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|A diagnosis of Hypertension is made by a blood pressure value greater than
|140/90 obtained on two seperate occasions with orthostatic readings
|Hypertension is classified as either
|Primary or Secondary
|Often the client with hypertension will have no symptoms at all or might complain of an early morning headache and fatigue--name given is
|The silent killer, if left untreated, can lead to coranary disease, renal, and strokes
|Managenment of HTN includes
|Diet, exercise, low fat, low cholestorl diet. If diet exercise unsucessfull MD might order diuretics and antihypertensives
|Hypertensive drugs include but are not limited to.
|Diuretics, beta blockers, calcium channel blockers, angiotensin comverting enzyme inhibitors, angiotension receptor blockers
|The SA node is considered the ______ pacer of the heart rate.
|The AV node ________ the impluse and ________ it to the Bundle of HIS
|Heart block is a condition in which
|The conduction system of the heart fails to conduct imppulses
|How many different heart block degrees are there
|3-first, second, third
|1st degree heart block occursw when the_____ _____ continues to function normally but, transmission fails
|Clients in 1st degree heart block are usually asymptomatic. T or F
|T--although heart rate is irregullar transmission eventually reaches the ventricles
|Second degree heart block is which impluses reach the ,________ but others do not.
|Third degree heart block or _________heart block none of the sinus impluses reach the ventricles
|Erratic heart rates, hyptension, seizures, cerbral ischemia or cardiac arrest. Would be charactristic of which heart block
|Heart blocks are detected by which procedure?
|Therapeutic levels of Digoxin is 0.5-2.0 ng/ml. T or F
|IF digoxin exceeds greather 2.0 there considered toxic. T or F
|Signs and symptoms include what for Digoxin toxicity?
|Nausea, vomiting, and seeing halos around lights, HR <60bpm
|Treatment for digoxin toxicity include.
|Hold Dig. administer K+ and if HR to low administer isoprel or atropine.
|Its okay for a patient with a pacemaker to have a MRI. T or F
|Its okay to drive a car immediately after discharge post pacemaker insertion.
|False usually must wait several months.
|When there is a blockage in one or more of the coronary artheries the client is considert to have a ____________ _________.
|The client can go into _________ ________ post MI.
|The most commonly reported S/S of and MI are.
|Substernal pain or pain over precordium lasting greater than 15mins, described as heavy, vise-like-radiating down left arm, not relieved by rest or nitro,
|Pain that is accompanied by SOB, pallor, diaphoresis, dizziness, nausea and vomiting are characteristics of which cardiac disorder
|Myocardial infarction had decreased heart rate, decrease blood pressure, increased temperature and increased respiratory rate. T or F
|False-Increased heart rate,< bp, > temp, > RR
|When experiencing Angina take ___nitro every ____ minutes. Do not exceed___ doses. Call 911 if more is needed.
|The most common diagnositc test to determine extent of an MI would be
|ECG and Serum enzymes and iso enzymes,
|CK-MB is specific for
|damage to the myocaridum
|The Troponin T and 1 are specific to
|Striated muscles and used to determine the severity of the attack
|CRP are used with CK-MB to
|determine if the client had an acute MI and the serverity of the attack.
|LDH is a nonspecific ensyme that is elevated with
|any muscle trauma.
|Ventricluar Tachycardia is often seen in patients who experienced and MI it is characterized by what ECG changes
|Rapid rhythm, 0 P wave, rate 140-180 bpm. Lethal rhytmn if left untreated
|Ventricular tachycardia is treated with
|O2 and medications to slow rate, and Heparin to prevent further thrombus and Morphine for pain
|Ventricular Fibrillation (V-fib) associated with
|sudden cardiac arrest
|V-fib ecg strip has a charactrestic ------- rythmn
|Treatment of V-fib is
|Cardiac Catherizaation detects_______ associated with MI and dysrthymias
|It is not okay to administer dye to a patient with a shellfish allergy. T or F
|Nursing interventions include post cardiac cath.
|Bedrest with leg straight, pressure dressing, check distal pulsed, force fluids.
|Cardiac tamponade happens when
|Blood is not drained from the mediastinal area, and fluid accumulates around the heart
|A swan-ganz catheter monitors
|Central venous pressure, pulmonary artery wedge presure and radial arterial blood pressure
|A diet post MI should include
|Low sodium, low fat and low cholesterol
|Caffiene is okay to have. T or F
|T in small amounts
|Nurse should check the PT/INR levels for Heparin. T or F
|False-PT/INR is for Coumadin, PTT is for Heparin
|The antidote for Heparin is
|The antidote for coumadin is
|B_______ disease results when spasms of the arteries and veins occur primarily in the lower extremities.....
|Symptoms of Buerger's disease are
|pallor of the extremities progressing to cyanosis, pain and parethesia
|Management of Buerger's involves Buerger Allen exercises, vasodilators and oxygentation. T or F
|True, also encourage to stop smoking because smoking makes the condition worse
|__________ occurs when there is inflammation of a vein with formation of a clot occurs.
|_________ sign is considered postitive is the cliet complains of pain on dorsiflexion of the foot.
|If client is diagnosised with thrombophlebitis the patient should be placed on
|bedrest with warm, moist compresses to the leg
|An ________ is ordered to reduce clotting
|Raynaud's syndrome is defined by
|Vascular spasms brought on by exposure to the cold.
|Most commonly affected areas of Raynaud's syndrome are
|The hands, nose and ears
|balloning of an artery
|Greatest risk associated with an aneurysm are
|rupture and hemmorage
|Three types of aneurysms are
|Fusiform, saccular, dissecting
|The client with a abdominal aortic aneurysm complains of felling her heart beating in
|her abdomen or lower back pain
|On ausculation of the abdomen a ______ can be heard with an abdominal aortic aneurysm
|Diagnosis of an abdominal aortic aneurysm is made by a
|ultrasound, arteriogram or abdominal xrays
|How big should a aneurysm be to schedule and immediate surgery in centimeters
|6 or more
|Avoid palpating what in an client with a suspectedd abdominal aortic aneurysm
|Most heart failures occur when the _____ ventricle fails to pump blood
|Left sided heart failure results in
|fluid backs up into lungs causeing pulmonary edema
|Signs of pulmonary edema are
|frothy, pink-tinged sputum, sob and orthopnea possible JVD
|Right sided CHF blood backs up into.
|Signs of Right sided heart failure are
|level of oxygentatoion of the blood particulary the hemoglobin and hematocrit
|Chest xray tells the nurse what about the heart?
|whether the heart is enlarged or an aneurysms are present
|Anteriogram revels the presence of what?
|blockages and abnormalities, turbulent flow, in the vascular system
|Cardiac catherization reveals
|blockages and abnormalities, turbulent flow, and arteriosclerotic heart disease.
|ECG interperation indicated abnormalities in the the________ and _________ of the conduction system of the heart
|Rate and rhythm
|What monitors the fluid volume status
|Central venous pressure monitoring
|______(lab test) used to diagnose heart failure in clients with acute dyspnea or differate dyspnea found in those with lund disorders from those with CHF
|BNP-b-type natriuretic peptide
|The nurse should check what when giving Diazoxide (Hyperstat) for hypertensive crisis. It causes an increase in this value.
|Blood glucose level
|Diazoxide (hyperstat) is given by which route.
|When a client is placed on rosuvastatin (crestor) they should report
|muscle weakness-sign of rhabdomyositis
|rosuvastatin (crestor) takes effect in how long
|Which value should be reported immediately to an MD while recieving Lanoxin elixir in a 6 mo. old client, bp 126/80, BGL 110mg/dl, HR 60 bpm, RR 30
|HR 60 bpm, bradycardia is associated with dig. toxicity
|It is okay to put nitroglycerine in a different bottle other than the brown bottle it is prescribed in. T or F
|F-Removing may cause nitro to loose potency
|The patient should replenish there nitro supply ever 6 months. T or F
|Which lab enzyme would be most specific for an diagnosis of a MI?
|Creatine phosphokinase or CK-MB, Troponin is also very reliable
|Cliet with left-sided CHF should be assessed for edema in the feet, neck, hands or Sacrum
|Neck veins should be assessed for neck vein distention
|at which point when checking central venous pressure. Phlebostatic axis, point of max impluse, Erb's point or Tail of Spence
|Phlebostatic axis which is located at the fifth intercostal space mid-axillary line.
|The MD orders lisinopril and furosemide to be administered concomitantly to the client with HTN the nurse should......
|Administer the meds
|The best method of evaluating the amount of peripheral edema is to???? wiegh daily, measure extremity, measure I and O's, or check for pitting?
|Measure the extremity
|Assessment findings for low cardiac output would be
|Hypotension, low urine output, cool extremities, larger than normal blood loss
|Intervention for Low cardiac output may include
|IV crystalloids, RBC's, diuretics, inotropic drugs, vasopressor drugs
|Assessment findings for Cardiac tamponade maybe
|decreased CT output, muffled heart sounds, pulsus paradoxus
|Interventions for Cardiac tamponade.
|Removal of clot from CT or CT changed, if no CT pericardiocenties, or return to surgery
|Assessment findings for Dysrthythmias may include
|Frequent PVC's, a-fib, bradycardic rhythms
|Interventions for Dysrthymias
|Treat K+ imbalance,andtidysrythmic drugs, temporary pacer wires to increase heart rate or overdrive pace tachycardic rythms
|Assessment findings for an Emboli
|dyspnea, faintness postivie lung scans,
|Intervention fo Emboli
|Anticoagulant therapy, observe for neuro changes
|Interventions for fever
|Blood, urine culture, antibiotic TX
|Common vavular diseases include
|Mitral stenosis, mitral valve regurgitation, mitral valve prolapse, aortic regurgitation, aortic stenosis, pulmonary stenosis
|Clinical findings of Mitral stenosis
|Dyspnea, fatigue, a-fib, heart failure, LOUD S!, diastolic murmur
|Clinical findings of Mitral valve regurgitation-chronic
|fatigue, weakness, dyspnea with activity, systolic murmor or thrill or both
|Clinical findings of Mitral valve regurgitation-acute
|pulmoanary edema and shock
|Clinical findings of mitral valve prolapse
|palpitations, dyspnea, angina, sycompe
|Clinical findings of aortic regurgitiation
|palpitations, angina, syncope, L=sided heart failure, visible apical pulse, soft S1 or presence of S3, systolic murmur at L sternal border
|Aortic stenosis clinical findings
|Palpitations, anginia, syncope, Left-sided HF, decreased cardiac output, S4(oftened discovered in youth)
|Pulmonary stenosis clinical findings
|syncope, angina, R-sided HF, systolic murmour at the L sternal border, split S2(congenital;rare)
|Hypovolemic shock is caused by rapid loss of ________________.
|Cardiogenic shock caused by
|MI, cardomyopathy, HF, pericardial tamponade, tension pneumothorax, pulmonary edema
|Anaphylatic shock is caused by a _______ ______ to food or meds
|Septic shock is when ______ _______ or ______ _______ bacteria are introduced causeing a systematic infection
|gram-negative/ gram postive bacteria
|Neurogenic shock caused by
|Spinal cord injury spinal anethesia,severe pain medication and hypoglycemia
|Assessment of shock include _____heart rate, restlessness, _____respiratory rate, _______urine output,_______ blood pressure cold clammy skin develoves
|Increased, increased, decreased, decreased
|Late stage shock _____-________ respirations and anuria develop
|During and exam client reports recent occipital headaches, blurred vision, fatigue, and increasing edema. These findings could be
|client asks " what is the prognosis for myocarditis?" a could response could be
|Recovery usually happens without any special treatment
|Which interventions would be appropriate for acute stage of bacterial endocarditis patient?
|rest, analgesics, antibiotics
|Why does a patient with hypertension need to have a urine sample checked for?
|Protein which may indicate the kidneys are affected.
|Are Nitro, O2, morphine appropriate for a MI patient
|Yes, question Asprin if a patient has open stomach ulcer may cause GI bleeding.
|rheumatic heart disease is frequently a result of
|What are priority nursing intervention during left sided heart failure exacerbation.
|High fowlers position, Oxygen, diuretics
|Iv fluid would be harmfull to a client experiencing Left sided heart failure. T or F
|I will do weekely finger-stick monitoring of my sodium level, patient will need more education or understands
|I will call my MD if I gain morre than two pounds a day. needs more education or understands
|Which manifestations indicate cardia tamponade? Muffled heart sounds, headache, hypotension, vision changes, cool, diaphoretic skin, tachycardia
|clincial manifestations of cardiac tamponade include muffled heart sounds, tachycardia, low blood pressure and cool diaphoretic skin,
|After a MI a client has concerns when is it safe to resume sex answer should be
|When your able to climb two flights of stairs comfortably.
|A driver for a patient post TEE is needed after discharge? Yes or NO
|Which med should you give if a patient with CAD develops chest pain, 1 tab nitro q15 times 3 doses or 0.4mg nitro IV push over 1-2 minutes
|1 tab po q 15 minutes times 3, than call 911 if not effective, nitro is not given IV push ever.
|Which diet choices are good for pt. with CAD...Mozzarella cheese, grilled chedder cheese sandwich, tomato juice, peanut butter sandwich, 2% milk, tortilla
|Out of the choices the best choices would be the moz cheese and tortilla, Chedder higher in fat, tomato juice high sodium, pb high fat content, skim milk perfered over 2%
|The nurse assesses the left foot of a client with known CAD that has become suddenly cold, painfull, and pulseless. What is your next intervention?
|Plans for nursing interventions for a client in the acute stage of bacterial endocarditis should include which nursing interventions.
|Antibiotics to combat the bacterial infection and analgesics for aches that may occur are appropriate interventions for acute-stage BE.
|It is important to notify the MD of an allergy to shellfish while obtaining a cardiac history prior to coronary angiogram. T or F
|Which age group are most likely to aquire rheumatic fever
|young aduldts after an beta-hemolytic streptococcal upper respiratory infection.
|Post CABG the patient should expect to have ? which devices, Chest tube, NG tube, ET tubes, IV,
|All of the above
|Because a client with sinus bradycardia is experiencing hypotension, plans intervention include administration of what drugs.
|Atropine->used for sinus bradycardia which a patient is symptomatic
|________ _______ is a dysrhytmia charc. by a very irritable atrium. The atria fire at a rate of 250-350 bpm. The waveforms resembles a saw tooth resemblance
|_________ _________ a lethal rhythm charc. by a chaotic rhythm that originates in the ventricles, it is unorganized and uncoordinated series of rapid impulses that cause the hearet to fibrillate rather than contract
|_____ ______ is an extremly irritable rhythm orginating in the atrium. There is a organized atrial activity
|____ _______ is a lethal rhythm that exists when three or more PVCs occur in a row at a rate greater thatn 100bpm
|____ ____ is a heart rhythm in which the S-A node fires at fewer than 60bpm. It may be normal in a healthy athlete and goes untreated unless symptomatic.
|Sinus brady cardia is treat with which drug if symptomatic
|A ____ degree heart block is a lethal rhytmn
|A _____ degree ______ _____ is a complete blockage of the atrial impulses into the bentricles
|third degree heart block...The block may be in the A-V node, bundle of His, or bundle branches resulting in the atria and ventricles beating independently of each other.
|A patient post pacemaker insertion should be instructedd to stay on bed rest for _____ hours with minimal activity of the affected arm and shoulder to prevent ________ the leads of the pacemaker.
|12 hours/ dislodgment
|Ventricluar tachycardia and ventricular fibrillatioin are not lethal dysrhtymias that require immediated intervention to maintain life.
|False....they require interventions
|Pacemaker placment is needed for sinus rhythm with a second-degree a-v block type 2 (Mobitz 2) true or false
|Sinus bradycardia usually goes unnoticed because the client can compensate for the decreased cardiac output. True or false
|Which patient should you assign to the licensed personal? ventricular tachycardia, sinus bradycardia, ventricular fibrillation, sinus rhythm with a second-degree A-V block type II(Mobitz II)
|which dysrhythmia is priority for the nurse to report 1st? Sinus rhythm with a 1st dree A-V block, suprventricular tachycardia (SVT), atrial fibrillation, Idioventricular rhythm (ventricluar escape rhythm?
|Idioventricular rhythm is a lethal rhythm in which there is a high pacemaker failure. No impulses are conducted to the ventricls from above the bundle of His
|prioritize the patients in order whom should be taken care of first to last. Sinus bradycardia, atrial flutter, ventricular fibrillation, sinus tachycardia
|ventricular fibrillation, atrial flutter, sinus tachycardia, sinus bradycardia
|In caring for a client with atrial flutter which of the following goals would have priority.
|Control the heart rate and maintain cardiac output.
|Which of the following should the nurse include in the plan of care for a client with sinus tachycardia? Administer lidocaine, assess the client, administer atropine, cardioversion
|assess the client, and treat as needed the most commonly used drugs are beta blockers.
|Define NANDA diagnosis ; Cardiac output decreased---
|Inadequate blood pumped by the heart to meet metabolic demands of the body
|Name some defining characteristics of Cardiac output, decreased
|Altered heart rate/rhythm, altered preload, altered after load, altered contractility,
|Examples of altered heart rate/rhythm
|Dysrhythmias(tachycardia, bradycardia); palpitations;electrocardiographic changes
|Jugular vein distention;fatige, edema, murmurs, increased/decreased central venous pressure (CVP), increased/decreased pulmonary artery wedge pressure (PAWP), wieght gain
|Cold/clammy skin, SOB/dyspnea, oliguria, prolonged capillary refill, decreased peripheral pulses, variations in blood pressure readings, increased/decreased systemic vascular resistance (SVR),>/< pulmonary vascular resisitance(PVR), skin color changes
|crackles, cough, orthopnea,noc. dyspnea, cardiac output<4L/min, cardiac index <2.5 L/Min, < EF, s3/s4 sounds
|hypo or hyper kalemia is common in heart c clients because of diuretic needs
|BNP, BMP, CBC which one is usefull in establishing or eliminating the diagnosis of heart failure in the client with dyspnea
|What is the best position for a patient with cardiac issues
|Best meal for a client with cardiac disease would be
|small sodium-restricted, low cholesterol meals. Decreased sodium helps decrease fluid volum excess, low cholesterol diets help decrease atheroscleroses, smaller meals are easier to digest less cardiac output needed.