NURB 340: Alterations of the cardiovascular system
NURB 340: Alterations of the cardiovascular system NURB 340
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This 7 page Class Notes was uploaded by Kelsey Forbeck on Friday October 14, 2016. The Class Notes belongs to NURB 340 at University of Indianapolis taught by Moore in Fall 2016. Since its upload, it has received 7 views. For similar materials see Pathophysiology in NURSING at University of Indianapolis.
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Date Created: 10/14/16
NURB 340: Pathophysiology Alterations of cardiovascular Function Arteriosclerosis o Defined: thickening and hardening of the vessel wall (they become stiff and thick) o They often restrict blood flow to organs and tissues o Arthrosclerosis A form of arteriosclerosis Caused by accumulation of fat that leads to the formation of plaque It is preventable which is why it is not considered a disease It is the leading cause of coronary artery disease You find arthrosclerosis with an injury leading us to dysfunction, then a fatty streak, then to plaque, and finally to a lesion. o Causes: Hypertension Smoking Hyperlipidemia Hemodynamic factors Toxins Viruses Immune reactions Progression of atherosclerosis o First is a chronic injury caused by the things listed above o This leads to dysfunctional and then to a fatty streak o After an injury and fatty streak, fibrous plaque forms. Raised visible areas in the blood vessels may calcify or harden which reduces our blood supply. o A complicated lesion comes next and if untreated it can cause myocardial infarction Plaque can get so big that it can become unstable and rupture Platelets will stick to the lesion (after the plaque is rupture and the lesion is open) because it is a strange thing that they don’t known. This clotting cascade can cause thrombosis Process of Low density lipoprotein oxidation o LDL enters arterial area o Come into through in intact epithelium o Then they start getting oxidized by oxidized free radicals o Pro inflammatory lipids are then created (these cause monocytes to come to the area) o The monocytes then turn into macrophages o The macrophages try to eat up all the oxidized LDL but instead they end up making the foam cells. Hypertension o Consistent elevation of systemic blood pressure o Abbreviation is HTN o African Americans and those with diabetes are more at risk for hypertension than anyone else. o Pre high and high blood pressure it increases your risk for cardiovascular disease because it causes cellular injury and starts the process of arthrosclerosis o Primary hypertension We don’t know the cause 90% of people have this kind o Secondary hypertension Caused by some underlying renal disorder In 5-8% of cases o Things that increase our risk for hypertension: Age Gender Race Dietary factors o Metabolic syndrome: Where we have hypertension, obesity, high cholesterol, and glucose intolerance o Clinical manifestations of hypertension: A silent disease First time people may notice they have it is when they come in for a stroke o Risk factors for primary hypertension Family history Advancing age Cig smoke Obesity Heavy alcohol consumption Gender (men greater chance than females before age 55 then women greater chance then men after the age of 55) Black race High dietary sodium intake Low dietary intake of potassium, calcium, magnesium Glucose intolerance (aka diabetes) o Pathological effects of sustained complication primary hypertension Myocardium (muscle of the heart): Will have to work harder to get blood pushed between the vessels that are getting hard and narrow Eventually the left ventricle is going to hypertrophy We can have ischemia and develop heart failure Coronary artery (all around the heart that feed myocardium): They provide nourishment to myocardium Hypertension accelerates arthrosclerosis process Eventually we will have ischemia or MI or sudden death Kidneys Hypertension will reduce blood flow Increase arterial pressure End up glomerular sclerosis and decreased glomerular filtration You may end up on dialysis Brain If we have hypertension and have a hard time getting blood to our heart, then we will have a hard time getting blood to our brain Reduce blood flow Hemorrhage Acute brain infection (stroke) Eyes Damage vessels that feed retinas Hypertension retinopathy Hemorrhage Aorta Weakened vessel wall causes aneurism Arteries of lower extremities Reducing blood flow Gangrene o S/S of malignant hypertension: Headache Stroke like symptoms Slurring of speech Difficulty with extremities o What is hypertension crisis? Diastolic pressure greater than 140 Reason people develop it is unknown o Possible causes of hypertension crisis: Complications of pregnancy Cocaine Certain medication reaction Adrenal tumors (on top of kidneys) Alcohol withdrawal o If not reduced, then there can be brain swelling or palpedma (eye swelling) Orthostatic hypotension o Defined: Decrease in systolic BP of at least 20 mm Hg or a decrease in diastolic BP of at least 10 mm Hg with 3 minutes of moving to a standing position o Often accompanied by dizziness, blurring or loss of vision, and syncope or fainting caused by insufficient vasomotor compensation and reduction of blood flow through the brain o If a doctor asks for an orthostatic blood pressure what are you supposed to do? Get their BP laying down, then sitting, and then standing o Can be chronic or acute o Can be caused by drug action (bp meds), prolonged immobility, starvation, physical exhaustion, dehydration, and diuresis Aneurysm o Defined: localized dilation or outpunching of a vessel wall or cardiac chamber o Can cause weakening o True Involved ALL THREE layers of the arterial wall- best described as weakening of the vessel wall o False An extravascular hematoma and it communicates with the intravascular space- common cause is a leak between a vascular graft and a natural artery o What will patients complain of with an aneurysm? Pain between the shoulder blades o Where are aneurysms most common? Thoracic aorta or abdominal aorta o Causes: Diet Stress on vessels Smoking Arthrosclerosis o Patients usually don’t realize they have them until they rupture Thrombus Formation (Clot) o Develop when intravascular conditions activate coagulation Stasis of blood flow Surgical procedures Inflammation Traumatic injury Infection Low blood pressure Obstruction that results in stasis Embolism o An obstruction of a vessel by an embolus Can be dislodged thrombus air bubble, amniotic fluid, fat, bacteria, cancer cells, or foreign substance Travels until can’t any longer Can cause ischemia or infarction distal to that obstruction Produce organ destruction or pain and can be life threatening o Massive ones can block important organs and may not be fixable Peripheral arterial disease o Any abnormality in the arteries or veins outside the heart o Any vascular disease Thromboangitis Obliterans (Berger disease) Raynaud phenomenon o Intermittent claudication Pain with walking aka leg pain associated with exercise and ischemia Legs hurt but the pain subsides with rest May feel tingling or burning sensation because no oxygen is getting there No pedal pulse They may have paleness of the legs Thick toenails
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