Adult Health_Exam 1
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Normal adult blood pressure?
Pre-hypertensive blood pressure?
140/90 and >
Hypertension is directly related to the development of __________ disorders, with or without the presence of other risk factors
What do arterial baroreceptors do?
They control blood pressure by altering the heart rate and/or causing vasconstriction or vasodilation
Renal dz, cushing's dz, primary aldosteronism, pheochromocytoma, brain tumors, encephalitis, estrogen therapy and steroids are all risk factors for what?
A client with HTN may experience few or no symptoms. List three possible symptoms of HTN.
Nursing implications for diuretics (thiazide and loop)?
Monitor potassium levels and watch for muscle weakness, irregular pulse, and dehydration
Side effects of calcium channel blockers?
- Decreased heart rate
What is hypertensive crisis?
- A state of malignant hypertension, when clients do not follow the medication therapy regimen. S/S include:
- Severe headache
- Extremely high blood pressure
- Bluured vision
What is an aneurysm?
A permanent dilation of an artery to at least two times its normal diameter
Where do the majority of aneurysms occur? (75%)
Between the renal arteries and the aortic bifurcation
What is the most common cause of aneurysms?
What is the most significant risk factor for the development and the rupture/dissection of an aneurysm?
What is hypovolemic shock?
A state of diaphoresis, n/v, faintness, apprehension, decreased or absent peripheral pulses, neurological deficits, hypotension, and initial tachycardia
What is the priority intervention regarding an aneurysm?
Reduce (and maintain) systolic blood pressure between 100 and 120 mm Hg; administer antihypertensive agents as prescribed
What causes peripheral arterial disease (PAD)?
Atherosclerosis in the arteries of the lower extremities
What is peripheral arterial disease (PAD)?
Inadequate flow of blood to the lower extremities
Where does the tissue damage occur in PAD in relation to the occlusion?
Below the arterial obstruction
What is an acute arterial occlusion?
Sudden occlusion of an artery by an embolus or a local thrombus
What is arteriography of lower extremities?
An arterial injection of contrast medium to visualize areas of decreased arterial flow on an x-ray (invasive and not commonly performed today)
What is exercise stress testing?
Stress test or treadmill with measurement of pulse volumes and blood pressures prior to and following the onset of symptoms or 5 mins of exercise. Delays in return to normal pressures and pulse waveforms indicate arterial disease.
What is percutaneous transluminal angioplasty (PTA)?
An invasive intra-arterial procedure using a balloon and stent to open and help maintain the patency of the vessel
What is laser-assisted angioplasty?
An invasive procedure in which a laser probe is advanced through a cannula to the site of stenosis in an artery in PAD. The laser is used to vaporize atherosclerotic plaque and open the artery. Anticoagulant therapy is used during surgery and antiplatet therapy for 3 months after.
What is atherectomy?
The use of a high-speed rotary metal burr to scrape plaque out of affected arteries in PAD and improve blood flow to ischemic limbs
What is arterial revascularization surgery?
Bypass grafts is an example of arterial revascularization surgery. Bypass graft surgery involves suturing graft material or autogenous saphenous veins before and after an occluded area of an artery. This procedure improves blood supply to the area normally served by the blocked area.
What is claudication?
Burning or cramping in calves, ankles, feet, and toes due to inadequate circulation to the extremities
Give 11 possible physical findings in peripheral arterial disease (PAD)?
- Increased cap refill of toes
- Decreased or nonpalpable pulses
- Loss of hair on lower calf, ankle, and foot
- Dry, scaly, mottled skin
- Thick toenails
- Cold and cyanotic extremity
- Pallor of extremity with elevation
- Dependent rubor
- Muscle atrophy
- Ulcers and possible gangrene of toes
Compartment syndrome is considered an emergency in the client with peripheral arterial disease (PAD). What is it?
A condition where tissue pressure within a confined body space becomes elevated and restricts blood flow. Resultant ischemia can lead to irreversible tissue damage within 4 to 6 hours and eventually tissue death. Symptoms include tingling, numbness, worsening pain, edema, pain on passive movement, and uneven pulses.
What is heart failure?
The inability of the heart to maintain adquate circulation to meet tissue needs for oxygen and nutrients.
Define the four classes of heart failure according to the New York Heart Association's functional classification scale?
- Class I: Client exhibits no symptoms with activity
- Class II: Client has symptoms with ordinary exertion
- Class III: Client displays symptoms with minimal exertion
- Class IV: Client has symptoms at rest
What is cardiomypoathy?
A change in the structure of cardiac muscle fibers that causes impaired cardiac function leading to heart failure
What are the three main types of cardiomypathy?
- Dilated: Decreased contractility and increased ventricular filling pressures
- Hypertrophic: Increased thickness of ventricular and/or septal muscles
- Restrictive: Ventricles become rigid and lose their compliance
Is low output or high output heart failure more commonly seen?
Left-sided heart (ventricular) failure results in inadequate left ventricle (cardiac) output and consequently in inadequate _______ ________?
Right-sided heart (ventricular) failure results in inadequate right ventricle (cardiac) output and ______ ______ _____?
Systemic venous congestion
Systolic heart failure consists of an ejection fraction below 40%, as well as ______ and _____ congestion?
Diastolic heart failure consists of inadequate ______?
Give 5 risk factors/causes of left-sided heart failure?
- Coronary artery disease
- Myocardial infarction (MI)
- Valvular disease
Give 3 risk factors/causes of right-sided heart failure?
- Left-sided heart failure
- Right ventricular myocardial infarction
- Pulmonary problems
Give 5 risk factors/causes of cardiomyopathy?
- Coronary artery disease
- Infection or inflammation of the heart muscle
- Various cancer treatments
- Prolonged alcohol abuse
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