CCRN HTN Crisis, Valves, PAD, CAD Flashcards Preview

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Flashcards in CCRN HTN Crisis, Valves, PAD, CAD Deck (18)
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1
Q

HTN Dx?

A

Dx: Critically elevated BP w/ end stage organ damage.

2
Q

HTN Crisis Presentation? dBP level greater than? (5)

A

Presents w/: AMS, seizures, vomiting, visual disturbances, headache, dBP>120mmHg, epitaxis. Think what occurs with extreme vasoconstriction.

3
Q

HTN Crisis Risk Factors? (7)

A

Risk factors: DM, smoking, obesity, HTN, PO contraceptives, HLD

4
Q

HTN Crisis Causes: (2)

A

Causes: 1. Uncontrolled HTN 2. Renal dysfunc/endocrine disorder

5
Q

Why is it so dangerous?

A

HTN enhances sympathetic stimulation, causes systemic vascular vasoconstriction. This decreases blood flow to vital organs. STROKE

6
Q

HTN Crisis Treatments (3)

A
  1. Nitroprusside: WATCH for cyanide toxicity secondary to thiocyanate. Watch for AMS. Can cause fetal renal impairment.
  2. Labetalol: long acting IV beta blocker, preferred w/ CAD
  3. Fenoldopam mesylate (Corlopam) long half life and hypokalemic effect though
7
Q

Describes what occurs to the valves during S1 phase

A
  1. Systolic ejection phase
    The ventricles are squeezing, and the semilunar valves (aortic and pulmonic) are open. The AV valves (mitral and tricuspid) are close, resuming in S1 (Lub)
8
Q

Describes what occurs to the valves during S2 phase

A
  1. Diastolic filling phase
    The ventricles are relaxed, allowing refill to occur. So AV Valves are open. Semilunar valves are closed (aortic and pulmonic). This results in a dub. This phase is longer since it’s the filling phase.
9
Q

What are S3 sounds associated with?

Describe the sound

A

Phase S1, S2, S3. KEN-TU-KEE. whole note-halfpause-halfnote-half note

Associated with high left ventricular pressure and heart failure. “ventricular gallop”

10
Q

What are S4 sounds associated with?

Describe the sound

Heard in a fib?

A

Associated with HTN, MI, infarction and aortic stenosis. “atrial gallop”

S4, S1, S2. half note half note half pause whole note
TEN-NE-SSEE

No heard in a fib cuz there’s no atrial contraction

11
Q

Acute PAD S/S? (5)

A

Pain, Pallor, Paresthesia, Pulselessness, Paralysis

12
Q

PAD Testing? (2)

A

Ankle-Brachial Index

13
Q

PAD Tx (3)

A

Positional: Bedrest in reverse Trendelenburg
Do not elevate affected extremity cuz it’s decrease perfusion
Mech: Embolectromy, bypass graft, angioplasty
Pharm: A/C,Antiplatelets, Vasodilators, thrombolytic

14
Q

S/S of Carotid Artery Disease? (4)

A

TIA, Monocular Visual disturbances, Aphasia, Stroke

15
Q

Testing of Carotid Artery Disease? (4)

A

Angiography (gold standard), Carotid U/S, MRA, CTA

16
Q

Carotid Artery Disease Tx? (4)

A

Carotid endarterectomy (CEA), Carotid Stending, Asa, statins

17
Q

Assessments for post procedure stenting/CEA for carotid artery disease?

A
  • frequent neuro checks
  • BP monitoring for low or high, labile bp, bradycardia, bleeding
  • hyperperfusion syndrome
18
Q

What is hyper perfusion syndrome? (r/t Carotid artery disease)

A

headache ipsilateral to revascularized internal carotid artery, focal motor seizures, intracerebral hemorrhage