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53 Cards in this Set
- Front
- Back
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Cardiac output
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Volume of blood ejected from ventricles every minute
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Formula for CO
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CO = SV X HR
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Normal CO range
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4-8 L/min
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What does S3 represent?
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Reduced ventricular compliance
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What does S4 represent?
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Ventricular resistance to filling
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Which extra heart sound may be normal on some people?
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S4
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What occurs in a cardiac friction rub?
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Heart is having resistance against pericordium
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What should be documented about an extra heart sound?
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Location, where it lies between systole and diastole, characteristic of sound
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What should the LDL value be?
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Under 120
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What should the HDL value be for men and for women?
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Men: 37-70
Women: 40-88 |
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Echocardiogram
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UA of heart structure and function
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Normal left ventricular ejection fraction as detected by echocardiogram
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55-65%
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HTN basic definition
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Systolic over 140
or Diastolic over 90 |
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Pre-hypertension
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Systolic 120-140
Diastolic 80-90 |
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HTN stage II
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Systolic over 160
Diastolic over 100 |
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At what age do most women have CVA?
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Postmenopausal
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What percentage of AA women have HTN after age 75
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75%
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Which ethnic group is least aware and least likely to receive tx for HTN?
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Hispanics
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Why do AA have more trouble with HTN?
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They produce less renin and respond to ACE inhibitors less
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Formula for BP
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CO x SVR
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Risk factors of HTN
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Obesity
DM Na retention SNS activity |
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Secondary HTN causes
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Renal disease
Sleep apnea Liver disease Drugs Congenital heart disease |
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HTN and renal failure
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Persistent HTN deteriorates renal filtering system
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HTN and retinal changes
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Can cause retinal damage from high pressure
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Systolic goals for patients with and without HTN comorbidities
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With comorbidiies - under 130
Without - under 140 |
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At what age is SBP more of a risk factor for CVD than DBP?
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Age 50
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What is the rule starting at 115/75?
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CVD risk doubles with each increment of 20/10
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BMI goal in HTN tx
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Less than 25
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Na restriction in HTN
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1.5-2.0 g/day
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Which diet for HTN?
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Dash diet - veggies, fruits, low fat, low Na, fewer meats
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Alcohol and HTN
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Men - less than 2 drinks/day
Women less than 1 drink/day |
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Do you treat pre-hypertension?
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No, only if there's a comorbidity
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Two main drug actions
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Diuresis
Reduce SVR |
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What is the first line drug therapy for HTN?
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Thiazides plus another drug
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Who will receive bigger initial drugs than thiazides?
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DM
Angina Renal problems |
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Do most patients receive monopharmacy to reach correct BP?
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No
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What patients is aldactone specifically used for with HTN tx?
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If there is also liver or heart failure, give aldactone for HTN
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What is a notable side effect of aldactone?
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Hypokalemia, hyponatremia
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Which metabolic disturbance do diuretics have?
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Hyperglycemia
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ACE inhibitor MOA
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Prevents conversion of Ang I to Ang II, and Ang II causes vasoconstriction
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Who gets ARB?
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People who can't tolerate ACE
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Does hormone replacement therapy raise BP?
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No, but oral contraceptives may.
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Which drugs can be used to treat HTN in pregnancy?
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Methyldopa, betablockers, vasodilators
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Which drugs cannot be used to treat HTN in pregnancy?
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ACE inhibitors and ARB
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Which drugs are given for hypertensive emergencies?
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Vasodilators - Nipride
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What does Nipride do?
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Quickly lowers SVR
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The side effects of nipride
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Tachy (b/c heart is trying to compensate for decreased bp)
Flushing (b/c you're vasodilating) Dizziness (b/c drop in BP) |
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How often do you monitor a patient who just received nipride?
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q 15 minutes
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What is HTN defined as at home?
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135/85, b/c this is accounting for the white coat effect
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What is a hypertensive crisis?
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A severe and abrupt change in blood pressure
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What causes HTN crisis?
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Noncompliance with medications or precipitation by drugs, ETOH, or illness
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Aortic aneurysm or dissection - what needs to happen?
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Systolic BP needs to be 100 or less ASAP
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During HTN crisis - if no organ failure occurring - do what?
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Give anti-hypertensive and put person in a quiet area
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