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Cardio Test Review

Adult Health I; Cardio Test 11-12-07

QuestionAnswer
Why is it important for someone with peripheral arterial disease to exercise? it will increase collateral circulation
What is the 1st assessment finding indicating occlusion of an aorto-femoral bypass graft? no pulses below the graft
What is the most desired treatment outcome for a client with congestive heart failure? respiratory status improves, edema reduction, breath sounds clearing
What assessment findings indicate left-sided heart failure? crackles and pink, frothy sputum
What is one of the first signs of a DVT? pain in calf
What physical finding does a client with chronic venous disease exhibit? edema and venous stasis ulcers
What is the emergency procedure for V-fib? Defibrillation; synchronize button OFF; increase charge to 200; this will stop and restart the heart
What is the name of the scheduled procedure performed for A-fib? Cardio version - conscious sedation; synchronize button ON; decrease charge to 50; this will restore normal rhythm
What is the BEST indicator that diuretics are working? Daily weights
When Digoxin and diuretics are adminstered to the patient with CHF, what lab test would you check and why? K+ - because some diuretics cause hypokalemia and hypokalemia can potentiate digitalis toxicity
What BP indicates hypertension and when should it be treated? 140/90; check 3x; drug therapy initiated much earlier
What measures should be taken to facilitate patency of a graft following surgical repair of an aneurysm? maintain systolic BP between 90-130; if it goes above 130, too much pressure and graft will tear; maintain extremities in neutral position
How can you verify that the graft is patent through your assessment? check pulses below the graft
What signs indicate a ruptured aneurysm? Abdominal pain, flank pain, pulsating mass, hypotension, shock
Following an abdominal aneurysm repair, the patient complains of severe flank pain and decreased urinary output. Why? Renal artery embolism
How do you ensure that the graft site does not leak or rupture? Keep the BP under control (systolic below 130)
What is the most common initial response for those experiencing chest pains due to a myocardial infarction? DENIAL; there is a typical 3 hour delay between the onset of pain and going to the hospital
Following cardiac catheterization, what would be the signs of retroperitoneal bleeding? bruising, pressure on the kidneys, back pain
Post op - CABG; What should you know about chest tube drainage amounts? 1 hour post op - 300 cc is normal; 8 hours post-op - 300 cc is ABnormal; when the patient sits up for the 1st time - 300 cc is normal
What is the significance of continued chest pain with tPA therapy? Continued chest pain indicates that tPA therapy is not working; do not give tPA therapy if there has been a recent trauma (tPA is a thrombolytic drug used to dissolve a clot)
PCTA does what? It is a BALLOON that pushes plaque away
A STENT does what? It holds the artery open
What is the most significant cardiac marker for MI Troponin; it is a myocardial muscle protein releases into the bloodstream ONLY if there is cardiac necrosis or MI; any increase in troponin levels indicates cardiac necrosis or MI
When is it best to perform a MIDCAB? When only one or two anterior coronary arteries are involved (such as the left anterior descending artery - LAD)
Safety precautions with a TEMPORARY pacemaker include wearing __________ gloves
Your patient is coughing up pink, frothy sputum; what does this indicate? pulmonary edema
The pain associated with angina is typically brought on by _________ and relieved by ________ brought on by exertion and relieved by resting
When a patient is experiencing chest pain (angina pectoris), what is the standard treatment? give Nitro sublingually and check BP
What is preload? refers to the amount of myocardial fiber stretch at the end of diastole just before contraction; it is determined by the amount of blood returning to the heart from both the venous system and the pulmonary system
What is afterload? the pressure or resistance that the ventricles must overcome to eject blood through the semilunar valves and into the peripheral blood vessels
What is the treatment for symptomatic bradycardia following an MI? Atropine 1st, then pacemaker; avoidance of parasympathetic stimulation such as prolonged suctioning or stimulation of the gag reflex
What is the most common cause of sudden cardiac death? ventricular fibrillation (v-fib, VF) usually preceded by ventricular tachycardia (v-tach,VT)
What is the most common arrhythmia following MI? PVC's (premature ventricular contractions)
a radial arterial line is placed to measure what? BP
What is arteriosclerosis? fatty plaque in arterial wall; arteries become narrowed and blood flow decreases
What is atherosclerosis? atheromatous plaques containing cholesterol and lipids on the innermost layer of the walls of large and medium-sized arteries; causes a thickening or hardening of the arterial wall
1 in 4 Americans (about 50 million) suffer from what? hypertension
List some of the symptoms of hypertension. None at first, then headache, dizziness, visual disturbances and confusion
Which classes of drugs are used to treat essential HTN? diuretics, ACE inhibitors, beta-blockers, calcium channel blockers and vasodialators (apresoline)
What does LEAD stand for? lower extremity arterial disease
The drugs Trental, ASA and Plavix are used for the management of what? peripheral arterial disease (PAD)
List some of the Post-Op nursing care responsibilities following a bypass graft risk for occlusion 1st 24 hours; check pulses every 15 minutes for 1st hour - then every hour with color and temp; mark location of pulses; assess for pain; keep leg straight
What is done if there is a graft occlusion? Immediate surgery; tPA therapy (tissue plasminogen activator); ReoPro (inhibits platelet aggregation)
What are the modifiable risk factors for coronary disease? weight, activity, diabetes, hypertension, smoking, cholesterol
What are the non-modifiable risk factors for coronary disease? age, sex, race, family history
The acronym MONA can be used to remember key terms for the management of an MI. What does MONA stand for? Morphine, Oxygen, Nitroglycerine, Aspirin
List some of the contraindications for tPA therapy active internal bleeding; CVA within previous 2 months; recent spinal or cerebral surgery; cranial neoplasm; prolonged CPR; recent eye surgery
What are the key indicators that cardiovascular perfusion has returned? chest pain abruptly subsides; sudden onset of PVC's; resolution of ST changes; marker of myocardial damage peak @ 12 hours
Why is aspirin given following MI? antiplatelet aggregation
Why are beta-blockers given following MI? to reduce muscle damage
Why are ACE inhibitors given following MI? to reduce CHF
Why are calcium channel blockers given following MI? to enhance myocardial perfusion
The surgical intervention performed if one or more coronary arteries are diseased is called a _____________ CABG (coronary artery bypass graft)
The surgical intervention performed if only one or two anterior coronary arteries is diseased is called a ___________ MIDCAB (minimally invasive direct coronary artery bypass)
When you listen over carotid arteries or sometimes over the aorta and you hear a swooshing or blowing sound you are hearing _________ bruits (brew-ees); a characteristic feature of atherosclerosis
Cyanosis of the great toe and dependent rubor of the foot is characteristic of ______________ _______________ aterial insufficiency
What is the procedure called when the plaque is kind of smashed against the arterial walls by inflating a balloon over and over again? PTA (percutaneous transluminal angioplasty)
How often do you check pedal and posterial tibial pulses immediately following an aortal-femoral bypass graft? Every 15 minutes for the first hour; then hourly along with temp and color
Remember the SIX P's when trying to determine if a patient has an arterial occlusion. What are the 6 P's? Pallor, Pain, Pulselessness, Paresthesia, Paralysis, Poikilothermia
long-standing, uncontrolled HTN can cause these; it is just like overinflating a bicycle innertube many times; causes it to become weak and burst aortic aneurysms
a ruptured abdominal aortic aneurysm (AAA) results in internal bleeding so severe that only ____% of victims survive 20%
Most aortic aneurysms are the result of ________________ atherosclerosis
Complications of a DVT would include a _________ ___________ and would necessitate the nurse monitoring closely for signs of ______________ pulmonary embolism; monitor closely for signs of SOB and chest pain (dyspnea)
Sudden cardiac death is caused by __________ ______________ Ventricular fibrillation
Dysrhythmias occur most commonly following a myocardial infarction due to ___________ irritability of the damaged heart muscle
What is the most effective way to reduce one's risk of restenosis of blocked coronary arteries? lowering LDL
Extensive muscle damage following myocardial damage can cause cardiogenic shock which is manifested by heart ___________ failure
Left flank pain and decreased urine output following aneurysm repair of the aorta indicates ______________ renal artery embolism
The pain of angina is preceded by what? exertion, emotions, elimination, extreme changes in temperature
Priority patient care following DVT includes... bedrest, do NOT massage the legs, be aware of complications of pulmonary embolism
left-sided heart failure lungs sound like ________ crackles
Diuretics do what to preload? decrease preload
What helps increase venous return? walking
What happens to the ST segment following a stent and angioplasty? ST should return to baseline
What is used to treat frequent PVC's following MI? Lidocaine
What action is required if you obtain a BP reading of 160/100 at a routine screening (after you recheck it two more times that day)? Refer the client to their MD for immediate attention
a high HDL to LDL ratio indicates what? low risk for CV disease
Uncontrolled atrial fibrillation increases the risk for what? stroke
Created by: KCdoula200
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