Cardiac Hypertension News, Links and Answers

Resolved Question: Anaphylaxis and hypertension?

How would you treat patient who is in anaphylaxis shock, with history of severe hypertension, cardiac problems. Is there anything else besides epi pen? more

Resolved Question: Hypertension (high blood pressure) would result from a/an:?

a) decreased cardiac output b) decreased secretion of thyroxin c) increased secretion of antidiuretic hormone d) dilation of arterioles more

Voting Question: nutrition case study, please help?

Margaret Leland is a retied 76 year old and lives alone. Her only daughter lives two hours away. She has a past medical history of heart attack, smoking for 20 years, hypertension and Type 2 Diabetes. She complains of decreased appetite and disinterest in food. 1. Ms. Leland is admitted to the cardiac unit with shortness of breath and fluid retention in her extremities. What is the most likely diagnosis? a. stroke b. congestive heart failure c. COPD d. Myocardial Infarction 2. Which medication is appropriate to improve her fluid status? a. diuretic b. vasodilator c. insulin d. Anti-coagulant 3. Which diet is the most appropriate for her condition? a. High Calorie- High Protein b. 2gm Na c. Low Fat d. 2gm Na/ No Concentrated Sweets 4 . Ms. Leland is discharged from the hospital and returns to her doctor due to constipation for greater than 3 days. Which of the following is the most probable cause for her change in bowl pattern? a. Decreased activity b. Diuretic usage c. Decreased intake of diet and liquids d. All of the above e. None of the above thank you :) more

Resolved Question: Heart review questions?

Heart Review Questions 1. Blood in arteries: a. always travels away from the heart c. always travels towards the heart b. is always oxygen rich d. is oxygen poor 2. The human heart: a. will contract as a result of stimuli from the SA node b. contracts only as a result of nerve stimulation from the central nervous system c. is independent of all nervous control 3. Which occurs during systole? a. oxygen rich blood is pumped to the lungs b. the heart muscle tissues contract c. the atrioventricular valves suddenly open 4. The part of the brain responsible for blood pressure and heart rate is: a. medulla c. cerebrum b. cerebellum d. pons 5. The heart is enclosed in the a. pleural sac c. peritoneal sac b. pericardial sac 6. The function of the pericardial fluid is to a. nourish the heart c. stretch the membranes b. lubricate the membranes 7. The chambers located in the bottom of the heart are called a. ventricles c. atria b. descending aorta d. septa 8. Which of the following is not an atrioventricular valve? a. mitral valve c. aortic valve b. bicuspid valve d. they all are the same valve 9. Name the only arteries that carry deoxygenated blood. a. vena cava c. pulmonary b. carotid d. jugular 10. The inner lining of the heart is the a. epicardium c. endocardium b. myocardium 11. The lubb sound of the heart is caused by the a. semilunar valves closing c. atrioventricular valves opening b. atrioventricular valves closing 12. The normal pacemaker of the heart is the a. SA node c. Bundle branches b. AV node d. Purkinje fibers 13. A cardiac arrhythmia is a. the heart beating normally c. the heart not beating at all b. the heart beating abnormally 14. Vasodilation a. widens the arterioles, decreasing vessel resistance b. narrows the arteriole, decreasing vessel resistance c. a and b 15. A small one cell thick vessel is called a/an a. artery c. capillary b. vein 16. An abnormal bulging of a vessel is known as a/an a. atherosclerosis c. plaques b. aneurysm 17. Which of the following classifications of cancer is associated with cancer of blood-forming tissue? a. carcinoma c. leukemia b. glioma d. sarcoma 18. The most common vascular disease is (hint: high blood pressure): a. phlebitis c. leukemia b. hypertension d. sickle cell anemia 19. When a blood clot becomes dislodged it is called a: a. thrombus c. embolism b. aneurysm d. stroke 20. In arteriosclerosis, a. there is a build up of calcium salts in arterial walls b. there is a build up of fibrous tissue in arterial walls c. arteries lose their elasticity d. all of these 21. A stroke is a rupture of a blood vessel in the: a. leg c. heart b. brain d. lung more

Resolved Question: Poll: Are you a VEGETARIAN or NON VEGETARIAN?! Let's have many answers?

Note: But be honest! Oh Yeah! I'm a vegetarian! If you've a non vegetarian ... If you're having time ... Read this! As more and more studies are coming up about the detrimental aspects of non vegetarian food, many people are anxious to know how they can stay healthy without giving up their favorite non vegetarian delicacies. The following points list the demerits as well as ways you can circumvent the harmful effects. 1. Non Vegetarian foods are fibreless: The roughage portion is missing in non vegetarian diets, therefore one should make a conscious effort to eat foods high in roughage. The foods high in roughage (insoluble fiber) are wheat bran, whole cereals like brown rice. Oat fiber is particularly beneficial for cardiac cholesterol related disorders. Oats have soluble fiber which dissolves in the body fluids and helps the body to decrease the cholesterol buildup. 2. Non Vegetarian foods are high in cholesterol: Since non vegetarian foods contain cholesterol, it is important to avoid other foods which can have additive affect on the cholesterol, like dairy products, particularly cheese. Besides these, one must avoid foods which have trans-fatty acids. 3. Non Vegetarian foods which are processed and preserved may contain high amounts of chemicals. Therefore, it is important to limit the quantity of non vegetarian food products which may contain preservatives. 4. Non Vegetarian foods are devoid of many vitamins. To keep up a healthy level of Vitamin B complex and Vitamin C, it is important to eat fruits and vegetables in adequate quantities to prevent any deficiency from coming up. Fruits should be eaten in their natural state and drinking packed juices is not the solution. Similar is the case with eating vegetables destroyed by deep frying beyond recognition. 5. Non vegetarians need strong digestive enzymes to be able to digest proteins. Hence, it is important to include sources of natural digestive enzymes in the diet to help the body keep its digestive capability high. Foods rich in enzymes are raw papaya (can be eaten as a salad) - rich in enzyme papain; pineapple - rich in the enzyme bromelene, and basic salads which are rich in natural enzymes. 6. Many authorities claim that people should be cautious while consuming fish found near industrial zones as they may be toxic. 7. Red meat should be consumed sparingly if you have increased incidence of hypertension and heart problems. Once a week, detox by eating fruits, sprouts, vegetable juices, salads and non-roasted nuts. Star please! ;oD more

Voting Question: Please help me understand beta-blockers and this nursing diagnosis?

I have this patient with Cardiac Dysrythmias. (Atril Fib) This means DECREASED cardiac output...because the blood cant be pumped to then body effeciently. So they are giving him a Beta Blocker to Lower his blood pressure. His blood pressure 180/110. But if you lower the B/P with a beta blocker....then isnt that decreasing the output even more??? how can i write this med as one of the interventions..if its not helping. Please help me understand thisss!!! How could someone with hypertension have decreased output!!?? im soo losttt. can a beta blocker slow the heart...which then increases cardiac output?? How will the BP play into this!?Yea but how does blood pressure play into it?? and cardiac output? more

Resolved Question: How do beta-clockers insrease cardiac output?

My professor said that if the person has hypertension for example, you can give them beta blocker and it will decrease their bp and hrt and will increase cardiac output. That doesn't make sense bc cardiac output= stroke vol x hrt rate more

Resolved Question: left ventricular hypertrophy-?

This is about someone who is quite close to me so i would really appreciate it if the answers were not just wild guesses.i am asking this here as right now i am not in a position to ask about this to anybody else . this person is hypertensive and has recently been diagnosed with left ventricular hypertrophy[after an echo cardiogram was done].the hypertensive condition is nothing recent.the subject has been living with it from past 5-6 years.the subject has been leading a very stressful life and is diabetic[Postprandial glucose levels not less than 250mg/dl anytime recently and fasting blood glucose level at around 180mg/dl] .another thing that i want to mention here is that the hypertension is familial and so is the diabetes[this thing is being passed on from about 5-6 generations as far as the subject knows and the subjects of previous generations died at around 65 or so.also their life was not half as stressful as this subject's is.] the subject is under medication but never exercises or controls the diet .the subject is 53 years old. what i want to know is that given that no sudden cardiac failure occurs, how long is this person going to live ?the thing is that the person is not going to change eating habits or the exercising habits.[its a psychology thing which is beyond the scope of explanation.we have not been able to convince the person ]the only thing i want to confirm is that whether the person will live for atleast another 4-5 years given that the person goes on just like this.i want to be able face the person's death and am more concerned about few others who are aslo close to the person and are very young i.e not yet strong enough to face this subject's death. more

Resolved Question: Do you agree that calcium channel blockers are the most dangerous blood pressure regulators?

I have always thought that a good course of action for prescribing blood pressure meds was this: angiotensin converting enzyme inhibitors like Lisinopril. After which you try strong diuretics like Lasix. If those don't work, you can try clonidine for CNS depression of cardiovascular system, or you can offer a beta blocker like Lopressor which works to slow the heart and decrease cardiac output hence pressure on arterial walls and vessels. Beta blockers are contraindicated in asthmatic patients (like myself, who hadn't had an asthma attack since I was a kid until I confidently feeling I no longer had asthma, decided it was safe to go w/ a beta blocker, but *oh no!*). So, I guess I am saying that before I would move beyond slowing the heart or knocking the CNS a bit back, those 2 being the outer limits of what is a first approach (and I'm not talking about slight hypertension, I am talking severe long-term medically dangerous hypertension that is difficult to control and not responding to diet/lifestyle modifications), the very last thing on my list is a calcium channel blocker, because it works by forcing vessels to dilate, the danger being someone who has had constricted vessels for a long time or heart conditions in general will more likely have plaque build up, blood clots, and etc. The calcium channel blocker, in my opinion, is dangerous b/c w/out the proper pre-tests, it can set someone who is pre-disposed to stroke, heart attack, or cardiac arrest due to past heart complications on a collision course with plagues that were previously lodged in places other than, say, your brain, lungs, leg arteries, and in or around the heart. Well, I finally had to go that route after unsuccessful treatment w/ everything *but* the betablocker. and clonidine only works for a short time. My diastolic pressure is the most "out there" at >100 nearly every time I test and sometimes much higher. My heart gets next to nothing in of rest between beats (and my pulse if very high at 120 +/- 10 pts at rest. That's why the betablocker was a good choice for me (too bad about the asthma). I haven't had any of the tests completed yet, and I can't really afford them right now, but I get horrible headaches and my vessels throb throughout my body. It's terrible and not an a symptomatic case in the least! Plus my biological died of stroke in her 50s, and I'm in my 30s. Any calcium channel blocker horror stories?Not true that "I have made up my mind." Obviously, I have taken the advice of my doctor and filled the prescription and started on it. I am ready to do just about anything that will help. Right now, my bp is my enemy, not my medication; still, I have been skeptical, which is why I asked the question. My blood pressure is slowly coming down, and my bood doesn't feel like a mercury guage. I am happy to read all you had to say, but wish it weren't so nastily toned toward me, personally. more

Resolved Question: having problems sleeping on my left side and stomach, can only sleep on my back because of chest pain (angina)?

i having angina pains for about 15 yrs, altho i live a relatively normal life, i am 34 yrs old, and is recieving treatment for hypertension. Towards the end of last yr, i drank/smoked heavily and woke and started having problem sleeping on my left side, if i try to, i have a feeling that my heart is filling up with blood and cannot pump them out effectively, i have to lie on my back to sleep or sit up.i also feel some discomfort or slight pain in my chest when i try to check my blood pressure. My doctor recommended an ECG, heart Echo and x-ray, the ecg was normal as well as the xray, but the cardiac echo test showed that i have enlarged left ventricle and thick endo..., but my doctor doesn't says he doesn't think the enlarged left venticle is responsible for my not been able to sleep on my left side, he told me take my bp drugs more often (captopril, norvasc, delayed action nitrates) and some NAID. He also recommended that i take GTN or some nitrates to relieve me of the pain when its very intense, i tried it and i got some relief last night, I want to know whats really wrong with me, is my condition getting worse, will the pain go away eventually or is it the beginning of the end for me... i have stopped drining and smoking since this yr but my gf upset me some days ago and i went out and drank and smoked heavily, i woke up in the middle of the night with my heart racing rapidly, i felt as if i will faint, i prayed to God to save me cos i knew something terrible might happen to me, God directed me to take some atenolol which i did and immediately my heart stopped racing...what is really happening to me more

Resolved Question: Can you reduce the amount of calcium deposits in your heart?

My mother just completed a Cardiac Scoring Exam of which the doctors found a considerable amount of calcium within her heart. She was placed within the 75th and 90th percentile for women her age. She has had major problems with hypertension for most of her life and has had to take medication for high blood pressure. Many times her medication were found to be unhelpful and she's had to either change doses or the medicine in general. I am worried about these results because I realize that her heart is blocked. Obviously, my mother will benefit greatly if she exercises more and eats right. If she does exercise and eat correctly though, will that help reduce the amount of calcium in her heart? If not, is there a less invasive surgery she can have to help correct her health issues? Thanks you! more

Resolved Question: What could be causing my blood pressure to remain high?

Let's add some background information: *22 year-old-male, normal height and weight *Vegetarian (not vegan) *Don't use tobacco or illegal drugs *Light drinker (2 to 3 per week, no more than 1 every other day) *Anti-depressant medications *Recent cardiac ablation for WPW Any ideas? Primary Hypertension maybe? Checked with the doc about my alcohol use and medications and she said the medications have no effect and I don't drink enough to induce alcohol-related hypertension.I've got Graves' Disease, it's got to be my thyroid. Bingo.Average BP is around 140/85I hate energy drinks and I don't drink caffeine at all as it induces a cardiac arrythmia. more

Resolved Question: 4) What effects does positive pressure ventilation have upon the cardiovascular system?

A) Reduced venous return which leads to a reduction in cardiac output. B) An increase in cardiac ouptut and venous return. C)Hypertension and an increase in systemic vascualr resistance. D) It does not have any significant effects.Im only a second year student nurse!! They expect me to know all of this! more

Voting Question: clinical pharmacy question on atrial fibrillation?

commenton this case: CC: SB is a man, age 62, who presents to the emergency department with light headache, palpitations, and shortness of breath, which have lasted for 2 days. Problem list 1.atrial fibrillation 2.hypertension 3.hyperlipidemia 4.chronic renal failure Problem 1. Atrial fibrillation S: patient complaints of dizziness, SOB, palpitations. O: BP 110/65, HR 146, pulse irregular irregularly, ECG: atrial fibrillation. A: the cause of SB’s atrial fibrillation (AF) is most likely his history of childhood rheumatic heart disease. However, AF may occur in patient with hypertension as well. On echocardiogram, the atria are enlarged and mild hypertrophy of left ventricle is noted. These enlarge are long-term results of hypertension. Rarely is atrial fibrillation a cause of mortality, but it can be significant cause of morbidity. The detrimental effects of AF are hemodynamic compromise and thromboembolic events. Both can be prevented by returning the heart to normal sinus rhythm. Direct current (DC) cardioversion is the most effective method to convert AF to normal sinus rhythm (NSR) with an 85 to 90 % success rate. Chemical conversion with antiarrhythmic has lower success rate, especially after AF as been present for longer than 24 hrs. SB is at risk for thromboembolic event at the time of cardioversion, even though no thrombi were seen on the echocardiogram. The risk for emboli is significant when the duration of AF is 2 days or more, because atrial function may not return for up to 2 weeks even after normal sinus rhythm is restored. The current standard of practice is to use anticoagulant for 3 weeks before cardioversion and for 4 weeks after in patient at risk for clot formation. In the interim, because SB is asymptomatic, the ventricular rate must be controlled to maintain adequate cardiac output. Digoxin, B- blockers, and calcium-channel blockers are all useful in controlling the ventricular rate by slowing conduction through the AV node. Digoxin is not the best choice in SB because the potential for toxicity if renal function continues to deteriorate. Furthermore, digoxin is not effective in controlling AF during exercise, and SG has reported palpitations during exercise. B-blockers could be used but there is the potential for decreased exercise tolerance. Calcium-channel blockers have been reported to have no effect or improve exercise tolerance in patients with AF. Calcium-channel blockers may also be used to control hypertension, potentially allowing the removal of other antihypertensives from the regimen SB is currently following. P: start either verapamil or deltiazem IV to control ventricular rate. Initiate anticoagulation with warfarin. Plan a direct current cardioversion in 3 weeks. Questions: Should SB be given an antiarrhythmic agent before cardioversion to maintain sinus rhythm? Should SB be loaded on warfarin to achieve steady state anticoagulation faster? more

Resolved Question: Cardiac or Psychiatric review? ER scenario (Med students).?

Jack is a 28 yr old sedentary male: pale, thin (non smoker) with a history of anxiety and unexplained chest pain and tachycardic events. He has had one event of SVT recorded on 24hr holter. All other events seen in ER have been sinus rhythm. He lives at home with his parents who care for him. He rarely goes out the home due to extreme fatigue, dizziness and a flu like feeling which he attributes to his 'condition'. He is not depressed and has been refered to the local mental health team who report he has Chronic Fatigue Syndrome and associated Dysautonomia, (presumed to be due to inactivity). There is little on offer in terms of treatment - apart from a raised pulse of 90 sitting and a pronounced tachycardia upon standing, - all clinical observations are unremarkable. He has previously undergone an Angiogram in the past, which was normal. Before the procedure, Jack reported he felt rather 'freaked out' and a supine pulse of 120bpm was observed. Of note was the procedure was stopped half way through due to an inappropriate sinus tachycardia (IST) of 170bpm before LV could be assessed. He was given IV Midazolam as a sedative and the procedure stopped. The cardiologist at his previous Hospital feels confident Jack does not suffer from CHD due to his age, normal BP, saturation readings, no signs of oedema, normal diet. He does not wish to repeat the procedure for safety reasons. Jack is admitted to Hospital several months later at midnight following a complaint of sudden onset severe chest pain, shortness of breath and tachycardia. He reports he was not exerting at the time of onset and was simply ''sitting at his computer''. On admission, he appears nervous, keen to explain his symptoms in detail and wants to know 'when it will stop'. He sees a Doctor at approx 12.30 am as a priority 2 case. Supine his observations were as follows: ----------------------------------------------------------- Heart rate 135 bpm Blood pressure 169/142 Respiration rate 16 Sa 02 is 99% Peak flow reading 450 (predicted 640). Q Wave II & III changes are shown on ECG Chest clear: A/t = bilaterally Temp: 36.5 Awake & Orientated Complaint: --------------- C/O 'tight' chest pain centrally radiating to the back. Anxious ++ Diagnosis: --------------- Chest tightness, tachycardia & hypertensive on admission. Gradually settled. Given 5mg Diazepam (refused 10mg). Still appears anxious & describes symptoms of anxiety very well, but denies any psychiatric problem. ECG = Sinus tachycardia (I think Q wave was due to anxiety?). Refer to family doctor only. ------------------------------------------------------------------------------------------------------ QUESTION: Jack denies he is having a panic attack and insists he has a physical problem, despite admitting feeling very anxious due to his symptoms. He remains calm and polite, yet the medical staff are concerned at his diastolic readings which are abnormal and do not wish to discharge him until this has settled. 5mg Diazepam is given to Jack orally after his sustained hypertension and chest pain is observed for 30 mins in triage. He takes approximately 2 hours to feel calmer and report his chest pain has resolved. He says the medication has made him feel 'stoned and sleepy'. 30 mins later, his observations are: -------------------------------------------------- Heart rate 128 bpm Blood pressure is 138/85 The medical staff feel it is now safe to discharge Jack back home and feel a referral is un-necessary. He has been in Hospital triage - 2hrs 30 mins. In less than 300 words explain: ------------------------------------------------ A) If you refer him for Psychiatric or Cardiac Review before discharge. b) Note why you think Q waves changes are important in your decision. c) Diazepam reduced hypertension & chest pain in Jack. Why? d) Is there any real evidence of Ischemic pain in the absence of CHD? e) Is Jack presenting with an IST or a Tachycardia due to anxiety? ------------------------------------------------------------------------------------------------------ Thank you - tough one, huh?! more

Resolved Question: 28 Y/O With Cardiac, Pulmonary & Other Various Symptoms-Syncope, High Blood Pressure, Difficulty Breathing?

At the age of 17 I began to have palpatations and begain to have sporatic episodes of syncope and Atrial Fibrillation. I was hospitalized for AFIB and the following tests were conducted at that time: MRI, EKG's, Stress Echo, Echo, Cardiac Cath, CT Scan, various blood work all in which were normal. Holter monitors caught some PVC's. A tilt table was conducted and I was diagnosed with vasal vagal episodes. I was not put on any type of medications at that time. Over the years of have had minor difficulty breathing with the feeling of rapid heart beat, palpatations, dizziness, near snycopol episodes, extreme fatique, etc. I am now 28 and my symptoms have greatly increased over the last 2 years or so and in the last couple of month much much worse. I am unable to do anything with exursion without shortness of breath and the feeling of rapid heart rate, I have had a couple of syncopal episodes, severe headaches around the eyes radiating to the back of the neck, dizziness, very extreme fatique, frequent urination, anxiety, the feeling of a fever (no elevated temp), high blood pressure, feeling of palpatations, sweating to name a few. I have again undergone a stress echo, echo, ekg's, blood work, hospitalized overnight for a CT scan of abdomen, Chest x-ray to rule out a lung embolism, or pulmonary hypertension. An EPS study (cath) was conducted and was negative. Chest xray was negative and CT scan was negative other than a small nodule (1cm) on my adrenal gland. I was released from the hospital with orders for an ultrasound of the coritid arteries and MRI of the abdomen all in which I am waiting for the scheduled date (unsure why this was not done in the hosp) I have also undergone additional blood work which was negative and a 24 hour catch to rule out Pheocromoytoma, these results are in however have yet to been read by the Endo specialist. On top of the symptoms I have mentioned above I have been having extreme dizziness (almost like vertigo) with the slightest movement. This does not come and go but is now constant, sometimes to the point I have waves of nausea. I am on the following medications: Metroprolol 50mg 1 daily, Paxil 20mg 1 daily, Ambien 10mg for sleep as needed, Pravastatin Sodium 10mg 1 daily, Diazepam 5mg every 8 hours if needed, Fish oil. My BP now seems to be mostly controlled with the beta-blocker however sometimes spikes for no reason and comes back down quickly. Prior to the medication the BP was running on average 170/90 and going up as much as 188/103. My heart has checked out ok, blood ok, lungs ok..does anyone have similar symptoms or diagnoses? Any ideas on what this may be any why the symptoms are persisting? This is getting very overwhelming and stressfull and I need to get this resolved. Many Dr's do not seem to take this seriously because they look at my age of 28 and state someone of my age would not have any major problems. more

Resolved Question: Glascow scale score of 6?

Can anyone tell me what a glascow score of 6 means in terms of prognosis and outcome for a person that has had some of their sedation (ventilator) reduced? I posted last night about her condition on this board -she has congestive heart failure, pulmonary edema, & pulmonary hypertension. She was recently hospitalized, went into cardiac arrest, they rescucitated her and put her on a ventilator. This was last friday and today they wanted to assess her brain function. Apparently they are gradually taking her off medicine but because she is overweight it takes time for the meds to be excreted from her body. However, they did say that as of this morning she was a 6 - what does that exactly mean? How good/bad prognosis is this? I know 15 is a fully awake person but does the glascow scale mean anything if a person is sedated?? Any help would be appreciated as I cannot ask the doctors since she doesn't live in the US. Thanks!Okay, so is it fair to say that the score is a bit meaningless when a person has been given meds to sedate them while they are on a ventilator?? It just seems obvious that the score would be lower if they were purposely given drugs to sedate them - you would think that effects the score substantially. Is it possible to be on a ventilator w meds and say have a score of 10?? more

Resolved Question: Should i be worried about my blood pressure?

I smoked weed on Friday night around 7:30pm i noticed my heart rate and blood pressure increased ALOT, i freaked out because i thought i was going to have a heart attack XD i know i shouldnt be cause it's normal but i really worry about my cardiac health since my dad and grandfather both suffer from hypertension and i think my mom does too. now (about 48+ hours later) my blood pressure and heart rate is still a little high i've been checking my bp during the day and it's always around 125-135/69-81 and my heart rate around 80-88 should i be worried about this or will it go away with time?(im 18 years old, around 5'6 and i weight around 145)i had a blood test done on Friday and my cholesterol and triglycerides are a little high *total cholesterol - 207 (should be lower than 200) *triglycerides - 215 (should be lower than 150) more

Resolved Question: can someone please help me with this cardiac question?

these are complications of heart failure but which ones are caused by left sided heart failure and which ones are caused by right sided heart failure? thanks. mitral regugitation pulmonary hypertension hypertension myocardial infarction sleep apnea aortic stenosis COPD more

Resolved Question: What is the relation of hypertension and risk for decrease cardiac output?

I am doing my nursing care plan and I can't get the relation of hypertension and risk for cardiac output. more

Resolved Question: Sudden hypertension in healthy 18 y/o?

I'm a healthy 18 y/o female with no medical history with no known family history of hypertension or heart disease. I don't smoke, drink, use drugs, or drink more than 2-3 caffeinated drinks per week. I exercise regularly and I'm in good shape. Because I am an EMT and have been taking and helping teach various health care classes for the past year, I've had my blood pressure taken regularly (about weekly) for a year. It's always been roughly 110/70. A couple of weeks ago I went to donate blood and it was 140/90. I didn't believe that number, but had multiple different people take my BP at different times, and it was indeed 140/90, although just a week or two prior it had been 110/70. I've been seeing my doctor and a cardiologist, who have confirmed my BP is 140/90. Two 12-lead EKGs have revealed no abnormalities. On auscultation an innocent heart murmur is heard. My GP took bloods and I haven't heard the results. The cardiologist scheduled me for a stress echo in 2 weeks. I'm currently hooked up to a month-long cardiac event monitor, which keeps triggering itself several times a day due to tachycardia at over 150 BPM, even though at the time I wasn't doing anything more strenuous than walking up stairs. I'm really concerned but the cardiologist seems really nonchalant. What are the possible causes? more

Resolved Question: secondary to hypertension?

i am making a nursing diagnoses, can i write there the problem, decreased cardiac output related to increased vascular resistance SECONDARY to hypertension? thnx more

Voting Question: Hypertension question?

How is hypertension in the body corrected? By increasing cardiac output and vasoconstriction or by decreasing cardiac output and vasodilation? more

Resolved Question: 10 pnts..My friend is being stubborn..his body is numb...?

He feels sick to his stomach, and has chest pain. I do work as a receptionist for a cardiologist office, and I do think it's cardiac related. Especially because he was in the ER last week, with the numbness and his BP was 208/..he can't remember the bottom #. He is 29. They did blood work, and the only thing they came up with is hypertension. He does drink a lot. What does this sound like to you??? Am I being paranoid? I am waiting for him to call me back, I told him to go to the ER, or Urgent Care......if I dont hear from him in the next 20 mins, I am calling his mother to take him. more

Resolved Question: Any one can help me with this septic shock state?

Which set of clinical manifestations is highly characteristic of a septic shock state? a. Tachycardia, generalized edema, and warm skin b. Confusion, bradycardia, and truncal rash c. Severe respiratory distress, jugular venous distention, and chest pain d. Decreased cardiac output, hypertension, and poor skin turgor more

Resolved Question: Is it true that too much salt is bad for you?

If one is perfectly healthy with no hypertension, or any cardiac problems, would high levels of salt use be detrimental to one's health in any way? Thanks by excessive, let be qualify by saying 2 grams table salt per day ingested*singer* read carefully---is 2 grams excessive? Of course one could kill oneself with salt. It has been done many times. But there we are talking about kilograms not grams! Of course too much of anything is bad. One died a few years ago from drinking too much water at a water drinking contest!salt causing kidney stones? I 'learn' something new everyday! And here I thought calcium was the main element in stones! more

Resolved Question: Give adrenaline with caution if presenting with hypertension or hypovolemia..why?

Im a student paramedic trying to learn my drugs...just some questions about adrenaline....Our indications for giving adrenaline pre-hospitally is: croup with life threatening airway compromise, anaphylaxis, asthma with imminent arrest, and cardiac arrest. Why is hypertension and hypovolemia a precaution for adrenaline? Please answer in as much detail as possible!! Thank you :) more

Resolved Question: Is there anybody out there that knows how to do an abstract?

My topic is treatment for Heart Disease and it is 200 words can anybody tell me how to do this? My teacher said this was wrong-Abstract Abstract Coronary heart disease is a cardiovascular ailment considered to be a complex of diseases of varied etiology. A primary factor that initiates a heart attack is the pathological buildup of abnormal plaque, or atheromas, in the arteries, plaque that gradually hardens through calcification. Coronary heart disease was not a leading cause of death in the United States until 1950, causing more than 30 percent of all deaths, and the figure is still climbing up to the present day. Today coronary heart disease accounts for about 45 percent of all deaths. The common causes of heart disease may be attributed to several factors such as hypertension, obesity, heredity, high cholesterol, emotional stress, and lack of regular exercise. Various methods to diagnose and treat heart disease have been developed over the years, but medical experts, still advise healthy diet and regular exercise as the best counter-measures for heart ailments. Laboratory methods to diagnose heart disease include blood test, electrocardiogram, exercise ECG, electrophysiology studies, cardiac catheterization, echocardiography, doppler ultrasonography and many other test. Treatments for heart disease include heart transplantation, artificial heart insertion, drug therapy, surgery, balloon catheter treatments, defibrillation, synchronized cardioversion, and pacemaker insertion. Family plays the biggest part for heart patients. more

Resolved Question: Can somebody please (10) points tell me what is wrong with my abstract?

My teacher is having a fit. Abstract Coronary heart disease is a cardiovascular ailment considered to be a complex of diseases of varied etiology. A primary factor that initiates a heart attack is the pathological buildup of abnormal plaque, or atheromas, in the arteries, plaque that gradually hardens through calcification. Coronary heart disease is not a leading cause of death in the United States until 1950, causing more than 30 percent of all deaths, and the figure is still climbing up to the present day. Today coronary heart disease accounts for about 45 percent of all deaths. The common causes of heart disease may be attributed to several factors such as hypertension, obesity, heredity, high cholesterol, emotional stress, and lack of regular exercise. Various methods to diagnose and treat heart disease have been developed over the years, but medical experts, still advise healthy diet and regular exercise as the best counter-measures for heart ailments. Laboratory methods to diagnose heart disease include blood test, electrocardiogram, exercise ECG, electrophysiology studies, cardiac catheterization, echocardiography, doppler ultrasonography and many other test. Treatments for heart disease include heart transplantation, artificial heart insertion, drug therapy, surgery, balloon catheter treatments, defibrillation, synchronized cardioversion, and pacemaker insertion. Family plays the biggest part for heart patients. more

Resolved Question: in hypertension, nusing diagnosis is: risk for/ decreased cardiac output related to______?

or any better nursing diagnosis substitutes? more

Resolved Question: Is this a NANDA Nursing Diagnosis??

Decreased cardiac output related to hypertension. please, need help. if not what would be a good one? more

Resolved Question: Spotting at 7 wks and high Blood pressure at 16 wks and no cardiac activity at 18 wks.What could the prob be?

I had slight spotting at 7 weeks, doc did a scan, after the scan showed that the fetus was fine Doc put me on progesterone.Then I had BP of 140/90 at week 16 so doc put me on Methyldopa and after a week I went for a scan and doctor sees no cardiac activity and it was supposedly a missed abortion. I am confused whether by putting me on progesterone the miscarriage was delayed or since I had High BP I had a miscarriage. I am otherwise healthy person with no prior history of hypertension. more

Resolved Question: Anemia and hypertension usually go along with renal insufficiency. If you are having antihypertensive medicati

Anemia and hypertension usually go along with renal insufficiency. If you are having antihypertensive medication it should be one of the ones that a) protect the kidney and b) prevent/reverse cardiac remodelling. The ACE inhibitors and angiotensin II antagonists have shown these effects where other antihypertensive drugs have not. more

Resolved Question: I underwent CABG during 2005. Now two grafts are occluded What could be reasons? What r remedies?

CARDIAC CATH Date of Cath: 20-05-2005 Ao.Pr.Sys/diast./mean(mean) : 130/80m 100 ANGIOS: LMCA: Normal LAD: 99% after D2, 20% distal LAD D2: 95% osteoproximal CX (nd): 60% ostial OM1: 70% osteoproximal SURGERY INFORMATION Date of Surgery: 26-05-2005 Through a limited median sternotomy on a beating heart without conventional cardio pulmonary bypass aorto coronary saphenous vein grafting to. -First diagonal artery -First obtuse marginal artery -Second right ventricular branch of right coronary artery -Ramus Intermedius artery -The left radial artery was grafted to the first ventricular branch of right coronary artery. -The left internal mammary artery was grafted to left anterior descending artery. POST OF PERIOD : He had fever in the post operative period and was managed by Dr. Ramasubramaniam (Infectious Disease Specialist). He had thrombophlebitis of right forearm which may be the cause of fever. His advice was followed. POST OF ECHO : Paradoxical IVS motion, no other regional wall motion abnormality, LV normal in size, adequate LV function, no LV clot. But on an Annual Check up and on undergoing 64 SLICE CT CORONARY ANGIOGRAM on 18.10.2007 the following are the findings:- Provisional Diagnosis/Clinical Data: Hypertension, Dyslipidemia, Chest pain, Post CABG. Report : 64 slice CT coronary angiogram was performed by injection of 60ml of nonionic intravenous contrast and retrospective ECG gating. Curved reconstructions, multiplanar reformats and 3 dimensional reconstruction were performed to evaluate the coronary arterial anatomy. Grafts : LIMA graft to left anterior descending (LAD) is patent with good distal run off. SVG to PLB is patent with good distal run off. SVG to D1 is patent with good distal run off. LRA to RCA is occluded. SVG to OM is occluded. Native vessels: The left main coronary artery (LMCA) reveals eccentric thin soft plaque with no significant stenosis. The proximal LAD reveals thick calcified plaque with critical stenosis. The mid LAD is occluded. The LCx reveals thick calcified plaques in its ostio – proximal segment causing about 50% stenosis of the ostium and 40% stenosis of the mid LCx. The first OM reveals ostial calcified plaque causing 60% stenosis. Diatally it is well perfused. The second OM reveals ostial stenosis at 40% by calcified plaque. Distally it is well perfused and large in calibre. The right coronary artery (RCA) reveals thrombotic occlusion of the mid segment for a length of 30 mm. The posterior descending artery (PDA) reveals mixed plaque in its distal segment causing 30 – 40% stenosis. Myocardium: The myocardium reveals no areas of focal thinning. more

Resolved Question: can you help me with this difficult case....?

Ms. A.b, 29 years old, female, married, G2P2, Filipino, Roman Catholic, resident of Cebu City, admitted for the 2nd time in Hospital X for abdominal enlargement. History: Six months prior to admission: -non-bloody, watery stools (1-2 episodes/day; 50 cc/episode) -no consult done -no medications taken Five months prior to admission: -Persistence of symptoms -Abdominal pain (prickling, intermittent without precipitating cause) -Gradual increase in abdominal girth -Easy fatigability -2-pillow orthopnea -Consult was done and nizatidine was given with other unrecalled medications Four months prior to admission: -increasing severity of easy fatigability -enlarge abdomen -consult was done at the ER and was subsequently admitted -Laboratory done: anemia and hypoalbuminemia -Abdominal and pelvic U/S and Barium enema – negative findings -Spironolactone, furosemide, and essentiale were given and transfusion of 2 units of packed red blood cells -Relief of symptoms -Patient lost to follow-up Three weeks prior to admission: -abdominal discomfort -abdominal enlargement -anorexia -Rapid weight loss (about 25%) One week prior to admission: -persistence of above symptoms -increasing abdominal girth -progressive episodes of dyspnea -episodes of diarrhea (soft stools amounting ½ cup/ episode; 2-3 times daily) -tea colored urine -no consult done -no medications taken Few hours prior to admission: -Severe progressive dyspnea -Consult at ER Past Medical History (-) Hypertension, DM, asthma, allergies and TB Admitted for childbirth and 4 months PTA for same problems Family History (+) Hypertension – both parents; (-) DM, asthma, malignancies Personal/Social History Non-smoker, non-alcoholic beverage drinker OB-GYN History G2P2 (2002) G1 – 1990, unremarkable G2 – March 2003, unremarkable No menses for the past 5 months. Previously on oral contraceptive pills then shifted to injectable contraceptive. Physical Examination Conscious, coherent, stretcher-borne BP: 100/60 mmHg HR: 89 bpm RR: 22cpm T: 37C HEENT: Pale palpebral conjunctivae, anicteric sclerae Neck: Supple, (-) neck vein engorgement, (-) cervical lymphadenopathy C/L: Symmetrical chest expansion, no retractions, clear breath sounds CVS: Adynamic precordium, AB 5th LICS, MCL, regular rate, normal rhythm, no murmur Abdomen: Globular, NABS, soft, non-tender, (+) palpable mass at the LUQ, firm, fixed extending to the R paraumbilical area Extremity: (+) grade 2 bipedal edema Course in the ward… First hospital day: -Spironolactone, aminoleban, ceftriaxone and vit. K were initially given. -Initial lab: anemia and leukocytosis with hyponatremia, hypoalbuminemia -Blood transfusion with 2 units of packed red blood cells. -Fecalysis – no parasites/ova seen -Chest x-ray – normal. Second hospital day: -paracentesis of ascetic fluid – leukocytosis with predominance of segementers -Repeat abdominal U/S – diffuse chronic liver parenchymal disease with normal sized spleen and massive ascites. Gallbladder, pancreas, kidneys and urinary bladder were normal. Third hospital stay: -Increased abdominal girth accompanied by dyspnea -Decrease in breath sounds over the Right lung field -Furoseminde was started -Repeat CXR – pleural effusion over the Right lung field -Repeat paracentesis -Thoracentesis was contemplated, however, patient could not tolerate an upright position -ABG – metabolic acidosis with low bicarbonate levels -Sodium bicarbonate was started Fourth hospital day: -patient develop hypotension (BP: 80/60 mmHg) -Improved with Dextran Fifth hospital day: -Again, hypotension developed refractory to dextran -Dopamine drip was started -Few hours later: progressive episodes of dyspnea prompting intubation -Patient went into cardiac arrest and expired! LABORATORY RESULTS CBC1st HD2nd HD3rd HD4th HD Hgb8.212.110.0 Hct0.280.380.31 RBC4.65.64.7 WBC13.511.214.1 Segs0.770.700.85 Lymph0.160.210.09 Eos0.020.020.01 Mono0.050.070.04 Stabs0.01 Platelets890749239 Retic Count2.83 BT (1-5’)2’00” CT(1-5’)3’30” PT (10-13.6)12.7 secs19.2 secs PTT(31.2-42.2)39.2 secs54.0 % Act (76-114)84.7%44.5% INR 1.101.71 Blood Chem1st HD2nd HD3rd HD4th HD Na135 meq/L118 K (3.5-5.1)3.5 meq/L3.73.8 RBS129 mg/dL77.4 BUN (1.7-8.3)3.4 mmol/L6.3 Crea (53-115)48 mmol/L100 AST (0-31)30.7 u/L73 ALT (0-32)41.9 u/L43 Alk Phos (50-136)106 ug/L831 Total protein (66-87)62.66463 Albumin (38-51)23.7302821 A/G ratio (0.5-2.5:1)0.6:10.9:10.8:10.7:1 Cholesterol6.0 Triglycerides4.5 HDL (1.16-1.68)0.2 LDL3.8 URINALYSIS1st HD3rd HD Color/TransparencyYellow/Clear pH/Sp.Gr.6.0/1.030 ProteinNegative SugarNegative RBC0-1 WBC0-1 Epith CellsFew Uric AcidOccasional BacteriaFew FECALYSIS Color/ConsistencyYellow/softGreenish-brown/watery Occult bloodNegative WBCOccasional RBCFew MicroscopyNegativeNegative HEPATITIS PROFILE HBsAgNon-reactive Anti-HBsNon-reactive HBeAgNon-reactive Anti-HBeNon-reactive Anti-HBc IgMNon-reactive Anti-HBc IgGReactive Anti-HAV IgMNon-reactive Anti-HAV IgGReactive Anti-HCVNon-reactive Peripheral Blood Smear: RBC: mild microcytosis, anisocytosis, and hypochromia with polychromasia WBC: Moderate shift to the left, no abnormal cells Adequate platelets Peritoneal Fluid Culture: No growth after 2 days Cell count Color: YellowLymph: 40% Transparency: turbidMono: 1% Total WBC: 1,728 cells/uLTotal cell count: 8,532 cells/uL Segs: 59%RBC count: 6,804 cells/uL Abdominal ultrasound Normal gallbladder, pancreas, spleen, and kidneys, urinary bladder Diffuse chronic parenchymal liver disease, Top normal-sized spleen Massive ascities Pelvic ultrasound: Normal uterus and adnexa Transvaginal ultrasound: Normal-sized uterus and adnexa; normal ovaries; ascites Abdomen, Barium enema: Essentially negative findings -end- Answer the following questions. 1.based on the history, physical examination on admission 1. what could be your impression or working diagnosis? Support your impression. 2. What could be two other differential diagnoses? Support. 3. What laboratory tests or procedures would you order? Why? 2.Interpret the course in the ward and he laboratory tests results of the patient. Knowing this, would you still stick with your impression or working diagnosis? If you do not agree anymore with your first impression, which differential diagnosis would you now consider? Or, would you have other differential diagnoses that were not considered during admission? 3. Support and discuss your final diagnosis.actually the lab result are in a table form but they can't be aligne. HD means Hospital day. Like each value is under a hospital day...like 1st 2nd or 3rd... more

Resolved Question: I am 33 yrs of age my weight is 67 kgs, height is 5.11” I have problem of Hypertension from last 1.8 yrs

I am 33 yrs of age my weight is 67 kgs, height is 5.11” I have problem of Hypertension from last 1.8 yrs . I am taking Lodoz 2.5 for the same. From last 2 yrs or so I am suffering from Chest pain. There is no specific timing of the pains. I had been to Cardiologist in the Month of May 2007. His report says “ Non Cardiac Chest Pain” On the 6th August I had been to another Cardiologist. He took out my ECG and I was told nothing wrong in ECG. He told me it’s because of Muscular pain Just now I checked my BP it was 120/80(It was checked by Doctor). Is there any way I can get rid of it. I have done: 2D Echo test & Stress test last year both came normal. How can I get rid of it. Thanks more

Resolved Question: i have to make a case study on preeclampsia. below are the guidelines/examples.. pls help?

I.Patient’s Profile General Data NameF.B. Age59 years old SexMale Civil StatusMarried OccupationHousewife History of Present Illness The patient has a known case of Rheumatic Heart Disease (RHD). Patient underwent Mitral Valve Repair (MVR) in 1999 and has been on Coumadin therapy with no regular follow up of bleeding parameters. Six days prior to admission, patient experienced headache and dizziness, but no consult was made. Instead, patient self-medicated with Bonamine which afforded relief. Three days prior to admission, headache persisted with increased severity, which prompted patient to seek medical assistance at FEU Hospital. Mobic and Iterax were given. Few hours prior to admission, patient was noted to have changes in sensorium and relatives decided to seek consult at Philippine Heart Center. Upon admission, patient was noted to be unresponsive, stuporous, and speechless, with GCS of 7 (E2V1M4). Past Medical History The patient has denies any history of Diabetes Mellitus and Hypertension. As mentioned, she had a history of Rheumatic Heart Disease and had Mitral Valve Repair in 1999. She is a non-smoker and non alcoholic drinker. Nursing Assessment (Problem-Based) Neurologic: LOC: drowsy to stuporous, 3-4 mm pupil size anisocoric, with brisk reaction to light; GCS – 9 (E4- Spontaneous eye opening V1- none/mechanical ventilation M4 – withdraws to pain) (+) doll’s eye reflex (+) babinski on right foot (-) corneal reflex, no visual threat Respiratory Patient is hooked to a mechanical ventilator through a tracheostomy. Ventilator set-up: 350/30/14/AC/5. (+) crackles on both lung fields. With equal breath sounds. Cardiac With atrial fibrillation; fine course, with occasional unifocal PVC’s. HR = 97 BP= 120’s-130’s/60’s-70’s. Musculo-Skeletal No contractures noted but there was stiffness noted at the right wrists and both ankle joints; with normal muscle tone and non-spontaneous movement; with severe weakness on both upper and lower extremities. Hematologic Latest PTPA: INR = 1.02 Act = 98% II.Anatomy and Physiology of the Brain Blood Supply of the Brain The blood supply of the brain derives from the aortic arch via the right innominate, left common carotid and left subclavian arteries. It includes the conducting and penetrating vessels. The venous system draining the brain is divided into vertebral veins that receive blood from the cerebellum. The cerebral veins have no valves. All the veins of the brain terminate into dural sinuses. External Brain Structures The brain is grossly divided into three main areas: the cerebrum, the brain stem and the cerebellum. The largest portion of the brain is the cerebrum. It consists of two hemispheres that are connected together at the corpus callosum. The cerebrum is often divided into five lobes that are responsible for different brain functions. The cerebrum’s surface—the neocortex—is convoluted into hundreds of folds. The neocortex is where all the higher brain functions take place. The cerebellum lies in the posterior fossa, separated from the cerebrum by tentorium cerebelli. It exerts ipsilateral control. It has three principal lobes. The Flocculonodular lobe is part of the vestibular system. It controls muscle tone, equilibrium and body position. The Anterior lobe receives most of the proprioreceptive and interoceptive input from head and body. It controls automatic movements and coordination. The posterior lobe coordinates voluntary movement. The ventricles The ventricles are a complex series of spaces and tunnels through the center of the brain. They secrete cerebrospinal fluid, which suspends the brain in the skull. They also provide a route for chemical messengers that are widely distributed through the central nervous system. Cerebrospinal fluid Cerebrospinal fluid (CSF) is a colorless liquid that bathes the brain and spine. It is formed within the ventricles of the brain, and it circulates throughout the central nervous system. It fills the ventricles and meninges, allowing the brain to “float” within the skull. The Meninges The meninges are layers of tissue that separate the skull and the brain. The Dura mater is the tough and fibrous membrane. The Arachnoid membrane is the delicate membrane and contains subarachnoid fluid. Pia mater is the vascular membrane. The subarachnoid space is fprmed by the arachnoid membrane and the pia mater. Normal Flow of Cerebrospinal Fluid Cerebrospinal fluid is produced in the Choroid plexuses of the ventricle. It flows from the lateral ventricles to the third ventricle passing through the interventricular foramen. Then it goes through the cerebral aqueduct to the fourth ventricle. From there fluid flows to the subarachnoid cisterns through the foramina of Magendie and Luschka to bathe the cerebral hemispheres. It exits through the saggital sinus to be absorbed by the arachnoid villi. III.Pathophysiology of Subarachnoid Hemorrhage (SAH) The term subarachnoid hemorrhage (SAH) refers to extravasation of blood into the subarachnoid space between the pial and arachnoid membranes. SAH comprises half of spontaneous atraumatic intracranial hemorrhages, the other half consist of bleeding that occurs within the brain parenchyma. Intracranial hemorrhage as a whole comprises 20% of all strokes. Nontraumatic SAH usually is the result of a ruptured cerebral aneurysm or AVM. Blood extravasation into the subarachnoid space has a detrimental effect on both local and global brain function and leads to high morbidity and mortality rates. The classic clinical picture of SAH is marked by the onset of very severe headache, tagged as the “worst in life”. Other associated signs and symptoms are loss of consciousness, seizures, diplopia and focal neurologic signs. The early complications of SAH are rebleeding and hydrocephalus. Other complications include vasospasm, neurologic deficits, hypothalamic dysfunction and hyponatremia. Vasospasm from arterial smooth muscle contraction is symptomatic in 36% of patients. Neurologic deficits from cerebral ischemia peak at days 4-12. Hypothalamic dysfunction causes excessive sympathetic stimulation, which may lead to myocardial ischemia or labile detrimental BP. Hyponatremia may result from cerebral salt wasting (SIADH). Nosocomial pneumonia and other complications of critical care may occur. Pathophysiology Diagram Pathological Cycle Resulting from Increased Intracranial Pressure Surgical Treatment Ventriculo-peritoneal Shunting The ventriculo-peritoneal shunt diverts CSF from a lateral ventricle or the spinal subarachnoid space to the peritoneal cavity. A tube is passed from the lateral ventricle through an occipital burr-hole subcutaneously through the posterior aspect of neck and paraspinal region to the peritoneal cavity through a small incision in the right lower quadrant. IV.Nursing Diagnoses 1.Ineffective Breathing Pattern r/t neuromuscular impairment 2.Ineffective airway clearance related totracheobronchial secretions 3.Altered Level of Consciousness r/t decreased cerebral perfusion 4.Impaired Physical Mobility r/t neuromuscular impairment 5.Risk for Injury r/t possible shunt malfunction 6.Risk for Infection r/t post-surgical wound V.Discharge Care Plan (METHODS) MEDICATION •Reinforce importance of medication compliance to patient and her relatives; its time, frequency, duration dosage and route. •Advice to report unusual manifestations and side effects of drugs to physician. •Monitor and evaluate effectiveness of medication regimen. ENVIRONMENT/ EXERCISE •Instruct patients watcher to provide calm and non stressful environment to prevent stimuli that could lead to seizures and an increase in Intracranial Pressure •Advice to limit visitors •Provide environment within normal room and body temperature. •Maintain safe environment. •Institute seizure precaution. •Initiate positional precaution to prevent increase in intracranial pressure. •Teach patient’s relative to perform passive range of motion exercises on patient’s extremities. TREATMENT •Teach patient’s relatives proper shunt care. •Teach patient’s relatives how to suction properly. HEALTH TEACHING ON DISEASE PROCESS •Explain to patient’s relatives regarding patient’s neurological status and disease process, and its manifestations. •Discuss possible complications of VP Shunt and its signs and symptoms OUT PATIENT FOLLOW UP •Inform relatives regarding importance of compliance on follow-up check up. •In case of continued Coumadin therapy, stress the importance of regular PTPA monitoring. Diet •Refer to dietician for dietary instructions. SPIRITUAL / SEXUAL •Encourage patient’s relatives to seek spiritual support. •Encourage patient’s husband on alternative ways on showing affections such as hugs and kisses. XI.Bibliography Nolte, J. The Human Brain: An Introduction to Its Functional Anatomy, Fifth Edition., Mosby, 2002. ISBN: 0-323-01320-1 Stoler, D. Coping with Mild Traumatic Brain Injury, Avery Penguin Putnam, 1998. ISBN: 0895297914 Human Anatomy and Physiology, Fifth Edition., 2000. ISBN: 0805349898. Zuccarello, M. and McMahon, N. “Subarachnoid Hemorrhage”. www.mayfield.com, June 2004. Rinkel GJ, Prins NE, Algra A. “Outcome Of Aneurysmal Subarachnoid Hemorrhage In Patients On Anticoagulant Treatment.” www.pubmed.gov, August 28, 2000. Newton, Todd R., Subarachnoid Hemorrhage. Emedicine from WebMD. www.emedicine.com., December 19, 2005. more

Resolved Question: Decreased or Increased Cardiac Output in Preeclampsia?

My groupmates and I have been debating for a while now the pathophysiology of preeclampsia in of course, women. It is quite troublesome because some of their research show that hypovolemia and decreased cardiac output accompanies preeclampsia while my own research show that hypervolemia causes edema while at the same time increases extracellular fluid increasing stroke volume thus increasing cardiac output and then leads to hypertension. What do you guys think is right? more

Resolved Question: Is Pitting Edema a sign of any type of a Cardiac Problem??

43yo, non smoking WF, no family hx except hypertension. I do not have high B/P. I have fibromyalgia, asthma, Osteoarthritis, chondromalacia patellae of both knees,gastric bypass. I have edema in my legs from knees down. This keeps happening off and on. Right now it is really bad, the pitting is 1+/2+ and my R is esp bad, even my foot is swollen and you can't see my ankle! I wonder if that chondro would cause this? I ask about Cardio because ppl will see me like this and say "Has your Dr had your heart checked out?" Once a Dr did a few blood studies but they were normal and I dont know what it was. I havent injured myself, I am on several meds but I have been on these same ones for a while now. My PCP has tx'd this with Lasix in the past. I can go to the ER but dont know if they'll do anything since I dont have ins. . Please give me some answers and not just see your DR. I am an RN and I know this. I just dont want to go and it be normal with my knees.. etc.. It is really uncomfortable. more

Resolved Question: Hypertension?

It is said that increased cardiac output may be an early feature, followed by increased peripheral resistance and normalisation of cardiac output. The increased peripheral resistance is developed in a compensatory manner to prevent the raised pressure being transmitted to the capillary bed where it would substantially affect homeostasis. What i don't understand is why is peripheral resistance developed when cardiac output increased? How does this mechanism work? And does this only apply to essential hypertension? Thanks. more

Resolved Question: My 78 year old mother had a heart catherization with stent. Is it normal to be grossly fatiqued after this?

She suffers from pulmonary hypertension and has been using oxygen for the last 3 weeks. The cardiac surgeon put her on PLavix and Zocor. She takes Cardizem, Effexor XR, Triamterene also. Today, another doctor ordered her to stop the TRiamterene because it is elevating her kidney levels. Could the Plavix and the Zocor contribute to the fatigue?? more

Resolved Question: Fasting in Ramadan ridiculous?

To those who say fasting is ridiculous, what do you think of this site and how it proves the medical benefits of it? How do you feel about this quote? "Decrease of cholesterol level in blood. Several studies proved that cholesterol level in blood during fasting, as well as the rate of precipitating on the walls of arteries have decreased. This in turn reduces the chances of cardiac and cerebrovascular accidents, and prevents the raise of hypertension. Shortage of fats in blood helps reduce stones of gall and choledocus. The Prophet (PBUH) said; “Fast! You will be healthy.”" http://www.islamicmedicine.org/medmiraclesofquran/medmiracleseng.htm#ramadan more

Resolved Question: What does working with a personal trainer entail?

I am thinking of hiring a personal trainer for diet and exercise help. I have been battling hypertension for a few years now. I recently had a bad exacerbation of HTN a few weeks ago, and put on new blood pressure meds. I am 5'3 120lbs. Weight is not my problem, but I would like a trainer to assist me in a cardiac workout slowly and build up. I have had a full cardiac workup and loads of bloodwork which all came back normal, except cholesterol a little high. ( Heart disease runs in my family...BAD!) Anyway how do personal trainers work? Do they come to your house, or do you usually work at a gym, and they won't overwork me will they? And lastly, about how much do they cost?? more

Resolved Question: QE ll welwyn or chase farm enfield?

i am a cardiac technician and have hypertension my gp is refering me to see a consultant and i do not want to be seen at my own hospital so does anyone have any views good or bad on either of these two hospitals cardiac dept please as i have been given the chance of these two hospitals to chose from thanks more

Resolved Question: High cardiac output?

I am only looking for the medical term to describe a symptom to an illness. It is the word to describe cardiac force which is too high. Palpitations is not a good word since it can describe arrythmias awareness, such as ectopic beats, tachycardia and so on. Hypertension is not a good word since this usually is for describing artrial hypertension, it does not usually give reference to cardiac contraction force. Cardiac output is no good because cardiac contraction force is one aspect of cardiac output, heart rate being the other. If you excluding the names of conditions such as angina, cardiac hypertrophy and so on; I am trying to find the medical term to only describe the symptom of elevated cardiac contraction force. Have any ideas? more

Resolved Question: Should Desperate Trophy Wife lace hubby's 2% low fat milk with VIAGRA?

Like many such cases the wife is at least 20 years younger, in her prime in need of good batting practice. Hubby is into power politics and big bucks flaunting wife at parties but unable to raise pole when it is time to hoist the flag. Also, hubby is down with Hypertension, Cardiac Issues and Diabetes, so doctor cant prescribe the blue pill. Wife secretly has been lacing hubbys milk with Viagra. The other day hubby landed in emergency with a four hour gargantuan obelisk that wouldnt come down. After various sedatives, pumps and vacuums the doctor managed to bring down the unwelcome stiffness and asked hubby what the reason might be for his sudden encounter with the mountain of youth. Hubby replied "must have been the shampoo, recently changed brands and I take a shower every night." Good hygiene but bad clue. Doctor has other suspicions and have warned hubby to stay away from artificial aids as it may cause a life threatening episode. What should the wife do? more

Resolved Question: Blood pressure question,help please?

My husband is 65 and in pretty good health. His blood pressure has been okay but occasionally was 130/90. Last week his pressure spiked to 210/150 and we went to the hospital. They addmited him and brought the pressure down. They did a cardiac cat scan, ultras sound of the heart, several ekg and blood tests. He was discharged and put on 25mg of metratroporal. The next day he went to his regular doctor and he put him on 50 mg. and did a kidney test. His blood pressure was fine for a few days and is now l40/95. He called the doctor and he said to take more medication. Does it take a while to regulate blood pressure? We are at a loss as to what is going on. This is our first experience with hypertension. Do you think all of the tests which came out fine, are enough? Are we missing any? Also, his stomach is upset today, does the medication do this? Should he have had a cat scan of the brain? Thank you very much. more

Resolved Question: I just had a cardiac catheter to check for Pulmonary Hypertension, but I have not heard from my doctor yet.?

The results for my Pulmonary Artery was: 30/15 with the average of 20. According to the internet, it should be >15. Is this something I should be pushing for an answer or is this normal range? more

Resolved Question: Is the Grammatically correct?

If hypertrophy is present without an elevated cardiac function, this suggests an abnormal adaptation has taken in response to a malignant state such as hypertension more

Resolved Question: Why did my husband die of a cardiac arryhthmia so fast? 1 min defibulator 4 min ems. 10 sec blue and cpr.?

HYPERTENSION CARDIA ARRYHTHMIA. PRIPR OLYMPIC ATHLETE. GOOD SHAPE 5 DATYS AFTER HIS 51ST BIRTHDAY. NO SYMPTOM. TURNED OVER TO GO TO SLEEP. WHY WITH ALL THE IMMEDIATE HELP, HE COULDN'T BE SAVED? more