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Ashley Shared "PN 164 Week 9" - 10 Picmonics

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PN 164 Week 9

Hypertension Assessment
Mechanism
Essential Hypertension
Secondary Hypertension
Assessment
Headache
Vision Changes
Nosebleed (Epistaxis)
Chest Pain
Syncope (Fainting)
Diagnosis
Average 2 Sets, 2 Minutes Apart
After 2 or More Visits (within 1-4 weeks)
Nursing Considerations
Take BP Both Arms
Common in African Americans
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2 mins
Primary Hypertension Risk Factors
Excessive Alcohol Consumption
High Sodium Diet
Dyslipidemia
Obesity
People of African Descent
Advanced Age
Vitamin D Deficiency
Reduced Nephron Number
Diabetes
Lack of Physical Activity
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2 mins
Hypertension Medications
Diuretics
ACE Inhibitors
Angiotensin Receptor Blockers (ARBs)
Beta Blockers
Dihydropyridine Calcium Channel Blockers
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2 mins
Hypertension Intervention
Lifestyle Modifications
Weight Reduction and Exercise
Diet Changes
Relaxation Techniques
Smoking Cessation
Medications
Encourage Self Monitoring
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1 min
Peripheral Artery Disease (PAD)
Mechanism
Atherosclerosis
Assessment
Intermittent Claudication
Pain with Exercise
Paresthesias
Arterial Ulcers
Critical Limb Ischemia
Amputation
Consideration
Ankle-Brachial Index (ABI)
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2 mins
Arterial Ulcer Assessment
Absent or Decreased Pulses
Intermittent Claudication
Sharp Pain
Dependent Rubor
Well Defined Edges
Over Bony Areas
Smooth, Shiny Skin
Toes, Heels, Lateral Lower Legs
Cool
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2 mins
Venous Thromboembolism (DVT) Assessment
Mechanism
Venous Wall Inflammation caused by Thrombus
Assessment
Tenderness
Edema
Warmth
Asymmetry
Considerations
Could be Asymptomatic
Monitor for Pulmonary Embolism
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58 secs
Venous Thromboembolism (DVT) Interventions
Anticoagulants
Prevention Education
Frequent Ambulation
Leg Exercises
Compression Stockings or SCD's
Avoid Nicotine and Oral Contraceptives
Surgery
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1 min
DVT after surgery
3 Months to 3 Years
warfarin preferred in long term in renal failur
unfractionated heparin
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PE/DVT Treatment
Wells greater than 4 or positive workup
Hemodynamically Unstable PE or Limb Threatening Ischemia?
Yes: Thrombolytics OK?
Yes: give tPA
No, or tpa didn't work: surgical/mechanical thrombectomy
h/o intracranial hemorrhage
Life-threatening active bleeding
Head trauma/stroke in past 3 months
Recent surgery
No: Anticoagulants OK?
No: IVC Filter
Yes: LMWH
Unfractionated heparin in renal failure
Septic embolization: antibiotics
Wells less than 4: Do workup (D dimer, CT PE, etc)
Recurrent DVT
Recurrent DVT
INR therapeutic but still getting DVTs: IVC Filter
INR therapeutic but still getting DVTs: IVC Filter
INR Subtherapeutic: Change or restart anticoagulants
INR Subtherapeutic: Change or restart anticoagulants
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Ashley Shared PN 164 Week 9 - 10 Picmonics