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Cardiovascular System Essentials: Anatomy, Flow, and Complications, Exams of Nursing

Rasmussen College - Illinois Nursing

A concise overview of key concepts in cardiovascular medicine, including cardiovascular anatomy, blood flow complications, hypertension, heart failure, lipid management, valve disease, aneurysms, dvt/pe management, pad, pleural effusions, atrial arrhythmias, anticoagulation bridging, myocardial infarctions, common cardiac procedures, and asthma. It covers diagnostic criteria, treatment options, and management strategies for various cardiovascular conditions, making it a valuable resource for medical students and healthcare professionals. The notes include key points such as jnc8 guidelines for hypertension, classification of heart failure, statin use in lipid management, and ekg characteristics of atrial fibrillation. It also touches on asthma mechanisms and treatment approaches.

Typology: Exams

2024/2025

Available from 06/23/2025

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NR667 CEA Module Notes Correctly

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Cardiovascular anatomy and flow complications - correct answer.Ø Location

- Central anterior chest

- RV is anteriorly located

- LV is posteriorly located

Ø Flow of blood in the body

- Lungs > pulmonary veins > left atrium > left ventricle > aorta > body tissues > vena

cava > right atrium > right ventricle > pulmonary arteries > lungs.

Ø Blood flow complications

- Contractility: EF, CAD, LVH, Cardiomyopathy

- Preload: Central fluid volume status

- Afterload: Arterial backpressure on outflow (Chronic hypertension). (**RAAS system

typically manages this).

Hypertension - correct answer.Ø JNC8

- Defined as 140/90

- Secondary HTN: Up flow issue going up to kidney, ex: renal stenosis.

- Age > 60 or < 60 years. (>60 = 150/90).

- DM and CKD: ACE/ARBs (nephro protective).

- Non-black vs. Black: Calcium channel blocker for African Ascent.

- General starting place: Thiazides/ACE/ARBs.

- ACE/ARBS: "Prils" and "Sartans"

- Beta Blockers: "olol" not on JNC8 guidelines, history of cardiac disease, reduce HR.

Carvedilol is a dual alpha/beta, great for Heart failure.

- CCB: Dihydropyrines and Non-Dihydropyrines. Dihydropyrines work more peripherally

(amlodipine, etc). Non-Dihydropyrines work more on heart (Verapamil and diltiazem).

Common ASE: Constipation and peripheral edema.

- Diuretics: Thiazides, Loops. Thiazides are less potent. Thiazide= Low electrolytes,

Higher calcium. Loops- lowers everything. Potassium-sparing diuretics (Increase

potassium, lowers sodium).

Heart failure - correct answer.Ø HFrEF (Less than 40%)

Ø HFpEF (Higher than 40%)

Ø Systolic heart failure: inability for myocardium to effectively contract.

Ø Diastolic heart failure: inability to myocardium to effectively relax.

Ø Typical patient: elderly with comorbidities of HTN, DM, Smoking.

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NR667 CEA Module Notes Correctly

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Cardiovascular anatomy and flow complications - correct answer.Ø Location

Central anterior chest
RV is anteriorly located
LV is posteriorly located Ø Flow of blood in the body
Lungs > pulmonary veins > left atrium > left ventricle > aorta > body tissues > vena cava > right atrium > right ventricle > pulmonary arteries > lungs. Ø Blood flow complications
Contractility: EF, CAD, LVH, Cardiomyopathy
Preload: Central fluid volume status
Afterload: Arterial backpressure on outflow (Chronic hypertension). (**RAAS system typically manages this). Hypertension - correct answer.Ø JNC
Defined as 140/
Secondary HTN: Up flow issue going up to kidney, ex: renal stenosis.
Age > 60 or < 60 years. (>60 = 150/90).
DM and CKD: ACE/ARBs (nephro protective).
Non-black vs. Black: Calcium channel blocker for African Ascent.
General starting place: Thiazides/ACE/ARBs.
ACE/ARBS: "Prils" and "Sartans"
Beta Blockers: "olol" not on JNC8 guidelines, history of cardiac disease, reduce HR. Carvedilol is a dual alpha/beta, great for Heart failure.
CCB: Dihydropyrines and Non-Dihydropyrines. Dihydropyrines work more peripherally (amlodipine, etc). Non-Dihydropyrines work more on heart (Verapamil and diltiazem). Common ASE: Constipation and peripheral edema.
Diuretics: Thiazides, Loops. Thiazides are less potent. Thiazide= Low electrolytes, Higher calcium. Loops- lowers everything. Potassium-sparing diuretics (Increase potassium, lowers sodium). Heart failure - correct answer.Ø HFrEF (Less than 40%) Ø HFpEF (Higher than 40%) Ø Systolic heart failure: inability for myocardium to effectively contract. Ø Diastolic heart failure: inability to myocardium to effectively relax. Ø Typical patient: elderly with comorbidities of HTN, DM, Smoking.

Class I: Mild symptoms
Class II-III: Symptoms with exertion (II), ADL's cause symptoms (III)
Class IV: Symptoms severe, likely needs hospitalization. Ø Classic symptoms: SOB, Fatigue, exertional dyspnea, dependent and pulmonary edema, low activity tolerance, abdominal bloating, orthopnea. Ø Causes: ischemic heart disease, valve disease, MI, cardiomyopathy. Ø Treatment: ACE/ARB, ARB/ARNI, BB, Diuretics, nitrates plus hydralazine, Fluid and salt restriction, daily weights. Lipid management - correct answer.Ø AVSCD
Statins
Hight-intensity statins: Atorvastatin 40-80mg and Rovusatan 20-40mg (Don't require being taken at bedtime). LDL < 190
Common ASE: Myalgia. Rhabdomyolysis worse case scenario.
Statins, Ezetimibe in conjunction. PC9-Inhibitors (injectable Q2 weeks). (Cardiology at consult prior to PC9-Inhibitors).
Familial homozygous hyperlipidemia= PC9-Inhibitors.
HDL: "Cleaning agent."
LDL- "Scrum between glass window in shower" Valve disease and aneurysms - correct answer.Ø Aortic stenosis: Narrowing of outflow to aortic root through aortic valve due to calcification. Symptoms tend to mirror CAD with addition of syncope/near syncope. Ø Aortic Regurgitation/Insufficiency: instability for aortic valve to appropriately close. Commonly due to aortic root dilation or endocarditis/infection. A direct contraindication for IABP use (common board exam question). Ø Mitral stenosis: Narrowing of inflow into LV through the mitral valve due to calcification. Ø Mitral regurgitation/Insufficiency: instability for mitral valve leaflets to close. Commonly due to mitral root dilation from an MI, CHF, induced LV dilation, papillary muscle rupture, endocarditis. Ø Identifying Murmurs (left sternal border, 2nd intercoastal).
Aortic stenosis: swishing, systole, tends to radiate to neck.
Mitral stenosis- low-frequency, diastole, tends to radiate to lateral chest.
Mitral regurgitation: systole,
Aortic regurgitation, Diastole Ø Aortic layers
Tunica externa
Tunica media
Tunica intima Ø Aneurysm
Stanford A (Ascending before the left subclavian): requires surgery (risk of dissecting coronary ostia/aortic valve).
Stanford B (descending after the left subclavian): typically treated with endovascular grafting if anything at all.

Medications: colchicine and NSAIDs (usually indomethacin vs. ibuprofen)
Steroids may be considered but have elevated risk of reoccurrence of effusion after tapered off, not first-line. Atrial arrhythmias - correct answer.Ø Atrial Fibrillation (quivering of the heart).
EKG characterized by irregularly, irregular rhythm with no visible P waves.
Classic patient presentation: sudden onset of palpitations, fatigue, dizziness, tachycardia, rapid irregular rate. (>110-120).
Treatment: CHADS-VASc score, INR goal, Rate control, Rhythm control. Ø Aflutter (some beats come through)
EKG characterized "saw-tooth" pattern (atrial rate of 300). Similar presentation and treatment approach as trial fibrillation Anticoagulation bridging - correct answer.- Warfarin requires bridging (takes time to start working).
Typically required until INR is 2.0. (Can take 5-6 days to get to targeted INR).
Heparin or Lovenox typically used for bridging. (not if hx of thrombocytopenia, history of HIT, Cancer).
Warfarin is the safest drug (used for valvular heart disease). Myocardial infarctions - correct answer.Ø STEMI
EKG changes plus enzyme elevation
Door to balloon is key for myocardial survivability Ø NSTEMI
No EKG changes, just enzyme elevation
Still post a considerable MACE risk based on complexity and diseases (TIMI scoring).
Labs will be elevated (Troponin I, CK-MB).
Morphine, Oxygen, Nitroglycerin, Aspirin. (MONA).
History of cardiac disease= NO TRIPTANS. (Clamps down on vessels).
Ischemia: T wave Inversion
Q wave: history of MI.
Nitroglycerin=Drop diastolic blood pressure.
Inferior, Anterior, and lateral MI. Common cardiac procedures - correct answer.Ø 2D Echocardiogram
ultrasound probe on the chest for view of chambers, valves, and muscular function of the heart.
Little to no risks to perform
Great for routine, surveillance but sometimes views are limited due to habitus. Ø 3D/4D echocardiogram (transesophageal)
Ultrasound probe in esophagus to look directly at heart for better definition, useful to see vegetation, structures.
Requires sedation.
Biggest risks include airway compromise, esophageal damage, aspiration. Ø Coronary angiogram
Direct vascular access with visualization of endovascular anatomy.

May include angioplasty (expanding plaque) and PCI (stenting).
Risks include retroperitoneal bleeding (flank pain, sense of impending poop), and contrast induced nephropathy. Ø Ablation
LAA ligation can drastically reduce risk of a-fib related thromboembolic events.
Commonly performed for ectopic foci, aberrant tracts, atrial fibrillation.
Common source of atrial fibrillation in junction of PV and LA. Ø CT angiography/ Cardiac MR
Non-interventional view of timed dye-load through scanning to contrast vascular walls.
More expensive and may be available at all hospitals.
Very beneficial for measuring vascular structures for preparing for surgery (TAVR, aneurysm repairs, myocardial viability). Asthma - correct answer.Ø Mechanisms
Inflammation
Bronchospasm Ø Gold standard treatment is beta-2 agonist and inhaled anti-inflammatory agents. (Albuterol). Ø No LABA without ICS (risk of death). Ø Stepwise approach to therapy (SABA, ICS (wash out mouth), LABA or LABA-ICS, then other options). Ø Pulmonary function tests is key for diagnostic evaluation (Obstructive vs. Restrictive). Ø Peak flow is a great at-home test for current status. Ø Status asthmaticus: IV steroids, work way back down. COPD - correct answer.Ø Emphysema (pink puffers)
Air trapping causes difficulty evacuating lungs
Alveoli may become enlarged into bullae
Smoking is a common element in most patients. Ø Chronic Bronchitis (blue bloaters)
Frequent bronchogenic mucous
Serial or cyclinical pneumonia/bronchitis
May be due to lack of ciliary action due to smoking
Trademark exam: 1:1 A/P/lateral ration, elongated lungs with barrel chest, minimal subcutaneous tissue, resonant voice. Ø Medications
Beta- 2 - agonists
ICS
Leukotriene inhibitors
Anticholinergics Pulmonary function testing - correct answer.Ø Elements of PFT
FEV
FVC
FEV1/FVC ratio Ø Interpretation

If treated in this stage, can shorten disease course.

Second stage

Paroxysmal coughing that lasts 2-4 weeks

Third stage (convalescent)

Lasts 1-2 weeks Ø First line treatment is macrolides. (- "mycins) Tuberculosis - correct answer.Ø Mycobacterial infection Ø Highly associated with developing world and poor hygiene Ø Recent travel to developing world and their immigrants are at risk.
Exam includes cavilary lesions and apical "fallout" on CXR as well as positive T-spot or Mantoux skin test. Ø Treatment
Social quarantine of patient and family testing
Mandatory reporting to dept of public heath
Up to 4 drug combo therapy is typical "RIPE" (Rifampin, Isoniazid, Pyrazinamide, ethambutol).
Negative pressure. Pleural effusions - correct answer.Ø Collection of fluid around the lungs Ø May be chronic vs. acute
Look for underlying causes (history, exam), post-surgical, trauma, cancer. Ø Treatment based on chronically of effusion
Immediate thoracentesis
Chronic indwelling catheter (Pleur-X catheter)
Surgical fix: Pleurodesis. Pulmonary edema - correct answer.Ø Radiographic evidence of increased hydrostatic vascular pressure within lungs or a decrease in oncotic pressure in the bloodstream due to low albumin/blood counts. Ø May suggest either absolute fluid volume overload or relative overload from inability for heart to pump it out. Ø May see evidence on CXR such as Kerley B lines. Ø Treatment
If poor cardiac function, may include diuresis, nitrates, inotropic support, PEEP (Bipap, CPAP).
If poor oncotic pressure, diuresis, increase osmolarity and blood replacement if needed. Oxygen therapy - correct answer.Ø Basic adjuncts provide 4% per liter over 21% atmospheric. Ø Nasal canal (< 40% unless hi-flow cannula). Ø Venti mask (% based on adapter base used to face mask). Ø Non-rebreather (90-100% with bag mask properly inflated). Pneumothorax - correct answer.Ø Air in the pleural space between lung and ribcage

Commonly found with traumatic MOI
Spontaneous rupture of bullous emphysema (Blebs)
Barotrauma during resuscitation/CPR Ø Tension pneumothorax particularly deadly
Air gets in pleura, but can't get out.
Shifts mediastinum and IVC kinks, causing fatal drops in preload/filling pressure. Ø Signs and symptoms
Tracheal deviated to unaffected side
Absent lung sounds on affected side
Tympanic lung sounds on affected side Ø Treatment
Needle decompression (temporary)
Chest tube thoracostomy (definitive). High-risk respiratory behaviors - correct answer.Ø Smoking/vaping > cessation is a must > Low-dose CT to evaluate for pulmonary disease/cancer when history indicates risk. Ø COPD and asthma exacerbation risk increase with smoking inflammation Ø Cold air or exercise may trigger asthma. Pneumonia vaccine - correct answer.Ø Recommended for all adults, 19-64, with certain medical conditions, and all adults age > 65. Ø Pneumococcal conjugate (PCV 13, 15, and 20).
PCV 13 and PCV 15 is recommended for all children < 2 or 5-16 with certain medical conditions.
PCV 15 or PCV 20 is recommended for those who have never received a pneumonia vaccine age > 65 or 19-64 with certain medical conditions. Pneumococcal polysaccharide (PPSV23).
Recommended for children 2-18 with certain medical conditions and adults 19 and older who receive PCV 15
PPSV23 should be give at least 1 year after PCV 15 but is not indicated if PCV 20 was used. Ø Medical conditions
Impaired immunity
Blood disorders
Chronic heart, lung, liver, renal disease. pertussis vaccine - correct answer.Ø Infants and children
CDC recommends 5 doses of DTap Ø Adolescents
Single dose of Tdap Ø Pregnancy
Single dose Tdap, preferably during weeks 27- 38 Ø Adults who have never received Tdap
Single dose of Tdap followed by Td or Tdap booster every 10 years.

5% of hiatal hernias
Typically occur as complications associated with surgical dissection of the nature.
Can occur during anti-reflux procedures, esophagiomytuomy, or partial gastrectomy. Ø Diagnosis
EGD
Barium swallow typically Upper GI bleed - correct answer.Ø Peptic ulcer Ø Esophageal varices Ø Mallory-Weiss tears Ø EGD to diagnose. Ø Digested blood in stool. Fresh blood- lower GI bleed Peptic ulcer - correct answer.Ø Almost always caused by H. pylori Ø Risk factors
Alcohol
Aspirin, NSAIDs,
Tobacco, chewing tobacco
Radiation exposure
Stress Ø Treatment: Antibiotics and H2 receptor blocker. Acute diarrhea - correct answer.Ø Most cases are due to infections and are self-limited Ø Important to ask
Food history
Character of symptoms
Exposures such as recent travel
Medical history (I.e history of C-diff). Ø < 2 weeks. Ø Stool workup Cholangitis - correct answer.Ø Stasis and infection in the biliary tract Ø Characterized by fever, jaundice, and abdominal pain, itching skin, pale stool. Ø Biliary stones, strictures. Ø Reynolds-Payton and Charcles triad. Acute cholecystitis - correct answer.Ø Right upper quadrant pain, fever, and leukocytosis, associated with gallbladder inflammation. Ø Causes
Gallstones
Acalculous cholecystitis accounts for about 5-10 percent of cases Ø Typically requires surgical intervention since most cases tend to have complications if left untreated. Jaundice - correct answer.- Primary biliary cholangitis

Primary sclerosing cholangitis
Viral hepatitis
Progressive familial intrahepatic cholestasis
Intrahepatic cholestasis of pregnancy
corticosteroids Acute pancreatitis - correct answer.Ø acute inflammatory process of the pancreas Ø most cases caused by biliary obstruction Ø etiology
gallstones
alcohol
hypertriglyceridemia
post ERCP
genetic
medication Ø Mortality 10-70%, worse outcomes with necrotizing pancreas. Ø Symptoms
Fever, nausea, vomiting, acute onset of epigastric pain that radiates to the LUQ
Guarding, rebound tenderness over the epigastric region
Positive Cullen's and Grey Turner sign. Ø Treatment
Refer to ED
Possible need for hydration, antibiotics, gut rest, and watch for complications (pseudocyst, necrosis) pancreatic cancer - correct answer.Ø Hight mortality rate Ø Fourth leading cause of cancer, related death in the US. Ø Secondly only to colorectal cancer Ø Painless Jaundice. Appendicitis - correct answer.Ø Psoas
Downward pressure applied to raised right leg of supine patient.
Positive= RLQ abdominal pain with passive extension of right hip. Ø Obturator
Rotation of right hip through full ROM
Positive- RLQ abdominal pain with internal ROM. Ø Roving's
Deep palpation of the LLQ
Positive= refereed pain to the RLQ Ø McBurney's point
Point of tenderness 1.5-2 inches from the anterior superior iliac spine. Ø Markle test
Sudden drop of raised heels
Positive- RLQ pain is elicited by movement. Hepatitis A - correct answer.Ø Caused by the hepatitis A virus

Found mainly in the liver, kidneys, and pancreas. Cirrhosis - correct answer.Ø Late stage of progressive hepatic fibrosis Ø Characterized by distortion of the hepatic architecture and the formation of regenerative nodules. Ø Abdominal ultrasound (shoes information about appearance, blood flow. Ø Liver biopsy required to confirm diagnosis of cirrhosis.
Not generally necessary if clinical, laboratory, and radiology data suggest presence. Diverticulitis - correct answer.Ø Infected diverticula (pouch-like herniations of the external surface of the colon)
High risk of rupture and bleeding. Ø Symptoms/PE findings
Constant LLQ pain present for several days
Associated with fever, nausea, and vomiting.
May have constipation or diarrhea
Rebound tenderness, positive Roving's sign, and board-like abdomen. Ø Labs
Leukocytosis, neutropenia, and possible shift to the left FOBT positive. Ø Treatment
Uncomplicated cases can be treated outpatient with liquid diet and oral analgesia (reassess in 2-3 days to assess for resolution of symptoms).
Oral antibiotics only indicated if patient is at higher risk (i.e immunocompromised, major comorbidities, etc).
If no response in 2-3 days, or patient develops severe symptoms, refer to ED. Ø Complications
Perforation
Abscess
Obstruction
Fistula C-diff diarrhea - correct answer.Ø Gram-positive, spore-forming anaerobic bacillus.
Releases toxins that produce clinical disease
Often recurrent after first episode. Ø Classic symptoms
Watery diarrhea a few days after starting antibiotic therapy (> 3 stools in 24 hours).
Lower abdominal cramping and pain, anorexia, nausea, and low-grade fever.
Result of alteration to intestinal flora caused by antibiotics.
Most likely offenders: clindamycin, fluroquinolones, cephalosporins, and PCN. Ø Treatment
Discontinue inciting agent
Fidomoxicillin 200 mg PO BID x 10 days or vancomycin 125 mg PO QID x 10 days.
Supportive care with hydration, BRAT diet. Ø Handwashing. IBS vs. IBD - correct answer.Ø IBD

Inflammatory disease
Less common
Can be life threatening
Red flags in history/exam
Treatment often includes immunosuppressive anti-inflammatory medications.
Surveillance labs and endoscopy needed. Ø IBS
Functional GI disorder
More common
Not life threatening
No red flags
Treatment often includes dietary modifications, physical activity, coping skills development.
No labs, imaging, or endoscopy needed for diagnosis or surveillance. Ø Both
Chronic disorder
May have similar presenting symptoms (abdominal pain, change in stool characteristics)
Quality of life improvement
Manageable, but not curable. Crohn's disease - correct answer.Ø Characterized by transmural inflammation. Ø May involve any portion of luminal gastrointestinal tract, from the oral cavity to the perianal area. Ø The cardinal symptoms
Abdominal pain
Diarrhea (with or without bleeding)
Fatigue
Weight loss Ø Diagnostic
Colonoscopy and biopsy Ø Management
Avoid triggers, modulators, steroids, etc. Ulcerative colitis - correct answer.Ø Characterized by recurring episodes of inflammation limited to the mucosal layer of the colon. Ø Commonly involves the rectum and may extend in a proximal and continuous fashion to involve other parts of the colon. Ø Patients usually present with diarrhea, which may be associated with blood. Ø Bowel movements are frequent and small in volume. Ø Associated symptoms
Colicky abdominal pain, urgency, tenesmus, and incontinence. Patients with mainly distal disease may have constipation accompanied by frequent discharge of blood and mucus. Ø May have systemic symptoms including fever, fatigue, and weight loss. Ø May have symptoms of anemia (various causes).

Ø Balance the constituents of the circulation Ø The afferent arterioles from a tuft of high-pressure capillaries about 200 um in diabeter the glomerus. Ø The rest of the nephron consists of a continuous sophisticated tubule who's proximal and surrounds the glomeruli this is Bowman's capsule. Ø The glomerulus and bowman's capsule together form the renal corpuscle Ø These glomerular capillaries filter the blood based on particle size. Ø After passing through the renal corpuscle, the capillaries form a second arteriole, the different arteriole. Glomerular filtration rate - correct answer.Ø The volume of filtrate formed by both kidneys per minute Ø Approximately 20% of one liter enters the kidneys to be filtered Ø Filtrate production

125 ml/min filtrate in med
105 ml/min filtrate in females Daily equivalent of 180 L/day in men and 150 L/day in women Net filtration pressure - correct answer.Ø Osmotic plus hydrostatic pressure. Ø Determines filtration rates though the kidney. Ø Minor changes in osmolarity of the blood or changes in capillary blood pressure result in major changes in the amount of filtrate formed at any given point in time. Tubular reabsorption - correct answer.Ø Most water is recovered in the PCT, loop of Henle, and DCT. Ø About 10 percent (about 18 L) reaches the collecting ducts. Ø The collecting ducts, under the influence of ADH, can recover almost all the water passing through them. Endocrine regulation of kidney function - correct answer.Ø Renin-angiotensin- aldosterone Ø Antidiuretic hormone (ADH) Ø Endothelin Ø Natriuretic hormones (ANP, BNP) Ø Parathyroid hormone Renin-angiotensin aldolsterone - correct answer.Ø Renin: enzyme that is produced by the granular cells at the JGA. Converts angiotensinogen into angiotensin I. Releases its stimulated by prostaglandins and NO from the JGA in response to decreased extracellular fluid volume. Ø ACE: not a hormone, regulates systemic blood pressure and kidney function. Produced in the lungs but binds to the surfaces of endothelial cells. Converts inactive angiotensin I into active angiotensin II. Ace-antagonist: Lowers blood pressure. Ø Angiotensin II: vasoconstrictor that regulates blood pressure. Causes vasoconstriction as well as constriction of both the afferent and efferent arterioles of the glomerulus.

Ø Aldosterone: "salt=retaining hormone" released from the adrenal cortex in response to angiotensin II or directly in response to increased plasma K. Promotes Na reabsorption by the nephron, promoting the retention of water. Regulates K, promoting excretion. Chronic kidney disease - correct answer.Ø Kidney damage for greater or equal to 3 months as defied by structural or functional abnormalities of the kidney with or without decreased GFR.

GFR < 60 for greater than or equal to 3 months with or without kidney damage.
Microalbumin
Microalbumin. Ø Stages
Stage 1: GFR > 99
Stage 2: GFR 60- 89
Stage 3: GFR 30- 59
Stage 4: GFR 15- 29
Stage 5: GFR < 15 (dialysis) Ø Testing for kidney disease
CMP
Urine (proteins)
Albumin
Urine protein/creatinine
Condition marked by very high levels of protein in the urine, low levels of protein in the blood, sweating, especially around the eyes, feet, and hands, and high cholesterol.
Nephrotic syndrome is a set of symptoms, not a disease itself. causes of kidney disease - correct answer.- Diabetes and hypertension
Polycystic kidney disease
Infection
Nephrotoxic agents
Lupus nephritis
igA glomerulonephritis
Goodpasture syndrome
lead poisoning
renal artery stenosis
Henoch-schoneit purpura DIet/exercise - correct answer.Ø The dash eating plan (low fat and cholesterol) Ø Regular physical activity Ø BMI lower than 25 Ø Smoking cessation Ø Stress reduction End stage Renal disease - correct answer.Ø Kidney failure that is treated by dialysis or kidney transplant Ø Symptoms include

Ø Identification

WBC casts in urine, UA positive for WBC, leuk est, nitrates, UC positive for G bacteria, CT abdomen. Ø Treatment
First line: fluroquinolones (cipro 500 mg BID X 7 days or levofloxacin 750 mg x 7 days.)
Second line: amoxicillin/clavulanic acid, Bactrim. (Monitor Kidney function on Bactrim). No fluroquinolones in Connective tissue disorders. UTI - correct answer.Ø Commonly due to gram negative bacteria
Women: most common is E-coli
Men: the most common is proteus mirabilis. Ø Symptoms
Frequency, burning, painful urination. Ø Identification
Urinalysis with reflex urine culture, or simply urine culture, presence of leukocyte esterase, nitrates WBCs in UA. Ø Treatment
Women: uncomplicated, Bactrim BID x 3 days if less than 20% resistance, Macrobid 100 mg BID x 5 days if > 20 % resistance.
Women (complicated) and all men: typically hospitalized, manage with broad spectrum IV antibiotics after culture, guide therapy with culture/sensitivity, then narrow spectrum as able.
Pyridium: numb the bladder, turns urine orange, stains underwear. Toxic shock - correct answer.Ø Bacterial overgrowth from retained vaginal items Ø Staph Aureus most common agent Ø Typically retained tampons, commonly made of polyester foam
Less common for cotton or rayon tampons
May also be from feminine contraceptives retained 30+ hours
Cervical caps, sponges, diaphragm Ø Symptoms
Septic shock with addition of "sunburned? Palms and feet, diarrhea. Ø Treatment
Nafcillin, oxacillin, and first gen cephalosporins are useful (gram + coverage). Pelvic inflammatory disease - correct answer.Ø Infection of one or more the upper reproductive organs
Uterus, fallopian tubes, ovaries. Ø Typically identified by shuffling gait and mid lower abdomen pain.
Causative agents include gonorrhea and chlamydia
Left untreated can cause scarring, infertility, increased risk of ectopic pregnancy. Ø Treatment
Ceftriaxone
Cefoxitin 2 gm IM PLUS Doxycycline AND Metronidazole BID x 14 days

Dysfunctional uterine bleeding - correct answer.Ø Workup should include a thorough reproductive and menstrual history.

HCG
CBC
Pap smear
Endometrial sampling polycystic ovarian syndrome - correct answer.Ø Anovulation, oligovulation, infertility, excessive estrogen, high androgen, and insulin resistance. Ø Caused by hormonal abnormality Ø Symptoms/PE findings
Excessive facial hair, hirsutism, acne, and amenorrhea. Ø Increased risk of
CAD, DM2, breast and endometrial cancer, central obesity, infertility, NAFLD (non- alcoholic fatty liver disease). Ø Treatment
Clomid (clomiphene citrate)- helps regulate menstrual cycle for those who have irregular menses.
Femara (letrazole)- aromatase inhibitor lowers estrogen production to help with fertility
Metformin- manage insulin resistance
Spirolnactone- secondary androgen facial hair distribution., Ovarian cancer - correct answer.Ø Risk factors: obesity and smoking Ø Symptoms
Abdominal pain, bloating, changes in bowel habits, fatigue, weight loss. Ø Diagnosis
Transvaginal ultrasound, CA-125 marker Ø Treatment
Hysterectomy with bilateral salpingo-oophorectomy, plus chemo. Radiation. Uterine cancer - correct answer.Ø Post-menopausal, menstrual bleeding Ø Symptoms
Vaginal bleeding after menopause and bleeding between periods Ø Identification
TVUS and CA-125 marker, endometrial biopsy, D&C with hysteroscopy. Ø Treatment: hysterectomy. Breast cancer - correct answer.Ø Female sex, increased age, family history Ø Symptoms
Swelling of all or part of breast, skin irritation, or dimpling, breast or nipple pain, inversion of nipple, redness, scaliness, or thickening of the nipple or breast skin, nipple discharge, lump in the underarms. Ø Identification
Self-exam, mammogram (annual at 40), ultrasound, biopsy, MRI, PET, tumor markers such as HER2, FISH, and genetic testing. Ø Treatment

Cardiovascular System Essentials: Anatomy, Flow, and Complications, Exams of Nursing

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NR667 CEA Module Notes Correctly

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