NUR 2 Test 3

the amount of resistance to enjection of blood from the ventricle

Amount of blood ejected per heart beat, the avg is 70 ml per heart beat

• -Don't bare down, can trigger a vagal response and cause bradycardia
• -stool softeners

the contractibility decreases and O2 is cut off causing muscle death or ischemia

Troponin, positive for an MI if greater than 4

they rise within a few(3-4) hours and stay elevated for up to 3 weeks

Acute Coronary Syndrome (ACS)

Angina

dialates the Coronary arteries, decrease myocardial O2 consumption

Phase 1

Phase 2

Phase 3

Walking is good ;) moderation and supervised exercise is part of cardiac rehabilitation.

ventricle is enlarged but muscle is not

restrictive cardiomyopathy

• -Pulmonary congestion
• -edema
• -HTN
• -aortic regurgitation
• -fatigue
• -exercise intolerance

• Dyspnea
• SOB
• Orthopnea
• PND
• Cough
• Pulmonary crackles
• low O2 Sats

respiratory distress that wakes them up at night

• JVD *Jugular Vein Distention*
• dependant edema
• hepatomegaly
• acsities
• anorexia
• nausea
• weakness
• weight gain

A BNP (B-type Natriuretic Peptide)is the lab that is indicitive of heart failure if less than 100 no heart failure, greater than 100 = heart failure.

• -Administer Diuretics or ACE inhibitors
• -sodium restriction

a diruetic also known as lasix

• can lower BP to much and also can cause hypokalemia, and hypotension
• *DAILY weight* and labs!

• -check PT/INR every day to make sure it is at a theraputic level
• -avoid foods high in Vitamin K, such as spinach, broccili.

• *STOP SMOKING*
• -diet
• -exercise
• -daily skin inspection
• -teach when to seek medical care
• -medications

Vericose veins

• frequent walking,
• elevate legs
• compression stockings
• avoid prolonged standing and/or sitting

a beta blocker that decreases heart rate and BP, can cause brady cardia and *impotance*, pulmonary edema, CHF and depression

• a class of medications that
• -Decrease myocardial contractility, HR, SVR, BP
• -Used in 1st hours of MI to reduce the size of the infarct
• -Continue medications indefinitely

• dizziness, fatigue, lethartgy,impotence
• hypotension, bradycardia, ****FALLS RISK***

HTN with an unidentified cause in 90-95% of cases

• -family HX
• -age(older)
• -race(african american)
• -obesity
• -insulin resistance
• -excessive alcohol, smoking or stress
• -diet
• *diagnosis requires that BP be elevated on at least three occasions during several weeks**

prevent complications and death by acheiving and maintaining a BP of less then 140/90, even 139/89 :)

• a muscle cramp that is caused by excertion and relieved by rest.
• (Ischemic muscle ache or pain
• Precipitated by exercise, walking
• Resolves within 10 minutes or less with rest and is reproducible )

• –Progressive changes to intimal lining
• Causes scarring and narrowing –Decreased lumen size

• -loss of hair on lower extremities
• -thin shiny skin
• -intermittent claudication
• -rest pain
• -pallor on the feet
• -sensory loss
• -deminished or absent pedal pulses

Medications that increase sodium excretion and cause arteriolar vasodilation by preventing the movement of extracellular calcium into the cells.

• Increases the relaxation of the smooth muscle that surrounds the coronary arteries and causes them to dialate which increases the blood flow to the heart and decreases the work load of the heart.
• * Avoid grapefruit juice*

below 200 mg/dL

Below 100 mg /dL

60mg/dL and above

below 150 mg/dL

• if BP is low can make it lower, watch for hypotension,
• can lower potassium and cause hypokalemia

• *STOP SMOKING*
• -avoid cold enviroment
• -decrease stress
• -encourage cardiovascular exercise
• -avoid vasoconstricting drugs

• -prolonged immobility
• -surgery trauma, cancer, obesity,
• -birth control pills
• clotting disorders, and >65 years old

• hematuria
• edema
• azotemia
• protienuria
• hypertension

many RBCs are in it so it is the color of "cola" or "Tea"

• *stress-caused by sneeze, cough
• *urge-unable to reach toilet in time
• *Reflex-no control, paralyzed
• *overflow-weak muscles
• *functional-physical or mental alterations
• *iatrogenic-extrinsic factor

Glucose and protien there is almost no blood in urine less than 0.5 is ok

Kidneys cannot remove the body's metabolic wastes or perform their regulatory functions

• *oliguria/anuria* (most common)
• -low urinary output
• -Edema
• -pain in the back, or lower flanks
• -headaches

• •Peripheral Edema
• –Decreased serum albumin
• •Fluid shifts from vascular space to tissues
• •Ascites
• •Weight gain
• •Massive proteinuria
• •Hypertension
• •Hyperlipidemia
• –LDLs increase in an attempt to compensate for albumin loss
• •Elevated lipid levels can lead to atherosclerosis
• •Hypoalbuminemia

• provide privacy
• warm bath
• bladder retraining
• analgesics
• treat infection(if one)
• prevent overdistention

the most common, non invasive treatment for kidney stones, if they are too big.

The end stage of renal disease---DUH ! :) if pt does not get on dialysis soon they will die :(

*Diabeties*

elevated BUN and Creatnine

• –Bind phosphate in bowel and excrete
• –Example: Sevelamer hydrochloride (Renagel)
• Pt teaching*
• »Should be administered with each meal
• -Side effect: Constipation

Pain caused by not enough blood getting to extremities, not a disease just a symptom!

• large amounts of fluid
• pee after sex
• good hygeine

• altered mental satus
• incontinence

when BP and fluid are low renin is release and creates angiotensin 1 which the body automaticly converts to angiotensin 2 (BAD!!) so an ACE inhibitor is given which prevents angiotensin 1 from converting to angiotensin 2