Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
114 Cards in this Set
- Front
- Back
|
erikson stage for middle aged
|
generativity vs stagnation
|
|
|
how is appearance affected in middle ager
|
gray thinning hair, skin turgor and moisture decrease, drop in subq fat, nose and ears continue to grow
|
|
|
how is cardiovascular system affected in middle ager
|
blood vessels lose elasticity and become thicket, heart muscle walls thicken
|
|
|
urinary system changes in middle agers
|
bladder capacity declines, kidney less efficient, nephron units are lost, glomerular filtration rate decreases
|
|
|
male equivalent of menopause, drop in testosterone and human growth horomone
|
climacteric
|
|
|
erikson stage for elderly
|
integrity vs despair (satisfaction vs dissappointment)
|
|
|
heart wall thickening called
|
myocardial hypertrophy
|
|
|
which disease increases the risk of CVD by 3x?
|
diabetes
|
|
|
WHo is at greater risk for CVD, men or women?
|
Men, until menopause, then women are at much greater risk after menopause
|
|
|
when you feel a vibration under the skin when palpating the carotid artery.
|
a thrill
|
|
|
If you can hear a vibration in the carotid artery (this is considered good if heard in a fistula for dialysis)
|
a bruit
|
|
|
if thyroid is large and palpated can be an indication of ....
|
HTN (can change blood pressure)
|
|
|
causes sodium and water retention. Increases blood pressure by increasing blood volume
|
aldosterone
|
|
|
bulging vein in the neck. If seen, it is a sign of retained fluid/ fluid overload
|
jugular venous distention (JVD)
|
|
|
if thrill and bruit are present in aorta in abdomen, may be a sign of...
|
aneurism (weakening of aortic wall)
|
|
|
BP 120-139/80-89
|
prehypertension
|
|
|
BP 140-159/90-99
|
hypertension stage 1
|
|
|
bp >160/ >100
|
hypertension stage 2
|
|
|
what are the target organs damaged by HTN?
|
heart, kidneys, brain, blood vessels, eyes
|
|
|
what is the first choice of medication for high blood pressure?
|
thiazide diuretic
|
|
|
where are the baroreceptors?
|
carotid sinus and aortic arch
|
|
|
where are the chemoreceptors?
|
in the brain
|
|
|
what do the baroreceptors and chemoreceptors do?
|
sense changes in blood pressure and signal kidneys which then releases angiotensin II and aldosterone
|
|
|
what is the safe range for potassium?
|
3.5-5 - if too high or too low, it can affect cardiac function
|
|
|
side effects of thiazide
|
increased urination, electrolyte imbalances, hyperuricemia, hypokalemia, hyperglycemia
|
|
|
diuretic used more for heart failure patients
|
potassium sparing diuretic and loop diuretics
|
|
|
side effects of potassium sparing diuretic
|
increase potassium levels, cause hyperkalemia, can lead to life threatening cardiac arrhythmias
|
|
|
can be combined (taken 30 minutes prior to) a loop diuretic and it increases the effects of the loop diuretic in the system
|
potassium sparing diuretic
|
|
|
HTN medication not good for diabetics due to it increasing blood sugar levels
|
Thiazides HCTZ
|
|
|
what is a beta-adrenergic blocker given for? How does it work?
|
hypertension. They reduce myocardial stimulation and contractility
|
|
|
How do beta blockers prevent angina attacks?
|
they lower the demand for Oxygen
|
|
|
what is the most common side effect of beta blockers?
|
bradycardia (also hypotension and erectile dysfunction)
|
|
|
Side effects of loop diuretics .
|
increased urination, electrolyte imbalances, hypokalemia
|
|
|
HTN medication that causes a large amount of fluid loss 20%
|
loop diuretic
|
|
|
Furosemide ( lasix)
|
loop diuretic
|
|
|
Bumentanide (bumex)
|
loop diuretic
|
|
|
Torsemide (demadex)
|
loop diuretic
|
|
|
Side effects of loop diuretics .
|
increased urination, electrolyte imbalances, hypokalemia
|
|
|
Triamterene ( dyrenium)
|
potassium sparing diuretic
|
|
|
Spironolactone ( Aldactone)
|
potassium sparing diuretic
|
|
|
Potassium depleting diuretic
|
loop diuretic
|
|
|
If BUN level is up and creatinine is also elevated what does this suggest?
|
renal failure
|
|
|
If BUN level is up and creatinine is normal what does this suggest?
|
dehydration
|
|
|
What do ACE inhibitors do?
|
they prevent angiotensi I from converting into angiotensin II
|
|
|
what is the most common side effect of ACE inhibitor?
|
cough- ACE works mostly in the kidneys but also in the lungs which produces the cough
|
|
|
how do calcium channel blockers work?
|
they interfere with moving calcium causing vasodilation
|
|
|
what are the common side effect for non-dihydropyridine calcium channel blockers?
|
bradycardia, constipation
|
|
|
What type of CCBs work directly on the heart? (they increase systolic BP)
|
non-dihydropyridines
|
|
|
What type of CCs work on the blood vessels? (they increase the dystolic BP)
|
dihydropyridines
|
|
|
what is the common side effect for dihydropyridine CCBs?
|
peripheral edema
|
|
|
what are the two non-dihydropyridine medications called?
|
diltiazem (cardizem), verapamil (calan, isoptin)
|
|
|
What do dihydropyridine CCB end in?
|
-pine
|
|
|
If no other medications used work for HTN, this is the last line of agents
|
Vasodilators (old class of drugs)
|
|
|
hydralazine (Apresoline)
|
vasodilators- IV push. This quickly lowers BP.
|
|
|
Side effects of vasodilators
|
tachycardia on both (need beta blockers to slow down HR), fluid retention on minoxidil (need diuretic for retention), and lupus with the hydralazine
|
|
|
minoxidil (Loniten)
|
vasodilator
|
|
|
smooth muscle relaxation, common side effect is postural hypotension and mortality
|
Alpha I blocker
|
|
|
doxazosin (Cardura), prazosin (Minipres), and terazosin (Hytrin)
|
Alpha I blocker
|
|
|
what is non-compliance now called?
|
ineffective management of theropeutic regiment
|
|
|
what level of A1C indicates a need to adjust a treatment plan?
|
8 or greater
|
|
|
molecule checked to get the average blood glucose levels over the past 3 months
|
Hemoglobin A1C
|
|
|
What in the body causes diabetes II
|
insulin resistence, and pancreas underproducing insulin after exhausting itself over years
|
|
|
What are the target organs to protect with diabetes?
|
eyes kidneys nerves (microvascular) and cardiovascular (macrovascular)
|
|
|
common complications of diabetes mellitus
|
heart disease, stroke, blindness, renal disease, HTN, dental disease, NS disease, charcot foot, sexual disfunction
|
|
|
nerve damage in stomach causes food to sit and not pass into intestines. Give reglan to help.
|
gastroperisis
|
|
|
what are the 3 common symptoms of diabetes mellitus?
|
polyuris, polydipsia, polyphagia
|
|
|
bones in foot become acutely softened and collapse. flat wide foot or foot is like a rocker.
|
charcot foot
|
|
|
What do Alpha I blockers end in?
|
-sin
|
|
|
medication that needs to be tapered down in order to stop taking it otherwise can cause rebound HTN and tachycardia
|
Alpha 2 agonists and adrenergic antagonists
|
|
|
clonidine(catapres)
|
alpha 2 agonists and adrenergic antagonists
|
|
|
methyldopa(aldomet)
|
alpha 2 agonists and adrenergic antagonists
|
|
|
reserpine
|
alpha 2 agonists and adrenergic antagonists
|
|
|
guanfacine(Tenes)
|
alpha 2 agonists and adrenergic antagonists
|
|
|
In african americans, BBs ACEIs ARBs are less effective unless taken with this...
|
a diuretic
|
|
|
hardening and thickening of arteries from a variety of causes
|
arteriosclerosis
|
|
|
hardening and thickening of arteries from plaque development
|
atherosclerosis
|
|
|
atorvastatin (Lipitor)
|
lipid-lowering agent
|
|
|
lovastatin (Mevacor)
|
lipid-lowering agent
|
|
|
fenofibrate (Tricor)
|
lipid-lowering agent
|
|
|
niacin (Niaspan)
|
lipid-lowering agent
|
|
|
gemfibrozil (Lopid)
|
lipid-lowering agent
|
|
|
cholestyramine(Questran)
|
lipid-lowering agent- a powder that lowers absorption in GI tract causing loose fatty stools
|
|
|
What do lipid-lowering agents do?
|
they lower cholesterol by lowering lesion formation in the vessels. Lesions then replaced with connective tissue
|
|
|
other cardio vascular medications that are not thinners or coagulants, they are
|
antiplatelet agents
|
|
|
clopidogrel(plavix)
|
antiplatelet agent
|
|
|
ticlopidine (ticlid)
|
antiplatelet agent
|
|
|
cilostazol (pletal)
|
antiplatelet agent
|
|
|
what is claudication?
|
pain when you walk
|
|
|
What is pentoxifyline (trental)used for?
|
it's an antiplatelet agent that decreases blood viscosity, increase RBC flexibility and helps in stopping intermittent claudication
|
|
|
If their is a risk for bleeding (surgery,trauma) or if blood is in the stool, or if their is a history of GI bleed or ulcers need to go off these meds
|
Plavix & Ticlid- bleeding is a side effect. Give with food
|
|
|
beta blockers and calcium channel blockers are also used for this...
|
antiarrhythmics
|
|
|
test to determine inflammation is present but will not specify location of the inflammation
|
c-reactive protein (crp)
|
|
|
sucralfate (Carafate)
|
PPI adheres to ulcer like a bandaid, must be given AC on empty stomach, Only given orally- pill must be disolved as a slurry
|
|
|
metoclopramide (Reglan)
|
PPI anti-emetic(antinausea), speeds up emptying time of stomach, can be used to treat stress ulcers. Used for nausea/vomiting with kemo (PO, IVP, IVPB)
|
|
|
famotadine (pepcid)
|
PPI anti ulcer agent, Given orally or IV piggyback. Works on histamine, H2 blocker
|
|
|
pantoprazole (protonix)
|
Proton pump inhibitor
|
|
|
Are stomach ulcers a result of increased stomach acid?
|
No, they are a result of decreased mucosal blood flow and decreased mucosal resistence
|
|
|
decreases conduction through SA and AV nodes which decrease HR, increase force of myocardial contractions
|
antiarrhythmics
|
|
|
dejoxin (Lanoxin)
|
antiarrhythmics
|
|
|
dejoxin levels can be drawn from blood to determine it is in therapeutic levels. What is the safe range?
|
0.5-2
|
|
|
What in the stomach declines with age?
|
hydrochloric acid
|
|
|
What can a decline in intrinsic factor lead to?
|
pernitious anemia
|
|
|
What can a decline in absorption, motility, and blood flow lead to?
|
constipation
|
|
|
what happens to the liver with age?
|
the size decreases which can cause trouble metabolizing medications
|
|
|
What nursing assesments must be done with a patient that has diarrhea?
|
monitor I&O, assess color of urine, assess color of stool and amount of stool
|
|
|
WHat type of drug is given for severe diarrhea?
|
diphenoxylate/atroline (Lomotil)
|
|
|
The diarrheal drug Lomotil has two agents- dophenoxylate and atroline. What else can atroline be used for?.
|
it is a cardiac drug- it can speed up the HR. It's used to dry up secretions
|
|
|
What type of drug should be given initially for diarrhea (that's not severe)
|
loperamine (Imodium)
|
|
|
what does GERD stand for?
|
gastro esophageal reflux disease
|
|
|
The need for this vitamin is tripled in the elderly, and why is it needed so much more?
|
Vitamin D; to assist with bone mineralization and calcium absorption. Must be taken orally and not through skin
|
|
|
How much vitamin D and Calcium is needed in middle age/elderly?
|
1200mg over age 50
|
|
|
How should calcium be given (dosage breakdown)?
|
majority given before bedtime, the rest spread throughout the day to ensure it is all absorbed
|
|
|
When removing fecal impaction need to be careful not to stimulate this...
|
vegas nerve which will drop BP and HR and could cause patient to pass out
|
|
|
what are protonix?
|
proton pump inhibitor used to treat GERD
|
