Debbies Final Exam 2023- NRSG 2501 Graded A
What are varicose veins?
What is the cause?
Progress to?
A superficial vein in which blood has pooled, caused by trauma leading to damage of
one or more valves or gradual venous distention involving gravity and venous
constriction
Chronic venous insufficiency is a condition that occurs when the venous wall and/or
valves in the leg veins are not working effectively, making it difficult for blood to return
to the heart from the legs
Thrombus?
Thromboembolism?
What is DVT?
Promotion of venous thrombosis? (AKA Virchow Triad)
Post thrombotic syndrome? (PTS)
Thrombus = clot attached to vessel wall
Thromboembolism = detached clot
Deep vein thrombosis (DVT) = clot formation in large veins, primarily of the lower
extremities
1)Venous stasis
2)Venous endothelial damage
3)Hypercoagulable states
Venous outflow obstruction & venous insuffic result in chronic venous hyperT
•Symptoms : painful, heavy calves, pruritus, swelling, varicose v. and venous ulceration
Superior vena cava syndrome?
Leading cause?
Clinical manifestations?
Progressive occlusion of the SVC that leads to venous distention of the upper
extremities and head
Bronchogenic cancer
•Edema and venous extension of upper extremities
•Feeling of fullness
•Headache, visual disturbances, impaired consciousness
What is hypertension?
Results in?
Sustained elevation of the systemic arterial blood pressure
,•Increases in cardiac output, total peripheral resistance, or both
•CO = SV x HR, therefore any condition that increases either SV or HR leads to
increase in CO
•Peripheral resistance is increased by any factor that increases blood viscosity or
reduces vessel diameter (vasoconstriction)
Values:
Prehypertension?
Isolated systolic hypertension?
Hypertension?
Prehypertension: 120 to 139 mmHg systolic; 80 to 90 mmHg diastolic
Isolated systolic hypertension: Elevated systolic BP accompanied by normal diastolic
BP
Hypertension
Consistent elevation of systemic arterial BP
Sustained elevation of 140 mmHg systolic or higher OR 90 mmHg diastolic or higher
Hypertension: primary vs secondary?
Primary
No known cause
95% individuals diagnosed with hypertension
Secondary
Altered hemodynamics from an underlying primary disease or drugs
Complicated hypertension?
Malignant hypertension?
•Complicated hypertension
•Hypertrophy and hyperplasia with associated fibrosis of the tunica intima and media in
a process known as vascular remodeling
•Malignant hypertension
•Rapidly progressive hypertension
•Diastolic pressure is usually >140mmHg
•Can lead to encephalopathy
Orthostatic (Postural) Hypotension
•Decrease in the systolic and diastolic blood pressures on standing by 20 mmHg or
more and by 10 mmHg or more, respectively
•Lack of normal BP compensation in response to gravitational changes on the
circulation, leading to pooling and vasodilation
Acute (temporary): drug action, prolonged immobility, starvation, any condition that
produces massive volume depletion
Chronic: secondary to a specific disease and/or idiopathic
, What is an aneurysm?
True vs false?
Causes?
Clinical manifestations?
Local dilation or outpouching of a vessel wall or cardiac chamber
True aneurysms
•Involvement of all three layers of the arterial wall (weakening of vessel wall)
•Fusiform, circumferential
•Fusiform, saccular
False aneurysms
•Involve a break in the vessel wall, usually caused by trauma
Causes
Hypertension and arteriosclerosis are found in more than ½ of individuals with
aneurysms
Infections
Traumatic injury to chest or abdomen
Clinical manifestations:
•Heart: dysrhythmias, heart failure, emboli
•Abdomen: impaired blood flow to extremities
•Thoracic: dysphasia and dyspnea (secondary to pressure on surrounding organs)
•Aortic: asymptomatic until rupture
Aortic dissection
Devastating complication that allows bld to flow b/w the layers of the aortic wall forcing
the layers apart. Involves the aorta (ascending, arch, or descending); can disrupt the
flow through the arterial branches
Sudden severe chest or back pain - Surgical emergency
Arterial thrombus formation?
Develop wherever intravascular conditions promote activation of the coagulation
cascade
Caused by roughening of the tunica intima by atherosclerosis
2 potential threats to circulation
•Thrombus may grow large enough to occlude the artery
•Thrombus may dislodge
Embolism
Bolus of matter that circulates in the bloodstream until it reaches a vessel through which
it cannot fit
Boluses of matter: dislodged thrombus (often a DVT), air bubble, amniotic fluid, fat,
bacteria, cancer cells, or foreign substance
Causes ischemia or infarction in tissues distal to the obstruction
What is the major difference between a thrombus and embolus?
What are varicose veins?
What is the cause?
Progress to?
A superficial vein in which blood has pooled, caused by trauma leading to damage of
one or more valves or gradual venous distention involving gravity and venous
constriction
Chronic venous insufficiency is a condition that occurs when the venous wall and/or
valves in the leg veins are not working effectively, making it difficult for blood to return
to the heart from the legs
Thrombus?
Thromboembolism?
What is DVT?
Promotion of venous thrombosis? (AKA Virchow Triad)
Post thrombotic syndrome? (PTS)
Thrombus = clot attached to vessel wall
Thromboembolism = detached clot
Deep vein thrombosis (DVT) = clot formation in large veins, primarily of the lower
extremities
1)Venous stasis
2)Venous endothelial damage
3)Hypercoagulable states
Venous outflow obstruction & venous insuffic result in chronic venous hyperT
•Symptoms : painful, heavy calves, pruritus, swelling, varicose v. and venous ulceration
Superior vena cava syndrome?
Leading cause?
Clinical manifestations?
Progressive occlusion of the SVC that leads to venous distention of the upper
extremities and head
Bronchogenic cancer
•Edema and venous extension of upper extremities
•Feeling of fullness
•Headache, visual disturbances, impaired consciousness
What is hypertension?
Results in?
Sustained elevation of the systemic arterial blood pressure
,•Increases in cardiac output, total peripheral resistance, or both
•CO = SV x HR, therefore any condition that increases either SV or HR leads to
increase in CO
•Peripheral resistance is increased by any factor that increases blood viscosity or
reduces vessel diameter (vasoconstriction)
Values:
Prehypertension?
Isolated systolic hypertension?
Hypertension?
Prehypertension: 120 to 139 mmHg systolic; 80 to 90 mmHg diastolic
Isolated systolic hypertension: Elevated systolic BP accompanied by normal diastolic
BP
Hypertension
Consistent elevation of systemic arterial BP
Sustained elevation of 140 mmHg systolic or higher OR 90 mmHg diastolic or higher
Hypertension: primary vs secondary?
Primary
No known cause
95% individuals diagnosed with hypertension
Secondary
Altered hemodynamics from an underlying primary disease or drugs
Complicated hypertension?
Malignant hypertension?
•Complicated hypertension
•Hypertrophy and hyperplasia with associated fibrosis of the tunica intima and media in
a process known as vascular remodeling
•Malignant hypertension
•Rapidly progressive hypertension
•Diastolic pressure is usually >140mmHg
•Can lead to encephalopathy
Orthostatic (Postural) Hypotension
•Decrease in the systolic and diastolic blood pressures on standing by 20 mmHg or
more and by 10 mmHg or more, respectively
•Lack of normal BP compensation in response to gravitational changes on the
circulation, leading to pooling and vasodilation
Acute (temporary): drug action, prolonged immobility, starvation, any condition that
produces massive volume depletion
Chronic: secondary to a specific disease and/or idiopathic
, What is an aneurysm?
True vs false?
Causes?
Clinical manifestations?
Local dilation or outpouching of a vessel wall or cardiac chamber
True aneurysms
•Involvement of all three layers of the arterial wall (weakening of vessel wall)
•Fusiform, circumferential
•Fusiform, saccular
False aneurysms
•Involve a break in the vessel wall, usually caused by trauma
Causes
Hypertension and arteriosclerosis are found in more than ½ of individuals with
aneurysms
Infections
Traumatic injury to chest or abdomen
Clinical manifestations:
•Heart: dysrhythmias, heart failure, emboli
•Abdomen: impaired blood flow to extremities
•Thoracic: dysphasia and dyspnea (secondary to pressure on surrounding organs)
•Aortic: asymptomatic until rupture
Aortic dissection
Devastating complication that allows bld to flow b/w the layers of the aortic wall forcing
the layers apart. Involves the aorta (ascending, arch, or descending); can disrupt the
flow through the arterial branches
Sudden severe chest or back pain - Surgical emergency
Arterial thrombus formation?
Develop wherever intravascular conditions promote activation of the coagulation
cascade
Caused by roughening of the tunica intima by atherosclerosis
2 potential threats to circulation
•Thrombus may grow large enough to occlude the artery
•Thrombus may dislodge
Embolism
Bolus of matter that circulates in the bloodstream until it reaches a vessel through which
it cannot fit
Boluses of matter: dislodged thrombus (often a DVT), air bubble, amniotic fluid, fat,
bacteria, cancer cells, or foreign substance
Causes ischemia or infarction in tissues distal to the obstruction
What is the major difference between a thrombus and embolus?
