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Med Surg Test 2

QuestionAnswer
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
Created by: 1165464016811006