Unit 3 Circulation Def (Hinkle/Taylor)

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1

systolic pressure

highest point of pressure on arterial walls when the ventricles contract

2

vital signs

body temp, pulse & respiratory rates & BP (cardinal signs)

3

pulse pressure

difference between systolic and diastolic pressure

4

pulse deficit

the difference between the apical and radial pulse rates

5

vesicular breath sounds

normal sound of respirations heard on auscultation over peripheral lung areas
(Taylor 625)

6

bruits

unusual sounds usually abnormal heard in auscultation

7

adventitious breath sounds

abnormal breath sounds heard over the lungs

8

dyslipidemia

abnormal blood lipid levels, including high total low density lipoprotein and triglyceride levels as well as low high density lipoprotein levels

9

glomerular filtration rate (GFR)

flow rate of filtered fluid through the kidney an indicator of renal function

10

hypertensive emergency

a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage

11

hypertensive urgency

a situation in which blood pressure is severely elevated but there is no evidence of target organ damage

12

isolated systolic hypertension

a condition most commonly seen in the older adult in which the systolic pressure is greater that 140 mm Hg and the diastolic pressure is WNL less than 90 mm Hg

13

monotherapy

medication therapy with a single medication

14

primary hypertension

denotes high blood pressure from an unidentified cause; also called essential hypertension

15

rebound hypertension

blood pressure that is controlled with medication and becomes uncontrolled (abnormally high) with the abrupt discontinuation of medication

16

secondary hypertension

high blood pressure from an identified cause such as renal disease

17

acute coronary syndrome

refers to rupture of an atheromatous plaque in a diseased coronary artery which rapidly form an obstructive thrombus

18

afterload

the amount of resistance to ejection of blood from the ventricle

19

apical impulse

impose normally palpated at the fifth intercostal space, left midclavicular line; caused by contraction of the left ventricle; also called the PMI

20

AV node

secondary pacemaker of the heart, located in the right atrial wall near the tricuspid valve

21

baroreceptors

nerve fibers located in the aortic arch and carotid arteries that are responsible for control of the blood pressure

22

cardiac catheterization

an invasive procedure used to measure cardiac chamber pressures and assess potency of the coronary arteries

23

cardiac conduction system

specialized heart cells strategically located throughout the heart that are responsible for methodically generating and coordinating the transmission of electrical impulses to the myocardial cells

24

cardiac output

around the blood pumped by each ventricle in liters per minute

25

cardiac stress test

a test used to evaluate the functioning of the heart during a period of increased oxygen demand test may be initiated by exercise or medications

26

contractility

ability of the cardiac muscle to shorten in response to an electrical impulse

27

depolarization

electrical activation of a cell caused by the influx of sodium into the cell while potassium exits the cell

28

diastole

period of ventricular relaxation resulting in ventricular filling

29

ejection fraction

percentage of the end diastolic blood volume ejected from the ventricle with each heartbeat

30

hemodynamic monitoring

the use of pressure monitoring devices to directly measure cardiovascular function

31

hypertension

BP greater than 140/90 mm Hg

32

hypotension

BP less than 100/60 mm Hg that compromises systemic perfusion

33

murmurs

sounds created by abnormal turbulent flow of blood in the heart

34

myocardial ischemia

condition in which heart muscle cells receive less oxygen than needed

35

myocardium

muscle layer of the heart responsible for the pumping action of the heart

36

normal heart sounds

sounds produced when the valves close; normal heart sounds are S1(atrioventricular valves) and S2 (semilunar valves)

37

opening snaps

abnormal diastolic sound generated during opening of a rigid atrioventricular valve leaflet

38

postural (orthostatic) hypotension

a significant drop in blood pressure (20 mm Hg systolic or more) after an upright posture is assumed

39

preload

degree of stretch of the cardiac muscle fibers at the end of diastole

40

pulmonary vascular resistance

resistance to blood flow out of the right ventricle created by the pulmonary circulatory system

41

repolarization

return of the cell to resting state, caused by reentry of potassium into the cell while sodium exits the cell

42

S1

the first heart sound produced by closure of the atrioventricular (mitral & tricuspid) valves

43

S2

the second heart sound produced by closure of the semilunar (aortic & pulmonic) valves

44

S3

an abnormal heart sound detected early in diastole as resistance is met to blood entering either ventricle; most often due to volume overload associated with heart failure

45

S4

an abnormal heart sound detected late in diastole as resistance is met to blood entering either ventricle during atrial contraction most often caused by hypertrophy of the ventricle

46

SA node

primary pacemaker of the heart located in the right atrium

47

stroke volume

amount of blood ejected from one of the ventricles per heartbeat

48

summation gallop

abnormal sounds created by the presence of an S3 and S4 during periods of tachycardia

49

systemic vascular resistance

resistance to blood flow out of the left ventricle created by the systemic circulatory system

50

systole

period of ventricular contraction resulting in ejection of blood from the ventricles into the pulmonary artery and aorta

51

systolic click

abnormal systolic sound created by the opening of a calcified aortic or pulmonic valve during ventricular contraction

52

chronotropy

rate of impulse formation

53

dromotropy

conduction velocity

54

dysrhythmia

disorder of the formation or conduction (or both) of the electrical impulse within the heart, altering the heart rate, heart rhythm, or both and potentially causing altered blood flow (also referred to as arrhythmia)

55

inotropy

force of myocardial contraction

56

P wave

the part of an ECG that reflects conduction of an electrical impulse through the atrium; atrial depolarization

57

PP interval

the duration between the beginning of one P wave and the beginning of the next P wave; used to calculate atrial rate and rhythm

58

PR interval

the part of an ECG that reflects conduction of an electrical impulse from the sinoatrial node through the atrioventricual node

59

QRS complex

the part of an ECG that reflects conduction of an electrical impulse through the ventricles; ventricular depolarization

60

RR interval

the duration between the beginning of the one QRS complex and the beginning of the next QRS complex; used to calculate ventricular rate and rhythm

61

sinus rhythm

electrical activity of the heart initiated by the sinoatrial node

62

ST segment

the part of an ECG that reflects the end of the QRS complex to the beginning of the T wave

63

T wave

the part of an ECG that reflects depolarization of the ventricles

64

Newborn normal heart rate

100-180

65

1week-3month infant normal heart rate

100-220

66

3mo-2yr child normal heart rate

80-150

67

2-10 year old child normal heart rate

70-110

68

10 yr - adult normal heart rate

55-90

69

P wave represents

atrial depolarization

70

QRS represents

ventricular depolarization and contraction

71

T wave represents

ventricular repolarization

72

U wave indicates

recovery of Purkinje conduction Fibers

73

EKG five step proceduce

Rhythm, rate, P wave, PR interval, QRS interval

74

Normal PR interval

0.12 - 0.20 (3-5 small boxes)

75

Normal QRS complex

0.10 seconds or less

76

Stroke Volume is influenced by

Heart rate Ventricular preload, Ventricular contractility, Ventricular afterload

77

Normal Adult BP

120/80

78

Normal Adult pulse

60-100

79

Normal Map for 120/80 BP

93

80

MAP calculation

(2xDBP] + SBP)/3

needs to be greater than >65

81

Cardiac Output calculation

HR x SV/ 1000

(4.0 - 8.0 L/min) normal

82

Pre Hypertension Adult BP

120/80 - 139/89

83

HTN Stage 1 Adult BP

140/90 - 159/99

84

HTN Stage 2 adult BP

>160/100

85

Normal BMI range

19 -25 kg

86

Chlorothiazide (what type of drug)

thiazide diuretic

87

Hydrocholorothiazide (what type of drug)

thiazide diuretic

88

Thiazide Diuretics (what actions, effects,caution, nursing)

action; inhibits Na+/H2o reabsorption in distal tube

Effects/use; diuresis & lower BP

Caution; avoid in neonates

Nursing; monitor Bp, Labs(BUN, creatinine)weight (I/O), change positions slowly when getting up

Dosage; 12.5mg - 25mg

89

Furosemide (what type of drug)

loop diuretic

90

Torsemide (what type of drug)

loop diuretic

91

Bumetanide (what type of drug)

loop diuretic

92

Loop Diuretics (action, effects, caution, nursing)

Action; inhibits Na+/H2o reabsorption from the loop of henle

Effects/use; diuresis & lower BP

Caustion; geriatrics @ risk of increased side effects

Nursing; monitor I/Os, weight, BP labs(Bun,Creatinine) K+, orthostatic precautions, take in am

93

Metoprolol (what type of drug)

Beta Blockers

94

Propranolol (what type of drug)

Beta Blockers

95

Carvedilol (what type of drug)

Beta Blockers

96

Atenolol (what type of drug)

Beta Blockers

97

Beta blockers (action, effect, caution, nursing)

action; blocks beta receptors therefore the effects of (norepinephrine/epi) which effects heart rate

Effects/use; reduce heart rate, reduce BP by vasodilation

Caution; contraindicated if bradycardic uncompensated CHF, Shock

Nursing; if IV monitor for CHF & Rhythm; monitor HR &BP extended release DO NOT CRUSH; abrupt withdrawal may precipitate life threatening arrhythmia

98

Diltiazem (what type of drug)

Calcium Channel Blockers

99

Amlodipine (what type of drug)

Calcium Channel Blockers

100

Verapamil (what type of drug)

Calcium channel blockers

101

Nifedipine (what type of drug)

Calcium Channel Blockers

102

Calcium Channel blockers (action, effects, caution, nursing)

actions; inhibits transport of calcium into vascular smooth muscles resulting in vasodialation & decrease in excitability of heart muscles and decrease heart muscle need for O2

Effects/use; decrease BP, treats angina and some abnormal rapid heart rhythms (atrial)

Caution; can reduce elimination of & thus increase blood levels of carbamazepine and some statins

nursing; can cause edema, assess for signs of CHF, IF, IV tele monitor DONT CRUSH

103

Benazepril (what type of drug)

Ace Inhibitors

104

Captopril (what type of drug)

Ace Inhibitors

105

Enalapril (what type of drug)

Ace Inhibitors

106

Lisinopril (what type of drug)

Ace Inhibitors

107

Ramipril (what type of drug)

Ace Inhibitors

108

Ace Inhibitors (action, effects, caution, nursing)

actions; angiotensin converting enzyme inhibitor; decrease production of angiotensin 2

effects/use; dilates vessels so decrease BP makes it easier for heart to pump so can improve CHF...so used in HTN and Tx for CHF

caution; in patients with bilateral renal artery stenosis

nursing; common side effects are Cough, may take up to 1 month to subside, elevated K+, weakness, metallic taste, rare but...kidney failure and angio edema; monitor electrolytes & kidney function (BUN, Creatinine)

109

Valsartan (what type of drug)

ARBS

110

Olmesartan (what type of drug)

ARBS

111

Losartan (what type of drug)

ARBS

112

ARBS (action, effects, caution, nursing)

action; angiotensin 2 receptor blockers (vasoconstrictor)

effects/use; blood vessel dilation also increase the H2o release & salt to the urine, which in turn decreases BP

Caution; contraindicated meds containing (aliskiren)

Nursing; often used when clients have ace inhibitor cough; monitor electrolytes & kidney fucntion

113

Mg++ normal levels

1.3 - 2.3 mEq/L

114

K+ normal levels

3.5 - 5.0mEq/L

115

Na+ normal levels

135 - 145 mEq/L

116

BUN normal levels

10 - 20 mg/dL

117

Creatinine normal levels

0.7 - 1.4mg/dL

118

Ca++ normal levels

8.6 - 10.2 mg/dL

119

HCT

34-44

120

Hgb

11-15

121

WBC

4500-11,000mm3