Risk factors & Labs
Worst type of cholesterol in the body
LDLs
"low-down dirty"
Can hypertension cause damage to the endothelium?
Yes. Microdamage and inflammation of the vessels; plaque can adhere; clots; occlusions; MI or PVD
2 symptoms of MI that females get more often
back pain, neck pain, GI symptoms like nausea
(What are classic male symptoms?)
Lab drawn for HF
BNP
What is the leg pain called when spasms occur that are relieved by resting?
Intermittent claudication
3 lab tests for lipids in the body
HDLs, LDL, Total cholesterol; triglycerides
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
Describe the purposes of 1) daily weights, 2) JVD measurement, 3) low sodium diet, and 4) nutrition for patients with heart failure.
Daily weights--fluid overload measured
JVD--left-sided progressed to right-sided?
Low sodium--"water follows salt"; edema
Nutrition--nourishingfor high metabolic needs
T/F Patients with peripheral vascular disease should not exercise because they have pain.
False. PREMEDICATE!
3 assessments used for CV status
Heart rhythm, rate, pulses, cap refill, pallor, temperature of extremities, JVD, BP, edema, SOB, dizziness (others)
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 (others)
How would you instruct a new nurse on taking a patient's BP in the doctor's office?
Avoid food/nicotine 30 min before; feet flat; measure at level at heart; correct size of cuff; use both arms
If a patient had a troponin of 0.1 (ref: <0.04) and BNP of 1100 (ref: <100 pg/nL), what can we conclude?
A heart failure patient is also having a myocardial infarction.
Why are diuretics and beta blockers given to HF patients?
Diuretics: remove excess fluid (reduce workload)
Beta blockers: slow heart rate and drop BP (reduce workload
What would you teach your patient about the purpose of compression stockings?
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 answers)
Digoxin: postive inotrope
ACE inhibitors: reduce BP by reducing fluid kept in system
Name three conditions that can arise from peripheral vascular disease.
amphetamines; nicotine; testosterone; phenylephrine; vasopressors (eipnephrine, norepi; vasopressin)
What tests diagnose MI?
Troponin
EKG
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?
What should we teach heart failure patients about exercise?
Start low, go slow
Isometrics
Low-impact
Consult with provider