Exam 3

Beta Blockers (-lol’s)

Examples: Metoprolol, Atenolol, Propranolol

Side Effects:

  • Fatigue, dizziness

  • Bradycardia, hypotension

  • Depression, insomnia

  • Cold extremities

Adverse Effects:

  • Bronchospasm (caution in asthma/COPD)

  • Heart block

  • Worsening heart failure

  • Masked hypoglycemia (diabetics)

Nursing Implications:

  • Monitor HR (hold if <50-60 bpm), BP

  • Watch for signs of worsening HF (dyspnea, weight gain, edema)

  • Check blood glucose in diabetics

Patient Education:

  • Do not stop abruptly (risk of rebound hypertension)

  • Take at same time daily

  • Monitor BP and HR at home

ACE Inhibitors (-pril’s)

Examples: Lisinopril, Enalapril

Side Effects:

  • Dry, persistent cough

  • Hypotension, dizziness

  • Hyperkalemia

Adverse Effects:

  • Angioedema

  • Renal impairment

Nursing Implications:

  • Monitor BP, renal function (BUN, Cr), potassium

  • Assess for angioedema (emergency)

Patient Education:

  • Report persistent cough or swelling

  • Avoid potassium supplements/salt substitutes

  • Rise slowly to avoid dizziness

Angiotensin Receptor Blockers (ARBs, -sartan’s)

Examples: Losartan, Valsartan

Side Effects:

  • Dizziness, headache

  • Hyperkalemia

Adverse Effects:

  • Renal dysfunction

  • Angioedema (less common than ACEIs)

Nursing Implications:

  • Monitor BP, potassium, renal function

  • Assess for angioedema

Patient Education:

  • Do not use with ACE inhibitors

  • Avoid potassium-rich foods

Calcium Channel Blockers (Dihydropyridines, -pine’s)

Examples: Amlodipine, Nifedipine

Side Effects:

  • Peripheral edema

  • Dizziness, hypotension

  • Flushing, headache

Adverse Effects:

  • Reflex tachycardia

  • Heart block (non-dihydropyridines like Verapamil, Diltiazem)

Nursing Implications:

  • Monitor BP, HR, edema

  • Avoid in HF (some CCBs cause worsening edema)

Patient Education:

  • May cause swelling in legs

  • Avoid grapefruit juice (affects metabolism)

Loop Diuretics (Furosemide, Bumetanide)

Side Effects:

  • Hypokalemia, dehydration

  • Hypotension, dizziness

Adverse Effects:

  • Ototoxicity (high doses)

  • Nephrotoxicity

Nursing Implications:

  • Monitor electrolytes (K+, Na+, Mg++), kidney function (BUN, Cr)

  • Check daily weights

Patient Education:

  • Take in the morning (avoid nocturia)

  • Increase potassium intake (bananas, oranges)

Thiazide Diuretics (Hydrochlorothiazide, Chlorthalidone)

Side Effects:

  • Hypokalemia, hyperglycemia

  • Dizziness, hypotension

Adverse Effects:

  • Hyperuricemia (gout risk)

  • Photosensitivity

Nursing Implications:

  • Monitor electrolytes, glucose, uric acid

  • Encourage fluids

Patient Education:

  • Take in morning

  • Use sunscreen (photosensitivity)

Potassium-Sparing Diuretics (Spironolactone, Eplerenone)

Side Effects:

  • Hyperkalemia

  • Gynecomastia (Spironolactone)

Adverse Effects:

  • Arrhythmias (from high K+)

  • Hepatotoxicity

Nursing Implications:

  • Monitor potassium levels, kidney function

Patient Education:

  • Avoid potassium-rich foods

  • Report signs of high potassium (muscle weakness, irregular HR)

Digoxin (Cardiac Glycoside)

Side Effects:

  • Nausea, vomiting, fatigue

  • Blurred vision, yellow halos

Adverse Effects:

  • Digoxin toxicity (bradycardia, arrhythmias, confusion)

Nursing Implications:

  • Monitor HR (hold if <60 bpm), digoxin level (0.5-2 ng/mL)

  • Watch K+ levels (hypokalemia increases toxicity risk)

Patient Education:

  • Teach pulse check before taking

  • Report vision changes, nausea

Potassium Supplements

Side Effects:

  • GI upset, nausea

  • Hyperkalemia

Adverse Effects:

  • Cardiac arrhythmias (if too high)

Nursing Implications:

  • Monitor K+ levels

  • Administer with food to prevent GI upset

Patient Education:

  • Do not crush extended-release tablets

  • Avoid potassium-rich foods if on potassium-sparing meds

Statins (Cholesterol Meds, -statin’s)

Examples: Atorvastatin, Simvastatin

Side Effects:

  • Myalgia, fatigue

  • Mild GI upset

Adverse Effects:

  • Rhabdomyolysis (muscle pain, dark urine)

  • Liver damage

Nursing Implications:

  • Monitor LFTs, CK (for muscle breakdown)

  • Give in evening

Patient Education:

  • Report muscle pain/weakness

  • Avoid grapefruit juice

Niacin (Vitamin B3, Lipid Lowering)

Side Effects:

  • Flushing, itching

  • GI upset

Adverse Effects:

  • Hepatotoxicity

  • Hyperglycemia

Nursing Implications:

  • Monitor LFTs, glucose

Patient Education:

  • Take aspirin 30 min before to reduce flushing

Fibric Acid Derivatives (Lopid, Gemfibrozil)

Side Effects:

  • GI upset, gallstones

  • Myopathy (esp. with statins)

Adverse Effects:

  • Hepatotoxicity

Nursing Implications:

  • Monitor LFTs, CK levels

Patient Education:

  • Take 30 min before breakfast/dinner

Aspirin (Salicylate, Antiplatelet)

Side Effects:

  • GI upset, tinnitus

Adverse Effects:

  • Bleeding, ulcers

  • Reye’s Syndrome (children)

Nursing Implications:

  • Monitor platelets, signs of bleeding

Patient Education:

  • Take with food

  • Avoid alcohol, NSAIDs (bleeding risk)

Clopidogrel (Plavix, Antiplatelet)

Side Effects:

  • Bleeding, bruising

Adverse Effects:

  • Thrombocytopenia (low platelets)

Nursing Implications:

  • Monitor platelets, signs of bleeding

Patient Education:

  • Avoid NSAIDs, alcohol

Nitroglycerin (Nitrate, Antianginal)

Side Effects:

  • Headache, flushing

  • Hypotension, dizziness

Adverse Effects:

  • Severe hypotension

Nursing Implications:

  • Monitor BP

  • Keep sublingual tablets in dark container

Patient Education:

  • Sit down before taking

  • If pain persists after 3 doses (5 min apart), call 911

Hypertension (HTN)

L – Look (Observe Initial Impressions)

  • May appear asymptomatic (“silent killer”)

  • Elevated blood pressure readings (Stage 1: 130-139/80-89 mmHg, Stage 2: ≥140/≥90 mmHg)

  • Signs of target organ damage (headache, blurry vision, dizziness, chest pain)

  • Edema, bounding pulses if heart failure is present

A – Assess (Vital Signs, Symptoms, History)

  • Blood pressure readings (monitor for white coat syndrome using ambulatory BP monitoring)

  • Risk factors: age, obesity, smoking, diabetes, high sodium intake, family history

  • Assess for symptoms of hypertensive crisis (severe headache, confusion, nausea/vomiting, seizure)

  • Labs: Lipid panel, BMP, urinalysis, ECG, echocardiogram

T – Test (Diagnostics & Lab Work)

  • BP readings taken in both arms

  • Blood Tests: BMP (renal function), CBC, lipid profile, uric acid

  • Electrocardiogram (ECG) to assess for left ventricular hypertrophy

  • Echocardiogram for structural heart changes

  • Ambulatory BP monitoring (ABPM)

T – Treat (Interventions & Medications)

  • Lifestyle Modifications: Weight loss, low-sodium DASH diet, exercise, smoking cessation

  • Medications:

    • Diuretics (Hydrochlorothiazide) – reduce blood volume

    • ACE inhibitors (Lisinopril) – prevent vasoconstriction

    • Beta-blockers (Metoprolol) – decrease heart rate and workload

    • Calcium channel blockers (Amlodipine) – relax blood vessels

  • Monitor for orthostatic hypotension

E – Educate (Patient Teaching & Self-Care)

  • Importance of medication adherence

  • Self-monitoring BP at home

  • Dietary sodium intake <2,300 mg/day (1,500 mg/day for high-risk patients)

  • Avoid smoking, alcohol, and high caffeine intake

Peripheral Artery Disease (PAD)

L – Look

  • Intermittent claudication (pain with walking, relieved by rest)

  • Cool, pale extremities with dependent rubor (redness when lowered)

  • Loss of hair on legs, shiny skin, thickened nails

  • Ulcers, gangrene (in severe cases)

A – Assess

  • Risk factors: Smoking, diabetes, hypertension, hyperlipidemia

  • Decreased pulses, prolonged capillary refill

  • Bruit over femoral/aortic arteries

T – Test

  • Ankle-Brachial Index (ABI) <0.9 indicates PAD

  • Doppler ultrasound for blood flow assessment

  • Arteriography to visualize occlusion

  • Exercise testing for claudication severity

T – Treat

  • Medications:

    • Antiplatelets (Aspirin, Clopidogrel) – reduce clot risk

    • Cilostazol (Pletal) – improves claudication symptoms

    • Statins – lower cholesterol

  • Exercise therapy (30-45 min walking, 3x/week)

  • Angioplasty or bypass surgery for severe cases

  • Smoking cessation, foot care

E – Educate

  • Avoid extreme temperatures (especially cold)

  • Daily foot checks, proper footwear

  • Supervised exercise improves symptoms

  • Smoking cessation is crucial

Chronic Heart Failure (CHF)

L – Look

  • Left-sided HF: Dyspnea, crackles in lungs, fatigue, pulmonary congestion

  • Right-sided HF: Edema, ascites, jugular vein distention (JVD), weight gain

  • Pink frothy sputum in pulmonary edema

A – Assess

  • Vital signs: Tachycardia, low oxygen levels

  • History of CAD, hypertension, diabetes

  • Daily weight monitoring (3 lb in 2 days or 5 lb in a week is a concern!)

T – Test

  • BNP (>100 pg/mL suggests HF)

  • Echocardiogram to assess ejection fraction (EF)

    • HFrEF: EF <40% (systolic HF)

    • HFpEF: EF >50% (diastolic HF)

  • Chest X-ray for cardiomegaly, pulmonary congestion

T – Treat

  • Medications:

    • Diuretics (Furosemide) – reduce fluid overload

    • ACE inhibitors/ARBs – lower BP and heart strain

    • Beta-blockers (Carvedilol, Metoprolol) – decrease workload

    • Digoxin (for severe cases) – increases contractility

  • Low sodium diet (2 g/day), fluid restriction if severe

  • Daily weights, oxygen therapy, cardiac rehab

E – Educate

  • Monitor fluid intake, daily weights

  • Medication adherence, avoid NSAIDs

  • Exercise with caution, avoid overexertion

Cardiomyopathy

L – Look

  • Dilated: Weak heart, low ejection fraction, fatigue

  • Hypertrophic: Thickened LV, dyspnea, syncope, sudden cardiac death

  • Restrictive: Stiff ventricles, decreased filling, right HF symptoms

A – Assess

  • History of alcohol use, infections, family history

  • S3/S4 heart sounds, edema, crackles

  • Fatigue, chest pain, syncope

T – Test

  • Echocardiogram (EF & ventricular function)

  • BNP, ECG, chest X-ray

  • Heart biopsy (for restrictive type)

T – Treat

  • Medications: Beta-blockers, diuretics, ACE inhibitors

  • Pacemaker, implantable cardioverter-defibrillator (ICD) if needed

  • Heart transplant for severe cases

E – Educate

  • Avoid strenuous exercise in hypertrophic cardiomyopathy

  • Monitor weight, fluid balance

  • Lifelong medication adherence

Valvular Heart Disease

L – Look

  • Mitral/Aortic stenosis: Dyspnea, fatigue, murmur

  • Regurgitation: Pulmonary congestion, palpitations

  • Mitral valve prolapse: Asymptomatic or palpitations, chest pain

A – Assess

  • Listen for murmurs

  • History of rheumatic fever, endocarditis

  • Symptoms of HF if severe

T – Test

  • Echocardiogram (valve function)

  • Chest X-ray (enlarged heart, pulmonary congestion)

  • ECG (atrial fibrillation risk in mitral disease)

T – Treat

  • Medications:

    • Diuretics (for congestion)

    • Beta-blockers, ACE inhibitors

    • Anticoagulants for atrial fibrillation risk

  • Valve repair/replacement for severe cases

E – Educate

  • Prophylactic antibiotics before dental work if history of endocarditis

  • Avoid stimulants like caffeine

  • Monitor for worsening symptoms (dyspnea, fatigue, edema)

Lower Extremity Peripheral Artery Disease (PAD)

L – Look

  • Intermittent claudication (leg pain with walking, relieved by rest)

  • Shiny, hairless skin, thickened nails

  • Pale extremities, dependent rubor (redness when lowered)

  • Non-healing ulcers on toes or lateral malleolus

A – Assess

  • Risk factors: Smoking, diabetes, hypertension, high cholesterol

  • Decreased/absent pedal pulses

  • Prolonged capillary refill (>3 sec)

  • Pain worsens when legs are elevated

T – Test

  • Ankle-Brachial Index (ABI) (<0.9 indicates PAD)

  • Doppler ultrasound

  • Angiography to assess occlusions

T – Treat

  • Medications:

    • Antiplatelets (Aspirin, Clopidogrel)

    • Statins (for cholesterol)

    • Cilostazol (Pletal) (improves walking distance)

  • Exercise therapy (walking 30-45 min/day, 3x/week)

  • Angioplasty, stenting, bypass surgery if severe

  • Smoking cessation, foot care

E – Educate

  • Encourage daily foot inspection and proper footwear

  • Avoid cold exposure and tight clothing

  • Exercise improves symptoms over time

Thromboangiitis Obliterans (Buerger’s Disease)

L – Look

  • Claudication of hands, feet, or legs

  • Cold, pale extremities with color changes

  • Pain, ischemic ulcers, gangrene in severe cases

A – Assess

  • History of smoking or marijuana use

  • Absent or weak peripheral pulses

  • Cold sensitivity (similar to Raynaud’s)

T – Test

  • Doppler ultrasound for blood flow

  • Exclusion of other vascular diseases

T – Treat

  • Complete smoking/tobacco/marijuana cessation

  • Antiplatelet therapy (Aspirin, Clopidogrel)

  • Avoid cold exposure, avoid trauma

  • Surgical amputation if severe gangrene develops

E – Educate

  • Absolutely no smoking or nicotine products

  • Protect extremities from injury and cold

  • Encourage walking to improve circulation

Raynaud’s Phenomenon

L – Look

  • Fingers/toes turn white, blue, then red

  • Cold sensitivity, numbness, tingling

  • Ulcers and thickened skin if severe

A – Assess

  • Triggers: Cold, stress, smoking, caffeine

  • More common in women, ages 15-40

  • History of autoimmune diseases (e.g., lupus, scleroderma)

T – Test

  • Clinical diagnosis (based on symptoms)

  • Nailfold capillaroscopy (to assess blood flow)

T – Treat

  • Calcium Channel Blockers (Nifedipine, Amlodipine)

  • Avoid vasoconstrictors (decongestants, caffeine, smoking)

  • Wear gloves and warm clothing in cold weather

E – Educate

  • Reduce stress, avoid cold exposure

  • No smoking or caffeine

  • Seek medical help for skin ulcers or worsening symptoms

Chronic Venous Insufficiency (CVI) & Venous Leg Ulcers

L – Look

  • Brownish skin discoloration on lower legs

  • Edema, aching legs, worse at the end of the day

  • Venous ulcers (shallow, irregular, on medial malleolus)

A – Assess

  • History of prolonged standing, pregnancy, obesity

  • Check for varicose veins, hemosiderin staining

  • Pulses are present (unlike PAD)

T – Test

  • Venous duplex ultrasound

T – Treat

  • Compression stockings (check for PAD before use!)

  • Leg elevation (above heart level)

  • Moist dressings for venous ulcers

  • Diuretics for edema management

E – Educate

  • Elevate legs, avoid prolonged standing

  • Use compression therapy

  • Good skin care to prevent infections

Left-Sided Heart Failure (HF)

L – Look

  • Dyspnea, orthopnea (trouble breathing when lying down)

  • Pink frothy sputum (pulmonary edema)

  • Crackles in lungs, fatigue

A – Assess

  • History of hypertension, CAD, diabetes

  • Elevated BNP (>100 pg/mL suggests HF)

  • Assess lung sounds for crackles, S3 heart sound

T – Test

  • Echocardiogram (EF <40% in HFrEF)

  • Chest X-ray (pulmonary congestion, cardiomegaly)

T – Treat

  • Diuretics (Furosemide)

  • ACE inhibitors, Beta-blockers

  • Digoxin (for severe cases)

E – Educate

  • Monitor weight daily (gain of 3 lb in 2 days = concern!)

  • Low sodium diet (<2 g/day), fluid restriction

Right-Sided Heart Failure

L – Look

  • Peripheral edema, ascites, JVD

  • Hepatomegaly, weight gain

A – Assess

  • Assess for history of lung disease (COPD, pulmonary HTN)

  • Check for lower extremity swelling

T – Test

  • BNP levels, echocardiogram

T – Treat

  • Diuretics, low sodium diet

  • Oxygen for hypoxia

E – Educate

  • Monitor fluid intake, daily weights

  • Elevate legs to reduce swelling

Dilated Cardiomyopathy

L – Look

  • Severe fatigue, dyspnea, palpitations

  • Peripheral edema, crackles in lungs

A – Assess

  • History of alcohol use, infections, genetic factors

  • Assess for heart murmur, S3 sound

T – Test

  • Echocardiogram (low EF)

  • BNP levels, heart biopsy if needed

T – Treat

  • Beta-blockers, ACE inhibitors, diuretics

  • Pacemaker, heart transplant if severe

E – Educate

  • Avoid alcohol, manage fluid intake

  • Monitor symptoms closely

Hypertrophic Cardiomyopathy

L – Look

  • Exertional dyspnea, syncope, angina

  • Sudden cardiac death in young athletes

A – Assess

  • Family history, genetic testing

T – Test

  • Echocardiogram (thickened LV wall)

T – Treat

  • Beta-blockers, avoid vasodilators

  • ICD placement if at risk for arrhythmias

E – Educate

  • Avoid strenuous activity, dehydration

Mitral & Aortic Valve Disorders

L – Look

  • Mitral Stenosis: Dyspnea, murmur, A-fib risk

  • Aortic Stenosis: Syncope, angina, dyspnea (SAD)

  • Mitral/Aortic Regurgitation: Pulmonary congestion

A – Assess

  • History of rheumatic fever

T – Test

  • Echocardiogram, chest X-ray

T – Treat

  • Diuretics, beta-blockers, valve surgery

E – Educate

  • Prophylactic antibiotics before dental work

  • Monitor symptoms for worsening HF

Mitral Valve Stenosis

L – Look

  • Dyspnea on exertion (due to pulmonary congestion)

  • Fatigue, palpitations

  • Loud S1 heart sound, diastolic murmur (low-pitched, rumbling at apex)

  • Atrial fibrillation (common complication)

A – Assess

  • History of rheumatic fever (most common cause)

  • Assess for signs of right-sided HF (JVD, edema, hepatomegaly) if severe

  • Symptoms worsen with pregnancy or increased demand on heart

T – Test

  • Echocardiogram (assesses valve narrowing and left atrial enlargement)

  • Chest X-ray (left atrial enlargement, pulmonary congestion)

  • ECG (A-fib, left atrial enlargement)

T – Treat

  • Medications:

    • Beta-blockers, calcium channel blockers – slow HR to improve diastolic filling

    • Diuretics – reduce pulmonary congestion

    • Anticoagulants (Warfarin) – prevent thromboembolism from A-fib

  • Balloon valvuloplasty (for symptomatic cases, if no severe calcification)

  • Valve replacement if severe or symptomatic

E – Educate

  • Prevent rheumatic fever with prompt treatment of strep infections

  • Take anticoagulants as prescribed (monitor INR if on Warfarin)

  • Avoid high-sodium diet to reduce fluid retention

  • Monitor for worsening symptoms (dyspnea, fatigue, irregular heartbeat)

Mitral Valve Regurgitation

L – Look

  • Acute: Pulmonary edema, dyspnea, crackles, cardiogenic shock

  • Chronic: Fatigue, palpitations, exertional dyspnea, orthopnea

  • S3 heart sound, holosystolic murmur at apex

A – Assess

  • History of rheumatic heart disease, MI, mitral valve prolapse

  • Assess for signs of left-sided HF

T – Test

  • Echocardiogram (shows valve regurgitation and left ventricular dilation)

  • Chest X-ray (LV and LA enlargement in chronic cases)

  • ECG (A-fib may be present)

T – Treat

  • Medications:

    • ACE inhibitors/ARBs – reduce afterload

    • Diuretics – relieve pulmonary congestion

    • Beta-blockers – control HR if A-fib is present

    • Anticoagulants if A-fib is present

  • Surgical valve repair or replacement if severe

E – Educate

  • Monitor for worsening symptoms (dyspnea, fatigue, palpitations)

  • Adhere to medications, especially anticoagulants if needed

  • Avoid excessive fluid intake to prevent worsening congestion

Mitral Valve Prolapse (MVP)

L – Look

  • Often asymptomatic

  • Atypical chest pain, palpitations, dizziness, syncope

  • Mid-systolic click, late systolic murmur at apex

A – Assess

  • Family history (genetic component possible)

  • Symptoms worsen with stress, caffeine, or dehydration

T – Test

  • Echocardiogram (confirms leaflet prolapse)

  • Holter monitor (if arrhythmias are suspected)

T – Treat

  • Beta-blockers (for palpitations, chest pain)

  • Hydration, avoid stimulants (caffeine, alcohol)

  • Valve repair/replacement if significant regurgitation develops

E – Educate

  • Avoid stimulants, stay hydrated

  • Encourage moderate exercise, but avoid extreme exertion

  • Seek medical care if experiencing severe palpitations, syncope, or worsening dyspnea

Aortic Valve Stenosis

L – Look

  • Classic Triad (SAD): Syncope, Angina, Dyspnea

  • Systolic ejection murmur (harsh, crescendo-decrescendo at right second intercostal space)

  • Weak peripheral pulses, delayed carotid upstroke

A – Assess

  • History of congenital bicuspid valve, rheumatic heart disease, or aging (calcification)

  • Assess for symptoms of left-sided HF

T – Test

  • Echocardiogram (assesses valve narrowing and LV hypertrophy)

  • ECG (shows LV hypertrophy)

  • Cardiac catheterization if surgical intervention is considered

T – Treat

  • Medications (for symptom control, but do not cure):

    • Beta-blockers (reduce myocardial oxygen demand)

    • Diuretics (for pulmonary congestion)

    • Avoid nitrates! (can worsen hypotension)

  • Aortic valve replacement (AVR) is definitive treatment

E – Educate

  • Avoid strenuous activity if symptomatic

  • Monitor for worsening dyspnea, chest pain, or syncope

  • Discuss valve replacement options early

Aortic Valve Regurgitation

L – Look

  • Chronic: Asymptomatic for years, then exertional dyspnea, fatigue, bounding pulse

  • Acute: Sudden severe dyspnea, pulmonary edema, hypotension (cardiogenic shock)

  • Diastolic murmur (high-pitched, blowing at left sternal border)

A – Assess

  • History of rheumatic fever, endocarditis, connective tissue disorders (Marfan’s, syphilis)

  • Assess for signs of left HF (dyspnea, crackles, fatigue)

T – Test

  • Echocardiogram (evaluates valve regurgitation, LV function)

  • Chest X-ray (LV dilation, pulmonary congestion in chronic cases)

  • Cardiac catheterization (if surgical intervention is planned)

T – Treat

  • Medications:

    • Vasodilators (ACE inhibitors, hydralazine) – reduce afterload

    • Diuretics – relieve congestion

    • Avoid beta-blockers in severe cases (can worsen regurgitation)

  • Surgical aortic valve replacement (AVR) for symptomatic patients

E – Educate

  • Report worsening dyspnea, angina, or palpitations

  • Monitor BP regularly (avoid excessive drops in BP)

  • Prepare for possible valve surgery if symptoms progress

Exam Review

  • 30min a day 5 days a week

  • educate patient to exercise at least 3 times a week

  • Cardiac diet- low sodium, low fat, high protein (read nutritional label)

  • teach heart failure patients to restrict fluids

    • reduce stress, coping mechanisms, stress management class

  • hypertension- 120-129 (elevated) smoking, diet, stress, obesity obstructive sleep apnea→ modifiable

  • first type of treatment for hypertension- diuretic

  • what is a life threatening symptom of lisinorpil- angioadema

  • most common side effect of lisinopril- dry cough

  • hydrochlorathizide- take early

  • combine nitroglycerine and viagra- double vasodilator → decrease BP

  • left sided heart failure- pink sputum, fluid excess, pulmonary congestion, crackles, orthopnea, SOB (dyspnea), heavy breathlessness

  • right sided HR- JDV, peripheral edema, acities, splenomegaly, heptaomegaly

PAD-oxygenated → blood flow down to body, cold extremities, pain at rest, dangle extremities to help,

Risk factors- hypertension, smoking, obesity(BMI over 30),

PVD- not oxygenated→ coming up

varicose veins- impaired tissue perfusion

venous insufficiency- swelling in lower extremities, discoloration (brown),

***compression socks to combat this

Dioxin side effects- ototoxicity, N/V and pooping, slows heart down,

educate pt on diuretics- daily weights, taking meds consistently,

risk factor for developing hypertrophic cardiomyopathy → genetics

symptom for mitral valve stenosis → murmur (any valve problems)

pt SOB, fatigue, edema → diuretic

potential complications with mechanical valves →. clots

pt with restrictive cardiomyopathy → for dental work take antibiotics (bad tooth can cause endocarditis)

aortic valve stenosis → dyspnea, syncope(dizzy), angina

history of radiation for cancer is a risk factor for restrictive cardiomyopathy

side effects of beta blockers→ bradycardia, hypo-tension, decreased sexual dysfunction