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NURS-114 > EXAM 2 > Flashcards

EXAM 2 Flashcards

1
Q

what is the normal ejection fraction?

A

55-70%

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2
Q

what is considered a reduced ejection fraction?

A

less than 45%

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3
Q

an ejection fraction greater than 45% is good or bad?

A

good

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4
Q

what is the ejection fraction for left-sided heart failure?

A

reduced less than 45%

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5
Q

what are the signs and symptoms of left sided heart failure?

A

SOB, tachypnea, low PaO2, tachycardia, orthopnea, crackles, fatigue, poor color, weak pulses, cool extremeties, mottling

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6
Q

what are the signs and symptoms of right-sided heart failure?

A

JVD, generalized edema, hepatomegaly, ascites

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7
Q

left sided HF can cause

A

right-sided HF

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8
Q

what are the symptoms of a pulmonary edema?

A

pink frothy sputum

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9
Q

WHAT ARE THE SYMPTOMS OF CHRONIC HF

A

fatigue dyspnea, orthopnea, paraoxysmal nocturnal dyspnea, cough, increased hr, a fib, edema, jvd, uo changes

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10
Q

if your pt has a pink frothy sputum, what should you do?

A

apply oxygen, IV diuretics, CPAP or BiPAP

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11
Q

what are the diagnostic studies for chronic heart failure?

A

echo

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12
Q

what lap should you get for heart failure?

A

proBNP (most specific), cardiac biomarkers, chem 7 or 12

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13
Q

what does an echo show?

A

ejection fraction

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14
Q

what is the first line treatment for chronic heart failure?

A

diuretics

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15
Q

what should you watch for with fureosemide?

A

potassium, urinary output, weight loss

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16
Q

what are some diuretics that could be used?

A

lasix IVP or spironolactone

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17
Q

what are the types of treatments for chronic heart failure?

A

diuretics, vasodilators, positive inotropes, ace inhibitors, ARBS, angiotensin receptors, aldosterone antagonists, beta-blockers

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18
Q

when do you use vasodialators for HF pt?

A

in absence of hypotension

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19
Q

how do vasodialators help hf patients?

A

reduces preload

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20
Q
A
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21
Q

what are some examples of positive inotopes?

A

digoxin

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22
Q

what should you watch for when you give positive inotopes (digoxin)?

A

vision disturbances

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23
Q

what is an adverse reaction with ace inhibitors?

A

angioedema

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23
Q

what do ace inhbitors end in?

A

pril

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24
Q

what are the side effects of ace inhibitors?

A

low bp, dry hacky cough, high potassium, renal insufficiency

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25
Q

when do you give ARBS?

A

for tps that cannot tolerace ACE inhibitors

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26
Q

how do arbs work?

A

decrease afterload and promotes vasodilation

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27
Q

what do arbs end in?

A

sartan

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28
Q

when would you give angiotensin receptors?

A

when BNP is greater than 100

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29
Q

what are some examples of angiotensin receptors?

A

valsartan/sacubiltril

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30
Q

how do beta blockers work?

A

decrease heart rate and myocardial workload/afterload

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31
Q

what are some aldosterone antagonists?

A

spironolactone

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32
Q

what surgical management is used for pts with chronic heart failure?

A

internal cardiac defibrilator and pacemaker for dysrhythmia control

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33
Q

what is important for hf patients to do?

A

daily weights

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34
Q

when should you report weight gain?

A

1 kg in a day or 2 kg in a week

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35
Q

what type of diet is someone with heart failure on?

A

low sodium 1600 mg day

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36
Q

what is important to remember that heart failure patients cannot take?

A

NSAIDSw

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37
Q

what are the complications of heart failure?

A

pulmonary edema

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37
Q

what action should you do for your patient with heart failure?

A

elevate hob

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38
Q

what are the symptoms of pulmonary edema?

A

pink frothy sputum

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38
Q

when should you start the blood infusion/

A

30 minutes of obtaining blood from the lab

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39
Q

when should you obtain vital signs of someone with a blood transfusion/

A

after first 5 minutes then 15 minutes then 30 min for an hour, then hourly

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40
Q

what are the signs and ysmpotms of a reaction to the blood transfusion?

A

fever, chills, flank pain, chest pain

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41
Q

hypertension has a major risk factor for developing?

A

vision loss

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42
Q

if you suspect a transfusion reaction what should you do?

A

stop infusion, get vital signs, get ns bag and infuse, and notify HCP

43
Q

what race has a greater chance of developing hypertension?

A

african americans

44
Q

what are the risk factors for hypertension?

A

smoking, obesity, inactivity, excessive alcohol usewhat

45
Q

are the signs and symptoms of hypertension?

A

headaches, vision changes, SOB, nosebleeds

45
Q

what is hypertension stage 1?

A

130-139/80-89

46
Q

what is elevated blood pressure?

A

120-129/ less than 80

47
Q

what is normal blood pressure?

A

120/80

48
Q

what is hypertension stage 2?

A

140 or higher/ 90 or higher

49
Q

what is a hypertensive crisis?

A

higher than 180/ higher than 120

50
Q

what lifestyle changes should you make regarding hypertension?

A

control cholesterol, eat dash diet, ldl lower than 100

51
Q

what is a DASH diet?

A

fruits, veggies, fat-free or low-fat milk, whole grains, fish, poultry, beans, seeds, nuts

52
Q

how many drinks can men and women drink a day?

A

men: 2 or less ; women: 1 or less

53
Q

what medications are given to pts with hypertension?

A

diuretics, calcium channel blockers

54
Q

how much exercise should someone with hypertension be doing a week?

A

90-150 minutes/week or 30 min a day

55
Q

what diuretic is given for hypertension?

A

thiazide, calcium channel blockers, ace inhibitors, arbs

56
Q

what should you monitor for with thiasize?

A

hypotension, low potassium

57
Q

what should you avoid when taking a calcium channel blocker?

A

avoid grapefruit juice

58
Q

what do ace inhibitors do?

A

block formation of angiotensin Ii

59
Q

what do ace inhibitors end in ?

A

pril

60
Q

what do arbs end in?

A

sartan

61
Q

how do arbs wrok?

A

blocks action of angiotensin 2

62
Q

how long do arbs take to wrok

A

3-6 weeks

63
Q

what should you use in a hypertensive crisis?

A

iv vasodilator hydralazine

64
Q

what are the signs and symptoms of peripheral artery disease?

A

muscle pain-ache, cramp, numbness

65
Q

what is the goal of a hypertension emergency?

A

reduce bp by 20-25% over 24 hours

66
Q

for an ankle-brachial index, what needs to be treated?

A

anything less than 0.9

67
Q

what is the most effective exercise for individuals with claudications?

A

walking

68
Q

what is the treatment of peripheral artery disease?

A

prevent progression of disease

69
Q

what are the signs and symptoms of deep vein thrombosis?

A

pain, swelling, tenderness, discoloration, redness, warmth

70
Q

what is the number 1 thing to do to prevent dvt?

A

ambulation

71
Q

what anticoagulants are given for pts with dvts?

A

unfractionated heparin, low molecular weight heparin, warfarin

72
Q

what are the signs and symptoms of a pulmonary embolism?

A

sob, low o2 sat, high hr, low bp, sweating, chest pain, hemoptysis

72
Q

what are the complications of a dvt?

A

pulmonary embolism/

73
Q

what does the skin look like for chronic venous insufficiency

A

brownish leathery skin discoloration

74
Q

how does the wound bed appear for chronic venous insufficiency?

A

“ruddy” or beefy not punched out

74
Q

how should you keep the leg for chronic venous insufficency

A

elevated

75
Q

what are good sources of iron?

A

dark green veggies, beets, dried beans, legumes, fortified grains, meat eggs

75
Q

what are good sources of b12?

A

meat, seafood, eggs, dairy products

76
Q

what are good sources of folic acid?

A

dark green veggies, dried beans, legumes, fortified grains, nuts, bran, yeast, avocados, oranges, bananas, liver

77
Q

what are the signs and symptoms of iron deficiency anemia?

A

hypoxia, fatigue, pallor, tachycardia, tachypnea, jaundice

78
Q

vitamin b12 is also known as

A

cobalamin

78
Q

what are the side effects of iron supplements?

A

constipation and black poop

79
Q

what are the risk factors for vitamin b12 anemia?

A

gastric bypass, crohns disease, celiac disease, strict vegetarians, long term use of ppis

80
Q

what are the symptoms of vitamin b12 anemia?

A

sore, red, beefy, shiny tongue, n/v, anorexia, abd pain, peripheral neuropathy, altered mental status, visual changes, high hr, sob, dizziness

81
Q

what are the signs and symptoms of folic acid deficiency anemia?

A

pallor, high hr, tachypnea, dizziness, fatigue

82
Q

what are the prevention/treatments of sickle cell

A

hydration, pain meds, antibiotics, oxygenw

82
Q

what are the signs and symptoms of sickle cell disease?

A

pain, swelling, fatigue, sob, growth delay

83
Q

what are the actions you should do if your pt has sickle cell anemia?

A

give oxygen, hydrate, manage pain, give antipyretics, supportive measures

83
Q

what are the signs and symptoms of aplastic anemia besides fatigue, sob, high hr?

A

infections, bleeding, headache

84
Q

what are thes igns and symptoms of glucose 6 phosphate dehydrogenase?

A

pallor, jaundice, dark urine, fatigue, sob, high hr, enlarged spleen

85
Q

what is the treatment for G6PD?

A

Avoid fava beans

86
Q

what is primary polycthemia vera?

A

increased RBC, WBC, and platelets; occurs bc of JAK2 gene mutation

87
Q

what is secondary polycthemia vera/

A

increased rbc and wbc and platelets remain normal; happens because of hypoxia, high altitudes, heavy smoking

88
Q

what are the signs and symptoms of polycthemia vera?

A

sob, splenomegaly, blurred vision, itchiness after bathing, weakness

89
Q

what are the signs and symptoms of thrombocytopenia?

A

petechiae, purpura, ecchymosis, prolonged bleeding

90
Q

what is thrombocytopenia?

A

low platelets

91
Q

what should you teach your patient with bleeding precautions?

A

bleeding gums, cuts bleed longer than others, watch platelet count, avoid aspirin, no contact sports, weak helment, avoid IM shots, avoid intercourse if extremely low, replace platelets after surgery

92
Q

how many people must verify the blood?

A

two

93
Q

what do you need to obtain before starting the blood transfusion?

A

informed consent

94
Q

what labs should you get for iron deficient anemia?

A

serum iron tests

95
Q

what is the treatment of iron deficiency anemia?

A

iron supplements 150-200 mg/day

96
Q

iron is best obsorbed with

A

citric acid

97
Q

what should a pt take dietary iron?

A

before meals

98
Q

what are risk factors for b12 anemia?

A

excess alcohol, meds that decrease gastric acid (PPIs)

99
Q

vitamin B is caused by?

A

pernicious anemia

100
Q

what are the signs and symptoms of vitamin b12 anemia?

A

altered mental status, depression, sore/red/beefy, shiny tongue

NURS-114 (5 decks)

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