Final Exam: NUR2502/ NUR 2502 (New 2023/ 2024 Update) Multidimensional Care III/ MDC 3 Exam| Complete Guide with Questions and Verified Answers| 100% Correct – Rasmussen
Final Exam: NUR2502/ NUR 2502 (New
2023/ 2024 Update) Multidimensional Care
III/ MDC 3 Exam| Complete Guide with
Questions and Verified Answers| 100%
Correct – Rasmussen
QUESTION
Valvular Heart disease
Answer:
-caused by structural abnormalities
-causes 3 main problems: stenosis, regurgitation, and prolapse.
QUESTION
Most common valvular disease
Answer:
MITRAL valve (left atria to left ventricle) and AORTIC valve (left ventricle to aorta)
QUESTION
stenosis is
Answer:
stiffening due to calcification or thickening causes narrowing and prevents normal flow
QUESTION
regurgitation is
Answer:
incomplete valve closure caused by fibrotic changes or calcification and causes back flow
QUESTION
prolapse is
Answer:
enlarges valve leaflets result in protrusion into the atria during systole
QUESTION
Remember the 3 main parts of valvular heart disease
Answer:
stenosis, regurgitation, prolapse
QUESTION
Mitral stenosis
Answer:
-The valve thickens by fibrosis and calcification
-valve prevents normal flow of blood from the left atrium to the left ventricle
QUESTION
Mitral stenosis causes this series of problems
Answer:
-increased left arterial pressure
-back flow pressure into the pulmonary arteries eventually into the right ventricle
–the right ventricle hypertrophies and right sided heart failure occurs
QUESTION
Risk factors for mitral stenosis
Answer:
-Rheumatic carditis (inflammation of the heart muscle)
-Rheumatic fever (disease from inadequately treated strep throat or scarlet fever)
-Congenital abnormalities
QUESTION
S/S of Mitral Stenosis early and late
Answer:
-early: dyspnea, orthopnea, paroxysmal nocturnal dyspnea, palpitations (afib), dry cough,
fatigue.
-Late symptoms (associated with HF): hemoptysis (blood in cough), hepatomegaly (enlargement
of liver), neck vein distention, pitting edema.
Rumbling, apical diastolic murmur
QUESTION
*What is a main sign of late stage mitral stenosis *
Answer:
Rumbling, apical diastolic murmur
QUESTION
Mitral valvular STENOSIS heart disease goes with heart failure while mitral valvular
REGURGITATION heart disease goes with heart failure
Answer:
right sided
left sided then right
QUESTION
Valvular Heart disease Mitral REGURGITATION
Answer:
-fibrotic and calcification changes prevent the mitral valve from closing completely during
systole, causing backflow of blood from ventricle to the atria during contraction because of the
backflow the heart has to compensate by increasing volume and pressure THIS ICNREASED
DEMAND CAUSES VENTRICULAR DILATION AND HYPERTROPHY CAUSING LEFT SIDED HEART FAILURE
-overtime it eventually leads to right as well
QUESTION
Risk factors for Valvular heart disease mitral regurgitation
Answer:
-mitral prolapse
-rheumatic heart disease
-affects women more than men
-infective endocarditis
-Papillary muscle dysfunction
QUESTION
S/S of valvular heart disease mitral regurgitation
Answer:
S/S progress slowly and may be assymptomatic for decades
-Early signs: fatigue, chronic weakness, anxiety, atypical chest pain, palpitations.
-later signs: dyspnea of exertion, orthopnea.
QUESTION
When right sided heart failure begins from Mitral regurgitation you will see
Answer:
-Neck vein distention
-pitting edema
–HIGH PITCHED HOLOSYSTOLIC MURMUR
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Responsibility of the Heart
-trasnports O2 and CO2
-transports nutrients & wastes
-transports hormones
-protects against disease & infections
-regulates body temp
Cardiovascular disease is the
leading cause of death in the US
Anatomy of the heart
fist size organ and pumps approx: 60ml with each beat and 5L every minute (can be increased when demand increases)
Blood flow steps of the heart
- Right atrium receives deoxygenated blood from superior inferior vena cava
- right ventricle received blood via the trcupsid valve
- right ventricle contracts and pumps blood through the pulmonic valve into the pulmonary arter for gas exchange
- left atrium receives oxygenated blood from the pulmonary veins
- left ventricle receives blood via the mitral valve
- the left ventricle contracts and pumps blood to the body via the aortic valve
Age related changes
-cardiac valves
-conduction system
-left ventricle
-aortic & other large arteries
-Baroreceptors
How do the cardiac valves change with increased age?
-murmurs appear
-valvular abnormalities result in rhythm changes
How does the conduction system change with increased age?
-Pacemaker cell decreases (the regulator of the heart)
-Fibrous tissue & SA node increase (the heart gets thicker)
-Decrease muscle fibers in atrial myocardium and bundle of His
-Conduction time increases (bradycardia possible)
How does the left ventricle change with age?
-size increases (cardiomyopathy)
-walls s tiffen (stroke volume and ejection fraction decrease)
-Fibrotic changes happen (filling speed is decreased and less able to increase cardiac output activity)
How does the aorta and large arteries change with age?
walls thicken and stiffen (main responsibility of hypertension in older adults)
How do the baroreceptors work?
They have a set point that the blood pressure should be at and make changes to the heart rate to change the blood pressure.
How do the baroreceptors change in age?
they become less sensitive bc they are responsible for knowing when to increase or decrease the flow of blood based on the increase or decrease of movement they are responsible for orthostatic changes which lead to increased dizziness and fainting
Remember that systole is _ and distole is ___
-systole is CARDIAC CONTRACTION
-distole is CARDIAC FILLING
Cycle of the heart
-passive filling of ventricles & atria (diastole)
-Atrial contraction (artial systole) P wave
-Ventricular ejection (ventricular systole)
Cardiac output =
heart rate x stroke volume
Normal CO range (cardiac output)
4-7 L/min
Stroke volume is
the amount of blood ejected during each contraction impacted by preload, afterload, contractility, and HR
stroke volume (preload)
how much the myocardial ventricle STRETCHES (impacted by volume returning)
stroke volume (afterload)
how much RESISTANCE the ventricle must overcome to pump directly related to arterial blood pressure & diameter of blood vessels
Stroke volume (contractility)
how well the heart can constrict or relax to ensure appropriate FORCE of contraction
Blood pressure is
the force of blood exerted against the vessel wall
Systolic BP
the amount of pressure during ventricular systole
Diastolic BP
the amount of pressure remaining in the system during diastole
HEART FAILURE IS
PUMP FAILURE
3 major types of heart failure
-Left sided heart failure
-Right sided heart failure
-High output heart failure (least common)
Left sided heart failure
most common
-ineffective left ventricular contraction causing back up to the pulmonary system causing pulmonary congestion
Right sided heart failure
-results from ineffective right ventricular contraction causing back up to the periphery causing peripheral edema
High output failure
-not as common
-cause by conditions that increase metabolic needs (septicemia, anemia, hyperthyroid)
These systems try to compensate for heart failure initially being helpful but eventually causing more damage:
-sympathetic nervous system: increased HR and BP
-Renin-angiotensin system activation: angiotensin II contributes to ventricular remodeling causing progressive contractile dysfunction
-Myocardial hypertropy: the walls thicken to provide more muscle mass however too much growth can lead to less oxygenated muscles.
Risk factors for left sided heart failure
-african americans
-hypertension
-coronary artery disease
-valvular disease
-cardiomyopathy
-substance abuse
-congenital defects
-cardiac infections
-dysrhythmias
-diabetes
-smoking
-family history
-obesity
-severe lung disease*
-sleep apnea
-metabolic disorders hyperthyroidism*
Risk factors for right sided heart failure
-left sided heart failure
-MI on the right side
-Pulmonary hypertension
-severe lung disease*
S/S of Left sided heart failure
-Nocturnal cough
-fatigue
-reduced activity tolerance
-chest discomfort/ angina
-palpitations or tachycardia
-dyspnea/ orthopnea
-crackles in lungs
-paroxysmal nocturnal dyspnea
-confusion/restlessness
-weak peripheral pulses/ cool extremities
S/S of right sided heart failure
-peripheral edema
-nausea & anorexia
-jugular vein distention
-enlarged liver/ spleen
-polyuria at night
-weight gain
-BP changes
-progressive edema from periphery inward
If the cough in left sided heart failure is pink or tinged it means
disease has progressed
Diagnostic testing for heart failure
-echocardiogram
-lab tests
-CXR (chest xray)
-ECG
Treatment for heart failure
-medications
-fluid & sodium restrictions
-CPAP
-Surgery (heart transplant or VAD)
Echocardiagram
used to determine how well the heart is pumping and is best tool for HR non invasive
what can an echocardiogram identify
-EF (ejection fraction) (normal 55-70%)
-Can identify valvular changes
-can identify pericardial effusions
-can identify chamber enlargement or ventricular hypertrophy
Lab tests consist of:
-electrolyte panel
-H&H (hematocrit and hemoglobin)
-BNP
-Urinalysis
-ABG
Electrolyte panel for heart failure
-sodium
-potassium
-magnesium
-calcium
-chloride
-renal panel
H&H (hemoglobin and hematocrit)
-identify anemia issues early which can a cause of RIGHT sided HF
B-type natriuretic peptide (BNP)
used for diagnosing HF
Urinalysis for detecting heart failure
proteinuria and specific gravity
ECG tests can identify
-dysrhythmias
-MI
-Ischemia
-Ventricular hypertrophy
Medications include meds that improve stroke volume
-ACE & ARBS (reduce afterload)
-Human B-Type Natriuretic Peptides (treat acute HF)
-Diuretics
-Venous vasodilators
-Nitrites
-Digoxin
-Beta blockers
-Inotropic drugs
Nutrition therapy
-reducing sodium
-Fluid restriction
-monitor I & O
-Daily weight (1 kg = 1 L of fluid)
When monitoring weight it is important to remember
-same scale
-in the morning before breakfast
-can be delegated
surgical measures for HF
-CPAP (helps a person with sleep apnea sleep better)
-CRT (cardiac resynchronization therapy)
-CardioMems (implanted monitoring system)
-Gene therapy
-VAD (ventricular assist devices) an implanted mechanical pump
-heart transplant is most ideal but not available to everyone
What is a main psychosocial factor to help encourage with patients experiencing heart failure?
hope the more hopeful they are usually the better outcome
Nursing interventions
-anticipate decreasing fatigue
-Monitor for pulmonary edema
Prevention of pulmonary edema in a patient with HF
-Monitor for s/s: crackles, dyspnea, confusion, tachycardia, BP changes, pink tinged sputum, dysrhythmias, anxiety, lethargy
Interventions for patient possibly experiencing pulmonary edema
-sit patient up
-provide oxygen to maintain saturations >90% consider CPAP (machine to breath easier)
-provide Nitro if BP allows
-Lasix or bumex IV
When preparing for discharge of a patient with HF
-diet, activity, meds, weight monitoring
-what to do if symptoms worsen
-smoking cessation
-see provider within 7 days
-ensure ACE or ARB in left ventricular HF
-identify home health needs
Valvular Heart disease
-caused by structural abnormalities
-causes 3 main problems: stenosis, regurgitation, and prolapse.
Most common valvular disease
MITRAL valve (left atria to left ventricle) and AORTIC valve (left ventricle to aorta)
stenosis is
stiffening due to calcification or thickening causes narrowing and prevents normal flow
regurgitation is
incomplete valve closure caused by fibrotic changes or calcification and causes back flow
prolapse is
enlarges valve leaflets result in protrusion into the atria during systole
Remember the 3 main parts of valvular heart disease
stenosis, regurgitation, prolapse
Mitral stenosis
-The valve thickens by fibrosis and calcification
-valve prevents normal flow of blood from the left atrium to the left ventricle
Mitral stenosis causes this series of problems
-increased left arterial pressure
-back flow pressure into the pulmonary arteries eventually into the right ventricle
-the right ventricle hypertrophies and right sided heart failure occurs
Risk factors for mitral stenosis
-Rheumatic carditis (inflammation of the heart muscle)
-Rheumatic fever (disease from inadequately treated strep throat or scarlet fever)
-Congenital abnormalities
S/S of Mitral Stenosis early and late
-early: dyspnea, orthopnea, paroxysmal nocturnal dyspnea, palpitations (afib), dry cough, fatigue.
-Late symptoms (associated with HF): hemoptysis (blood in cough), hepatomegaly (enlargement of liver), neck vein distention, pitting edema.
Rumbling, apical diastolic murmur
What is a main sign of late stage mitral stenosis
Rumbling, apical diastolic murmur
Mitral valvular STENOSIS heart disease goes with heart failure while mitral valvular REGURGITATION heart disease goes with heart failure
right sided
left sided then right
Valvular Heart disease Mitral REGURGITATION
-fibrotic and calcification changes prevent the mitral valve from closing completely during systole, causing backflow of blood from ventricle to the atria during contraction because of the backflow the heart has to compensate by increasing volume and pressure THIS ICNREASED DEMAND CAUSES VENTRICULAR DILATION AND HYPERTROPHY CAUSING LEFT SIDED HEART FAILURE
-overtime it eventually leads to right as well
Risk factors for Valvular heart disease mitral regurgitation
-mitral prolapse
-rheumatic heart disease
-affects women more than men
-infective endocarditis
-Papillary muscle dysfunction
S/S of valvular heart disease mitral regurgitation
S/S progress slowly and may be assymptomatic for decades
-Early signs: fatigue, chronic weakness, anxiety, atypical chest pain, palpitations.
-later signs: dyspnea of exertion, orthopnea.
When right sided heart failure begins from Mitral regurgitation you will see
-Neck vein distention
-pitting edema
-HIGH PITCHED HOLOSYSTOLIC MURMUR
What is the main sigh of mitral regurgitation that is leading to right sided heart failure
high pitched holosystolic murmur
valvular disease mitral prolapse
-valve LEAFLETS enlarge and prolapse into the right atrium during sytole and may progress into mitral regurgitation and left sided heart failure
Risk factors of Valvular heart disease mitral PROLAPSE
-marfan syndrome (an inherited disorder that affects connective tissue)
-congenital cardiac defects
-genetics
S/S of valvular mitral prolapse
-atypical chest pain
-palpitations
-exercise intolerance
-atrial or ventricular dysrhythmias usually the cause of: dizziness or syncope
systolic click
Main sign of mitral PROLAPSE
systolic click
Valvular disease aortic stenosis
-considered a disease of wear and tear
-the CO cannot be increased to meet the body’s demands
-stenosis causes symptoms then progresses to left sided heart failure and eventually right
Valvular aortic stenosis
is the most common dysfunction
Risk factors for Aortic Stenosis
-congenital bicupsid or unicupsid aortic valves
-rheumatic disease
-arthersoclerosis
-degnerative calcification
Main prevention for Aortic Stenosis
arthersclerotic disease
Signs and symptoms of Aortic Stenosis
-classic: dyspnea, angina, syncope of exertion.
-Late stage: fatigue, peripheral cyanosis, orthopnea, paroxysmal nocturnal dyspnea, narrow pulse pressure.
harsh systolic crescendo-decresendo murmur
Main sign of aortic stenosis
harsh, systolic crescendo-decrescendo murmur
Valvular disease Aortic Regurgitation
the aortic valves leaflets do not close properly and leads to LEFT then right heart sided heart failure
Risk factors of Aortic Regurgitation
-non rheumatic conditions
-infective endocarditis
-congenital abnormalities
-hypertension
-marfan syndrome
S/S of Aortic regurgitation
-major symptoms: exertional dyspnea, orthopnea, paraxysmal nocturnal dyspnea, fatigue.
-In late disease: palpitations, nocturnal angina with diaphoresis.
Blowing, decrescendo diastolic murmur
main sign of aortic regurgitation
blowing, decrescendo diastolic murmur
ALL OF THE DIFFERENT AUSCULTATION SOUNDS
-Mitral stenosis (diastolic murmur): Rumbling, apical diastolic murmur
-Mitral regurgitation (systolic murmur): high pitched holosystolic murmur
-Mitral Prolapse: systolic click
-Aortic stenosis (sytolic murmur): *harsh systolic crescendo-decrescendo murmur (diamond shaped murmur)
-Aortic regurgitation (diastolic murmur): blowing decrescendo, diastolic murmur
Diagnostic testing for valvular disease
-history
-physical assessment
-echocardiogram
-TEE (transesophageal echo)
-ETT (exercise tolerance testing)
-chest x ray
-ECG
Treatment of valvular disease meds
-Anticoagulation (if AFIB is present): Coumadin/ warfarin drug of choice
-Diuretics, beta blocker, ACEI, digoxin, O2
Noninvasive heart valve procedures
-ballon valvuloplasty
-TAVR (transcatheter aortic valve replacement)
Invasive surgeries for valvular heart disease
-heart valve repair
-heart valve replacement
when a patient is taking coumadin (warfarin) watch for/educate what
-avoid foods high in vitamin K and use of electric razors
preoperatively of heart surgery check for what
full dental evaluation and treatment of any dental issues before surgery
Infective endocarditis
-infection of the endocardium or heart valves caused by viruses, bacteria, or fungi. lesions are caused and then stuff gets stuck in the lesions causing obstruction STENOSIS .
https://www.youtube.com/watch?v=wYZbMoWjLEg
link for heart stuff
infective endocarditis prevalence
Common in IVDU intravenous drug users
very high mortality
Risk factors of infective endocarditis
-iv drug use
-valve replacements
-alteration in immunity
-structural cardiac defects
-streptococcus aureus
-staphylococcus aureus
prevention and risk reduction of infective endocarditis
-prophylactic antibiotics for certain conditions when having dental procedures
-assessment of skin in susceptible individuals
-awareness of surgical complications in susceptible individuals
s/s of infective endocarditis
-severity dependent of infecting organism
-fever associated with chills, night sweats, malaise and fatigue
-identify murmur (all patients with infective endocarditis have a new or changed murmur)
-HF is most common complication of infective endocarditis
-Up to half develop aterial embolization
-anorexia
-petechia or splinter hemorrhages
-oslers nodes (on palms of hands or soles of feet)
-janeways lesions (flattened reddned maculae on hands and feet), positive blood cultures.
diagnostics and testing for infective endocarditis
-blood cultures
-echocardiogram
-TEE
Treatment for infective endocarditis
-antimicrobials (usually for 4-6 weeks IV)
-Close adherence to asepsis (high risk of secondary infections)
-Rest balanced with activity
-supportive treatment for new heart failure
-valve replacement
-repair or remove shunts
-valve repair
-abscess drainage
other considerations for infective endocarditis
-prophylactic antibiotics for dental work
-good oral hygeine (but no irrigation or floss)
-Continue IV therapy at home (if appropriate)
-PICC line insertion and education
-Follow up care
-Monitor and keep skin clear
-seek attention if concerned
pericarditis
-inflammation of the pericardium and the problem can be: fibrous, serous, hemmorhagic, purulent, or neoplastic
pericarditis is commonly associated with
-infection
-Dressler’s syndrome (post MI syndrome
-Post pericardiotomy syndrome
-Systemic connective tissue disorders
-chronic inflammation caused by thickening of the pericardial fibrous tissue (TB, radiation, trauma, CKD, cancer)
-chronic can lead to heart failure
risk factors of pericarditis
-infective organism
-post-myocardial infestion syndrome
-post-pericardiotomy syndrome
-acute exacerbation of systemic tissue disorders
-tuberculosis
-radiation therapy
-trauma
-renal failure
-metastic cancer
S/S of pericarditis
-substernal pain
-pain described as “grating” or “oppressive”
-worsening pain with coughing or lying down
-elevated WBC in acute**
-fever in acute**
-ST elevation in all leads**
-Afib possible
-Chronic shows signs of right sided heart failure: JV distention, hepatic engorgement, dependent edema.
Treatment of pericarditis
-focused on treating the cause and comfort
-pain management (NSAIDS)
-steroid therapy
-antibiotics for bacterial infective causes
-pericardiectomy
-monitor for complications such as pericardial effusion or cardiac tamponade
nursing care of pericarditis
-assess chest pain
-ausculate
-maintain comfortable position
-anti inflammatory meds
-education
Cardiac tamponade is
when fluid fills the spaces and encases the heart and heart muscle (seen in pericarditis)
How do you assess for cardiac tamponade in relation to pericarditis?
-pulsus paradoxus
-JV distention with clear lungs
-muffled heart sounds
-decreased cardiac output
Rheumatic Carditis
-develops after a URI with Group A-beta- hemolytic streptococci
-occurs in half of the patients with rheumatic fever
-causes inflammation in ALL layers of the heart
Because Rheumatic carditis causes inflammation in all parts of the heart it :
-impairs contractility
-thickens the pericardium
-causes valvular damage
-impacts CO
To prevent rheumatic fever which leads to rheumatic carditis you should
get adequate antibiotic coverage for strep infections (penicillin for 10 days)
s/s of rheumatic carditis
-tachycardia
-cardiomegaly
-new murmur or change in murmur
-pericardial friction rub
-ECK changes (prolonger PR interval)
-Indications of HF
-evidence of strep infections
diagnostics and testing for rheumatic carditis
cultures
treatment for rheumatic carditis
penicillin for primary infection
Nursing care for rheumatic carditis
-education on antibiotic compliance
-fever management
-hydration
-rest
-antibiotic prophylaxis
Cardiomyopathy
-disease of the myocardium that impedes the pumping ability of the heart
-4 different categories: Dilated, hypertrophic, restrictive, and arthyomogenic right ventricular.
most common is dilated cardiomyopathy
Risk factors for Dilated cardiomyopathy
-alcohol abuse
-chemotherapy
-infection
-inflammation
-poor nutrition
-genetics
Risk factors for hypertrophic cardiomyopathy
-genetics
Risk factors for restrictive cardiomyopathy
-endocardial or myocardial disease
-sarcoidosis
-amyloidosis
Risk factors for Arrythmogenic right ventricular cardiomyopathy
-family history
S/s of dilated cardiomyopathy
-fatigue
-heart failure LEFT
-Dysrhythmias
-Systemic or pulmonary emboli
-moderate to severe cardiomegaly
s/s of hypertrophic cardiomyopathy
-dyspnea
-angina
-fatigue, syncope
-mild cardiomegaly
-ventricular dysrhythmias
-sudden death common**
-heart failure
s/s of restrictive cardiomyopathy
similar to HF
diagnostic testing for cardiomyopathy
-history
-echocardiogram
-redionuclide imaging
-angiocardiography during cathertization
Treatment of cardiomyopathy
-symptomatic treatment: diuretics, vasodilators (dilated), betablockers (hypertrophic)
-control dysrhythmias
-medications to improve underlying issue
surgery for cardiomyopathy
-ventriculomyomectomy
-percutaenous alcohol septal ablation
nursing care for a patient with cardiomyopathy
prepare for major surgery
-life expectancy 1 year
-heart class III or IV
-normal or only slightly increased pulmonary vascular resistance
-absence of active infection
-stable psychosocial status
-no evidence of current drug or alcohol use
post op care for patient who underwent surgery for cardiomyopathy
-monitor for signs of bleeding and/or tamponade
-monitor for signs of rejection: sob, fatigue, fluid gain, abdominal bloating, new bradycardia, hypotension, afid or flutter, decreased activity tolerance.
What is the most major cause of death post transplant
infection make sure you are performing strict handwashing and asepsis
Hypertension
Blood pressure is the force exerted by blood during ventricular contraction, against the walls of the blood vessels.
what is part of the autonomic nervouse system involved in maintaing BP, along with hormones
-Atrial baroreceptors
-Renin-angiotensin system
-Epinephrine
-Norepinephrine
Types of hypertensions (3)
-Primary: most common caused by an existing health problem
-Secondary: caused by specific disease processes or medications- kidney disease is the most common cause
-Malignant: most severe form where BP increases rapidly to dangerous levels
Risk factors of hypertension
-kidney disease
-genetics
-race (african americans are more likely)
-Obesity
-Smoking
-Alcoholism
-Poor diet
-Alcoholism
-Poor diet
-Sedentary lifestyle
-Age
-Diabetes
-Pregnancy
-metabolic disorders
-certain drugs and medications
Untreated hypertension can lead to
stroke, MI, kidney failure, and death
When to treat high BP according to age
-Treat BP 150/90 in > 60 year olds
-Treat BP 140/90 in < 60 year olds
S/S of hypertension
-usually none
-headaches
-facial flushing
-dizziness or fainting
Diagnostic testing for hypertension
-BP in both arms
-2 or more readings at the same visit (white coat syndrome)
-BMP, Urinalysis, Xray, ECG.
Treatment for hypertension
-diuretics
-beta blockers
-calcium channel blockers
-Angiotensin- converting enzymes (ace) inhibitors
-Angiotensin II receptor blockers (ARBs)
diet education to stop hypertension (DASH)
-encourage intake of veggies, fruits, whole grains
-low fat dairy products, poultry, fish, legumes, non tropical vegetable oils & nuts
-limit sweets, sugar sweetened beverages and red meat
-lower sodium intake <2400 mg per day prefer <1500 mg
-engage in aerobic activity 3-4 times per week for 40+ min
other education for hypertension
-stop smoking
-reduce alcohol
-lose weight
-adhere to medication regime
-evaluate stressors
-help identify relaxation techniques
herbal supplements you MUST discuss with provider
-Garlic & CoQ10
Arthersclerosis
arterial walls become thick and heart causing a narrowing that impedes blood flow (usually affects large arteries: coronary artery, aorta, carotid, renal, iliac, femoral arteries)
thrombosis
is a STABLE blood clot that can obstruct a vessel lumen and can lead to inadequate perfusion and oxygenation to distal tissues
unstable plaque ruptures
underlying tissue causes platelete aggregation and rapid thrombus formation which suddenly blocks a blood vessel can cause ischemia & infarction
risk factors for artherosclerosis
-blood vessel damage
-genetics
-hyperlipidemia (high LDL-C, Low HDL-C, High triglycerides)
-diabetes
-obesity
-smoking
-sedentary lifestyle
-stress
-african american or hispanic
-age
hyperlipidemia
*high LDL, Low HDL-C, High triglycerides)
think of HDL as HAPPY CHOLESTEROL and LDL as LOWSY CHOLESTEROL
Remember less cardiac output less oxygen to the body
sources;
https://www.gcu.edu/
https://yaveni.com/
https://www.rasmussen.edu/