Exam 2 Patho studyguide

Which dysrhythmia is considered to be the most fatal and requires immediate treatment?

Ventricular fibrillation

Acute regulation of Systematic Arterial Blood Pressure

-Corrects temporary imbalances neural: ANS, baroreceptors/chemoreceptors; stretch the vessel Humoral: renin angiotensin aldosterone; constricts the blood vessels

What is primary dyslipidemia?

-Genetic -Familial hypercholesterolemia -caused because LDL receptor is deficient or defective

Clinical Manifestations of artherosclerosis

-Narrowing of vessel and ischemia -vessel obstruction -thrombosis -aneurysm formation

Primary Hypertension

-genetic -race-Black community develops it at an early age -Age-adults and elderly more susceptible -insulin resistance- stimulates SNS and causes renal sodium retention -diet- poor eating habits, high in sodium -obesity -alcohol

Complications due to atherosclerosis

-ischemic heart disease -stroke -peripheral vascular heart disease *thrombosis

Secondary Hypertension

-renal hypertension -adrenocortical hormones-stimulates production of cortisol (stress hormone) -Aortic coarctations-aorta constricting or narrowing -oral contraceptives

Four clients were admitted to the emergency department with severe chest pain. All were given preliminary treatment with aspirin, morphine, oxygen, and nitrates and were monitored by ECG. Which client most likely experienced myocardial infarction?

80-year-old woman whose pain was not relieved by nitrates or rest; the ECG showed ST-segment elevation with inverted T waves and abnormal Q waves; levels of cardiac markers subsequently rose she was the only one non responsive to the drugs prescribed

normal serum cholesterol

<200 mg/dL

What happens if baroreceptors decrease in stretching?

A decrease in BP decreases baroreflex activation causing HR to increase and restore BP levels

A patient takes a drug that is a sympathetic agonist. Which of the following would you expect to occur? A. Increase HR and BP B. Increased HR and decreased BP C. Decreased HR and increased BP D. Decreased HR and BP

A. Increase HR & BP Sympathetic agonists adrenergic NS

What happens to your BP if you get an ACE inhibitor?

ACE help relax your veins and arteries regulating your BP, if inhibited it will cause high BP and heart will be working harder

Beta blockers and blood pressure

Beta blockers block the effects of the hormone epinephrine (adrenaline) causing heart to beat slowly and lowers your blood pressure improving blood flow

What immediate threat do unstable plaques represent? A. Clot formation will increase pressure in the vessel B. Plaque may lead to angina C. Clots may break loose and block blood flow to key organs D. All of the above

C. clots may or may not break loose and block blood flow to key organs

What is secondary dyslipidemia?

Caused by obesity, dietary, or type II diabetes

What passes from blood into the tissues?

Food and O2

gestational hypertension

High blood pressure during pregnancy get it after 20 weeks pregnant -resolves 12 weeks postpartum

What can IDLs become and what can they do?

IDLs become low-density lipoproteins ("bad cholesterol") They deliver cholesterol to the liver and other tissues

A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor?

Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction

Raynaud's disease

Intense vasospasm in the small arteries and arterioles of the fingers and, less commonly, toes. -Numbing and tingling

While discussing the heart, the nursing instructor teaches about pericarditis. Which statement does the instructor state best defines this disease?

It is an inflammatory process.

foam cells

Macrophages that have consumed lipid, seen in atherosclerosis pathogenesis

Which of the following is called the pacemaker of the heart?

Sinoatrial (SA) node

A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume?

Sinus bradycardia

Atherosclerosis occlusive disease

Sudden event that interrupts arterial flow to the affected tissues or organs -gradual -cold -weak pulses -blanching when elevated -brittle toe nails

A 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of:

Sympathetic nervous system

A client has just been admitted to the cardiac intensive care unit with a diagnosis of infective endocarditis. His wife appears distraught and asks the nurse what caused this to happen to her husband. What would be the nurse's best response?

The most common cause is a staph infection.

How does artherosclerosis develop?

The scavenger cells encounter fatty deposits in the artery lining and try destroying them by oxidizing the fatty deposits

What is an aortic dissection?

The separation of the muscular wall from the membrane of the artery, putting the pt at risk for aortic rupture and death -onset pain, chest and back -diagnosis based on vascular imaging, CT, MRI -Resections and replacements of artery

A client has been diagnosed with aortic stenosis and asks the nurse what this means. The most appropriate response would be:

The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta.

What is the blood vessel structure and what is it composed of?

Tunica externa-Collagen fibers Tunica Media- Smooth muscle Tunica intima- endothelium

What do the vascular smooth muscle cells stimulate?

Vasoconstriction/dilation of blood vessels inflammation

What does the vascular endothelium help stimulate?

Vasodilation vasoconstriction inflammation blood clots smooth muscle

What is dyslipidemia?

abnormal amount of lipids in the blood -Triglycerides: used in energy metabolism -Phospholipids: -blood clotting components -myelin sheath -cell membranes Cholesterol: chemical activities of other lipid substances

Preclampsia

abnormal condition associated with pregnancy marked by high blood pressure proteinuria, and edema. -main cause unknown; but occurs often when not enough blood makes its way to the placenta for the baby.

Aneurysms

an excessive localized enlargement of an artery caused by a weakening of the artery wall.

Secondary Hypercholesterolemia

associated with other health problems and behaviors acquired

deep vein thrombosis

blood clot forms in a large vein, usually in a lower limb associated with bed rest, immobility, spinal cord injuries shock, venous obstruction oVenous stasis oIncreased blood coagulability oVessel wall injury

What are dietary lipids absorbed as?

chylomicrons Large triglycerides

How does vasodilation affect blood pressure?

decreases blood pressure due to smooth muscle relaxing

Hypoxia and Blood pressure

due to the increase in HR and CO you will have elevated BP

An 80-year-old male client arrives for his yearly physical without any complaints, and following the checkup the physician explains that he has noted atrial fibrillation (AF) on the client's ECG. Before the physician can explain the disorder, the client becomes very upset and states he thinks he is going to die. The physician explains that atrial fibrillation involves the top chambers of the heart and that:

many people live with atrial fibrillation without even knowing they have it.

An older adult client has been diagnosed with orthostatic hypotension. When planning the client's subsequent care, the nurse should prioritize which diagnosis?

risk for falls

How do you find the pulse pressure?

systolic pressure - diastolic pressure

types of venous circulation disorders

varicose veins and thrombophlebitis

What passes from tissues into the blood?

waste and CO2

Long Term regulation of Systematic Arterial Blood Pressure

kidneys: control extracellular fluid volume blood pressure drops during the night time

orthostatic hypotension

low blood pressure that occurs upon standing up Etiology: blood is shifting to lower parts of body Associated with age, blood volume, bedrest, drugs

The more lipid the ______the density

lower

7 P's of acute arterial embolism

1. Pistolshot (acute onset) 2. Pallor 3. Polar (cold) 4. Pulselessness 5. Pain 6. Paresthesia 7. Paralysis

How do you find the MAP?

1/3 systolic + 2/3 Diastolic

Varicose Veins

abnormally swollen, twisted veins with defective valves; most often seen in the legs -Edema -Redness -Brown -Ulcers

Types of lesions associated with atherosclerosis

fatty streaks- Thin, flat, yellow discolorations that progressively enlarge fibrous atheromatous plaque- Accumulations if IC and EC lipids complicated lesion-contains hemorrhage, ulceration and scar tissue deposits

What is artherosclerosis?

hardening of the arteries -Hypercholesterolemia put you at a higher risk -men >45 women>55 -family history -smoking, obesity, hypertension, diabetes, inactivity and stress

primary hypercholesterolemia

describes elevated cholesterol levels that develop independent of other health problems or lifestyle behaviors

Hypercholesterolemia

excessive cholesterol in the blood >240mg Excessive amounts can contribute to heart attack or stroke or CV issues

The more protein the ______ the density.

higher