Risk factors & Labs
Worst type of cholesterol in the body
LDLs
"low-down dirty"
Can hypertension cause damage to the endothelium?
Yes. Plaque can form; clots; pocclusions; MI or PVD
2 symptoms of MI that females get more often
back pain, neck pain, GI symptoms like nausea
(Classis male symptoms?)
Lab drawn for HF
BNP
What is the leg pain called when spasms occur that are relieved by resting?
Intermittent claudication
Three lab tests for lipids in the body
HDLs, LDL, Total cholesterol; triglycerides
What systolic number is the start of stage 1 HTN?
What disastolic number is the start of stage 1 HTN?
130 mmHg
80 mmHg
Patient teaching for people taking nitroglycerin for angina? State 3.
Headache is common due to _____; flushing, hypotension; keep in the dark bottle; keep cool; refill 6 mo.; premedicating is ok; call 911 after 3 doses if unresolved; put under tongue, don't swallow
Describe the purposes of 1) daily weights, 2) JVD measurement, 3) low sodium diet, and 4) nutrition status for patients with heart failure.
Daily weights--fluid retention measured
JVD--left-sided progressed to right?
Low sodium--"water follows salt"; edema
Nutrition--easy nourishment for high metabolic needs
T/F Patients with peripheral vascular disease should not exercise because they have pain.
False. PREMEDICATE!
What should we teach them about exercise?
Name 3 assessments used for CV status
Heart rhythm, rate, pulses, cap refill, pallor, temperature of extremities, JVD, BP, edema, SOB, dizziness
What does "The patients has primary hypertension" mean?
No known cause.
Secondary HTN= there's a known underlying cause
3 labs drawn for MI
troponin; CK-MB; myoglobin
3 signs of right-sided heart failure
peripheral edema; ascites; JVD
What leg position is used for people with arterial insuffiencies in extremities?
Dangle; let gravity assist
Modifiable CV risk factors: name 4
Diet, exercise, weight, tobacco use/vape, BMI, alcohol use, stress, sleep
How would you instruct a new nurse on taking a patient's BP in the doctor's office?
Have pt. avoid food/nicotine 30 min before; feet flat; measure at level at heart; choose correct size of cuff; use both arms; serial BPs are best over time
If a patient had a troponin of 0.1 (ref: <0.04 ng/mL) and BNP of 1100 (ref: <100 pg/mL), what can we conclude?
They are a heart failure patient who is also having a myocardial infarction. Yikes!
Why are diuretics and beta blockers given to HF patients?
Diuretics: remove excess fluid (reduce workload)
Beta blockers: slow heart rate and therefore drops BP (reduces workload)
What would you teach your patient about the purpose of compression stockings?
Promote venous return; put on before getting up for the day, while lying down; used for venous conditions, not arterial
What are 4 characteristics of metabolic syndrome? What conditions can it lead to?
Weight around the middle; high blood sugar; high BP; high triglyceride levels; low HDLs; high LDLs---> Leading to stroke, DM, heart disease, heart failure, others
Managing a hypertensive crisis: what are the purpose of nitroglycerine; labetalol; and nicardipine?
Nitro: potent vasodilator
Labetalol: beta adrenergic blocker (Lowers HR/P)
Nicardipine: calcium channel blocker (lowers contractility of heart muscle, so drops BP)
Name 2 surgical interventions a patient having an MI might undergo.
1) PCTA: Stent placement (percutaneous transluminal coronary angiolasty) --ICU
2) CABG (coronoary artery bypass graft) --ICU
Why are digoxin and ACE inhibitors given to patients in heart failure? (separate reasons)
Digoxin: postive inotrope
ACE: reduce BP by reducing fluid kept in system
Name three conditions that can arise from peripheral vascular disease.
DVT, MI, stroke, PE, infection, thrombosis, cellulitis
Drugs that increase BP (name 2)
amphetamines; nicotine; testosterone; phenylephrine; vasopressors (eipnephrine, norepi; vasopressin)
Which lab is the definitive MI lab test?
What other order/test would be used?
troponin (ref for negative MI: <0.04 ng/mL)
EKG/ECG
3 signs of left-sided heart failure
Nocturnal dyspnea; fluid in lungs=crackles/wheezing; ejection fraction low; blood-tinged sputum on Kleenex; fatigue; cyanosis. BONUS: Why confusion?