NR 507 Week 8 Group Final Exam Questions

Most common cardiac valve disease in women? Mitral valve prolapse is the most common valve disorder in the U.S. with a prevalence estimated at 3%, MVP tends to be most prevalent in young women pg. 1094 Common in young women, leaflets of valve prolapse into atrium- may cause mitral regurgitation, back flow of blood-murmur https://youtu.be/Q84DwBABbY0At risk for stroke and endocarditis Left ventricle become hypertrophied- pulmonary hypertension- right sided heart failure Valve repair and surgery may be warranted Dermatomes: are spinal cord levels that are associated with a specific area https://youtu.be/CYZBH6NX8wgAgnosia: is when an individual is unable to visualize or recognize objects due to injury When myocardial ischemia may be reversible? If blood flow is restored within 20 min **** Key to perfusion Many individuals with reversible myocardial ischemia exhibit a normal physical examination between episodes. Physical examination of an individual experiencing myocardial ischemia may disclose tachycardia, extra heart sounds (gallops or murmurs) and pulmonary congestion indicating impaired left ventricular function. Unstable angina is the result of reversible myocardial ischemia and is a harbinger of impending infarction Pt with coronary artery disease may experience ischemia during mental emotional or body stress like exercise. Ischemia is low blood supply- cells are alive but starving- do not functions normally Symptoms of Stable Angina: Atypical chest pain, palpitations, sense of unease, severe fatigue, angina pectoris, radiation to neck, lower jaw, left arm, left shoulder, or occasionally back or down right arm. https://youtu.be/7XkOuo5DwAUGradual luminal narrowing, heart can not meet the demands- chest pain develops- with rest it subsides. Relieved with Nitroglycerin Pain eases with rest- gold standard Orthostatic Hypotension: BP changes from lying to sitting or standing position Decrease of systolic BP by at least 20mmHg and diastolic by at least 10mmHg within 3 minutes of standing. When it occurs patients feel syncopal, fainting, dizziness, and loss of vision. Treatment: correct underlying disorder, raise HOB, watch salt intake, adjust BP meds, TED hose, Why increase HOB- so the body can adjust to sitting before standing- so the sympathetic system has time to catch up in elderly or hypovolemic patients. Isolated systolic hypertension: High systolic with normal diastolic: Systolic >140 mmHg/ Diastolic <90mmHg Becoming more prevalent in all age groups and is strongly associated with cardiovascular/CVA events. Results of sustained controlled hypertension: Pg. 555 Increased peripheral resistance and increased blood volume causes HTN- sustained over time- remodeling of vessels resulting in changes known as hyaline sclerosis and atherosclerosis. Effects eyes- retinal changes- kidneys- heart- brain Insulin resistance on the development of primary resistance: Common in HTN, important to note they are not diabetic Risk factor for CAD due to endothelial damage, thickening of vessel wals, increased inflammation and leukocyte adhesion. DM is also associated with dyslipidemia Insulin resistance activates the sympathetic nervous system, contributes to the development of diabetes, dyslipidemia, and eventually atherosclerosis, promotes thrombus formation Defects in the normal secretion of natriuretic hormones and the impact on the renal system: BNP from ventricle https://youtu.be/vOgQnsKd830Natriuretic hormones include atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP, C-type