Med Surge 1 Final Review

Front 1

CHF

Causes

Back 1

Diminished force of contraction of ventricles due to primary heart muscle diseases (cardiomyopathies) or coronory artery disease
Mechanical failure in filling the ventricles during diastole due to narrowing of the mitral valve opening (mitral stenosis) or accumulation of fluid in the pericardium (pericardial tamponade)
Overloading of the ventricles during systole due to:
-high blood pressure (hypertensive cardiovascular disease)
-narrowing and obstruction of aortic valve (aortic stenosis)
-incomplete closure of aortic valve (aortic valvular regurgitation)
-congenital defect in ventricular septum (ventricular septal defect)

Front 2

HTN

Back 2

Increased cardiac output leads to decreased cardiac output (left ventricle can’t keep up), increased systemic vascular resistance, decreased stroke volume

Front 3

Renin angiotensin aldosterone system dysfunction leads to

Back 3

increased body water=vasoconstriction=elevated BP (kidneys responding to decreased blood flow
-Major risk factors: CAD, CHF, DM, MI, Stroke, Kidney failure

Front 4

primary HTN,

Back 4

no known cause

Front 5

Secondary HTN

Back 5

caused by renal artery stenosis (blood flow not making it to kidneys) and adrenal dysfunction

Front 6

Untreated HTN leads to increased risk for

Back 6

CAD, proteinuria (loss of protein in urine which is a huge sign of kidney failure), changes in vision, and potentially stroke

Front 7

-Management and risk reduction includes

Back 7

weight reduction, smoking cessation, reduction of alcohol intake,

Front 8

Thiazide diuretics are the first line of defense against HTN

Back 8

followed by or in conjunction with ACE inhibitors, BB, and CCB

Front 9

Management of HTN

Back 9

Take meds is key

Front 10

Management of CAD

Back 10

Controlling BP

Front 11

PVD & PAD

Back 11

Exercise, drug therapy, surgically bypassing blocked areas, medications and vascular rehabilitation programs

Front 12

Management of DVT

Back 12

Stopping your blood clot from getting any bigger, preventing the clot from breaking loose and causing a pulmonary embolism, reducing your chances of deep vein thrombosis happening again.

Front 13

prevents clots from entering the lungs

Back 13

blood thinners (Coumadin, heparin), compression stockings, and IVC Filters (Inferior Vena Cava Filters)

Front 14

CHF

causes, treatment, labs, diet

Back 14

Cardiac or pump failure, inability of the heart to pump blood to meet demands of body due to increased cellular demand
-Results in decreased cardiac output and inadequate perfusion of peripheral tissue

Front 15

CHF

Risk factors

Back 15

CAD, HTN, family history, cardiotoxic drugs, smoking, obesity, alcohol abuse, DM, and sleep disorders

Front 16

CHF

treatment

Back 16

ACE inhibitors (for stage B HF) which interrupt angiotensin system, causes increased potassium, only affects BP; Beta Blockers decrease workload of the heart (slows things down dropping BP); Calcium Channel Blockers; Diuretcis class C patients which removes fluid, creating more room for fluid to go

Front 17

CHF

Labs

Back 17

: CBC, elevated creatinine, thyroid function, increased BNP = decreased EF; BNP greater than 500 is diagnostic, 100-500 nondiagnostic. BNP measures left ventricle over stretching, the higher the BNP the more symptoms

Front 18

Diet

Back 18

Heart healthy diet, low sodium, low fat, carb controlled, fluid restriction

Front 19

Normal cardiovascular changes

Back 19

left ventricular wall is thicker
^collagen/ connective tissue
accumulation of lipofusion

Front 20

amyloid

Back 20

(excess of protein, too much accumulation causes disease

Front 21

Resting HR in UNCHANGED with age but there is small decline in

Back 21

cardiac output

Front 22

cardiac output

Back 22

the amount of blood pumped out per minute and is calculated by the heart rate x stroke volume
-Increased HR = Increased CO until 150 beats, then CO decreases, 150 beats/min is not enough time for the heart to fill

Front 23

atrial fibrillation

Back 23

Random arrival of impulses to AV node which causes an irregularly irregular heart rate
-EKG shows no P wave in A fib, incidence increases with age, occurs post-surgery
-Caused by HTN, valvular stenosis; may cause clots that can go to brain and cause stroke
-S/S: SOB, decreased BP, decreased pulse ox

Front 24

atrial fib

Back 24

-S/S: SOB, decreased BP, decreased pulse ox

Front 25

atrial fib

treatment

Back 25

: Heparin or Coumadin to prevent clot formation, monitor effects of INR (2-3), monitor PTT, control ventricular rate with BB or CCB