NUR2 Test 3

• Affects stroke volume
• Resistance or pressure in aorta and peripheral arteries that the L ventricle must work against to eject blood from the heart.
• Vasodilation = AL decrease
• Vasoconstriction = AL increase

• The amount of blood ejected per heart beat (70mL average)
• Determined by preload, afterload, & contractility
• Increase PL = Increase SV
• Increase AL= Decreased SV
• Increased contractility = Increased SV

• Sup/Inf Vena Cava --> R Atrium (RA)
• RA through tricuspid valve --> R Ventricle (RV)
• RV through pul. Valve --> pul. artery and lungs
• Lungs --> pul. Vein --> L Atrium (LA)
• LA through mitral valve --> L ventricle (LV)
• LV through aortic valve --> Aorta

Left Ventricle is usually 2.5 times larger

• Heart -70-80%
• Body -20%

• Specialized cells in carotid arteries and aortic arch that
• signals body to increase/decrease BP & HR

The degree of stretch of the ventricular cardiac muscle at the end of diastole

• Don’t bare down b/c of vegal nerve response (can provoke dysrhythmias & bradycardia)
• Take stool softeners

Below 200 mg/dL

100-129 mg/dL

• Low LDL <100
• High HDL >60

• Indicator of heart failure protein released in heart failure Hormone released by heart from increase in atrial volume and ventricular pressure
• Promotes venous and arterial vasodilation

Ensure they are not allergic to Iodine

• Palpate site of CC for hematoma.
• Strict bed rest 4-6 hrs
• Instruct pt. not to move leg

Hardening of the arteries without atheroma (plaques)

• Pain caused by insufficient coronary blood flow; atherosclerosis AND increased demand for O2
• *Anxiety attack can mimic chest pain
• *Diabetics will not experience chest pain

• Vasodilator
• *Decreases myocardial oxygen consumption

If they have this they can switch to another type of medication

• Prevent platelet aggregation
• *Watch for s/s of bleeding*
• Eptifibatide (Integrilin)
• Abciximab (Reopro)
• Tirofiban (Aggrastat)

• Accurate/reliable indicator of myocardial injury used if pt.waits > 24hrs to seek tx.
• Positive for MI if > 4
• Most sensitive indicator of MI

• Test does not indicate if MI occurred but neg. result rules out MI
• Starts to increase 1-3 hrs, peak within 12hrs

• M= Morphine; decrease pain, anxiety, workload on heart
• O= Oxygen; increased O2 will decrease workload on heart
• N= Nitrates; relieve angina pain
• A= ASA

Balance amount/intensity of activity to attain health benefit without causing symptoms.

0.5-2 ng/mL

Murmur, caused by; CAD, hypertrophy, aortic stenosis, ventricularfailure, mitral valve regurgitation

After S2

Before S1

• Progressive change in the arterial wall
• Normally endothelium cells repair themselves instantly, but with CAD endothelium cells slow repair allows LDL to thicken arterial wall.

Umbrella term for any symptoms of acute MI

• Results from sustained ischemia (>20 min)
• Irreversible myocardial cell death
• Occurs when coronary artery is occluded or in a vasospasm
• Cells eventually die from hypoxia

• ECG, monitor VS, lab studies
• Decrease cardiac workload and anxiety

• Dyspnea
• Decrease O2 sats
• HTN
• Tachycardia & tachypnea

Jugular vein distention

To assess changes in fluid volume

• Daily weights
• What to do if symptoms return
• Diet
• Activity
• Medications

• Thin, shiny, taught skin
• Loss of hair on lower legs
• Diminished/absent peripheral pulses
• Pallor of the feet, uneven peripheral pulses bi-lateral

• Symptom of PAD
• Pain caused by too little blood flow generally in legs when
• exercising

Walk 30-60 minutes per day or until pain discomfort begins

• Protect from trauma
• Wear well-fitting shoes
• Avoid tight-fitting socks

• Inflammatory disease involving fingers where blood vessel become blocked
• Most often associated with smoking
• *Treatment is to stop smoking*

• *Prolonged immobility* and other stasis of blood
• Trauma to vein
• Hypercoagulability

• INR
• Antidote: Vitamin K

Requires at least 3 elevated readings over several weeks

• *Self monitor BP*
• Weight loss
• Reduce sodium
• Regular physical activity

• Names, actions, doses, side effects of all drugs
• Do not abruptly d/c
• Never double-up to account for a missed dose
• Watch for orthostatic hypotension
• Monitor OTC ingredients

• Protein (trace amount ok)
• Glucose
• Blood (trace ok)

• Vasa Recta in kidneys detect a decrease in BP
• Low BP stimulates renin secretion
• Renin converts angiotensin to angiotensin I
• ACE from lungs converts angiotensin I to II
• Vasa Recta senses increase in BP and secretion of rennin ceases

No urine output

Very little urine output (<30 mL/hr)

• Inflammation of the glomerular capillaries;
• Acute = acute nephritic syndrome
• Chronic

• HTN, Weight loss, Azotemia
• *Dark red or “cola” colored urine
• *check daily weights*

Abnormally high levels of nitrogen-containing compounds in urine

• Oliguria(decrease lvl of urine output)
• Anuria (very little to no urine output)
• Azotemia (highlvl of nitrogen compounds in urine)

• Stress- intacturethra (sneeze, laugh)
• Urge- strong urgebut unable to reach toilet in time
• Reflex- bladder empties w/o any control
• Overflow- weak muscle
• Functional- no muscle weakness, physical/mental limits
• Iatrogenic- incontinence effected by medication/intrinsic factors

• Proteinuria
• Edema;periorbital, ascites

• Depletion of water, sodium, potassium
• Postural hypotension

• Absencein pain
• Palpitations
• Feelingsof doom
• Anxiety

• Phase1: Inpatient; measures abilities, light walking, pt. & family education of lifestyle changes
• Phase2: Closely supervised ambulatory outpatient program
• Phase3: Lifetime maintenance

• Also know as congestive, the heart is enlarged and weak
• Ventricular dilation w/o increase size of muscle
• *Exertion dyspnea*

• Fatigue
• Swollen feet/hands
• Dyspnea w/ exertion

• Skin color goes;
• white --> blue --> red

• Elevate legs q2 hrs for15 min
• Sleepwith feet raised 6 inches
• Compression stockings
• Avoid prolonged sitting/ cross legs/ tight clothes & socks Monitorskin daily

• Don’t stand for extended periods of time
• Walk to promote circulation
• Tedhose

• Most common
• Unable to determine single cause for increase BP
• Idiopathic

• *Drink plenty of fluids*
• Hygiene

• Confusion/altered mental status
• Incontenance

• Non-invasive procedure that blasts kidney stones with shockwaves to break them up.
• Used for stones too large to pass through ureters

Take with food