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cardio test nursing
chapter 38
| Question | Answer |
|---|---|
| arteriosclerosis: | thickening/hardening of arterial wall - associated with aging |
| atherosclerosis: | formation of pack within the arterial wall - leading risk factor for CAV |
| risk factors for atherosclerosis: | high LDL, low HDL, diabetes mellitus, obesity, sedentary lifestyle, smoking, stress, African American/Hispanic ethnicity, genetic predisposition |
| Assessment: | bp in both arms, palpate pulses, check capillary refill (>3s), assess bruits with stethescope |
| interventions for atherosclerosis: | cholesterol screening and history, nutrition-one of most important parts |
| nutrition: | fruits, vegetables, whole grains, fat-free/low-fat dairy products, lean meats |
| foods high in cholesterol to stay away from: | meats and eggs |
| Drug therapy: | 'STATINs' |
| complementary therapy: | Niaspan, B vitamin, Omega-2 |
| Hypertension: | 140/90 |
| patients with diabetes and heart disease should have a BP below ___ | 130/90 |
| Primary Hypertension: | family history, genetics, smoking, excessive caffeine, obesity, physical inactivity, stress, older than 60 |
| Secondary hypertension: | kidney disease, pregnancy, estrogen therapy/oral contraceptives |
| isolate systolic hypertension: | most common form of hypertension in older adults |
| ___ - most common cause of secondary hypertension in women: | oral contraceptives |
| lifestyle changes to control hypertension: | restrict sodium intake, lose weight, use less alcohol, exercise 5 X a week, use relaxation techniques to reduce stress, avoid tobacco and caffeine |
| Drug therapy: | . |
| Thiazide (low-ceiling): | diuretic - inhibits sodium, chloride, water reabsorption |
| Loop (high-ceiling) diuretics: | furosemide/Lasix - inhibits sodium, chloride, water retension |
| potassium-sparing diuretics: | spironolactone, aldactone |
| calcium channel blockers: | verapamil, amlodipine |
| ACE inhibitors: | "pril" drugs (captopril, lisinopril, enalapril |
| Angiotensin II receptor antagonist:(ARBs) | ' -sartan drugs (valsartan, losartan) |
| Beta-blockers: | ends in 'lol' (atenolol, metoprolol, bisoprolol |
| Peripheral vascular disease (PVD) - | affects legs more frequently than arms |
| assessment findings in PVD: | intermittent claudication, rest pain, burning or cramping in calves, ankles, feet and toes, loos of hair on lower calf, extremity is cold, palpate both leg's pulses, arterial ulcers (punched out appearance) |
| imaging assessments for PVD: | arteriography (determines amount of narrowing before peripheral bypass surgery) |
| noninvasive diagnosistic technique: | Doppler probe (systolic bp of thigh, calf) |
| exercise in patients with ___ is not advised: | gangrene, severe rest pain, venous ulcers |
| instruct patient to walk to the point of ___, then ___ then ___: | point of claudication, stop and rest, then walk a little further |
| drug therapy for patients with PAD/antiplatelet agents: | aspirin/plavix |
| patients should avoid raising their ___: | legs above the level of the heart |
| treatment for "Raynaud's phenomenon": | sympathectomy, nifedipine & phenoxybenzamine, smoking cesation |
| treatment for burger's disease: | NO CURE- stop smoking, nifedipine |
| most common symptom of aortic dissection: | PAIN |
| cause of buerger's disease: | unknown (strong ass. w/ tobacco smoke) |
| treatment for Aortic dissection: | Nipride |
| hypertension drug therapy: | . |
| Diuretics: | THIAZIDE (low-ceiling) - HCTZ LOOP (high-ceiling) - lasix POTASSIUM-SPARING-spironolactone |
| Calcium channel blockers: | Verapamil |
| ACE inhibitors: | "pril" drugs |
| ARBS: | 'sartan' drugs |
| Beta-blockers: | '-lol ' drugs |
| The nurse is caring for a client with peripheral arterial occlusive disease (PAD). For which symptoms should the nurse assess? | leg pain with exercise |
| Which teaching should the nurse include for a client with peripheral arterial disease (PAD | Walk to the point of leg pain, then rest, resuming when pain stops |
| Which of these problems identified by the nursing student correctly identifies the client at risk for secondary hypertension? | renal failure |
| The client with hypertension is started on verapamil (Isoptin). What teaching does the nurse provide for this client? | avoid grapefruit juice |
| The nurse is teaching the client precautions to take while on warfarin (Coumadin) therapy. Which statement made by the client demonstrates that teaching has been effective? | green beans arnt high in vitamin K / wont interfere w/ anticoagulant effects |
| Which vascular assessment technique by the student nurse requires intervention by the supervising nurse? | Simultaneously palpating the bilateral carotids |
| The client has just undergone arterial revascularization. Things to assess? | 6 p's pain, poikilothermia, paresthesia, pulselessness, and paralysis and pallor |
| The 70-year-old with a history of diabetes who has "tearing" back pain and is diaphoretic. the nurse should assess them first due to: | clinical manifestations suggest possible aortic dissection and shock |
| abdominal aortic aneurysm (AAA), the nurse recognizes that which problem must be addressed immediately to prevent rupture? | BP of 192/102 Elevated blood pressure can increase the rate of aneurysmal enlargement and risk for early rupture. |
| abdominal aortic aneurysm (AAA), the nurse suspects dissection of the aneurysm when the client states which of these? | I just started to feel a tearing pain in my belly; Severe pain of sudden onset in the back or lower abdomen |
| The nurse caring for a client who has had AAA repair would be most alarmed by which finding | Urine output of 20 mL over 2 hours (Renal failure is a complication of AAA repair ) |
| Which of the following is essential to report to the provider when caring for a client with Raynaud's phenomenon? | affected extremity becomes purple and cold; indicates an occlusion |
| The client is receiving unfractionated heparin by infusion. Of which finding should the nurse notify the provider? | platelets 32,000 |
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