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121 Cards in this Set
- Front
- Back
What are modifiable lipoprotein risk factors for CVD?
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LDL, HDL, and total TG
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What are modifiable inflammatory markers for CVD?
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fibrinogen
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What are modifiable lifestyle risk factors for CVD?
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tobacco use
poor diet stress excessive alcohol physical inactivity |
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What related diseases are modifiable risk factors for CVD?
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HTN
Diabetes Obesity Metabolic Syndrome |
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What are non-modifiable risk factors for CVD?
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age ( >45 for men, >55 for women)
menopausal status family history |
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What hormone helps prevent against CVD?
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estrogen
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Family history of what in a male 1st degree relative is a risk factor for CVD? (women <65, men <55)
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MI or sudden death
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What is the function of the lipoprotein, chylomicrons?
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transports dietary fat and cholestrol from SI to Liver
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Can chylomicrons be atherogenic or not?
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ATHEROGENIC
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What % of total cholestrol is in LDL, HDL, and VLDL?
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60-70% in LDL
20-30% in HDL 10-15% in VLDL |
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What does the liver convert into LDL? is this lipoprotein atherogenic or not>
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IDL
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What is the main function of LDL?
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it is the main cholesterol carrier in the blood
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What type of apoprotein is mainly found in LDL?
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Apo B"ad"
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60% of LDL is taken up by receptors on what organ
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liver
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What determines the amount of LDL cholesterol in the blood?
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# and activity of receptors
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is LDL + apoB atherogenic or not?
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ATHEROGENIC
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What is LDL the product od>
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VLDL catabolism
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Which lipoprotein contains the most protein?
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HDL
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High HDL levels are associated with low levels of what lipoproteins?
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chylomicrons, VLDL, and small dense LDL
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What is the function of VLDL?
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transports endogenous TG and cholestrol
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What percent of VLDL is TG?
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60% TG
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Is VLDL atherogenic or not?
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NOT ATHEROGENIC
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What are the atherogenic remnants of VLDL?
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IDL
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What is the TLC diet low in in order to reduce blood cholesterol levels and chance of developing heart disease
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low in sat fat and cholesterol
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What happens your first visit to the doctor in regard to a TLC diet?
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begin lifestyle therapies
- emphasized reduction in sat fat and chol - encourage moderate physical activity |
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What happens your second visit to the doctor in regard to a TLC diet?
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evaluate LDL response and if goal isnt achieved then intensify LDL-lowering tx
- increase fiber intake |
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At what dr visit is adding plant sterols/ stanols to the diet considered?
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2nd visit
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What happens your third visit to the doctor in regard to a TLC diet?
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evaluate LDL response and if goal not met consider adding drug tx
-intensify wt management and physical act -initiate tx for metabolic syndrome |
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What happens at a follow up visit in regard to the TLC diet?
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monitor adherence
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How many weeks pass between the first and second dr visits?
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6 weeks
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When does a follow up visit usually happen?
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between 4-6 months after 3rd visit
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What nutrients have good effects on cholesterol levels?
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omega-6 linoleic acid
omega-3 EPA and DHA monounsaturated fatty acids fiber stanols / sterols |
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What effect does omega-6 have on lipoproteins?
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decreases LDL and HDL
decreases synthesis of VLDL, HDL, and apoB |
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Omega-3 decreases TG levels by inhibiting the synthesis of what?
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LDL apo B
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What lipoproteins does MUFA decrease?
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cholesterol, LDL and TG
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What lipoproteins does fiber decrease?
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cholesterol and LDL
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What do plant stanols/sterols inhibit the absorption of?
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cholesterol
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What does sat fat increase the levels of?
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LDL cholesterol
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Trans fat increases what and decreases what lipoproteins?
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increases LDL
decreases HDL |
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What parameter of BP defines HTN?
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persistently high arterial BP >140 / 90
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What BP defines stage 1 HTN?
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140-159 / 90-99
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What BP defines stage 2 HTN?
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160-179 / 100-109
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What BP defines stage 3 HTN?
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>180 / >110
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What is the short term regulator of HTN?
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sympathetic nervous system
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what is the long term regulator of HTN?
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the kidneys
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what vasoconstricting hormone does the SNS secrete when BP drops
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norepinephrine
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How does norepinephrine work on BP
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increases peripheral resistance to raise BP by acting on small arteries and arterioles
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What does the kidneys excrete to regulate BP?
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Renin
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what system does the renin excreted by the kidneys activate?
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renin-angiotensin system
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What abdominal measurements are a risk factor of metabolic syndrome?
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men: >102 cm
women > 88 cm |
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What TG level is a risk factor of metabolic syndrome?
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> 150 mg/dL
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What BP level is a risk factor of metabolic syndrome?
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>130 / 85 or on HTN tx
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What HDL level in men and women is a risk factor of metabolic syndrome?
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men <40 mg/dL
women <50 mg/dL |
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What fasting glucose level is a risk factor of metabolic syndrome
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>100 mg/dL
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What parameters make up your framingham score>
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age
HDL total cholestrol smoker vs non-smoker BP |
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How do diuretics work? (anti-HTN)
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reduce the blood volume
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How do beta blockers work? (anti-HTN)
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they slow down the work of the heart
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how do alpha-1 receptor blockers work? (anti-HTN)
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control norepinephrine from tightening muscles in the smaller arteries
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How do ACE inhibitors work? (anti-HTN)
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by inhibiting angiotensin 1 conversion to angiotensin 2
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How do calcium antagonists work? (anti-HTN)
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by preventing calcium from entering the heart and blood vessel walls; relaxes and widens them
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how do direct vasodilators work? (anti-HTN)
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dilate blood vessels
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What is the main drug class used for treating cholestrol?
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bile acid sequestrants
nicotenic acid HMG CoA reductase inhibitors (statins) |
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Which classes of diuretics causes a loss (waste) of K+
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loop diuretics and thiazide diuretics
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What classes of diuretics spares K+
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spironolactone
triamterene aldactone |
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What are risk factors for CHF?
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HTN
CHD Diabetes left ventricular hypertrophy (LVH) |
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What are ways the heart compensates in CHF?
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increase force of contraction
increase in size pump more often stimulate kidneys to conserve Na and H20 |
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What stage of CHF has slight limitations to physical activity but comfort at rest?
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stage 2
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What stage do symptoms of cardiac insufficiency or chest pain at rest show
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stage 4
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What are symtoms of CHF?
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dyspnea
nausea fullness pulmonary edema cardiac edema peripheral edema cardiac cachexia |
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What are the 3 hallmarker symptoms pf CHF>
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fatique, shortness of breath, and fluid retention
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What condition is characteristic of cool forearms and legs and sleeping feeling
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CHF
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what is cardiac cachexia?
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involuntary wt loss of atleast 6% or 6-month period characterized by loss of lean body mass
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By how many days does the DASH diet work in at lowering BP?
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14 days
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What is the focus of the DASH diet?
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lowering BP
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How many servings of whole grains does the DASH diet recommend?
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7-8
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How many servings of low-fat or fat-free dairy products does the DASH diet recommend?
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2-3
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How many servings of legumes, nuts, or beans does the DASH diet recommend PER WEEK?
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4-5
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How many ounces of lean meat, poultry, or fish does the DASH diet recommend?
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6 oz or less
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The DASH diet recommends 4-5 servings each of what foods?
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fruits and veggies
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How many servings of fat and oils does the DASH diet recommend?
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2-3
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What % of total calories does the DASH diet recommend fat and oils be>
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27%
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What is the Friedwald formula used to calculate LDL?
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LDL = TC - HDL - (TG/5)
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What are focuses of the post MI diet?
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promote healing
fight infection provide energy for ambulation, rehab, and PT replenish nutrient stores pay attention to protein stores when on corticosteroids |
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What class of drug causes protein to be catabolized more quickly?
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corticosteroids
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What level of Na intake does the dietary guidelines for Americans recommend?
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< 2,300 mg/day
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What level of Na intake does the dietary guidelines for Americans recommend for ppl 51+, aa, or has a diagnosis of HTN, CM, or CKD?
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1,500 mg/day
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What Na+ levels correlated with a no added salt diet order?
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4,000 mg/day (4g)
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What Na+ levels correlated with a mild-moderate Na+ restriction diet order?
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2,000-3,000 mg/day (2-3g)
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What Na+ levels correlated with a strict Na+ restriction diet order?
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1,000 mg (1g)
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What Na+ levels correlated with a severe Na+ restriction diet order?
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500 mg (.5g)
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What does a "very low sodium" term on a food label mean?
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<35 mg/serving
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What does a "low sodium" term on a food label mean?
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<140 mg/ serving
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What does a "reduced sodium" term on a food label mean?
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50% less than comparison food
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What does a "sodium free, no sodium" term on a food label mean?
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<5mg/serving
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What are the parameters for saturated fat under the TLC diet?
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<7% total cals
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What are the parameters for polyunsaturated fat under the TLC diet?
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up to 10% total cals
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What are the parameters for monounsaturated fat under the TLC diet?
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up to 20% total cals
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What are the parameters for total fat under the TLC diet?
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25-35% total cals
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What are the parameters for carbs under the TLC diet?
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50-60% total cals
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What are the parameters for protein under the TLC diet?
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about 15% total cals
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What are the parameters for fiber under the TLC diet?
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25-30 g/day
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What are the parameters for cholesterol under the TLC diet?
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<200 mg/day
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At what point would you use a fluid restriction in CHF>
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if serum Na+ is <130 mEq/L
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If the pt is severely decompensated in CHF what is the fluid restriction?
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1000-1500 mL daily
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What vitamins and minerals may need to be supplemented in CHF?
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Calcium
vit d magnesium thiamin |
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Why might a HF pt need a calcium supplement?
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at risk for osteoporosis
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Why might a HF pt need a vit d supplement?
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it helps reduce inflammation
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Why might a HF pt need a magnesium supplement?
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because def is common because of poor diet and the use of diuretics
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Why might a HF pt need a thiamin supplement?
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because theres a risk of def because of poor diet, loop diuretics use (increases excretion), and advanced age
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What happens as a result of an occlusion or hemorrhage of a cerebral artery resulting in impaired function, tissue damage, or death
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stroke
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what are the two type of stroke?
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ischemic and hemorrhagic
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which type of stroke accounts for 87% of all strokes?
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ischemic
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Which type of stroke involves a clot as a result of an obstruction within blood vessel supplying the brain?
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ischemic
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what is the most common cause of an ischemic stroke?
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plaque build up due to high cholesterol
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What type of stroke involves bleeding and occurs when weakened blood vessels rupture?
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hemorrhagic
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what is the most common cause of a hemorrhagic stroke?
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uncontrolled HTN
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What are two types of weakened blood vessels that cause a stroke?
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aneurysms
arteriovenous malformations |
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What is a significant risk factor for a stroke?
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old age
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what is the function of rtPA
* recombinant tissue plasminogen activator |
a protein that is made by the body to dissolve blood clots
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What type of foods are easier to chew and swallow?
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low viscosity foods
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To reduce fat the chance of drug nutrient interactions, what diet modification may be recommended to a stroke pt?
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reduce fat intake to reduce cholesterol by increasing intake of fruits and veggies
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