Adult Health and Cardiovascular Nursing Review

These practice flashcards cover adult health assessment, cardiovascular diseases like heart failure and myocardial infarction, types of shock, and medical emergencies such as sepsis and anaphylaxis based on the lecture notes.

How is blood pressure regulated by the parasympathetic and sympathetic nervous systems?

The parasympathetic system releases acetylcholine to slow the heart, while the sympathetic system releases catecholamines like epinephrine (adrenaline) and norepinephrine (noradrenaline) to increase heart rate.

What are the steps of the RAAS system in response to a drop in blood pressure?

$$1) \text{ Blood pressure drops } 2) \text{ Sympathetic nervous system stimulates } 3) \text{ Kidneys release RENIN } 4) \text{ Liver activates angiotensinogen } 5) \text{ Creates angiotensin 1 } 6) \text{ ACE converts angiotensin 1 to angiotensin 2 } 7) \text{ Angiotensin 2 constricts vessels and increases blood volume.}$$

According to the transcript, what are the normal and hypertension values for Blood Pressure?

$$\text{Optimal } <120/<80\, \text{Normal } <130/<90\, \text{High Normal } 120-139/85-90\, \text{Hypertension } >140/>90$$

What do the P, QRS, and T waves represent in an electrical impulse (ECG) of the heart?

$$P: \text{ Atrial depolarisation } QRS: \text{ Ventricle depolarisation } T: \text{ Ventricle repolarisation }$$

Which factors decrease oxygen supply to the heart?

Atherosclerosis, anaemia, and low coronary blood flow (caused by hypotension or aortic valve incompetence).

What is the difference between stable and unstable angina?

Stable angina involves pain only on exertion and is relieved by rest or Glyceryl trinitrate; unstable angina occurs at any time (including rest), lasts longer than $10\, \text{minutes}$, and may not be fully relieved by medication.

What is the functional difference between Systolic and Diastolic heart failure?

Systolic failure is a contraction issue where the heart cannot squeeze with enough force, while Diastolic failure is a filling issue where the heart does not fill with enough blood.

What are the common symptoms of Left-sided Heart Failure?

Symptoms of lungs "drowning," including dyspnoea, rales, orthopnoea, weakness, nocturia, nagging cough, and weight gain.

What are the common symptoms of Right-sided Heart Failure?

Symptoms of the body "swelling," including enlarged liver, swelling in hands and legs, weight gain, oedema, large neck vein, lethargy, and irregular heart rate.

What specific enzyme is released into the blood after heart muscle injury during a Myocardial Infarction?

TROPONIN T

What ECG changes are observed in the hours following a Myocardial Infarction?

Large peaked T waves (hyperacute), followed by ST elevation, negative T waves, and finally pathologic Q waves.

What is the difference between Type A and Type B Aortic Dissection?

Type A occurs closer to the heart, while Type B goes down the aorta.

What are the four main types of shock described in the notes?

Obstructive Shock, Cardiogenic Shock, Distributive Shock, and Hypovolemic Shock.

What is the primary difference between Relative and Absolute Hypovolemic Shock?

Relative is an inside fluid shift (e.g., internal bleeding, burns) from the intravascular system to interstitial spaces; Absolute is an outside fluid shift (e.g., massive bleeding, vomiting) to the outside of the body.

At what threshold of blood volume loss does a patient typically start showing symptoms of hypovolemic shock?

$$15\% \text{ or more of their blood volume.}$$

What is the preferred positioning for a patient in hypovolemic or anaphylactic shock?

Modified Trendelenburg

What distinguishes an Anaphylactoid reaction from a true Anaphylactic reaction?

Anaphylactic reactions involve sensitisation and IgE antibodies (Type I hypersensitivity); Anaphylactoid reactions are non-IgE related and can happen on first-time exposure (e.g., exposure to contrast dyes or NSAIDS).

What are the clinical criteria for the "Warm Phase" (Early) Sepsis?

Temperature above $38^{\circ}C$ or below $36^{\circ}C$, heart rate above $90$, respiratory rate above $20$ (or $PaCO_2 < 32$), and white blood cell count above $12,000$ or below $4,000$.

What are the signs of the "Cold Phase" (Late) Septic Shock?

Cold/clammy skin, severe hypotension not fixed by fluids, oliguria (less than $400\, \text{mL}$ in $24\, \text{hours}$), coma, hypothermia, and lactate levels between $2-4\, \text{mmol/L}$.

How does histamine affect the body during anaphylaxis?

Causes dilation of vessels (lowering BP), bronchoconstriction, increased heart rate, increased vessel permeability (leading to swelling), and increased gastric secretions.