatelet/anticoagulant agents
    • Drug used to prevent clot formation
    • Coumadin with a side efffect of hemmorage
  37. What is a good fasting blood sugar level
    Anything less than or equal to 110
  38. Hemoglobin
    Reflection of #RBC with O2/CO2 carrying capacity
  39. Hematocrit
    • % of blood volume made up of RBC's
    • 42% - 52%