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Heart nclex
cardiology nclex
| Question | Answer |
|---|---|
| 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. | main |
| The AV node ________ the impluse and ________ it to the Bundle of HIS | recieves/transmits |
| 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 | SA node |
| 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. | Ventricles |
| Third degree heart block or _________heart block none of the sinus impluses reach the ventricles | Complete |
| Erratic heart rates, hyptension, seizures, cerbral ischemia or cardiac arrest. Would be charactristic of which heart block | Third |
| Heart blocks are detected by which procedure? | ECG |
| Therapeutic levels of Digoxin is 0.5-2.0 ng/ml. T or F | True |
| IF digoxin exceeds greather 2.0 there considered toxic. T or F | True |
| 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 | False |
| 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 ____________ _________. | Myocardial Infarction |
| The client can go into _________ ________ post MI. | Cardiogenic shock |
| 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 | myocarial infarction |
| 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. | 1/5min/3 |
| 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 | saw tooth |
| Treatment of V-fib is | defibrillation. |
| Cardiac Catherizaation detects_______ associated with MI and dysrthymias | blockages |
| It is not okay to administer dye to a patient with a shellfish allergy. T or F | False |
| 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 | protamine sulfate |
| The antidote for coumadin is | Vitamin K |
| B_______ disease results when spasms of the arteries and veins occur primarily in the lower extremities..... | Buerger's |
| 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. | Thrombophlebitis |
| _________ sign is considered postitive is the cliet complains of pain on dorsiflexion of the foot. | Homan's sign |
| 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 | anticoagulant |
| 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 |
| Aneurysms are | 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 | bruit |
| 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 | abdomen |
| Most heart failures occur when the _____ ventricle fails to pump blood | left |
| 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. | peripheral areas |
| Signs of Right sided heart failure are | pitting edema |
| CBC evaluates? | 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. | IV push |
| When a client is placed on rosuvastatin (crestor) they should report | muscle weakness-sign of rhabdomyositis |
| rosuvastatin (crestor) takes effect in how long | One month |
| 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 | True |
| 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 ________________. | Fluid |
| Cardiogenic shock caused by | MI, cardomyopathy, HF, pericardial tamponade, tension pneumothorax, pulmonary edema |
| Anaphylatic shock is caused by a _______ ______ to food or meds | Allergy |
| 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 | Cheyne-stokes |
| During and exam client reports recent occipital headaches, blurred vision, fatigue, and increasing edema. These findings could be | hypertension |
| 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 | streptococcal infection |
| 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 | True |
| I will do weekely finger-stick monitoring of my sodium level, patient will need more education or understands | More education |
| I will call my MD if I gain morre than two pounds a day. needs more education or understands | Understands care |
| 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 | YES |
| 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? | Call MD |
| 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 | T |
| 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 | Atrial flutter |
| _________ _________ 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 | ventricular fibrillation |
| _____ ______ is an extremly irritable rhythm orginating in the atrium. There is a organized atrial activity | Atrial fibrillation |
| ____ _______ is a lethal rhythm that exists when three or more PVCs occur in a row at a rate greater thatn 100bpm | Ventricular tachycardia |
| ____ ____ 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 bradycardia |
| Sinus brady cardia is treat with which drug if symptomatic | Atropine |
| A ____ degree heart block is a lethal rhytmn | third |
| 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 | True |
| Sinus bradycardia usually goes unnoticed because the client can compensate for the decreased cardiac output. True or false | true |
| 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) | Sinus bradycardia |
| 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 |
| Altered preload- | Jugular vein distention;fatige, edema, murmurs, increased/decreased central venous pressure (CVP), increased/decreased pulmonary artery wedge pressure (PAWP), wieght gain |
| Altered afterload- | 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 |
| Altered contractility- | crackles, cough, orthopnea,noc. dyspnea, cardiac output<4L/min, cardiac index <2.5 L/Min, < EF, s3/s4 sounds |
| behavioral/emotional | anxiety/ restlessness |
| hypo or hyper kalemia is common in heart c clients because of diuretic needs | hypo |
| BNP, BMP, CBC which one is usefull in establishing or eliminating the diagnosis of heart failure in the client with dyspnea | BNP |
| What is the best position for a patient with cardiac issues | Semi-fowlers |
| 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. |
Created by:
jensen1106
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