Term
|
Definition
systolic 120-139
diastolic 80-89
follow-up in 1 year
encourage lifestyle modification
no drug therapy required |
|
|
Term
|
Definition
systolic 140-159
diastolic 90-99
follow-up in 2 months
encourage lifestyle modification
drug therapy: thiazide diuretics, ACEI, ARB, BB, CCB, or a combination |
|
|
Term
|
Definition
systolic >160
diastolic >100
follow-up in 1 month
encourage lifestyle modification
drug therapy: two-drug combination - thiazide diuretic AND ACEI or ARB or BB or CCB |
|
|
Term
|
Definition
systolic >180
diastolic >120
seek treatment immediately, then follow-up weekly
encourage lifestyle modification
drug therapy: two-drug combination (same as stage 2)
pt has s/s of target organ dysfunction-can cause MI, HF
BP is GRADUALLY lowered in the hospital, but Nipride is given immediately to start decreasing BP |
|
|
Term
| most common thiazide diuretic |
|
Definition
| HCTZ (hydrochlorothiazide) |
|
|
Term
| thiazide diuretics impair... |
|
Definition
| carbohydrate tolerance, so blood sugars increase |
|
|
Term
| monitor pts taking thiazide diuretics for... |
|
Definition
photosensitivity
cross-sensitivity (allergies) to sulfa drugs |
|
|
Term
| diuretics are used to treat... |
|
Definition
HTN
CHF
angina
some arrythmias |
|
|
Term
| how thiazide diuretics work |
|
Definition
causes body to get rid of excess fluids and Na+ through urination
increased urine output
decreased blood volume
decrease in Na+ in body
vasodilation
decrease in BP |
|
|
Term
| adverse effects of thiazide diuretics |
|
Definition
hypokalemia
hyperglycemia
hypercalcemia
anorexia |
|
|
Term
| hardest ethnic group to treat for HTN |
|
Definition
African Americans:
-men are more likely to have HTN at
a young age (30's)
-more NA+ sensitive
-more likely to develop
complications associated with HTN
(stroke, kidney disease) |
|
|
Term
|
Definition
systolic <120
diastolic <80
follow-up in 2 years |
|
|
Term
|
Definition
systolic >180
diastolic >120
no signs of target organ dysfunction
s/s: headache, nosebleed, SOB, anxiety
drug therapy: two-drug combination (same as stage 2)
follow-up in a few days |
|
|
Term
| nursing responsibilities BEFORE giving a diuretic |
|
Definition
-ask about medication hx (herbals and OTC)
-check BP (call dr if BP is low)
-ask women if they are pregnant or breastfeeding
-check K+ levels (call dr if low)
-ask about allergies |
|
|
Term
| nursing responsibilities AFTER giving a diuretic |
|
Definition
-monitor VS q4-8h
-monitor for dizziness or light-headedness (BP is too low)
-monitor for orthostatic hypotension (take BP when lying down, sitting, and standing)
-monitor urine output
-monitor K+ levels |
|
|
Term
| patient teaching about diuretics |
|
Definition
-keep a daily record of BP and weight
-keep all follow-up appts
-take all doses as prescribed
-notify dr of s/s of hypotension or chest pain
-lifestyle changes |
|
|
Term
| cultural considerations r/t HTN medications |
|
Definition
-African Americans respond better to diuretcs such as Lasix (furosemide) and HCTZ
-European Americans respond better to BB
-Chinese are more sensitive to propanolol (BB), so require 1/2 the blood level |
|
|
Term
|
Definition
-take medications as prescribed
-change positions slowly to prevent falls
-modify diet to reduce Na+ and fat
-stop smoking
-exercise
-limit alcohol intake
-get adequate sleep |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| clotting factor synthesis inhibitor (anticoagulant) |
|
|
Term
|
Definition
| thrombin inhibitor (anticoagulant) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| pathophysiology of mitral stenosis |
|
Definition
| mitral valve thickens, chordae tendinae shorten->blood flow is obstructed b/w L atrium and L ventricle->L atrium enlarges to hold extra blood->blood backs up in pulmonary circulation and in R ventricle->R ventricle enlarges to hold extra blood->R ventricle fails->less blood is pumped to L atrium and L ventricle->CO is decreased |
|
|
Term
| etiology of mitral stenosis |
|
Definition
-rheumatic fever (major cause)
-symptoms of valve damage take 2-4 years to appear after having rheumatic fever
-rheumatic fever is less common today, so mitral stenosis is less common as well |
|
|
Term
|
Definition
-might not have symptoms
-click/low-pitched murmur might be heard
-exertional dyspnea
-cough
-hemoptysis (bloody sputum)
-respiratory infections
-edema of ankles and feet |
|
|
Term
| complications of mitral stenosis |
|
Definition
-emboli can form from blood sitting in L atrium and can cause stroke/seizures
-A fib
-when R ventricle fails, symptoms r/t HF appear
-pulmonary edema |
|
|
Term
| diagnostic tests for mitral stenosis, aortic stenosis, mitral regurgitation, aortic regurgitation |
|
Definition
-ECG
-chest xray
-cardiac catheterization |
|
|
Term
| therapeutic treatment of mitral stenosis |
|
Definition
-no symptoms = no treatment
-anticoagulants to prevent emboli
-percutaneous balloon valvuloplasty (opens the mitral valve)
-valvuloplasty (valve repair)
-mitral valve replacement |
|
|
Term
| pathophysiology of aortic stenosis |
|
Definition
| aortic valve thickens->blood flow obstructed between L ventricle and aorta->L ventricle contracts harder and hypertrophies->decreases CO and eventual HF |
|
|
Term
| etiology of aortic stenosis |
|
Definition
-rheumatic heart disease and congenital defects (major causes)
-can be r/t aging |
|
|
Term
|
Definition
-symptoms take many years to be seen
-angina (primary symptom)
-murmur
-syncope
-HF symptoms
-DOE
-fatigue
-pulmonary edema |
|
|
Term
| complications of aortic stenosis |
|
Definition
-HF
-arrythmias
-endocarditis |
|
|
Term
| therapeutic treatment of aortic stenosis |
|
Definition
-valve replacement
-HF symptoms treated carefully |
|
|
Term
| pathophysiology of mitral regurgitation |
|
Definition
| mitral valve does not close completely->blood backs up in L atrium->L atrium enlarges to hold extra blood->L ventricle enlarges to hold extra blood from the L atrium->blood backs up in pulmonary circulation and in R ventricle->R and L ventricles may eventually fail |
|
|
Term
| etiology of mitral regurgitation |
|
Definition
-rheumatic heart disease
-endocarditis
-rupture/dysfunction of chordae tendinae/papillary muscles
-HTN
-MI
-may be r/t aging
-congenital defects |
|
|
Term
| s/s of mitral regurgitation |
|
Definition
-no symptoms at first
-murmur
-DOE
-fatigue
-syncope
-cough
-edema
-irregular pulse |
|
|
Term
| complications of mitral regurgitation |
|
Definition
-A fib
-HTN
-HF
-endocarditis |
|
|
Term
| therapeutic treatments for mitral regurgitation |
|
Definition
-no symptoms = no treatment
-ACEI prescribed to reduce workload
-anticoagulants prescribed to prevent emboli
-HF symptoms treated
-emergency surgery |
|
|
Term
| pathophysiology of aortic regurgitation |
|
Definition
| aortic valves don't close completely->blood gets backed up between aorta and L ventricle->L ventricle enlarges to hold extra blood->L ventricle contracts harder to pump the higher blood volume out->L ventricle fails eventually->CO decreases |
|
|
Term
| etiology of aortic regurgitation |
|
Definition
-rheumatic heart disease
-congenital defects
-may be r/t aging
-syphilis
-HTN
-endocarditis |
|
|
Term
| s/s of aortic regurgitation |
|
Definition
-may not have symptoms for years
-DOE
-fatigue
-murmur
-diastolic BP decreases
-angina
-diaphoresis |
|
|
Term
| complications of aortic regurgitation |
|
Definition
|
|
Term
| therapeutic treatments for aortic regurgitation |
|
Definition
-vasodilators
-valve repair
-valve replacement |
|
|
Term
| nursing process for postop cardiac surgery |
|
Definition
-pt goes to ICU for 1-2 days for close observation
-pt connected to cardiac monitor and ventilator
-pt put under a warming device
-head to toe assessment completed
-monitor tubes (chest tube, NG tube, catheter)
-monitor body temp
-VS, O2 sat, and BP monitored every 15-30 mins (decreases in time as pt stabilizes)
-I&Os measured
-12 lead ECG and xray is done
-when pt awakes: keep eye contact, touch carefully, explain procedure in simple terms
-monitor pain levels |
|
|
Term
|
Definition
-do not thin blood, do not dissolve clots
-normal INR labs: 2-3.5, done every 3-5 days
-do not use aspirin
-antidote is vitamin K
-prescribed: after valve replacement, to reduce risk of stroke/HA, during open heart surgery, for pts on bed rest |
|
|
Term
| nursing responsibilities BEFORE giving an anticoagulant |
|
Definition
-review medication hx (herbals and OTC)
-check HR and BP and baseline coagulating results
-ask about pregnancy and breastfeeding
-review hx of bleeding problems
-teach about side effects and signs of bleeding |
|
|
Term
| nursing responsibilities AFTER giving an anticoagulant |
|
Definition
-monitor for s/s of bleeding
-monitor for allergic reactions
-check HR and BP
-avoid giving any injections
-make sure follow-up coagulation labs are drawn
-teach pt: keep all follow-up appts, take meds as prescribed, use soft toothbrush and electric shaver, avoid activities that may cause injury |
|
|
Term
| considerations of anticoagulation therapy |
|
Definition
-heparin may be prescribed if anticoagulation therapy is necessary during pregnancy/breastfeeding, but may cause bleeding during 3rd trimester and/or delivery
-older adults are more sensitive to coagulation therapy, and are more likely to experience side effects (especially older women)
-older adults may require lower doses |
|
|
Term
|
Definition
formation of a blood clot in a deep vein (thigh or calf muscle usually)
at risk: over 60, smoker, overweight, sedentary lifestyle
s/s: edema, pain, tenderness, warmth at affected area, red/discolored skin at affected area, visible surface veins, leg fatigue
prevention: ambulate, low dose anticoagulant, compression stockings
treatment: thrombolytics, surgery, O2, anticoagulants |
|
|
Term
|
Definition
blood clot has traveled into a pulmonary artery
at risk: sedentary lifestyle, recent surgery, cancer, HF, stroke, pregnancy, childbirth, birth control, hormone therapy, smoker
s/s: sudden onset of dyspnea, tachycardia, tachypnea, cough, crackles in lungs, chest pain
prevention: ambulation, anticoagulants, compression stockings
treatment: thrombolytics, surgery, O2, anticoagulants |
|
|
Term
|
Definition
infection of endocardium-organism attaches to endocardium, lesions form
s/s: fever, chills, aching muscles and joints, fatigue, dyspnea, cough, edema, hematuria, mumur, splinter hemorrhages, petechiae, Janeway lesions, Osler's nodes
prevention: daily oral care, prophylactic antibiotics
treatment: hospitalization, antimicrobial drugs, rest, surgical repair/replacement of any damaged valves
more common in men |
|
|
Term
|
Definition
inflammation of pericardium
s/s: chest pain (most common), dyspnea, low-grade fever, cough, pericardial friction rub
treatment: anti-inflammatories, corticosteroids, surgery, bedrest |
|
|
Term
|
Definition
-enlargement of heart muscle
-3 types: dilated, hypertrophic, restrictive
s/s: HF, DOE, orthopnea, fatigue, A-fib, syncope, arrythmias, thrombi
treatment: no cure, managing HF, palliative care, ACEI/ARB/BB/diuretics/digoxin prescribed, surgery, transplant |
|
|
Term
|
Definition
angina, MI, ischemia, sudden cardiac death (includes all four of these)
s/s: chest pain, SOB, dizziness, nausea, sweating, crackles/wheezes in lungs, irregular pulse, mumur
treatment: aspirin, O2 therapy, PCI, "fab four" drugs (antiplatelets, statins, ACEIs, BB), analgesics, limited activity, diet and weight loss, smoking cessation |
|
|
Term
|
Definition
-neonates and infants <2 months old-most likely to present with CHF r/t structural heart disease
-have a hard time feeding, takes extra time
s/s: increased respirations/SOB, pleural effusion, murmur, peripheral edema, diaphoresis, |
|
|
Term
| goal of treatment for HTN |
|
Definition
healthy person: 140/90
person with other health problems (diabetes/kidney issues): 130/80 |
|
|
Term
|
Definition
heart attack resulting in the death of heart muscle
cause: partial/complete blockage of a coronary artery; decreased blood supply to heart
at risk: men over 40, women who smoke or use oral contraceptives
s/s: chest pain, SOB, dizziness, nausea, sweating, crackles/wheezing in lungs, irregular pulse, murmur
treatment: (should be treated immediately); chew adult aspirin, O2, PCI, "fab four" drugs-antiplatelets, statins, ACEIs, BBs
prevention: diet with decreased fats, exercise, smoking cessation, |
|
|
Term
|
Definition
primary HTN: unknown cause, majority of people have this kind (90%)
secondary: known cause (kidney damage, stress) |
|
|
Term
| restrictive cardiomyopathy |
|
Definition
cardiac muscle stiffens
impairs ventricular stretching
very rare |
|
|
Term
| hypertrophic cardiomyopathy |
|
Definition
L ventricle muscle wall enlargement
decreased ventricular filling
causes sudden death in athletes |
|
|
Term
|
Definition
ventricular cavity enlarges
contractility decreases
stasis of blood
most common |
|
|
Term
|
Definition
-inflammation of blood vessels in children
-rare
-most common in Japan
cause: unknown
s/s: high fever, red eyes, cracked lips, red mucous membranes, swollen hands and feet, rash, swollen nodes, joint pain/swelling
treatment: IV gamma globulin, high dose aspirin
prevention: unknown cause = no prevention |
|
|
Term
|
Definition
autoimmune reaction to upper respiratory (strep) infection
usually occurs between ages 5-15
s/s: polyarthritis, chorea (uncontrolled movements), carditis, fever, pneumonitis
prevention: treating strep infection immediately
treatment: antibiotics, anti-inflammatories |
|
|
Term
|
Definition
-formation of a clot and inflammation within a vein
-most common disorder of veins, affecting legs most often
etiology: venous stasis, damage to vein lining (IV catheters), increased blood coagulation
prevention: prevent dehydration, ambulation, anti-embolism devices, ROM exercises
s/s: superficial veins-warmth, redness, swelling, tenderness; deep veins-swelling, edema, pain, warmth, tenderness, + homan's sign
treatment: superficial veins-warm/moist heat, analgesics, NSAIDs, compression stockings; deep veins-heparin, warfarin, bedrest, elevate extremity, warm/moist heat, compression stockings |
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