CSN Nurs 205 Exam 3
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| LEFT-SIDE HEART FAILURE | Decreased Cardiac Output
& Pulmonary Congestion
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| Decreased Cardiac Output | Fatigue
Weakness
Oliguria during the day
Angina
Confusion, restlessness
Dizziness
Tachycardia, palpitations
Pallor
Weak peripheral pulses
Cool extremities
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| Pulmonary Congestion | Hacking cough, worse at night
Dyspnea/breathlessness
Crackles or wheeze in lungs
Frothy, pink-tinged sputum
Tachypnea
S3/S4 summation gallop
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| RIGHT-SIDE HEART FAILURE: | Systemic Congestion
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| RIGHT-SIDE HEART FAILURE:Systemic Congestion | Jugular (neck vein) distention
Enlarged liver and spleen
Anorexia and nausea
Dependent edema (legs and sacrum)
Distended abdomen
Swollen hands and fingers
Polyuria at night
Weight gain
Increased blood pressure (from excess volume) or decreased blo
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| 'Culture' | refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.
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| 'Competence' | implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities
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| ‘Cultural | and linguistic competence’ is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.(Cross, 1989).
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| Cultural awareness= | a consciousness of one’s personal reactions to people who are different.
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| Cultural diversity= | e variety of human societies or cultures in a specific region, or in the world as a whole.
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| Cultural competence= | combination of awareness, sensitivity, experience, knowledge and desire to work effectively with people of a different culture other than your own.
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| Pulse pressure | the difference between systolic and diastolic. Normal is 30 to 40 mm of Hg.
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| A narrow pulse pressure can be attributed to? | hypovolemia, slow heart rate and hypertension
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| Heart Failure = Pump Failure Three types: | 1. Left sided heart failure
(Left sided heart failure is aka CHF)
a. Systolic failure
b. Diastolic Failure
2. Right sided heart failure
3. High-output heart failure
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| Physical Assessment: Left Heart Failure | - increased RR, hacking cough
- basalar crackles and wheezes
- tachacardia, palpatations, S3 gallop
- change in mental status
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| Physical Assessment: Right Heart Failure | - JVD
- dependent edema
- ascites, hepatomegaly
- N, V, and anorexia
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| Lasix & Bumex are | are loop diuretics consider K+ supplement
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| Aldactone is a diuretic but it is | potassium sparing
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| calcium channel blockers are? | Verapamil, Norvasc
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| What should you do with calcium channel blockers? | Monitor BP and pulse
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| Ace Inhibitors are? | The Prils - Captopril, Lasinopril. Change positions slowly especially after first dose,
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| What is a common side effect of Ace inhibitors? | Cough
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| What is the antidote of Heparin? | Protamin Sulfate
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| What is the antidote of coumadin? | Vitamin K
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| what it HITT? | Heparin-Induced
Thrombocytopenia and
Thrombosis
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| Who cannot undergo an MRI? | Patients with pacemaker or implanted defibrillator
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| A FIB - Irregular Heart Beat? Look out for? | Clots
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| Where do Clots of A FIB go? | TO the brain!
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| What should you do for A fib? | Give digoxin and coumadin - digoxin strengths but lowers and coumadin blood thinner
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| KCL - how much are you allowed? | only 10meq/hr
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| A crushing wound of the leg is bad why because of potassium? | Because all the potassium is inside the cell, so the cell is crushed and the potassium is let out, free floating potassium dysrthmia
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| Arteriosclerosis | a thickening, or hardening, of the arterial wall.
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| Atherosclerosis | a type of arteriosclerosis, involves the formation of plaque within the arterial wall
the leading contributor to coronary artery and cerebrovascular disease.
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| Diuretics | Monitor I&O and potassium levels
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| Calcium Channel Blocking Agents | Monitor BP & HR
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| Angiotensin-Converting Enzyme (ACE) Inhibitors | Monitor BP & HR, report edema and cough
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| Angiotensin II receptor Antagonists | Monitor BP & HR, report angioedema
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| Aldosterone Receptor Antagonists | Monitor renal function, Na+ and K+ level
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| Beta-adrenergic blockers | Monitor BP & HR
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| the most common cause of peripheral occlusions | An embolus
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| Raynaud’s disease occurs in women between the age | 17 and 50 years of age, usually bilaterally
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| Thrombosis | is the formation or presence of a blood clot inside a blood vessel or cavity of the heart.
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| A thrombus is | a blood clot that forms inside a blood vessel or cavity of the heart.
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| Thrombolysis | is the breaking up of a blood clot.
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| An embolus is | a blood clot that moves through the bloodstream until it lodges in a narrowed vessel and blocks circulation.
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| Phlebitis | An inflammation of the superficial veins caused by an irritant, such as IV therapy
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| Ischemia | occurs when insufficient oxygen is supplied to meet the requirements of the myocardium.
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| Infarction | (necrosis, or cell death) occurs when severe ischemia is prolonged and irreversible damage to tissue results.
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| Angina | Substernal chest discomfort:
Radiating to the left arm
Precipitated by exertion or stress
Relieved by nitroglycerin or rest
Lasting < 15 min
Few associated symptoms
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| Myocardial Infarction | Substernal chest pressure:
Radiating to the left arm, back, or jaw
Occurring without cause, usually in the morning
Relieved only by opioids
Lasting 30 minutes or more
Frequent associated symptoms: Nausea, Diaphoresis, Dyspnea, Feeling of fear and anx
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| for heart attacks what diagnostic assessments do u do? | Laboratory Assessment
Troponin T and I, CK-MB, and myoglobin
ECGs
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| Diuretic | – teach the clients to take the medication in the morning, daily weight before breakfast
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| ACE inhibitor | teach the clients to move slowly when change position, especially from a lying to a sitting position. Dizziness, light-headedness, and cough need to be reported to the provider
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| ACE inhibitor | Client taking diuretic and ACE Inhibitor – check serum potassium level and renal function every few months.
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| Digoxin | – teach the clients how to take pulse rate
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| High T waves on EKG = | Heart Attack - ischemia - the electrical has to go around the dead tissue - maybe potassium is high?
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| P waves | if they are fluttering that means electrical is going weird. sometimes u cannot distinguish it or it might be flat.
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| Complementary Therapy | treatmentused in addition to conventional therapy
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| Alternative Therapy | treatment used asa substitution for traditional therapy
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| Chronic Illness | one that has existed for at least three months
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| Rehabilitation | to return the client to thefullest possible capacity
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| Manipulative and Body-Based Therapies | MassageTai Chi
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| Biologic-Based Therapies | AromatherapyHerbal Preparation
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| Energy Therapies | Therapeutic TouchMagnetic Unruffling
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| Primary Dimensions of Diversity |
Age
Race
Ethnicity
Heritage
Gender
Physical abilities/qualities
Sexual/affection orientation
Mental abilities/
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| Secondary Dimensions of Diversity | Education
Communication style
Work background
Work style
Income
Marital status
Military experience
Religious beliefs
Geographic
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| paradigmis | a set of rules & regulations thatestablish boundaries andtells you how to besuccessful within theboundaries
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| Complementary and Alternative Therapies | focus on holistic care
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| Complementary Medicine | “A group of diagnostic and therapeutic disciplines that are used together with conventional medicine.”
Example: aromatherapy to help lesson a client’s pain/discomfort.
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| sed in place of | conventional medicine”
Example: “using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor.”
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| Integrative Medicine – “combines | treatments from conventional medicine and CAM for which there is evidence of safety and effectiveness”
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| Five domains/categories: | Systems of health care
Mind-body therapies
Manipulative and body-based therapies
Biologically based therapies
Energy therapies
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