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Med Surg Test 2
| Question | Answer |
|---|---|
| What is insuffiecent and causes blood to back up? | regurgitation |
| What are the 4 valves in the heart? | mitral, tricupsid, pulmonic, aortic |
| What causes damage to the vavles? | abnormal valvular functioning |
| What may result from congenital defects, rheumatic fever, or infections? | valve damage |
| What occurs at any age as an autoimmune reaction to the upper respiratory ? | rhematic fever |
| What is defined as a sore throat, typically occurs between ages 5&15? | streptocci infection |
| What is brief, rapid, uncontrolled movements called? | chornea |
| What does not allow left atrium to empty easily, so blood builds up in the left atrium? | stenosis |
| What is pressure in left ventricle rises, the flaps of the mitral valve normally remain closed? | ventricular systole |
| What is the normal and safe range for INR? | 2-3 |
| What are some complications of MVP? | emboli, infective endocartis |
| What is typically in women with slight chest deformities between the ages of 15-390? | MVP |
| How often should the nurse check the patient’s BP while administering Norepinephrine (Levophed)? | 2-5 mins |
| What are the adverse reactions associated with Norepinephrine (Levophed)? | Can cause severe tissue necrosis, sloughing, and gangrene with extravasation |
| Name a vasopressor that is used to promote cardiovascular perfusion in the failing heart. | Norepinephrine (Levophed) |
| What does the nurse monitor for when the patient has been given epinephrine (adrenaline) for cardiac arrest? | return of pulse, vital signs |
| Why is it important to monitor creatinine and BUN with the administration of Epinephrine? | Impaired renal function can cause toxicity |
| What are the main side effects associated with epinephrine (adrenaline)? | tachycardia, hypertension |
| What drug is given for cardiac arrest? | Epinephrine (adrenaline) |
| What condition greatly increases the risk for Digoxin toxicity? | hypokalemia |
| What assessments are especially important for the patient on Digoxin? | pulse rate and rhythm |
| What should we monitor and assess when our patient is taking Atropine (Atropisol) (3)? | Heart rate/rhythm, assess for chest pain and urinary retention |
| Atropine is therapeutic for what type of dysrhythmia? | Bradycardia |
| What assessments does the nurse watch for her patient taking a class III anti-arrhythmic? | Vital signs and ECG |
| What special instructions will the client taking amiodarone (Cordarone) need? | Wear sunglasses and sunscreen |
| What type of arrhythmias do Class III anti-arrhythmics treat? | ventricular dysrhythmias |
| What are the main side effects of propranolol (Inderal)? | Hypotension, Bradycardia, Bronchospasm |
| What are the contraindications for propranolol (Inderal)? | asthma, COPD |
| When are class I antiarrhythmics contraindicated? | Heart block |
| What complication should the nurse monitor the patient with valvular heart disease for? | atrial fibrillation with thrombus formation |
| Name 5 common causes of valvular disease(SHERC). | Rheumatic fever, Congenital heart disease, syphilis, endocarditis, hypertension |
| Describe what’s happening in mitral valve stenosis. | Blood slips through the stenosed mitral valve back into the left atrium. |
| Valvular dysfunction is more common on which side of the heart? Which valves are most commonly affected by valvular heart disease? | Most valvular dysfunction takes place on the left side of the heart. The mitral valve is the most common followed by the aortic valve. |
| Define valvular heart disease. | Heart valves that are unable to open fully (stenosis) or close fully (insufficiency or regurgitation) |
| Discuss the use of antibiotics as it relates to the patient with endocarditis. | Administer antibiotics for 4-6 wks. AHA recommends erythromycin before dental or genitourinary procedures. Clients may be instructed in IV therapy for home health care. |
| How does the nurse care for the patient with pericarditis? | Provide rest and position of comfort. Administer analgesics and anti-inflammatory drugs. |
| Give a couple of applicable nursing diagnoses for inflammatory/infectious heart disease patients. | Decreased cardiac output; Risk for injury: emboli |
| What is a defining symptom of pericarditis? | Friction rub |
| Explain how the heart valves are damaged with endocarditis. | by the growth of vegetative lesions |
| Define pericarditis. | inflammation of the outer lining of the heart |
| What symptoms might the nurse find on assessment of a patient with endocarditis (8)? | Fever, chills, malaise, night sweats, fatigue, symptoms of heart failure, atrial embolization, murmurs |
| Name 7 causes of pericarditis (TMN CHII). | Trauma, MI, Neoplasm, Connective tissue disease, Heart surgery, Idiopathic, Infections |
| Define Heart Failure. | Inability of the heart to pump sufficient blood to meet the oxygen demands of the tissues |
| Describe atrial flutter. What would it look like on an ECG? | fluttering in chest, ventricular rhythm stays regular, saw toothed waves between QRS spikes |
| How does ventricular tachycardia look on an ECG? | Wide, bizarre QRS |
| Name 3 electrolytes that if out of balance could result in dysrhythmias. | Potassium, calcium, and magnesium |
| Name 5 drugs that could cause dysrhythmias. | Digoxin, quinidine, caffeine, nicotine, alcohol |
| Define dysrhythmia. | disturbance in the heart rate or rhythm |
| What drug’s effectiveness is measured by PTT? | Heparin |
| How reliable is Homan sign? | Only about 10% of patients with phlebitis manifest Homan sign and there are many false positives |
| Define Thrombophlebitis. | Inflammation of the venous wall with the formation of a clot |
| What is the end result of an untreated abdominal aortic aneurysm? | Rupture/death |
| What is the most common cause of AAA? | Atherosclerosis |
| Define AAA (abdominal aortic aneurysm). | dilatation of the abdominal aorta caused by an alteration in the integrity of its wall |
| What is the antidote for Warfarin (Coumadine)? | Vitamin K |
| What is the antidote for heparin? | Protamine sulfate |
| How is heparin administered? | Heparin is administered SQ or IV |
| What drug may be given post surgery for PVD? Why? | Anticoagulant to prevent thrombosis |
| What complication does the nurse assess frequently for after surgical intervention for PVD? | hemorrhage |
| What can we teach the patient with PVD to prevent further injury? | Change position frequently; wear nonrestrictive clothing; avoid crossing legs; avoid keeping legs dependent; wear good shoes; proper foot and nail care |
| What lifestyle changes can the nurse teach the client with hypertension about? | stress reduction, weight loss, tobacco cessation, exercise |
| What is the most common form of valvular heart disease? | MVP |
| What is the 1st diagnostic step for MVP? | auscultation for a click caused by the stress on the chordae tendinea |
| What is a healthy life style for MVP? | good diet, exercise, stress management, avoid stimulants and caffeine |
| What medications reduce heart rate and may help relive chest pain? | beta blockers |
| What can cause stroke/seizures if right ventricle fails? | emboli |
| What confirms enlargement of affected heart chambers? | chest xray |
| What may be ordered to help prevent formation of blood clots on the valve? | aspirin or anticoagulants |
| The narrowed opening obstructs blood flow from the? | left atrium into the left ventricle |
| What is a major cause of mitral stenosis? | rheumatic fever |
| Balloon to dilate the stenosed heart valve done in a cardiac cath | valvuloplasty |
| insufficient or incomplete closure of the mitral valve leaflets | mitral regurgitation |
| Begins with s1 and continues during systole up to s2 | murmor |
| a risk due to the damaged valve | endocarditis |
| often used to reduce afterload | ace inhibitors |
| most commonly acquired valvular heart disease | aortic stenosis |
| primary symptom that occurs as a lack of oxygen to the myocardium | angina pectoris |
| require life long anticoagulation | mechanical valves |
| forceful heart beat felt while lying down, when lower pilse rate results in less O2 | aortic regurgitation |
| this procedure can result in sudden death | vavle replacement |
| this results in fewer complications than traditional open heart surgery | balloon valvuplasty |
| repairs a stenosed | commisurotomy |
| incision into the atrium | atriotomy |
| tissue valves come from xenograft, pig and cow | biological |
| uses patients own pulmonary vale to replace removed aortic vavlve | auto graft (ross procedure) |
| dont require life long anticoagulant therapy, but dont last as long as mech valves because of degenerative changes and calcification | tissue valves |
| durable 20-30 yrs but create turbulent blood flow, requiring lifelong anticoagulant therapy to prevent blood clots. | mechanical valves |
| What can occur from hemolysis of RBCs as they come in contact with mech valve structures? | anemia |
| forbidden animal to jews/muslims | pig |
| sacred among hindus | cow |
| forced air blanket, stopped when temp is near 98.6 | warming devices |
| greatly increases cardiac oxygen needs | shivering |
| layers of the heart | endocardium, pericardium, endocardium |
| infection of the endocardium that mostly occurs in the heart with artificial or damaged valves. | infective endocarditis |
| they develop IE more often than women, as do older adults compared with younger | men |
| janeway lesions | small, painless red blue lessions on palms and soles |
| yiny red or purple flat spots | petechie |
| small painful nodes on fingers and toes | oslers nodes |
| can be a major complication of IE | vegetative emboli |
| begins when the invading organism fungi/bacteria attaches to eroded endocardium where platelets and fibrin deposits have formed a vegetative lesion | IE |
| IV drug use, gingival gum disease | etiology risk factor |
| build up of fluid in pericarduak space | pericardial effusion |
| aspiration of fluid from pericardial | pericardiocentesis |
| surgical removal of the entire tough, calcified pericardium | pericardiectomy |
| life threatening compression of the heart | cardiac tamponade |
| rare condition devlops after viral infection | myocarditis |
| most freq type of cardiomyopathy | dilated |
| dilated | pallative care |
| enlargement visible on a chest xray | cardiomagaly |
| stasis of blood , damage to lining of vein wall, increased blood coagulation | virchow triagle |
| causes trauma to the vein | IV therapy, venipuncture |
| what increases blood coagulation? | smoking, oral contraceptives |
| dont remove air bubbble for what? | loganox |
| normal PT | 9-12 |
| how long does it take for coumadin to take effect | 4 to 5 days |
| traps clots | vena cava filters |
| tells if clot is present | d dimer |
| agina at night, corg pulse | aortic regugitation |
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