NURS216 Exam 3

Atherosclerosis that develops in the femoral and popliteal arteries.

Peripheral Arterial Disease

Intermittent claudication

Peripheral Arterial Disease symptom

weak pulse, cool skin, pallor, hair loss

signs of chronic hypoxia

Chronic reduced blood flow in peripheral arteries

Signs of Peripheral Arterial Disease

Peripheral Meaning

away from the body

Sudden blockage of an artery

Acute Arterial Occlusion

completely blocks blood flow distal to the blockage. Sudden onset

Acute Arterial Occlusion

Emboli from heart, fat emboli from broken bones, air emboli

Common causes for acute arterial occlusion.

Pistol shot, pallor, polar, pulselessness, pain, paresthesia, paralysis

Manifestations of Acute Arterial Occlusion

atrophy or weakness of the medial layer or vessel wall causes a dilation of the artery in weak areas.

Causes aneursyms

increasing radius at the weaken spot increase tension.

Law of LaPlace

1. Accounts for 90-95% of HTN

2. >140 or >=90

Essential Hypertension

contraction of the heart; pumping

Systole

relaxation of the heart; filling.

Diastole

pulse pressure

systole-diastole

where are lipoproteins made

made in the small intestine and liver.

• Triglycerides 55-65%

• cholesterol 10%

• protein 5-10%

main source of energy when fasting

Very low density lipoprotein (vldl)

• Triglycerides 10%

• cholesterol 50%

• protein 25%

transports cholesterol out the blood

Low density lipoproteins (LDL)

• Triglycerides 5%

• cholesterol 20%

• protein 50%

facilitates reverse transport of cholesterol, back to the liver to be secreted into the bile.

high density of lipoprotiens (HDL)

Elevated levels of LDL, and/or Triglycerides

Dyslipidema (Hyperlipidemia)

Treatments for Dyslipidemia

diet, exercise, medication as a last resort.

Xanthomas

cholesterol deposits caused by dyslipidemia

Dyslipidema can cause…

Acute arterial blockages can be caused by….

development of fibrous, fatty lesion in the intima of large and medium sized arteries

Atherosclerosis

most common cause of coronary heart disease

atherosclerosis is the most common cause of….

Thrombosis

bloodclots

narrowing of vessels, decreased blood flow

atherosclerosis

reduced blood flow

ischemia

atherosclerosis risk factors

family history, hyperlipidemia, increased age, male, smoking, obesity, diabetes, emerging role of inflammation.

Intermittent claudication

occurs when the patient is active; oxygen deficiency will happen in that area that will need more oxygen and won’t be able to get any because of reduced blood flow.

Biological factors for essential hypertension

genetics

lifestyle risk factors for essential hypertension.

weight, exercise

Criteria for HTN diagnonsis

2 separate readings of High bp

Secondary Hypertension

• 5-10% of HTN cases

develop as a result of another condition, like kidney disease. correction of underlying cause usually treats the bp.

Target organ damage of hypertension

heart: lv hypertrophy, angina (chest pain), MI, heart failure

TIA or stokes in brain.

chronic kidney disease

peripheral vascular disease

retinopathy

>180 &/or >120

risk of hypoperfusion, and ischemic injury

hypertensive crisis bp range

mental status changes, ICH, heart failure (HF), acute kidney injury (AKI), angina, acute myocardial infarction (AMI), CVA stroke.

hypertensive emergency signs and sytoms

BP quickly drops, decreasing CBF, HR increase → dizziness and & syncope (faints)

Orthostatic Hypotension

Orthostatic Hypotension cause

• reduced blood volume

• medications

• aging

• immobility, extended bed rest

  • ANS dysfunction

dilated, enlarged superficial veins

Varicose Veins

occurs due to impaired or blocked floe in deep veins, which creates increased pressure in superficial veins. common after 50, in obese person and women.

Varicose veins

Treatments for Varicose veins

support stockings, sclerosing agents, surgical repair

chronic venous insufficiency

caused by reflux/backflow through damaged veins.

chronic venous insufficiency

varicose veins, browning of the skin, eventual impaired nutrient delivery to tissues (necrosis, dermatitis, stasis ulcers - medial malleolus).

deep vein thromboses (DVTS) signs and symptoms

pain, swelling, deep muscle tenderness

DVTS risk factors.

blood stasis, vessel wall injury, increased coagulability.

Systolic BP = <20

Diastolic BP = <80

Normal BP

Systolic BP = 120-129

Diastolic BP = <80

Elevated BP

Systolic BP = 130-139

Diastolic BP = 80-89

Stage 1 Hypertension

Systolic BP = > 140

Diastolic BP = =>90

Stage 2 Hypertension

Heart disease due to impaired coronary blood flow

Coronary Artery Heart Disease

stable plague has what kind of growth

slow

unstable plague has what kind of growth

fast

leading cause of death in the US

coronary heart disease

The myocardial oxygen balance is supplied by…..

coronary blood flow, O2 carrying capacity (of blood), and vascular resistance (effects bp)

myocardial oxygen