CARDIAC- Pahto

Hyperlipidemia

high lipid levels in blood

What is HDL?

good cholesterol

What is the difference between HDL and LDL

HDL has high density liprotients which makes less likely to clog within blood vessels while ldl has low density lipoprotient which end up clogginf in blood vessels

What is hyperlipdemia a major risk for?

stroke, atheroscelorisois, CAD, PAD

What is the pahology of ashtereosceloroscis?

First it begins with an injury in the artery which can be caused by smoking or diabetes. Then LDL accumulates in the blood vessels so in response the immune system sends macophages to clean up the debris. The macrophages instead ingest lipids and decelop into a plaque which causes infammation and narrowing of arteries.

What happens when plaque becomes unstable?

it causes rupture and body forms clot at rupture site which blocks blood flow

What is thrombus?

clot that remains fixed in place

What is embolus?

a clot that breaks free and travels through circulation

What is the stenosis?

narrowing or partial closure of a vessel or valve

What is a mural

a clot attached to wall of a vessel or valve

What is the mechanism of action for statins?

reduce cholesterol production and decrease LDL removal

What is the side effects for statin?

muscle pain, myopathy,rhabdomyolosi, hepatoxicity

What are the nursing implications for statins?

monitor liver enzyme, CK levels, stop if there is dark urine present

What is patients education for statin?

take at bedtime and avoid grpefruit juice

What is the mechanism of action for bile acid sequexterants?

binds bile acids to the intestine and prevents reabsorption which causes liver to use cholesterol to make new bile acids

What is the side effects for bile acid sequesterants?

constipation bloating GI upset

What is the nursing implications for bile acid sequestrants?

take other drugs one hour prior or 4 hours after

What is the patients education for bile acid sequesterants?

mix juice with water and increase fluids and fiber

What is the mehcanism of action for cholesterol absorption inhibitor?

block direct cholesterol absorption in small intestine

What are the side effects for cholesterol absorption inhibitors?

Mild GI upset and possible increased LFTS

What is the nursing implication for cholesterol absorption inhibitors?

monitor LFT if using with statin

take daily with food or without food and report muscle pain

What is the mechanism of action for nicotonic acid?

prevents fat breakdown of fat tissue so fewer fatty acids reach liver which makes liver produce less triglycerides + VDL which decreases LDL and increased HDL

What are the side effects of nicotonic acids?

flsuhing, itching, GI upset, increased blood sugar, increased uric acid

What is the nursing implication for nicotonic acid?

monitor liver fucntion, blood glucose, and uric acid

What is the patient education for nicotonic acid?

take food with water, take asprin before 30 minutes to prevent flushing, and do no self medicate

What is the mechanism of action for fibric acid deratives?

activates receptors in liver and brown adipose tissue which increases breakdown of VDL patricles and lowers the triglucerides levels

What is the side effects for fibric acid deravitives?

gall stones, muscle pain, elevated liver enzyme

What is the patient education for fibric acid derivatives?

caution takein with statin, monitor liver function, and taking with warfarin increases bleeding risk

What is the nursing implications for fibric acid derivatives?

monitor if taking wiht warfarin and statin

What is the mehanism of action for short term Blood Pressure?

baroreceptor reflex

What is the mechanism of aciton for long term blood pressure

kidneys via Raas system and sodium and water balance

What does the vasopression do and what happens if it fails?

enhances water retention and failure to do it properly can lead to hypotension or hypertension

What are the pharmalogical treatments of hypertension?

diuretics, ACE inhibitors, beta blockers, alpha blockers,renin inhibiors,amgiotestive receptor II recpetor blockers, calcium channel blockers, and direct vasodilators

Diuretics

reduce blood volume

Beta Blockers

decrease heart rate and contractility

Alpha blockers

reduce sympathic tone

Renin inhibitors

blocks renin

ACE inhibitors

blocks angiotensin II formation

Calcium Channel Blockers

relax heart and vessel muscle

Direct vasodilators

widen blood vessels

What is the mechanism of action for directic: thiazide?

inhibit sodium reabsorption in the early distal convoluated reducing circulating volume and blood pressure

What are the side effects of direutic:

hypokalemia, hyponatremia , dehydration, dizziness,hyperglycemia, orthostatic hyptenstion

What is the nursing implications for thiazide?

monitor electrolytes, glucose, intake and output, daily weight , and BP, Use caution in diabetes

What is the patient education for thizaid?

take in the morning to avoid nightime urination, eat potassium rich foods, and change positions slowly to prevent dizziness

What is the mechanism of action for loop diuretics and give an example?

inhibit sodium reabsorption in the loop of henle and examples are furosemide and bumetanide

What are the side effects of loop diuretics?

hypokalemia, hyponatremia, hypochloremia ,dehydration, hypotension, ototoxcity

What is the nursing implications for loop diuretics?

monitor electrolytes, intake and output, daily weights , and hearing

What are the nursing implicaitons for loop diuretics?

eat potassium rich foods, take in the morning, change positions slowly

What is the mechanisc of action for potassium sparing diuretics and give an example?

preventing reabsorption of sodium from the late distal convuluted tube and collecting duct

What are the side effects of potassium sparing diuretics?

hyperkalemia, dizziness, and gynecomastia

What is the nursing implications of potassium sparing diuretics?

monitor potassium and renal function ; avoid potassium supplements or salt substitutes

What is the patient education for potassium sparing diuretics?

avoid food high in potassium and potassium supplemtns, report irregualrl heartbeat,and muscle weakness

What is the mechanism of action for the osmotic diuretics?

prevents reaborption of water from the proximal convulated tube and example is mannitol

What is the side effects of the osmotic diuretic?

dehydration, electrolyte imbalance , and headache

What is the nursing implications for osmotic diuretics?

monitor intake and output, electrolytes, neuro status , and use filter needle

What is the patient education for osmotic diuretics?

explain frequent urination and report confusion or swelling

What is the mechanism of action for beta - adregenic receptors in heart ?

slow heart and reduce contractility which reduces cardiac output

What is the mechanism of action for beta-adrenergic blockers in kidney?

decrease renin release which causes less angiotensin II and aldosterone resulting in reduced vasoconstrion and fluid retention

What are the side effects of beta adrengeic blockers?

depression, insomnia, bizzare dreams,bradycardia, bronchospasm, fatigue

What is the nursing implications for beta-adrenergic blockers?

monitor BP and HR , hold if BP is less than 60 bpm and cautio in COPD , asthma , or diabetes

What is the patient education for beta adrenergic blockers?

do not abruptly stop, check pulse before dosage, and change positions slowly

What is the mechanism of action for alpha 1 blockers and give examples?

block alpha 1 receptors in arteries and veins causing vasodilation and decreased peripheral resistance and examples are doxazosin, prazosin, and terazosin

What are the side effects of alpha 1 blockers?

orthostatic hypotension, dizziness , fatigue, and sexual dysfunction

What is the nursing implications for alpha 1 blockers?

monitor BP espically after first dose and advice slow position change

What is the mechanism of action for centrally acting alpha 2 agonists and give an example?

Stimulate alpha 2 receptors in the brainstem to reduce sympathetic outflow to heart and blood vessels which caused vasodilation and lower BP and ecamples are clodydine and methylopa

What are side effetcs of the centrally acting alpha 2 agnosits?

Dry mouth, sedation , fatigue, bradycardia, rebound hyptertension if stopped abruptly

What is the patient education for alpha 2 agonists?

strop driving until effects known,do not skip doses, rise slowly

What is the mechanism of action for renin-angiotensin-aldosterone system

bodys way of regulating blood pressure

What is the mechanism of action for renin inhibitiors and give an example?

blocks renin from coverting to angiostensinogen to angiotensin I which results in less angiotensin II and aldosterone which lowers BP

What are the side effects of renin inhibitors?

hyperkalemia , hypotension , renal stones , and angiodema

What is the nursing implications for renin inhibitors?

monitor BP , potassium, and kidney function and avoid use with ACE or ARB in diabetics

What is the patient education for renin inhibitors?

take daily at same time, avoid potassium and salt substitutes, and report face swelling

What is the mechanism of action for ACE inhibitors and give examples?

block conversion of angiotensin 1 to 2 and causes vasodilation , decreased aldosterone , and low sodium/water retention and examples are lisonpril, enalapril, captopril .

What are the side effects of ACE inhibitors?

bradykinin cough ) dry cough, angiodema, hypotension and dizziness

What are the nursing implications for ACE inhibitors?

monitor BP , potassium , and kidney function

What is patient education for ace inhibitors?

report cough or facial swelling, rise slowly avoid potassium supplements

What is hypertensive emergancy and what causes it ?

a sudden severe elevation in BP causing acute traget organ damage and it can be caused by non adhearance to drugs, renal disease, pregnancy, stimulant use

What s/s of hypertensive emergancy?

severe headacehes, vision changes, chest pain, confusion, shortness of breath, renail impairement

What is the treatment for hypertensive emergancy?

IV calcsium channel blockers

What are the nursing implications for hypertensive emergancy?

monitor vital signs , neuro statusm, urine outpirt, and signs of organ perfusion

What is the mechanism of reaction for ARBS and what are the examples?

block angiotension receptors II and prevent vasoconstion and aldosterone release which lowered the blood pressure

What are the side effects of ARBS?

dizziness, hypotension , ranre angioedema, renal failure

What is the patient education for ARBs?

monitor BP , potassium and renal funciton

What is the ARBs patient education?

rise slowly, eat potassium rich foods, and continue taking if you feel well

What is the mechanism of action for aldosterone antagonist?

block aldesterone receptors which excrete sodium and water , retain potassium which lowers BP and fluid

What is the side effects for aldosterone antagonist?

hyperkalemia , dizziness, menstural changes

What are the nursing implications for aldosterone anatagonists?

monitor potassium and renal function; avoid ACELs,ARBS, and supplements

What is the patient education for aldosterone antagonists?

avoid high potassium food , report muscle weakness or irregular heart beat, and take with food