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Terms in this set (17)
Responsible for long term regulation of blood pressure; activated see increase of BP
Starts when liver secretes angiotensingen
Kidney secretes and converts angiotensingen into angiotensin I
Have Angiotensin Converting Enzyme (ACE) secreted from lungs and kidneys and converts angiotensin I into angiotensin II - has all affects that will increase BP
(increase blood BP increase fluid volume tell brain need more fluid); stimulates thirst mechanism in the hypothalamus;
2 hormones Angiotensin II release of: ADH and aldosterone: these along with Angiotensin II tell the kidneys to retain sodium and water - more Na+ and more H2O increase fluid volume which will increase BP
Last thing do to raise BP: affect vasculature: will vasoconstrict - get smaller - all blood vessels smaller to increase pressure
This is how body raises BP; hypotensive this is what doing
What is the goal of the renin-angiotensin-aldosterone system (RAAS)?
A. Decrease blood pressure
B. Increase the heart rate
C. Increase the blood pressure
D. Decrease the heart rate
Rationale: This is the long term regulator of Blood Pressure. The goal when activated is to INCREASE BP.
RAAS - long term regulator
Select all the roles of angiotensin II when it is activated in the RAAS system SATA
A. Activates bradykinin
B. Triggers the release of aldosterone
C. Increases the blood volume
D. Causes vasodilation
E. Increases systemic vascular resistance
F. Causes the release of antidiuretic hormone
Rationale: These are the effects of Angiotensin 2 and all factors that lead to that increase in BP
Systemic vascular resistance - vasoconstriction - smaller resistance increases; blood volume - that is goal - why retaining water to increase blood volume
What is the role of aldosterone?
A. It causes constriction of vessels.
B. It causes the kidneys to keep sodium and water.
C. It causes the kidneys to keep potassium and water.
D. It causes the kidneys to only keep water.
Rationale: This is the role of Aldosterone in the RAAS system. Remember where NA goes Water will follow!
Na and H2O are best friends
What is the role of the antidiuretic hormone during RAAS?
A. Causes the kidneys to keep water
B. Leads to vasoconstriction of vessels
C. Activates the release of angiotensin I
D. Prevents the activation of the parasympathetic nervous system
Rationale: ANTI - DIURETIC (decreases urination). ADH tells the Kidneys to RETAIN water.
ADH - decreases urination and tells kidneys to retain water
Select below the CORRECT sequence in how the renin-angiotensin-aldosterone system works:
A. Angiotensin I -> Angiotensin II -> ACE -> Renin -> Angiotensinogen
B. Renin-> Angiotensinogen -> Angiotensin I -> ACE -> Angiotensin II
C. Renin -> Angiotensin I -> Angiotensinogen -> ACE -> Angiotensin II
D. Angiotensinogen -> Renin -> ACE -> Angiotensin I -> Angiotensin II
ACE: converts angiotensin I to angiotensin II
A 65-year-old woman weighs 200 lb and has a history of tobacco use, high blood pressure, high sodium intake, and sedentary lifestyle. When developing an individualized care plan for her, the nurse determines that the risk factors for peripheral artery disease (PAD) that need to be modified are: SATA
b. Post Menopausal status
c. tobacco use and high blood pressure.
d. Her increasing Age.
Answer: A, C
Rationale: The modifiable risk factors associated wtih PAD include: high cholesterol, smoking, obesity, HTN, and diabetes.
You are collecting a health history from a woman during her yearly visit. She states she is concerned because she notices the tips of her fingers turn a pale color and become numb followed by a period of time when they hurt and turn a bright red. What is the most important questions for you to ask?
A. Do you have a history of diabetes?
B. What are you doing and where are you at when this happens?
C. Have you had any illnesses lately?
D. Have you mentioned these concerns to your gynecologist?
Rationale: These are the classic clinical manifestations of Raynaud's phenomenon. The best treatment for this condition is to avoid triggers, so asking what precipitates these events can help identify her specific triggers
A patient is admitted to the hospital with a diagnosis of abdominal aortic aneurysm. Which signs and symptoms would suggest that his aneurysm has ruptured?
a. Sudden shortness of breath and hemoptysis
b. Sudden, severe back pain and bruising along his flank
c. Gradually increasing substernal chest pain and diaphoresis
d. Sudden, patchy blue mottling on feet and toes and rest pain
Rationale: these are the classic CM of a ruptured AAA and what you would be looking for in this patient. This is an emergency with a high mortality rate.
Hemoptysis: coughing up blood: not seen that; nothing with pulmonary; may SOB because POB; bruising along flank because bleeding and blood pooling; ruptures and aneurysm lot internal bleeding
The patient at highest risk for venous thromboembolism (VTE) is
a. a 5 year old child who is having his tonsils removed
b. a 32-year-old woman who smokes, takes oral contraceptives, and has a history of Afib and atherosclerotic disease
c. a 26-year-old woman who is 2 weeks postpartum and received maintenance IV fluids for 12 hours during her labor.
d. an active 72-year-old man at home recovering from transurethral resection of the prostate for benign prostatic hyperplasia.
Rationale: highest risk = MOST RISK FACTORS
Every risk factor in Virchow's Triad; add up risk factor and most of them under this pat
VTE - thinking veins; same thing as a DVT
Which are probable clinical findings in a person with an acute lower extremity VTE SATA?
a. Pallor and coolness of foot and calf
b. Mild to moderate calf pain and tenderness
c. Grossly diminished or absent pedal pulses
d. Unilateral edema and erythema
Rationale: A clot blocking a vein would cause blood to pool in the affected extremety
Which patient(s) are at risk for developing coronary artery disease? Select-all-that-apply:
A. A 25 year old patient who exercises 3 times per week for 30 minutes a day and has a history of cervical cancer.
B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day.
C. A 45 year old female that reports her father died at the age of 42 from a myocardial infraction and has a history of high cholesterol
D. A 29 year old that has type I diabetes.
Rationale: Risk factors for CAD are the same risk factors for atherosclerosis
CAD - atherosclerotic disease; BMI - obesity, smoking history; diabetes huge risk factor: Because it thickens the blood due to the high glucose content, blood is thick and full of sugar - thick blood and clots easier and increases viscosity and damages and increases thickness; type I and type II increased risk
A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the pain goes away when he rests. This is known as:
A. Unstable angina
B. Variant angina
C. Stable angina
D. Prinzmetal angina
Rationale: stable angina is relieved by rest and exacerbated by physical activity
Leg pain and goes away with rest in calf area - claudication pain: worried about PAD
A client comes to the outpatient clinic and tells the nurse that he has had leg pains that begin when he walks but cease when he stops walking. Which of the following conditions would the nurse assess for?
A. Peripheral Artery Disease in the legs.
B. DVT in the left leg.
D. Calcium deficiency.
Rationale: this client is experiencing intermittent claudication pain which is a classic CM of PAD
A client is admitted with a venous stasis leg ulcer. A nurse assesses the ulcer, expecting to note that the ulcer:
A. Has a pale colored base.
B. Is coin shaped, with approximated edges.
C. Has no exudate or weeping present.
D. Has brown pigmentation around it.
Rationale: venous ulcers are weeping, with rough edges and may have brown/brawny skin around the edges
Brown pigmentation, weeping around it; brawny skin around it
A significant cause of venous thrombosis embolism (VTE) is:
A. Altered blood coagulation
B. Stasis of blood
C. Vessel wall injury
D. All of the above
Rationale: This is Virchow's triad
With peripheral arterial disease, leg pain during rest can be reduced by:
A. Elevating the limb above heart level.
B. Lowering the limb so it is dependent.
C. Massaging the limb after application of cold compresses.
D. Placing the limb in a plane horizontal to the body.
Rationale: Arterial disease needs gravity to help restore blood flow to the area.
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