NURS 2090 Lecture Notes - Saturated Fat, Partial Thromboplastin Time, Nosebleed
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16 Apr 2013
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Clinical Models for Altered Perfusion
Hypertension (HTN)
Pathophysiology
• A progressive cardiovascular syndrome detected by an elevation in blood pressure and/or the
presence of organ damage due to persistent blood pressure elevations
• Primary versus secondary
Risk factors:
• Family history of hypertension
• Aging
• Diabetes mellitus
• Obesity
• Excessive dietary sodium intake
• Smoking
• Excessive alcohol intake
• Sedentary lifestyle
Clinical Manifestations
• Often asymptomatic
• When advanced, causes CNS changes:
• Headache
• Fatigue
• New-onset blurred vision
• Weakness
• Confusion
• Vomiting
• Mental status changes
• Nausea
Diagnostic Criteria
• History and physical examination
• Serial blood pressure measurements
• Laboratory studies
• Classification:
◦ Prehypertension
◦ Stage 1
◦ Stage 2
Treatment
• Pharmacologic treatments
• Lifestyle modifications
◦ Weight reduction
◦ Decreased alcohol, salt & saturated fat intake
◦ Increased aerobic physical activity
◦ Increased fruit and vegetable intake
◦ Smoking cessation
Shock
Pathophysiology
• A condition of circulatory failure and impaired perfusion of vital organs
• Sources of impaired perfusion:
◦ Cardiogenic Shock: Ineffective cardiac pumping
◦ Hypovolemic Shock: Decreased blood volume
• Sources of impaired infusion (cont’d):
◦ Massive systematic vasodilation:
Septic Shock
Neurogenic Shock
Anaphylactic Shock
Compensatory mechanisms
Clinical Manifestations
• Tachycardia, tachypnea
• Cool, clammy extremities with poor peripheral pulses
• Decreased arterial blood pressure (a late sign indicative of decompensation)
• Cyanosis and/or pallor
• Restlessness, apprehension, decreased mental function
• Poor urinary output
Diagnostic Criteria
• No one test is completely specific or sensitive for shock
• History and physical examination
• Laboratory studies
• Diagnostic testing
Treatment
• Medical emergency: airway, breathing, circulation
• Cardiogenic
• Hypovolemic
• Septic
• Neurogenic
• Anaphylactic