Test 3

The amount of resistance to the ejection of blood from the ventricle.

The amount of blood ejected per heart beat, AVG. 70 ml.

Increased after load= Decreased stroke volume.

Patient is asked to take stool softners, so they dont strain when taking a crap.

The myocardium is starved for O2 and the tissues dies and damage results.

• Troponin 1 indicates some amount of cardiac muscle damage with levels above .4 ng/ml.
• This is an accurate and reliable indicator of an myocardial infarction.
• Levels increase within hours and can stay elevated for 3 weeks.

• Not normal symptoms, can be shown as secondary symptoms.
• SOB, indigestion, nausea, anxiety, cool/clamy skin, tachycardia, tachypnea, or feeling of doom.
• Women are not usually diagnosed right off becaue they show these secondary s/s.

Atherosclerosis and increased O2 demand: from exercise stress, cold/vasoconstriction, and heavy meal causing blood to go to guts.

Decreases Myocardial oxygen consumption and are a vasodilator.

• I-Diagnosis of Atherosclerosis
• II-After discharge, exercise, diet, and eduction. 1-6 months
• III- Long-term outpatient program.

Because walking is good for heart health.

Rest, nitrates, oxygen, beta-blockers, calcium channel blockers, aspirin, and reduce risk factors like; stop smoking, HTN, and etc.

Dilated Most common, significant dilation of ventricles without hypertrophy (increased muscle wall thickness).

Manifestations- Arrythmogenic right ventricle, hypotension, fatigue, cough, orthopnea, edema, nausea, chest pain, palpitations, dizziness, and syncopy.

• Heart Failure=Inability of heart to pump sufficient blood to meed the needs of the tissues. Characterized by fluid overload or inadequate tissue perfusion.
• Edema, and daily weight.
• Dyspnea, SOB, arthopnea, cough, pulmonary crackles, low 02 stats.
• Ace inhibitiors and diuretics.
• Symptoms, echocardiogram, cardiac catheterization, chest x-ray, EKG, and stress test.

• Decrease water levels fast.
• Decrease Potassium Levels.

Patient are more prone to bleeding.

Venous Insufficiency= Obstruction of the venous valves in the legs or a reflux of blood through the valves.

Elevate legs, compression stocking, avoid crossing legs, keep skin clean, dry, soft, and avoid prolonged sitting and standing.

Exercise program, quit smoking, loose weight, medication, and surgery.

Walking/Exercise, protect from trauma, well fitting shoes, and avoid tight fitting clothes.

• Pain
• Paresthesia
• Paralysis
• Pulse
• Pallor

Varicose Veins= Abnormally dilated, tortuous, superficial veins caused by incompetent venous valves.

Avoid prolonged sitting/standing, compression stocking, elevate legs, frequent walking every hr., etc.

Beta-Adrenergic blocker/Cardiovascular agent working as a drug to control HTN, migranes, and antiarrhythmic effects.

Reduce myocardial oxygen consumption/reduces workload of heart.

• Bradycardia, lethargy, GI disturbance, CHP, decreased Blood Pressure, and depression.
• Orthostatic hypotension so caution on standing or moving to fast, so you do not pass out and fall.

• Overweight, smoking, and drinking too much alcohol.
• The Diagnosis of HTN have elevated reading 3x in several weeks.
• The Silent Killer!

Lower high blood pressure and prevention of CVA or stroke.

Intermittent Claudication= Is defined as resproducible ischemic muscle pain, in one of the most common manifestations of PAD caused by atherosclerosis.

• Ischemic muscle ache or pain.
• Shootng or burning pain in extremity.
• Produces loss of pressure and deep pain sensations.
• Treatment: Walking exercise program.

• Peripheral Arterial Occlusive Disease= When artery stenosis occurs an ther is insufficient blood flow to the tissue.
• Occurs at neck, abdomen, and extremities.
• Thin, shinny, and taught skin.
• Loss of hain on lower legs.
• Diminished pulses in legs.
• Pallor and unequal pulses.

Treatment: Protect from trauma, ware well fitting clothes, and avoid tight fitting socks.

Ca2+ channel blockers= Prevents calcium from entering muscle cells, which prevents muscle contractions, it promotes muscle relaxation.

Relaxation of smoothe muscle that surrounds the coronary arteries causing them to relax and dilate, which increases blood flow to the heart.

• Total= Below 200
• LDL= Below 100
• HDL= Above 60
• Triglycerides= Below 150

• Loop Diuretics= Reduce the vascular responce to Hypotension.
• Drop water levels fast, dehydration, hypotension, and decrease potassium levels.

Buerger's Desease= Inflammation of the small arteries and veins, linked to smoking.

• Encourage cardiovascular exercise.
• Well fitting clothes.
• Stop Smoking (Cessation)
• Avoid cold environments.
• Avoid constriction drugs.

DVT= Formation of Thrombus/ Prolonged immobility.

• Pulmonary Embolism
• CVA or Stroke.
• A cardiovascular blockage.

• Monitor: INR
• Antidote: Vitamin K

• Glomerulonephritis= A bacterial or Viral infection of the Kidneys.
• Proteinuria, edema, irritability, Head ache, malaise, hematuria, azotemia (Increases Nitrigen levels), HTN, dizziness, digestive problems, and Increased BUN/Creatinine levels.

Pink to dark brown cola look.

Urinary Incontinence= Involuntary loss of urine from the bladder.

• Types: Stress (cough or sneeze)
• Urge
• Reflex (Without control)
• Over flow (weak muscle)
• Functional (nothing wrong)
• Iatrogenic (caused by medicatons)

UTI= An infection of the urinary tract.

Prevention= Drink lots of fluids, pee after sex, hygine, and wear loose clothing.

Clinical manifestation in the ELDERLY: Altered mental status and incontinence.

Found- Water, sodium, chloride, bicarbonate, potassium, urea, creatinine, and uric acid.

Should not be found- Glucose, protein, or blood.

Renin-Angiotensin system= Vasarecta cells monitor BP for: low blood pressure and low blood volume, which causes the release of renic due to low BP.

• Renin changes to Angiotensin.
• Angiotension I converst to Angiotension II, by ace enzyme in the lungs.
• Angiotension II causes vasoconstriction and alderstrone production with ADH to retain sodium and water to raise fluid levels in the cardio vascular system. Which raises BP.

ARF= Kidneys can't remove body's metabolic wastes or perform regulatory functions.

Manifestations- Ill apperaence, lethargy, dry skin and mucus membranes, HA, increases BUN/Creatinine, hyperkalema, muscle twitching, and anemia.

Nephrotic Syndrome= Is glomerular premeability, where things are filterd through where they should not be.

Manifestaitons- Proteinuria, Hyperlipidemia, Hypoalbuminemia, edema, HA, Irritability, and malaise.

Interventions- Straight catheter as needed, administer medications as directed, privacy, warm bath, analgesics, and treat infection/ obstruction.

Kidney stones= Nephrolithiasis= Stones in the Kidney.

ESWL ( Extracorporeal shock wave lithotripsy) Most common treatment for stones.

Calcium stones are most common stone.

Risks- Diabetes, HTN, Chronic Glomerulonephritis, obstruction of urinary tract, medications, or toxic agents.

• Teaching- This drug may cause hypotension, dyspepsia, & N/V.
• Patient should take drug with meals and adhere to perscribed diet.