Week 3 180

Apex of the heart

Three layers
-Endocardium
-Myocardium
-Epicardium

-Innermost layer of the heart
-Made up of endothelial tissue and lines the heart and the valves

-Middle layer of the heart
-Consists of muscle fibers and is the thickest layer if the heart
-Responsible for the pumping action of the heart

-Outer layer of the heart
-Consists of a serous layer that protects the heart

-A fibrous sac that surrounds the heart
-Consists of two layers with a space in between that is filled with serous fluid that allows the layers to smoothly move against each other

-Deoxygenated blood travels through the superior and inferior vena cava into the right atrium through tricuspid valve into right ventricle out through pulmonary valve through pulmonary artery to lungs to pick up oxygen
-Oxygenated blood then returns to the heart through the pulmonary veins into the left atrium through the bicuspid valve into the left ventricle then through the aortic valve to the body

Three layers
-Tunica adventitia
-Tunica media
-Tunica intima

-Outside layer of arteries
-Supportive layer composed of connective tissue, vessels, and nerves

-Middle layer of arteries
-Composed of endothelium, subendothelium, and internal elastic lamina

-Innermost layer of arteries
-Composed of layers of smooth muscle that allow the artery to contract

High-pressure blood is transported from the heart to arteries and arterioles

Joins arteries and capillaries

Acts as a reservoir of blood and carries low-pressure blood to the heart from venules

Joins capillaries and veins

Permits gas exchange, the transfer of nutrients, and the removal of waste between blood and the fluid of tissues

Three

2

Durine diastole, they supply blood to the heart.
*with a resting or slow heart rate there is ample time for coronary perfusion, but if HR increases, diastole shortens and decreases perfusion time

The contraction phase of the cardiac cycle

The relaxation phase of the cardiac cycle

The total amount of blood that is ejected from one ventricle of the heart in liters per minute

-Vasoconstriction
-The compliance of the arteries
-Arterial pressure or afterload
-Dependent on the volume of blood entering the heart from the veins

5-6 L/min

Stroke volume multiplied by heart rate

The volume of blood ejected by one ventricle per heartbeat

Preload, afterload, and contractility

The degree of stretching of the ventricular muscle when the heart is at the end of diastole

The resistance or pressure that the ventricle needs to overcome to eject blood into the peripheral circulation during ventricular contraction

The force that the myocardium generates during contraction

-Sympathetic stimularion or inotropic medications may cause contractions to increase
-Hypoxia and negative inotropic medications may cause contractions to decrease

A heart condition that affects the heart’s ability to pump blood

-Ventricular gallop
-Loud “DUB” following S2
-Indicates decreased ventricular compliance

-Atrial gallop
-Loud “LUB” immediately before S1
-Due to ventricular compliance caused by conditions such as hypertension, aortic stenosis, coronary artery disease, and cardiomyopathy

-Turbulent blood flow through normal or abnormal heart valves
-Described as a “whooshing” sound

-Squeaky, scratchy sound created by friction occurring between the two layers of inflamed pericardial tissue

A noninvasive test for recording cardiac electrical activity

The heart’s action potential transmits electrical impulses that activate a contraction of the heart muscle

The action potential that allows the heart muscle to relax as it prepares to receive the next electrical impulse

ECG interpretation that represents the ocurrence of atrial depolarization

ECG interpretation measurement of time between atrial and ventricular depolarization

ECG interpretation measurement used to determine length of ventricular depolarization

ECG interpretation that represents the duration between ventricular depolarization and repolarization

ECG interpretation that represents repolarization of the ventricles

ECG interpretation measurement used to determine the length of ventricular depolarization and repolarization

1. Calculate heart rate
2. Determine if heart rhythm is regular
3. Assess for P waves
4. Measure PR interval
5. Measure duration of QRS complex
6. Assess ST segment
7. Observe for changes in T wave
8. Measure length of QT interval
9. Interpret the rhythm

Count the number of QRS complexes in a six-second strip and then multiply that number by 10

Heart rate above 100pm and all other normal sinus rhythm ECG interpretation criteria remains unchanged

-Administration of IV adenosine may be useful in altering the impulse excitability and can help determine if its sinus tachycardia or supraventricular tachycardia
-IV administration of IV beta blockers, such as metropolol, is also an option for clients who become hemodynamically unstable

-Nausea
-Nervousness
-Feeling of impending doom
-Skin flushing
-Sweating
-Lightheadedness
-Numbness

A cardiac procedure that uses hot or cold energy waves to destroy abnormal cardiac tissue

-Possible catheter ablation to destroy the abnormally excited cardiac cells

-Occur when irritated ventricular cells send electrical impulses early
-Early QRS and much wider QRS complex

-Can be normal
-PVCs that occur without identification of abnormal heart structures are considered benign and medically insignificant

-Hypertension
-MI
-Cardiomyopathy
-Ventricular tachycardia
-COPD
-Electrolyte imbalances
-Thyroid disorders
-Caffeine sensitivity

-Can increase risk of falls due to dizziness or lightheadedness
-May indicate underlying disease

-Electrolytes (especially potassium and magnesium) should be analyzed
-Thyroid hormone levels should be drawn to identify hyperthyroid disease

-Underlying cardiac rhythm is typically normal but may appear slightly irregular with premature QRS complexes
-QRS complex >0.12 seconds
-P wave may be hiddennidentifiable
-PR wave may be unmeasurable

-Using a Holter or Event monitor
-Cardiac electrodes are placed on clients chest
-Client typically wears monitor for 24-48 hours
-May be asked to write down manifestations such as palpitations, dizziness, or shortness of breath

A noninvasive ultrasound that uses sound waves to create images of the heart and blood vessels

-Thorough review of medical history
-Ask client for timeline of manifestations
-Client education: smoking cessation, restrict alcohol, eliminating illicit drug use

-Clients with frequent and persistent PVCs are often administered a beta blocker or antiarrhythmic medications
*Clients vital signs need to be closely monitored
-catheter ablation

-Benign cardiac rhythm occurrences that cause the heart’s electrical conduction system to activate an early heartbeat or impulse from one of the two atrial chambers

-Cause is typically unknown
-Atrial tissue irritation can be caused by conditions associated with alterations in cardiac function and perfusion (MI, hypertension, diabetes mellitus, CHF)
-Some medications (digoxin, beta blockers, chemotherapy drugs, some antidepressants)

-Benign and doesn’t pose a risk to most people
-Some people that are symptomatic experience shortness of breath

-Often discovered inadvertently

-Underlying rhythm is typically normal
-P wave may be hiddennidentifiable
-PR interval may be shortened or unmeasurable

-Reassurance about condition being benign
-Monitor fatigue during exercise
-Stress reduction methods
-Avoiding smoking and alcohol
-Contact provider if palpitations or shortness of breath interfere with ADLs

-Identify potential triggers or causes for the PACs

-Signal is delayed when traveling through the right atrium to the AV node
*Signal is not actually blocked, just slowed down

Antiarrhythmic medications
-Sodium channel blockers (Lidocaine)
-Beta blockers (Metroprolol)
-Calcium channel blockers (Diltiazem)
-Potassium channel blockers (Amiodarone)
-Cardiac glycosides (Digoxin)
-Magnesium

May be caused by:
-Increasing age
-History of cardiac disease (MI, CAD)
-Electrolyte imbalances (hypokalemia, hypomagnesemia)
-Endocarditis, rheumatoid arthritis, and COVID-19 can controbute
-Rheumatoid arthritis, lupus, and sarcoidosis

-Prolonged PR interval (>0.20 seconds)
-Consistent length

-Dietary habits/modifications (avoiding foods high in sodium, cholesterol, and triglycerides)
-Fall precaution from dizziness
Client education:
-Avoid smoking and alcohol
-Healthy, low-cholesterol diet

-Occurs when SA node is not firing appropriately
-Electrical impulses are rapid, chaotic, and irregular causing dysfunctional atrial contraction
-Cardiac output is decreased
-Blood clots can form

-Diabetes
-Hyperthyroidism
-Obstructive sleep apnea
-History of smoking and excessive alcohol consumption
-Sedentary lifestyle with other comprbidities
-Clients recovering from cardiac surgery

-Dizziness or heart palpitations
-Difficulty tolerating usual exercise routines
-Hypotension
-Irregular pulse
-Weight gain and increased urination

-Monitor for signs of stroke
-Increased risk for spontaneous bleeding

-May be precipitated by hyperthyroidism
-Thyroid function tests, CBC, creatinine, and glucose levels)

-Overall rhythm is irregular
-P waves are replaced by indiscernable (unidentifiable) atrial activity between QRS complexes
-Ventricular rate can be normal (60-100) or increased (100-200)

An increased heart rate (>100bpm) in A-fib

A detailed ultrasound, via the esophagus, that allows detailed images of the heart

-Increased fall risk (dizziness and lightheadedness)
-Increased risk of stroke, heart failure, and mortality
-Risk of bleeding (medications for treatment)

-Contact provider if manifestations such as heart palpitations, chest pain, irregular heart rate, dizziness, increased fatigue, or shortness of breath
-Take precautions to reduce risk of bleeding (soft-bristled toothbrush, safety razors, avoiding high-risk activities)

-Increases risk for clotting
-Coenzyme Q-10
-Ginseng
-Licorice
-St. John’s Wort

Increases risk for bleeding
-Danshen
-Evening primrose
-Ginkgo biloba
-Saw palmetto

An irregularity between apical and radial pulses obtained by subtracting the radial pulse from the apical pulse

Often the apical and radial pulse rates will differ in clients who have A-fib due to the irregularity of ventricular heart contractions

Inadequate cardiac output and potentially poor perfusion to the body’s organs

-Optimal outcome is to convert heart rhythm back into NSR

-Administration of antiarrhythmic medications or the use of synchronized electrical conversion

Delivering a timed electrical shock on the R wave to disrupt an irregular cardiac cycle
*Used when the client is unstable and not able to maintain blood pressure during episodes of atrial fibrillation

Common supraventricular (occurring before the ventricles) that occurs when the atria are beating in a regular rhythm and increased rate (240-400) caused by multiple rapid electrical impulses being sent and the AV node doesn’t have time to process it before transmission to the ventricles

-May have manifestations that negatively impact their ability to perform normal activities
-May experience lightheadedness or heart palpitations that make typical routines difficult

-Hypotension
-Lightheadedness or dizziness
-Palpitations or chest discomfort
-Shortness of breath
-Fatigue
-Syncopal episodes

-Overall rhythm is regular
-P waves are replaced by multiple sawtooth or flutter waves between QRS complexes
-Ventricular rate typically normal and atrial rate is increased (240-340)

-Thorough medical history with onset of manifestations and to help identify causitive factors
-Carefully monitor vital signs to determine if client is tolerating the rhythm

-Improve cardiac perfusion
-Control heart rate and blood pressure
-Prevent blood clot formation

-Monitoring vital signs
-Administering antiarrhythmics and anticoagulants
-Preparing for cardioversion

-Occurs when electrical impulses are originating from above the AV node causing excessive excitability of atrial tissue resulting in an increased heart rate

-Increased stress levels
-Smoking
-Caffeine (and other stimulating substances)
-History of heart failure
-Pregnancy
-Chronic lung disease

-May have increased levels of stress which can precipitate feelings of anxiety
-Leads to clients being unable to perform their usual exercise routines

-May have dizziness, lightheadedness, or syncopal episodes
-Increases fall risk

-Sudden onset of heart palpitations or chest discomfort
-Dizziness or lightheadedness
-Shortness of breath

-Regular rhythm
-Increased HR (100-220)
-Narrow QRS complex (<0.12 seconds)
-Undiscernable P wave

-Vagal maneuvers (valsalva maneuver)

-Hold Breath
-Bear down as if having a bowl movement for 15 seconds

-Vagal maneuvers such as the Valsalva maneuver
-IV adenosine

Atrial depolarization

Related to the rate of cardiac impulse transmitted from the AV node

Ventricular depolarization

A complex, progressive clinical syndrome that occurs due to abnormalities in either the structure or function of the heart. This leads to decreased cardiac output and increased pressure within the heart while at rest or during stress.

-Occurs when the heart is not able to meet the needs of the systemic circulatory system (either the ventricles are not filling properly, or the blood is not ejected into the system as it should)
-Conditions such as hypertension, CAD, uncontrolled arrhythmias, MI, and valve disease contribute to this

CAD, MI, and diabetes

For each 10 years after a client reaches the age of 65, the incidence of heart failure doubles for men and triples for females in the same age group

-Shortness of breath
-Fatigue
-Weakness
-Difficulty sleeping
-Edema in lower extremities

Often, they are not able to carry out ADLs independently due to activity intolerance and must rely on a caregiver

-JVD
-Shortness of breath
-Hypotension w/tachycardia
-Orthopnea
-Exertional or paroxysmal nocturnal dyspnea
-Edema in lower extremities
-Weight gain
-Pulmonary congestion (rales and productive coughing with white or pink blood-tinged sputum)

-JVD
-Shortness of breath
-Chest discomfort
-S3
-Murmurs
-Palpitations
-Ascites (abnormal accumulation of fluid within the abdomen)
-Peripheral edema
-Generalized swelling
-Enlarged liver and spleen

Manifestations of both left and right sided heart failure such as buildup of fluid and dyspnea

Shortness of breath that awakens a client from sleep, relieved when the client sits up

Framingham Diagnostic Criteria for Heart Failure. To be diagnosed with heart failure, the client must meet two criteria from the major criteria section or one major criterion and two minor criteria

New York Heart Association (NYHA) functional classification system
-Grades based on severity of clinical manifestations at various stages of physical activity

Serum B-type natriuretic peptide (BNP) (blood test)

BNP

Cardiac catheterization and percutaneous coronary intervention (PCI) can decrease the damage caused by the MI

-Angiotensin-converting enzyme (ACE) inhibitors
-Angiotensin-receptor neprilysin inhibitors (ARNIs)
-Angiotensin II receptor blockers
-Beta blockers
-Aldosterone antagonists
-Hydralazine and isosorbide dinitrate
-Diuretics

Narrowing or occlusion of the coronary artery that limits or blocks blood flow to the heart

-Men: 45
-Women: 55

Elevated fat levels (triglycerides and cholesterol) in the blood

-Can experience chest pain or an MI
-Can cause the heart to weaken and the client to develop heart failure and arrhythmias

Mental health disorders, such as depression, anxiety, stress, and PTSD, can not only influence cardiac health after a cardiac incident, but also can contribute to the development of cardiac disorders

-Initially, manifestations are asymptomatic
-Chest discomfort (angina); may be associated with activity at first (stable angina), but can progress to chest pain occurring at rest (unstable angina)
-Pain can radiate to the left arm, the neck, jar, or back
-Diaphoresis
-Dizziness and lightheadedness
-Nausea
-Vomiting
-Shortness of breath
-Weakness

*May not experience chest pain, instead, may experience:
-Extreme fatigue
-Dizziness
-Abdominal pain
-Nausea
-Pressure in the chest

An amino acid that the body uses to make proteins. Excess homocysteine in the blood can cause damage to the lining of the arteries and lead to blood clots or blockages in the arteries, increasing the risk for an MI

Inflammation

C-reactive protein (CRP)

Cardiac enzymes that are highly sensitive to cardiac injury and can be detected in the blood serum within four hours from the onset of acute MI manifestations. Peak in 24-48 hours and can remain elevated for days

An enzyme specific to the heart muscle; another serum cardiac marker that is valuable in diagnosing both cardiac and non-cardiac disorders. After MI, can be detected within 4 hr and peaks by 24 hr. Returns to normal in 2-3 days.

-myocardial injury
-It is a heme protein found in both cardiac and skeletal muscle
-Can be detected witnin one hour of MI and peaks within 4-12 hours, then returns to normal

-Myoglobin
-Creatine kinase-MB (CK-MB)
-Troponin I and T

Abnormal ST segment
-ST segment elevation or
-ST-segment depression or T wave inversion

An invasive procedure that involves injecting dye into a catheter that has been inserted into a large blood vessel in the groin, arm, or neck to visualize the chambers of the heart, the valves and the major blood vessels

-Client walks on a treadmill or rides a stationary bike with the speed and incline being incrementally increased during the test. The goal is for the client to reach 85% of the predicted heart rate for that client's age.
-ECGs are taken before, during, and after the stress test
-During exercise, heart rate and rhythm, blood pressure, and respirations are monitored

-Used to detect how well the heart is functioning and if there is decreased blood flow to the heart that is caused by CAD
-A transducer (a device that sends sound waves that capture images of the heart structure) is moved across the client's chest during different levels of activity

-A radioactive material (tracer) is injected into a client's vein for a nuclear stress test
-After circulating for 15-45 minutes, a special camers is used to scan the heart and take pictures
-Then the client performs exercise
-Once client has reached their maximum potential, the first two steps are repeated and compared to the first images

-Smoking cessation
-Heart-healthy diet (such as DASH diet)
-Obtaining and maintaining a healthy weight
-Becoming physically active
-Getting good-quality sleep for 7-9 hours a day
-Decreasing stress
-Controlling hypertension and diabetes

-Angioplasty or percutaneous coronary intervention (PCI)
-Coronary artery bypass grafting (CABG)

Can increase risk of dysrhythmias in clients with a-fib

Cardiac catheterization and percutaneous intervention

Heparin bolus followed by continuous infusion

Brain natrurietic peptide (BNP) - elevated levels indicate stretching of the ventricles from fluid overload

Standing for prolonged periods of time

-Hiccups
-Dysphagia (difficulty swallowing)
-Chest pain

0.9-1.2. Abnormal ABI is present in clients with peripheral artery disease. The test confirms the finding of decreased or absent pulses in the lower extremities

-If valves do not close completely, blood can back up into the chamber from which it came (regurgitation)
-If valves do not completely open, this causes a narrowed path for the blood to flow through (stenosis) due to progressive calcification of the valves
-This causes decreased blood flow and cardiac output, forcing the heart to work harder to pump the blood. Heart failure, cardiac arrest, and even death can occur as a result

-Born with it (congenital heart valve disease) *most commonly affected is the bicuspid valve
-Rheumatic disease can occur after a client has strep throat that was not promptly treated with antibiotics
-Endocarditis, an infection of the inner layer of the heart, is caused by septicemia or IV drug use.
-Hypertension, MI, atherosclerosis of aorta, and heart failure
-Autoimmune disorders, exposure to high dose of radiation, and the aging process

-Increased age
-Inactivity and unhealthy eating habits (foods high in fat and sodium, sweets, and sugar sweetened beverages)
-Smoking
-Obesity
-Family history of valvular disease
-Congenital defects
-Rheumatic fever, endocarditits, CAD, hypertension, autoimmune diseases, diabetes, and hyperlipidemia

-Can become debilitating for clients as the symptoms progress
-Can lead to heart failure, causing fluid overload resulting in edema and dyspnea
-Can have syncope which increases fall risk

-Palpitations
-Chest pain
-Heart murmur
-Fatigue
-Dizziness
-Weakness
-Dyspnea
-Arrhythmia
-Lower extremity edema
-Abdominal pain due to an enlarged liver

-Echocardiogram: Client lies on their left side and a sonographer moves a transducer that generates sound waves on the client's chest to create pictures of the heart

Shortness of breath when recumbent, relieved with sitting up or standing

-Many clients can be treated with drug therapy and careful monitoring, while others will require surgery

-Beta blockers, digoxin, and calcium channel blockers are used to control heart rate and help prevent arrhythmias
-Diuretics are used to control blood pressure and control fluid overload
-Vasodilators are used to reduce the workload of the heart

Fever, chills, fatigue, and petechiae

-Most common type of cardiomyopathy
-Progressive cardiac anomaly that occurs when dilation of the ventricles impairs the heart's ability to contract
-The muscle fibers in the walls of the ventricles weaken and inneffective heart contractions cause a decrease in cardiac output that leads to heart failure

-Cardiac disorder that results from hypertrophy or thickening of the left ventricular walls and septum.
-This doesn't allow for adequate blood refilling of the left ventricle, leading to a decrease in cardiac output

-Typically has a poor prognosis and is the lease common type of cardiomyopathy
-Characterized by stiffness of the ventricles, which causes a decrease in diastolic ventricular filling

-Occurs when ventricular wall muscle fibers are replaced with fibrous, fatty tissue.
-This causes electrical instability and lethal dysrhythmias, such as ventricular tachycardia or ventricular fibrillation, that can lead to sudden cardiac death

Abnormal accumulation of amyloid protein within the heart tissues

An inflammatory disease that causes an abnormal accumulation of inflammatory cells on major organs

Cardiomyopathy is closely associated with heart failure, and the risk factors, comorbidities, and epidemiology are the same

*Dilated Cardiomyopathy
-Chest discomfort
-Peripheral edema
-Exponentially increasing levels of fatigue as the condition progresses
-Exertionial dyspnea

*Hypertrophic Cardiomyopathy
-Some clients may be asymptomatic
-Fatigue
-Syncopal episodes
-Chest discomfort or palpitations
-Exhaustion
-Dyspnea
-Increased risk of sudden cardiac death, especially in clients without manifestations

*Restrictive Cardiomyopathy
-Progress over time and are similar to the heart failure manifestations

*Arrhythmogenic cardiomyopathy (ACM)
-Found to be caused by a genetic defect
-Closely associated with heart failure and the risk factors, comorbidities, and epidemiology are the same

-Need to make lifestyle modifications that will require ongoing management and modifications
-At risk of developing depression due to the loss of the ability to function independently
-Clients with arrhythmogenic or restrictive cardiomyopathy are at an increased risk of sudden cardiac death, particularly when participating in competitive recreational sports

-Frequent monitoring of vital signs and evaluation of the effectiveness of medications will be essential to ensure improved client outcomes
-Encourage lifestyle modifications such as reducing dietary intake of sodium, restricting fluids to approximately 2L each day, and eliminating or decreasing use of nicotine and alcohol
-Pace themself during exercise and activity and take rest periods as needed
-Monitor weight daily and for lower extremity edema

Improve cardiac output and quality of life

-Occurs when the pericardial sac of the heart becomes inflamed
-Untreated pericarditis may develop into a chronic inflammatory condition that can result in the pericardium becoming rigid and constricted

-Usually unknown
-May follow a GI or flu-like illness
-Acute pericarditis can occur following cardiac procedures
-Bacterial infections, lung and breast cancer, lymphoma, and autoimmune disorders
-People who have a previous diagnosis of pericarditis

-Chest palpitations or pain
-Syncopal episodes or dizziness
-Hiccups
-Dysphagia
-Low-grade fever
-Recent weight loss
-Pericardial friction rub

-Possible PR interval depression
-Possible ST segment elevation

Abnormal accumulation of fluid in the pericardial sac that surrounds the heart

-Importance of avoiding strenuous exercise and activities until a resolution of symptoms and cardiac markers as it can trigger exercise-induced tachycardia and add unnecessary stress to the pericardium

While auscultating heart sounds for a client with pericarditis, ask the client to hold their breath. If squeaky, scratchy sounds are still heard, this is a pericardial frictioni rub. A pleural friction rub can only be heard during inspiration

Hypertension, renal disease, and diabetes mellitus

-NSAIDs
-Colchicine: targets the pain and inflammatory processes associated with pericarditis. Taken for three months and has been found to decrease the recurrence of pericarditis
-Glucocorticoids: for clients who cannot tolerate NSAIDs

-Pressure created from the excess fluid accumulation in the pericardial sac compresses the heart and the chamgers are unable to expand for refilling of blood
-Cardiac output is significantly decreased

Emergent complication that occurs when the pericardial effusion has generated an xcessive accumulation of fluid, greater than 200 mL, within the pericardial sac

-Elevated temperature
-Chest pain or discomfort
-Dry cough
-Shortness of breath with exertion or when laying supine

-Sinus tachycardia
-Low voltage QRS complexes (determined by a decrease in vertical amplitude)

-Frequent cardiac focused assessments
-Client will require pericardiocentesis to remove excess fluid to avoid cardiac arrest. Assess for bleeding risk (anticoagulant use or history of thrombocytopenia)

Lack of sufficient platelets that slows blood clotting time

-Assess for fatigue, edema, dyspnea, and chest pain that is worst when lying down
-Closely monitor for manifestations of hemodynamic instability, such as hypotension, sinus tachycardia, and muffled heart sounds.

The client will be transferred to the ICU

A general term used to describe progressive conditions characterized by altered blood flow through vessels in areas outside of the heart. Often divided into three categories:
-Peripheral venous disease: involves the veins that carry deoxygenated blood back from the lower extremities to the heart
-Peripheral artery disease (PAD): affects blood flow to the arteries in the lower extremities
-Peripheral arterial disease (PAD)

-Narrowing of arteries that interrupts blood flow away from heart=no O2 to legs
-Symptoms: PAINS
Pressure (increased BP), Absence of hair,
Intermittent Claudication, No palpable pulse, skin cool
-Treatment: Antiplatelets to decrease blood clots, statins to decrease cholesterol, ACE/ARBs to decrease BP, low fat diet and exercise, DANGLE LEGS

-Narrowing of veins that interrupts blood flow back to the heart=POOLing of blood
-Symptoms: WIPED
Warm and brown extremities, Itching skin, Prolonged standing/sitting pain, Edema, Dull ache
-Treatment: Anticoagulants to decrease blood clots, statins to decrease cholesterol, thrombolytics to dissolve clot, compression stocking, elevate legs

-PAD: dAngle legs
-PVD: eleVate legs

-Pregnancy specific
-New-onset hypertension and proteinuria
-Occurs after 20 weeks gestation

-Severe hypertension (>160/>110)
-End-organ damage: kidney damage evidenced by decreased urine output, liver damage as evidenced by jaundice or epigastric pain
-Hyperreflexia, headache, blurred vision, confusion, numbness

Seizure that develops before, during, or after the labor

Ultimate treatment is delivery of baby

-For hypertension: IV labetalol and hydralazine, oral nifedipine
-Labor induction and antenatal corticosteroids to facilitate fetal lung development

Calcium gluconate

A complication of preeclampsia characterized by hemodialysis, elevated liver enzymes, and low platelets

-Atherosclerosis, peripheral arterial disease, coronary artery disease, cerebrovascular accident, and hypertension

-Elevated total cholesterol (TC)
-Elevated LDL
-Elevated Non-HDL
-Elevated triglycerides
-Decreased HDL

When recognized and treated in childhood, can reduce risk of premature adverse cardiovascular events and mortality

Should ideally be done after fasting for 8-9 hours

Occurs when fetal tissue implants outside of the uterus or attaches to an abnormal or scarred portion of the uterus

High rates of morbidity and mortality if not recognized and treated promptly

-Pain
-Vaginal bleeding
-More vague complaints such as nausea and vomiting

Transvaginal untrasound, pregnancy test