Card Set Information

2013-03-17 20:44:53

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  1. Afferent arterioles
    The small blood vessels approaching the glomerulus (proximal part of the nephron). (p. 404)
  2. Aldosterone
    A mineralocorticoid steroid hormone produced by the adrenal cortex that mediates the actions of the renal tubule in the regulation of sodium and potassium balance in the blood. (p. 404)
  3. Alpha1-blockers
    Drugs that primarily cause arterial and venous dilation through their action on peripheral sympathetic neurons. (p. 385)
  4. Antihypertensive drugs
    Medications used to treat hypertension. (p. 382)
  5. Ascites
    An abnormal intraperitoneal accumulation of fluid (defined as a volume of 500 mL or more) containing large amounts of protein and electrolytes. (p. 407)
  6. Cardiac output
    "The amount of blood ejected from the left ventricle, measured in liters per minute. (p. 383)"
  7. Centrally acting adrenergic drugs
    "Drugs that modify the function of the sympathetic nervous system in the brain by stimulating alpha2 receptors, which has a reverse sympathetic effect that causes decreased blood pressure. (p. 384)"
  8. Collecting duct
    "The most distal part of the nephron between the distal convoluted tubule and the ureters, which lead to the urinary bladder. (p. 404)"
  9. Distal convoluted tubule
    The part of the nephron immediately distal to the ascending loop of Henle and proximal to the collecting duct. (p. 404)
  10. Diuretics
    Drugs or other substances that tend to promote the formation and excretion of urine. (p. 403)
  11. Efferent arterioles
    The small blood vessels exiting the glomerulus. At this point blood has completed its filtration in the glomerulus. (p. 404)
  12. Essential hypertension
    Elevated systemic arterial pressure for which no cause can be found and which is often the only significant clinical finding; also called primary or idiopathic hypertension. (p. 393)
  13. Filtrate
    "The material that passes through a filter. In the case of the kidney, the filter is the glomerulus and the filtrate is the material extracted from the blood (normally liquid) that ultimately becomes urine. (p. 404)"
  14. Glomerular capsule
    "The open, rounded, and most proximal part of the proximal convoluted tubule that surrounds the glomerulus and receives the filtrate from the blood. (p. 404)"
  15. Glomerular filtration rate (GFR)
    The volume of ultrafiltrate extracted per unit of time from the plasma flowing through the glomeruli of the kidney. (p. 404)
  16. Glomerulus
    The cluster of kidney capillaries that marks the beginning of the nephron and is immediately proximal to the proximal convoluted tubule. (p. 404)
  17. Hypertension
    "A common, often asymptomatic disorder in which blood pressure persistently exceeds 140/90 mm Hg. (p. 382)"
  18. Loop of Henle
    The part of the nephron between the proximal and distal convoluted tubules. (p. 404)
  19. Nephron
    "The microscopic functional filtration unit of the kidney, consisting of (in anatomical order from proximal to distal) the glomerulus, proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting duct, which empties urine into the ureters. There are approximately 1 million nephrons in each kidney. (p. 404)"
  20. Open-angle glaucoma
    "A condition in which pressure is elevated in the eye because of obstruction of the outflow of aqueous humor, but access to the trabecular meshwork remains open. (p. 405)"
  21. Orthostatic hypotension
    "A common adverse effect of adrenergic drugs involving a sudden drop in blood pressure when a person changes position, especially when rising from a seated or horizontal position. (p. 386)"
  22. Prodrug
    "A drug that is inactive in its administered form and must be metabolized to its active form in the body, generally by the liver, to be effective. (p. 389)"
  23. Proximal convoluted (twisted) tubule
    The part of the nephron that is immediately distal to the glomerulus and proximal to the loop of Henle. (al 403)
  24. Secondary hypertension
    "High blood pressure associated with a primary disease such as Kidney disease, Coarctation of the aorta, Endocrine disorders, Neurologic disorders, Drug use"
  25. Primary or Essential hypertension
    "Persistently elevated systemic blood pressure; zContributing factors: High sodium intake; Low potassium, calcium, magnesium intake; Obesity; Excess alcohol; Insulin resistance; Genetics; Family history; Age; Race"
  26. White coat hypertension syndrome
    is a situation where patients have HBP in the doctor's office but nowhere else
  27. Malignant hypertension
    is a sudden and rapid development of extremely high blood pressure.
  28. HBP Cardio Complications
    "accelerates rate of atherosclerosis; Increases workload of left ventricle –hypertrophy; Hypertrophy increases risk for CAD, dysrrhythmia, and heart failure"
  29. HBP Neurological Complications
    "Atherosclerosis increases risk for strokes; Microaneurysms and cerebral hemorrhage; Hypertensive encephalopathy – altered L.O.C., increased intracranial pressure, papilledema, seizure"
  30. HBP Renal Complications
    Nephrosclerosis and renal insufficiency
  31. Tests to identify severity of hypertention
    "EKG, UA, blood glucose, hematocrit, serum K, creatinine, calcium, cholesterol and lipoprotein profile"
  32. Lifestyle modifications for hypertention
    "Diet: reduce sodium to 2-3 gm per day; Wt reduction: BMI greater than 27 Increase risk of HBP; Physical activity: 30-45 minutes 5-6 days/wk; Alcohol and tobacco use: limit intake to 1oz ethanol/day or 2 drinks (12 oz beer, 5 oz wine, 1.5 oz 80-proof whiskey) and stop smoking( smoking promotes vessel constriction thus increasing BP); "
  33. "Stress Reduction: exercise & possibly relaxation techniques"""
  34. Medications for hypertension
    "Diuretics, Alpha-adrenergic blockers, ACE inhibitors, ARBS, Vasodilators, Ca channel blockers, Centrally acting sympatholytics, Beta-adrenergic blocking agents"
  35. Diuretics
    Initial drug recommended for mild to mod hypertention; Reasonably safe; Act by increasing urine production and output; ALSO used to treat kidney disorder & heart failure
  36. types of Diuretics
    Thiazide and thiazide; Loop diuretics; Potassium sparing
  37. nurses role for diuretics
    "Assess kidney function and urine output; Monitor BP; Monitor laboratory values; Wt daily, report increase/decrease >2 lbs/24 hrs; Monitor I/O; Assess for edema; Assess lung sounds; Ensure safe toileting, answer call lights immediately; Instruct regarding photosensitivity (10-14 days after therapy started); Monitor potassium"
  38. ACE inhibitors
    Used since 1980; Act by blocking the conversion of angiotensin I to angiotensin II; Side effects usually minor; Less effective in African American clients; THE PRIL'S Eg. Enalapril (vasotec) – most frequently prescribed
  39. nurses role for ACE inhibitors
    "Be aware first dose may result in profound hypotension, also for hypersensitivity reaction esp. Angioedema (diff breathing, throat tightness, muscle cramps, hives, rash, tremors) can be life threatening; Monitor BP and for side effects, liver function; Monitor for hyperkalemia; Instruct client to avoid high K foods"
  40. Angiotensin II receptor blockers (ARBS)
    "Cozar, Avapro; Primary effect is on vascular smooth muscle and the adrenal glands; Act to block angiotensin II (A II) at the AII receptor sites in arterial smooth muscle thus blocking vasoconstriction and aldosterone secretion; Few side effects – H/A,SOB,GI symptoms; Less effective in African American clients"
  41. nurses role for Angiotensin II receptor blockers (ARBS)
    "Assess BP and WBC before starting, monitor BP 2 hrs after first dose and regularly; Monitor for hypersensitivity reaction; Do not give to clients with renal artery stenosis or pregnancy; Do not take potassium supplements"
  42. Adrenergic blockers
    "Beta adrenergic receptor blockers in heart (Are first line HTN treatment drugs, Decrease HR and contractility, Also inhibit secretion of renin and formation of angiotensin II); Alpha1-adrenergic receptor blockers in arterioles; Nonselective alpha and beta adrenergic blockers – revolutionized tx of HTN, many side effects, rarely used today; Stimulation of alpha2-receptors in brainstem (central acting); Peripheral adrenergic neuron blockers"
  43. Alpha1-adrenergic blockers
    "Use for HTN and BPH; First dose phenomenon can occur; Monitor BP routinely; Common side effects: weakness, dizziness, HA, N&V, and elderly esp. prone to hypertensive and hypothermic effects"
  44. Beta –adrenergic blocking agents
    "Also used for angina, certain dysrhythmias, heart failure, MI, and migraines; Eg: atenolol (Tenormin), metroprolol (Lopressor), timolol (Betimol); Monitor HR, rhythm and sounds assessing for bradycardia, heart block, fatigue and activity intolerance"
  45. Alpha2-adrenergic agonists
    "Multiple side effects only used when other options fail; Side effects: orthostatic hypotension, sedation, decreased libido, impotence, sodium/water retention, dry mouth"
  46. nurses roles for Adrenergic blockers
    "Baseline EKG, HR, BP; Do not give with grapefruit juice – could result in rapid toxic overdose; Instruct client: (Check BP daily, notify doc in <90/60; Immediately report chest pain, palpitations, racing heart, SOB, profound fatigue, frothy sputum, swelling of extremeties; Report dizziness or lightheadedness; Rise slowly from sitting or lying; Wt same time each day report gain or loss > 2 lbs)"
  47. Centrally acting sympatholytics
    Also centrally acting antiadrenergic
  48. "Eg: methyldopa (Aldomet), clonidine (Catapres); Act by stimulating CNS alpha-adrenergic receptors producing decrease in sympathetic outflow to heart, kidneys and blood vessels; Side effects: sedation, impotence, dry mouth; Monitor BP and pulse frequently, I/O, wt; Give at bedtime; Do not stop suddenly or skip doses; Change positions slowly"""
  49. Vasodilators
    "Reduce blood pressure by relaxing vascular smooth muscle and decreasing peripheral vascular resistance; Prescribed with beta blocker or diuretic because they can cause reflex tachycardia and fluid retention – but has some serious side effects used as last resort; Abrupt withdrawal may cause rebound HTN and anxiety; Contraindicated with lupus, angina, rheumatic heart disease, MI, or tachycardia"
  50. nurses roles for Vasodilators
    "Observe for butterfly rash over nose and cheeks, muscle aches and fatigue; If give IV – monitor BP q5-15 minutes, ensure patent IV; Monitor cardiac/cerebral circulation and ensure client understand what to report; Side effects: reflex tachycardia, lupus, Na & fluid retention and rarely priapism (sustained, painful erection can cause permanent impotence); Report BP <90/60 or > 140/90"