-
prehypertensive
120-130/80-89
-
Renin--with fall in bp
enzyme secreted from juxtaglomerular apparatus--released in response to decreased renal bl flow and decreased arterial pressure (then vasoconstriction)
-
hypertensive crisis
bp >240 sys. >120 dia
-
alpha 1, alpha 1
- 1-works right on vessles and dilates
- 2-affects HR and vessels>>slow down and dilate
-
Hypertension meds: central acting sympatholytics
- clonidine (Catepress)
- guinabenz (Wytensin)
- methyldopa (Aldomet)
-
Vasodilators
- Hydralazine (Apresoline)
- Minoxidil (Loniten)
- Diazoxide (Hyperstat) --only IV and for hypertensive crisis
- Nitroprusside (Nitropress)
-
Alpha-Adrenergic Blockers
- doxazosin (Cardura)
- prazosin (minipress)
- terazosin (Hytrin)
- Give first dose at bedtime to reduce rish of first dose syncope
- ZOSIN
- May have reflex tachycardia
-
Other meds: ACE inhibitors, ARBS, Beta adrenergic blockers, Ca++ ch. blockers
yep
-
clonidine
check patch often
-
symptom of arteriosclerosis: intermittent claudication
cramping or aching sensation in calves or arch of foot--develops with exercise and relieved with rest
-
complications of arteriosclerosis
gangrene and amputation; paralysis
-
Segmental BP
- compare BP with upper and lower extremities
- normal: similar when pt in supine pos
- PVD: bp may be lower in legs than arm
-
exercise stress test
id functional limitations with PVD
-
doppler ultrasound
eval bl flow
-
transcutantous oximetry
eval tissue O2
-
Angiography or magnetic resonance antiography
if surgery planned to locate and determine extent obstruction
-
meds--inhibit platelet aggregation
- asa
- clopidogrel (Plavix)
- cilostrazol (Pletal) also vasodilator
-
S&S of PVD
- Pain
- Pallor
- Pulselessness
- Paralysis
- Paresthesia
- Poikiloderma (hypo/hyper pigmentation of skin)
-
Buerger's Disease
- (thromboangiitis obliterans)
- Occusive disease sm and med sized peripheral arteries
- Vessels inflamed, spastic and thrombotic
- Cig smoking most sig cause
-
Raynauds Phenomenon
- Spasms sm arteries and arterioles extremities
- limit bl flow fingers and on toes, ear, and nose
- Vasospasm--fingers turn blue, then white, and then red
-
Aneurysm
weakness and localized dilation bl vessel wall
-
Fusiform
entire circumference vessel: grow slowly but progressivly; like partially blown up balloon
-
Sacular
Only a portion of vessel--forms outpouching on side of otherwise norm artery. Distends with bl until appears pulsating mass
-
Berry
Common type congenital saccular aneurysm in section cerebral arteries
-
Aortic dissection
- dissecting aneurysm
- -dev d/t weakening medial layer aorta
- -bl leaks into vessel wall--separating intimal layer of artery from adventia
-
Turner's sign
severe back pain and pooling bl>>bluish discoloration back and sides
-
aortic dissections
- tear inner layer aorta bleeding into middle layer
- Risk Marfan Syndrome
-
meds for aneurysms
anticoagulants
-
Virchow's triad (3 pathological factors associated with thrombosis)
- -Venous stasis
- -Increased bl coaguability
- -Vessel wall injury
-
Venous insufficiency
stasis venous flow lower extremities
-
diagnostic tests: ascending phlebography
contrast medium injected venins leg.... id location and extend thrombophlebitis
-
Doppler U/S
id obstruction larger veins legs
-
Plethysmography
used with doppler U/S; measure changes vol fluid passing thru veins
-
heparin induced thrombocytopenia Antidote
Protamine sulfate
-
Antidote for coumadin
Vit K
-
Varicose Veins
- Irregular, torturous veings with poorply functioning valves
- Hemorrhoids--rectum
- Esophagus--varices
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