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Nurs 205 Exam 3

CSN Nurs 205 Exam 3

LEFT-SIDE HEART FAILURE Decreased Cardiac Output & Pulmonary Congestion
Decreased Cardiac Output Fatigue Weakness Oliguria during the day Angina Confusion, restlessness Dizziness Tachycardia, palpitations Pallor Weak peripheral pulses Cool extremities
Pulmonary Congestion Hacking cough, worse at night Dyspnea/breathlessness Crackles or wheeze in lungs Frothy, pink-tinged sputum Tachypnea S3/S4 summation gallop
RIGHT-SIDE HEART FAILURE:Systemic Congestion Jugular (neck vein) distention Enlarged liver and spleen Anorexia and nausea Dependent edema (legs and sacrum) Distended abdomen Swollen hands and fingers Polyuria at night Weight gain Increased blood pressure (from excess volume) or decreased blo
'Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.
'Competence' implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities
‘Cultural and linguistic competence’ is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.(Cross, 1989).
Cultural awareness= a consciousness of one’s personal reactions to people who are different.
Cultural diversity= e variety of human societies or cultures in a specific region, or in the world as a whole.
Cultural competence= combination of awareness, sensitivity, experience, knowledge and desire to work effectively with people of a different culture other than your own.
Pulse pressure the difference between systolic and diastolic. Normal is 30 to 40 mm of Hg.
A narrow pulse pressure can be attributed to? hypovolemia, slow heart rate and hypertension
Heart Failure = Pump Failure Three types: 1. Left sided heart failure (Left sided heart failure is aka CHF) a. Systolic failure b. Diastolic Failure 2. Right sided heart failure 3. High-output heart failure
Physical Assessment: Left Heart Failure - increased RR, hacking cough - basalar crackles and wheezes - tachacardia, palpatations, S3 gallop - change in mental status
Physical Assessment: Right Heart Failure - JVD - dependent edema - ascites, hepatomegaly - N, V, and anorexia
Lasix & Bumex are are loop diuretics consider K+ supplement
Aldactone is a diuretic but it is potassium sparing
calcium channel blockers are? Verapamil, Norvasc
What should you do with calcium channel blockers? Monitor BP and pulse
Ace Inhibitors are? The Prils - Captopril, Lasinopril. Change positions slowly especially after first dose,
What is a common side effect of Ace inhibitors? Cough
What is the antidote of Heparin? Protamin Sulfate
What is the antidote of coumadin? Vitamin K
what it HITT? Heparin-Induced Thrombocytopenia and Thrombosis
Who cannot undergo an MRI? Patients with pacemaker or implanted defibrillator
A FIB - Irregular Heart Beat? Look out for? Clots
Where do Clots of A FIB go? TO the brain!
What should you do for A fib? Give digoxin and coumadin - digoxin strengths but lowers and coumadin blood thinner
KCL - how much are you allowed? only 10meq/hr
A crushing wound of the leg is bad why because of potassium? Because all the potassium is inside the cell, so the cell is crushed and the potassium is let out, free floating potassium dysrthmia
Arteriosclerosis a thickening, or hardening, of the arterial wall.
Atherosclerosis a type of arteriosclerosis, involves the formation of plaque within the arterial wall the leading contributor to coronary artery and cerebrovascular disease.
Diuretics Monitor I&O and potassium levels
Calcium Channel Blocking Agents Monitor BP & HR
Angiotensin-Converting Enzyme (ACE) Inhibitors Monitor BP & HR, report edema and cough
Angiotensin II receptor Antagonists Monitor BP & HR, report angioedema
Aldosterone Receptor Antagonists Monitor renal function, Na+ and K+ level
Beta-adrenergic blockers Monitor BP & HR
the most common cause of peripheral occlusions An embolus
Raynaud’s disease occurs in women between the age 17 and 50 years of age, usually bilaterally
Thrombosis is the formation or presence of a blood clot inside a blood vessel or cavity of the heart.
A thrombus is a blood clot that forms inside a blood vessel or cavity of the heart.
Thrombolysis  is the breaking up of a blood clot.
An embolus is a blood clot that moves through the bloodstream until it lodges in a narrowed vessel and blocks circulation.
Phlebitis An inflammation of the superficial veins caused by an irritant, such as IV therapy
Ischemia occurs when insufficient oxygen is supplied to meet the requirements of the myocardium.
Infarction (necrosis, or cell death) occurs when severe ischemia is prolonged and irreversible damage to tissue results.
Angina Substernal chest discomfort: Radiating to the left arm Precipitated by exertion or stress Relieved by nitroglycerin or rest Lasting < 15 min Few associated symptoms
Myocardial Infarction Substernal chest pressure: Radiating to the left arm, back, or jaw Occurring without cause, usually in the morning Relieved only by opioids Lasting 30 minutes or more Frequent associated symptoms: Nausea, Diaphoresis, Dyspnea, Feeling of fear and anx
for heart attacks what diagnostic assessments do u do? Laboratory Assessment Troponin T and I, CK-MB, and myoglobin ECGs
Diuretic – teach the clients to take the medication in the morning, daily weight before breakfast
ACE inhibitor teach the clients to move slowly when change position, especially from a lying to a sitting position. Dizziness, light-headedness, and cough need to be reported to the provider
ACE inhibitor Client taking diuretic and ACE Inhibitor – check serum potassium level and renal function every few months.
Digoxin – teach the clients how to take pulse rate
High T waves on EKG = Heart Attack - ischemia - the electrical has to go around the dead tissue - maybe potassium is high?
P waves if they are fluttering that means electrical is going weird. sometimes u cannot distinguish it or it might be flat.
Complementary Therapy treatmentused in addition to conventional therapy
Alternative Therapy treatment used asa substitution for traditional therapy
Chronic Illness one that has existed for at least three months
Rehabilitation to return the client to thefullest possible capacity
Manipulative and Body-Based Therapies MassageTai Chi
Biologic-Based Therapies AromatherapyHerbal Preparation
Energy Therapies Therapeutic TouchMagnetic Unruffling
Primary Dimensions of Diversity  Age  Race  Ethnicity  Heritage  Gender  Physical abilities/qualities  Sexual/affection orientation  Mental abilities/
Secondary Dimensions of Diversity Education  Communication style  Work background  Work style  Income  Marital status  Military experience  Religious beliefs  Geographic
paradigmis a set of rules & regulations thatestablish boundaries andtells you how to besuccessful within theboundaries
Complementary and Alternative Therapies focus on holistic care
Complementary Medicine “A group of diagnostic and therapeutic disciplines that are used together with conventional medicine.” Example: aromatherapy to help lesson a client’s pain/discomfort.
sed in place of conventional medicine” Example: “using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor.”
Integrative Medicine – “combines treatments from conventional medicine and CAM for which there is evidence of safety and effectiveness”
Five domains/categories: Systems of health care Mind-body therapies Manipulative and body-based therapies Biologically based therapies Energy therapies
Created by: starr8904