PC707 Module 4 Cardiac Exam Questions and Answers

PC707 Module 4 Cardiac Exam Questions and Answers What is BP? - Answer ️️ -Blood Pressure (BP) = Peripheral Vascular Resistance (PVR) x Cardiac Output (CO). Hypertension (HTN) Impact: - Answer ️️ -▪ Most preventable contributors to disease & death in the United States. ▪ If not detected early & treated appropriately, may lead to myocardial infarction (MI), stroke, & renal failure--& can cause target organ damage to the eyes, kidneys, ♥ & brain. ▪ It is the most common condition seen in primary care, so becoming familiar with its management is vital What affects BP? - Answer ️️ -Any ∆es in PVR or CO result in ∆es in blood pressure (either an increase or decrease). Na+ (Sodium) Factors influencing BP - Answer ️️ -Vascular volume is increased when water retention increases (increasing CO). Angiotensin I to Angiotensin II Factors influencing BP - Answer ️️ -Causes vasoconstriction (increasing PVR) Sympathetic System Stimulation Factors influencing BP - Answer ️️ -If epinephrine secretion occurs, tachycardia & vasoconstriction occur (increasing PVR). Vasodilation (Alpha-Blockers, Beta-Blockers, Calcium-Channel Blockers) - Answer ️️ - Decreases resistance (decreasing PVR) Factors influencing BP Severe Hemorrhage Factors influencing BP - Answer ️️ -Less blood volume (decreasing CO) The majority of hypertension in the United States today is - Answer ️️ -essential hypertension The cause of essential hypertension is - Answer ️️ -unknown; therefore, pharmacologic treatments are directed towards the physiologic control mechanisms that regulate blood pressure. Correct Blood Pressure Measurement - Answer ️️ -Have pt: ▪ Empty bladder ▪ Sit for 5 minutes with back support & legs resting on ground uncrossed. ▪ Rest arm on table @ ♥-level. ▪ Use a sphygmomanometer/stethoscope or automated electronic device (preferred) with the correct size arm cuff. ▪ Take two readings 1-2 mins apart, & average the readings (preferred). ▪ Measure blood pressure in both arms at initial evaluation. ▪ Use the higher reading for measurements thereafter. ▪ Consider checking standing readings after one & three minutes to screen for postural hypotension, especially in the elderly. ▪ Provide patients the SBP/DBP readings both verbally & in writing. HTN when to commence treatment - Answer ️️ -▪ Confirm the diagnosis of HTN at a subsequent visit one to four weeks after the first. ▪ If blood pressure is very high (e.g., systolic 180 mmHg or higher) or timely follow-up is unrealistic, treatment can be started after just one set of measurements. ▪ Ambulatory BP monitoring & Home BP monitoring are becoming more accepted now that BP targets have been lowered. Management of HTN Initial steps - Answer ️️ -▪ Lifestyle modifications are always part of the treatment plan to improve overall health. ▪ Patient education should be provided at every visit. ▪ Provide specific patient education that relates to your patient. ▪ Document the education provided. Weight loss recommendation & SBP benefit - Answer ️️ -▪ Maintain BMI 18.5-24.9 kg/m2 ▪ ↓ 5-20 mm Hg Dash eating plan education benefits - Answer ️️ -▪ Adopt a diet rich in vegetables, fruits, low- fat diary products, whole grains, fish, poultry, beans, seeds, & nuts ▪ ↓ 8-14 mm Hg Dietary sodium reduction education benefits - Answer ️️ -▪ Reduce dietary sodium intake to <2.4 g of Na+ or 6 g of NaCl ▪ ↓ 2-8 mm Hg Aerobic physical activity HTN education benefits - Answer ️️ -▪ Regular aerobic physical activity (e.g., brisk walking) at least 30 min per day, most days of the week ▪ ↓ 4-9 mm Hg Moderation of alcohol consumption HTN education benefits - Answer ️️ -▪ ♂ limit to 2 drinks or less per day ▪ ♀ limit to 1 drink or less per day ▪ ↓ 2-8 mm Hg Specific patient HTN Lifestyle Modification Recommendations - Answer ️️ -▪ Average SBP Reduction Rate ▪ Weight loss, if needed ▪ Dash* eating plan ▪ Dietary sodium reduction ▪ Aerobic physical activity ▪ Moderation of alcohol consumption The DASH eating plan - Answer ️️ -▪ rich in fruits, vegetables, fat-free or low-fat milk & milk products, whole grains, fish, poultry, beans, seeds, & nuts. ▪ It also contains less Na+, sweets, added sugars & beverages containing sugar, fats, & red meats than the typical American