Exam 2 - Summary Set Flashcards
____ is a loss of lung elastic tissue, leading to hyperinflation and air trapping
emphysema
___ is inflammation of the bronchi and bronchioles
chronic bronchitis
mucus plugs, inflammation, hypoxemia, and respiratory acidosis are associated with ____
chronic bronchitis
____ is the #1 risk factor for COPD
smoking
name at least 4 s/s of COPD
(1) dyspnea
(2) thin, dusky extremities
(3) barrel chest
(4) pursed lip breathing
(5) rapid, shallow respirations
(6) chronic cough and sputum production
(7) fatigue
barrel chest and pursed lip breathing is associated with
emphysema
name s/s of early hypoxia
(1) tachycardia
(2) tachypnea
(3) elevated BP
(4) pale skin
(5) O2 <90
(6) confusion
name s/s of late hypoxia
(1) stupor
(2) cyanosis
(3) bradycardia
(4) bradypnea
(5) hypotension
(6) dysrhythmias
name s/s of chronic hypoxia
(1) nail clubbing
(2) cyanosis
(3) delayed cap refill
(4) barrel chest
(5) pursed lip breathing
describe 4 components of a COPD exacerbation
(1) RR 40-50
(2) SpO2 80-85%
(3) Accessory muscle use
(4) Abnormal lung sounds (wheezing, crackles)
___-sided heart failure is a complication of COPD
right
how do you diagnose COPD? (5)
(1) History
(2) Peak flow expiratory flow
(3) ABGs
(4) Chest x-ray
(5) Sputum & WBC
____ is the #1 priority for COPD
impaired gas exchange
the 5 priorities r/t COPD are
(1) gas exchange
(2) anxiety
(3) weight loss
(4) fatigue
(5) preventing infection
name at least 3 nursing interventions for impaired gas exchange
(1) raise HOB
(2) give O2 to get SaO2 88-92%
(3) Hydration to thin secretions
(4) medication
(5) smoking cessation
(6) suctioning
name 3 nursing interventions for anxiety r/t COPD
(1) breathing exercises
(2) relaxation techniques
(3) anti-anxiety meds
pts with COPD should eat _____ type of meals to avoid weight loss
protein / calorie-dense meals; frequent and small
use ____ 30 minutes before meals
bronchodilator
what are the 5 main medications for COPD?
(1) short-acting b2 agonists
(2) long-acting b2 agonists
(3) inhaled corticosteroids
(4) inhaled anticholingergics
(5) mucolytics
____ is an example of a SABA
albuterol
____ is an example of a LABA
salmeterol
____ is an example of an inhaled anticholinergic
tiotropium
____ is an example of an inhaled corticosteroid
fluticasone
____ is the rescue inhaler
albuterol / SABA
which medication do you take first (before other meds)?
SABA / albuterol
what is the purpose of Tiotropium?
bronchodilator
___ is a side effect of inhaled anticholinergics / tiotropium
dry mouth
what is the purpose of Fluticasone?
reduce airway inflammation
teach pts to ____ when taking inhaled corticosteroids to decrease risk of thrush
rinse their mouth
____ is an example of a mucolytic
acetylcysteine
what is the action of mucolytics?
thin secretions
the main side effect of mucolytics is _____
hepatotoxicity
which medication can smell like rotten eggs?
acetylcysteine / mucolytics
explain the steps of MDI use:
(1) exhale completely
(2) inhale slowly and release one puff over 3-5 seconds
(3) hold breath for 10 seconds
(4) exhale
(5) wait 5 minutes before next dose
(6) rinse mouth after
in a COPD action plan, when do you call 911?
when the pt is in the red zone
___ is a lung infection that causes airway inflammation and fluid buildup
pneumonia
is the biggest risk factor for pneumonia
underlying lung condition
name at least 3 s/s of pneumonia
(1) fever, chills, malaise
(2) cough (sputum or not)
(3) dyspnea
(4) pleuritic chest pain
(5) increased RR
(6) wheezing, rhonchi, crackles
(7) low O2
WBC will be ___ in pneumonia
elevated
what are the 4 nursing priorities for pneumonia?
(1) gas exchange
(2) airway obstruction
(3) possible sepsis
(4) anxiety
encourage _____ L/day of ____ to thin secretions
2-3; fluids
what are the 2 main medications for pneumonia?
(1) cephalosporin (ceftriaxone)
(2) fluoroquinolone (levofloxacin)
___ is one of the safest antibiotics
ceftriaxone
name the 4 main side effects of levofloxacin
(1) N/V
(2) swelling of tendon
(3) C. diff
(4) yeast infections
the 3 things you should teach pts when taking levofloxacin are…
(1) take with food
(2) avoid sun exposure
(3) complete the course
multiple rapid impulses from the atria that are disorganized is ____
atrial fibrillation
chaotic rhythm, no atrial contraction, loss of atrial kick, and irregular ventricular response can all be used to describe
A Fib
the two biggest risk factors for A Fib are
HTN and CV disease
name at least 3 other risk factors for A Fib (besides HTN and CV disease)
(1) obesity
(2) DM
(3) advanced age
(4) smoking
(5) excessive alcohol use
(6) OSA
(7) hyperthyroidism
if CO is impacted by AFib, ___ is affected
perfusion
what are the key characteristics of A Fib on an ECG?
(1) heart rate can vary (normal 60-100 or rapid 100-200)
(2) irregular R to R rhythm
(3) no clear P wave
the 3 main nursing priorities for A Fib are
(1) risk for embolus formation
(2) risk for heart failure
(3) potential knowledge deficit
embolus formation can lead to ___, ___, and ___
stroke, DVT, and PE
the two main drug classes for A Fib are
antidysrhythmics and anticoagulants
___, ___, and ___ are antidysrhythmics
diltiazem, metoprolol, and digoxin
diltiazem class
Ca channel blocker
diltiazem action
slow conduction
diltiazem monitoring & ed
(1) monitor HR and BP
(2) slow position changes
(3) monitor s/s HF
metoprolol class
beta blocker
metoprolol action
slow ventricular response
metoprolol monitoring & ed
(1) monitor HR and BP
(2) slow position changes
(3) can cause bronchospasm
if HR<60 bpm hold _____ and call the provider
diltiazem, metoprolol, and digoxin
____ drugs are a high fall risk
antidysrhythmics
___ and ___ are the two anticoagulants used for A Fib
Coumadin / Warfarin, Apixaban / Rivaroxaban
Coumadin class
anticoagulant
Coumadin action
thin blood and prevent clot
Coumadin monitoring & ed
(1) INR testing required
(2) avoid / limit vit K
(3) herbals can interfere (ginseng, ginger)
(4) monitor for bleeding
Apixaban / Rivaroxaban class
DOAC
Apixaban / Rivaroxaban action
thin blood and prevent clots
Apixaban / Rivaroxaban monitoring & ed
(1) No INR testing
(2) Monitor for bleeding
name 5 ways to prevent bleeding when on anticoagulants
(1) electric razors
(2) no aspirin
(3) small gauge needles
(4) limit needles sticks
(5) protect from injury (falls, trauma, etc.)
3 lifestyle recommendations the nurse can provide for pts with A Fib include:
(1) 210 minutes of moderate to vigorous exercise
(2) smoking cessation
(3) weight reduction
(4) alcohol reduction to <3 drinks/week
(5) control HTN
____ is an increase in HR
sinus tachycardia
name at least 3 causes of sinus tachycardia
(1) anemia
(2) normal response to physical activity, stress, or pain
(3) hypoxia
(4) hyperthyroidism
(5) drugs
(6) compensation for decreased CO and BP
name at least 3 s/s of sinus tachycardia
(1) fatigue
(2) weakness
(3) SOB
(4) orthopnea
(5) decreased O2 sat
(6) decreased BP
the 2 nursing priorities with sinus tachycardia are
(1) avoid drugs that increase HR
(2) help with stress management
partial or total arterial occlusion
peripheral arterial disease (PAD)
___ can lead to decreased perfusion of the extremities / lower extremities
PAD
___ usually occurs on the toes and has well-defined edges
PAD
what is the main cause of PAD?
systemic atherosclerosis
name at least 3 s/s of PAD
(1) intermitent claudication
(2) weak or absent pedal pulses
(3) prolonged cap refill
(4) skin is hairless, shiny, dry, cool to touch
(5) pallor on elevation
(6) rubor in dependent position
the #1 priority for treatment of PAD is to ___
improve perfusion
why should people with PAD avoid smoking, caffeine, and nicotine?
b/c they are vasoconstrictors and can worsen poor perfusion
____ agents are used to treat PAD
antiplatelet
the 2 main meds used in PAD are ___ and ___
aspirin, clopidogrel
elevating the legs in _____ injuries will cause more pain
arterial
one key different between PAD and Venous insufficiency is that ____ has present pedal pulses and ____ does not
venous insufficiency; PAD
prolonged venous hypertension stretches the veins and damages the valves
venous insufficiency
venous insufficiency often occurs in the ____
malleolus medialis
venous insufficiency general cause is ____
anything that impacts venous return
what are 4 things that impact venous return?
(1) DVT
(2) decreased skeletal muscle pump
(3) increased ABD pressure
(4) sedentary lifestyle
name at least 3 s/s of venous insufficiency
(1) pitting edema
(2) eczema / dermatitis
(3) ulcers
(4) hyperpigmentation
(5) pedal pulses present and palpable
(6) ABI WNL
what are 3 things we can do to decrease edema (non-pharm)?
(1) avoid prolonged sitting
(2) compression stockings (Teds, Jobst)
(3) SCDs
which compression stocking requires a prescription?
Jobst
compression of 8-18 mmHg and can be worn in bed is which type of compression sock?
Teds
___ has a compression of 15-20 mmHg
Jobst
what is the most important thing about compression stockings?
Making sure they are the right size so they don’t fall down
name 3 ways to protect the skin and avoid infection
(1) use mild soap
(2) limit sun exposure
(3) avoid skin irritants
(4) wear shoes
patients with _____ should not wear constrictive clothing or cross their legs
venous insufficiency
____ are dressings with zinc oxide that are covered in a wrap that hardens
Unna boot
what is the difference between PR segment and PR interval?
PR segment starts AFTER the P wave; PR interval INCLUDES the P wave
on an ECG strip, each small square represents ___ seconds
0.04
on an ECG strip, each large square represents ____ seconds
0.20 seconds
____ represents atrial depolarization
P wave
P waves should measure ___ seconds
<0.12; no more than 3 small squares
____ demonstrates the delay of the AV node
PR segment
___ can help determine if there is a heart block
PR interval
if PR interval is ____, it can indicate a potential heart block
too long
PR interval should be ____ in duration
0.12-0.20 seconds; 3-5 small squares
___ represents ventricular depolarization
QRS complex
QRS interval should be ____ in duration
<0.12 seconds (no more than 3 small squares)
____ is where the QRS complex meets the ST segment
J point
____ represents the completion of ventricular depolarization and the beginning of ventricular repolarization
ST segment
what shape should the ST segment be?
flat / isoelectric
____ represents the beginning of ventricular repolarization
T wave
what shape should the T wave be?
round and upright (in most leads)
after the T wave we see ___
the flat line
which wave may be caused by hypokalemia and is not seen in all patients?
U wave
____ represents the time it takes for for electrical signals to cause ventricles to contract and then rest
QT interval
QT interval duration should be ___
0.35-0.44 seconds
who has shorter QT intervals - males or females?
males
a prolonged QT interval can indicate what?
increased risk of ventricular dysrhythmias, like Torsades de Pointes
what are the 3 Rs of ECG analysis?
(1) Regularity
(2) Rate
(3) Resemblance
Regularity in ECG readings means
making sure the waves / segments are the same distance from one another
Rate in ECG readings means
the number in a certain duration (like a 6-second strip)
Resemblance in ECG readings means
do the waves / segments resemble one another? are the measurements similar / normal?
which type of glaucoma is a medical emergency?
angle-closure glaucoma (ACG)
____ is the most common form of glaucoma
open-angle glaucoma (OAG)
what measures elevated intraocular pressure (IOP)?
tonometry
___ determines if glaucoma is open or closed-angle
gonioscopy
the 2 nursing priorities for glaucoma are:
(1) impaired visual sensory perception
(2) health teaching d/t treatment regimen
name at least 4 tips when communicating with someone with hearing loss
(1) Make sure room is well-lit
(2) Offer hearing devices
(3) Get the pt’s attention before you speak
(4) Position yourself directly in front of the patient
(5) Don’t stand or sit in front of a bright light or window
(6) Move closer to the better-hearing ear
(7) Do not shout
(8) Speak clearly and slowly
(9) Lowering voice can be helpful
(10) Keep hands and objects away from mouth
every ECG rhythm strip is ____ seconds long
6
which arrhythmia is highlighted as life-threatening?
ventricular fibrillation (V Fib)
_____ is full cardiac arrest
ventricular asystole
_____ is not a shockable rhythm
asystole
Brief, temporary moment of imbalance of O2 supply and demand can cause
stable angina
stable angina is usually resolved by
rest, nitroglycerin, and stopping the activity that triggered it
____ lasts <15 minutes
stable angina
name 4 key characteristics of unstable angina
(1) lasts >15 minutes
(2) not relieved by nitro
(3) may have ST segment changes
(4) no changes in troponin levels
normal troponin T levels are
<0.01 ng/mL
normal troponin I levels are
<0.03 ng/mL
name 3 non-modifiable risk factors for ACS
(1) increased age
(2) male sex
(3) family history
the biggest risk factor for ACS and MI is
atherosclerosis
silent ischemia is ____
ischemia without pain
silent ischemia is more common in ____
females
vasospasm, dissection, and narrowing of arteries are all causes of
NSTEMI
describe the ECG changes associated with NSTEMI
(1) ST depression
(2) T inversion
initial troponin levels will be normal and eventually elevate in ____
NSTEMI
rupture of atherosclerotic plaque is the main cause of ____
STEMI
what are the ECG changes associated with STEMI?
ST segment elevation on 2 contiguous leads
elevated troponin levels indicate which type of ACS?
STEMI
which type of ACS occurs without cause, usually in the morning?
MI
name at least 4 associated s/s of NSTEMI/STEMI
(1) N/V
(2) diaphoresis
(3) dyspnea
(4) anxiety, fear, impending doom
(5) dysrhythmias
(6) fatigue
(7) dizziness
(8) disorientation
(9) feeling SOB
name at least 3 distinct s/s of NSTEMI/STEMI for females
(1) indigestion
(2) pain b/t shoulders
(3) aching jaw
(4) flu-like symptoms
____ may experience indigestion, SOB, and confusion during an MI
older adults
name the initial steps a nurse should take if they learn the pt has chest pain / symptoms of ACS (6)
(1) delay rest of history
(2) assess pain but fast
(3) obtain vitals
(4) ensure IV access
(5) notify provider / call Rapid
(6) pain relief
only use O2 with ____ during possible MI
hypoxemia
What is the optimal positioning during a possible MI?
semi-fowler’s
the two meds for pain relief of MI initially are
(1) IV morphine
(2) Nitroglycerin sublingual
___ needs to be managed within 4-6 hours of symptoms
NSTEMI
___ needs to be managed within 90 minutes of symptoms
STEMI
which type of MI requires PCI?
STEMI
percutaneous coronary intervention (PCI) should be performed within ___ of onset of symptoms
90 minutes
if a patient can’t receive PCI, what is the next therapy choice?
fibrinolytics
on arrival to the ED with possible MI, what is given to pts?
aspirin, chewable 325 mg
___ is given 1-2 hours after MI and stable BP and HR
beta blocker
what is given within 24 hours of MI?
ACEIs or ARBs
what med do you give for MI pts with abnormal lipid panel?
Statin therapy
when should a MI pt stop walking therapy?
if they experience dyspnea, angina, or exceed their target pulse
when should MI pts resume sexual activity?
(1) after exercise tolerance test is completed
(2) when they can climb 2 flights of stairs without symptoms
avoid taking ____ with aspirin
NSAIDs
teach patients to monitor ___ and ____ on beta blockers
BP and HR
take ___ in the evening to be most effective
statins
what are 4 things to teach pts about Nitro?
(1) sun-resistant container
(2) carry at all times
(3) replace every 3-5 months
(4) if no relief after 5 mins, call 911
after a pt experiences an MI, when should they call the provider? (4)
(1) HR <50
(2) Dyspnea
(3) Weight gain 3 lbs/week or 1-2 lbs/day
(4) Activity intolerance
when should MI pts call 911?
(1) no relief with 1 dose of Nitro
(2) severe chest pain + associated symptoms
what is the medication management during a COPD exacerbation?
(1) nebulizer (albuterol / ipratropium)
(2) IV / oral corticosteroids
(3) monitor BG
(4) antibiotics if infection
what are the two diagnostic tests for PE?
D-dimer and CTPA
what D-dimer result indicates a positive test for PE?
> 250 ng/mL
what lab test can help differentiate if a cause is respiratory or cardiac?
BNP
asymmetric chest expansion and decreased or absent breath sounds are s/s of ____
pneumothorax
T/F: The three-way dressing for a chest tube will have one side open for air to exit during exhalation
true
atropine is used to treat ____
bradycardia
long-term A Fib leads to decreased CO and poor perfusion. This is associated with which s/s?
fatigue, dizziness, hypotension, chest discomfort
what do you give for MI pain?
IV morphine
Nitroglycerin
What other drugs do you give for the treatment of MI (in general)?
(1) aspirin chewable 325 mg
(2) platelet inhibitor (clopidogrel)
(3) Beta blocker
(4) ACEI or ARB
(5) statin therapy
give beta blocker ____ after MI and when pt is stabilized
1-2 hours
when do you give ACEI or ARB for MI?
within 24 hours of MI and when pt is stable
who should receive statin therapy for MI?
those with abnormal lipid panel
treat a STEMI within ___ of onset of symptoms
90 minutes
which type of MI receives PCI?
STEMI
if a patient can’t receive a PCI in time, what should they receive instead?
fibrinolytics within 30 minutes
treat NSTEMI within ____ of symptoms
4-6 hours
when do you give alteplase for PE?
patient deterioration and shock
excessive bubbling of a chest tube can indicate ___
a leak
what are the main causes of A Fib? (5)
(1) HTN
(2) CV disease
(3) ACS
(4) CAD
(5) HF
which antidysrhythmic is good for A Fib and HF?
digoxin
amlodipine will do what to heart rate?
decrease
when is the EF concerning in heart failure?
If EF <50%
which drug causes a dry cough?
ACEIs
what tool can be used to diagnose heart failure?
echocardiography
how do you treat pulmonary edema?
(1) high Fowler’s
(2) give O2
(3) IV push Furosemide over 1-2 minutes
(4) reassess respiratory
the three nursing interventions for a hypertensive crisis are:
(1) semi-fowler’s
(2) give O2
(3) call a rapid
avoid grapefruit juice with what med?
Ca channel blockers
the main risk factor for MI is
atherosclerosis
within 10 minutes of chest pain, what should happen?
a 12-lead ECG should be hooked up
name at least 4 pieces of discharge teaching for a MI
(1) risk factor modification
(2) diet
(3) exercise
(4) sexual activity
(5) medications
hypertensive crisis is defined as…
Systolic >180 and/or Diastolic >120
s/s of hypertensive crisis include
(1) severe headache
(2) blurred vision
(3) dyspnea
(4) anxiety
(5) uremia
____ glaucoma is slow vision loss over time
open-angle
what are the goals of medication for glaucoma?
(1) decrease pressure
(2) maintain vision
Holding pressure after eye drops to ensure the drop doesn’t go to the whole body via the lacrimal duct is called?
punctal occlusion
Name at least 3 guidelines for talking to patients with vision loss in the hospital
(1) announce yourself
(2) don’t move stuff around without telling them
(3) make sure they have their glasses
(4) speak in a normal voice
(5) don’t stand with window / light behind you
name at least 4 things for hearing aid care
(1) keep aid dry
(2) wash mold with warm water and gentle soap
(3) keep charged
(4) turn off when not in use
(5) avoid use of hairspray, cosmetics, etc.
(6) use soft brush to clean debris
name 4 risk factors for OSA
(1) obesity
(2) male sex
(3) genetics
(4) older age
name at least 3 s/s of OSA
(1) daytime sleepiness
(2) waking up gasping
(3) overweight
(4) irritability
(5) memory problems
ability to perceive stimulation through sensory organs
sensation
process of receiving, organizing, and interpreting sensation
perception
ability to receive inputs and translate into meaningful information
sensory perception
CN II controls ___
visual acuity and visual field
CN III is the ____ nerve
oculomotor
CN IV
trochlear
____ controls downward and inward eye movement
trochlear
____ controls the sensation of the eye
CN V / trigeminal
CN V
trigeminal
CN VI
abducens
___ controls lateral eye movement
abducens / CN VI
what are the 3 CN involved in taste?
CN VII, IX, and X
stage 1 of sleep is ____ sleep
light
during ___ (stage of sleep), eye movement stops and brain waves slow
stage 2
during stage 2 sleep, RR, HR, and temp will ____
decrease
___ takes 90-110 minutes to achieve (sleep type)
REM
deep sleep and little muscle activity is associated with which stage of sleep?
3 & 4
Describe characteristics of REM sleep
(1) increased RR and HR
(2) brain is active
(3) muscle paralysis
(4) active dreaming
tissue degeneration, muscle / bone development, immune enhancement, and hormone regulation occur during ___
deep sleep
recurring or chronic insufficient sleep time, poor quality of sleep despite adequate time, or problems falling or staying asleep
sleep disorders
3 primary sleep disorders are
(1) insomnia
(2) OSA
(3) RLS
name at least 3 physiological consequences of inadequate sleep
(1) HTN
(2) heart disease
(3) HF
(4) stroke
(5) obesity
what is the most important intervention for impaired sleep?
sleep hygiene
what are the 2 risks of sleep aids?
(1) make people drowsy
(2) increase risk of falls
a nurse is teaching a pt with a new rx for ferrous sulfate. which of the following should be included in the teaching?
a. stools will be dark
b. take with a glass of milk if GI distress
c. foods high in vitamin C will promote absorption
d. take for 14 days
C
when might we place a pacemaker?
if someone with sinus bradycardia can’t regain normal HR
we give ___ for sinus bradycardia (medication)
atropine
we give ___ for v tach with a pulse (medication)
amiodarone
always pulseless, apneic, absent heart sounds – what is this describing?
V fib
___ is the arrhythmia that typically precedes V fib
V Tach
complete absence of any ventricular rhythm
ventricular asystole
____ is not a shockable rhythm
ventricular asystole
idarucizumab is the antidote for ____
dabigatran
____ can cause bronchospasm (medication)
metoprolol
____ is a useful drug for both A fib and HF
Digoxin
what is Virchow’s Triad?
(1) decreased blood flow
(2) endothelial / vessel injury
(3) hypercoaguable state
Virchow’s Triad is a risk for ___ and ___.
DVT and PE
beta blockers, carbonic anhydrase inhibitors, and alpha agonists all treat ___
glaucoma
never give which two drugs together?
ACEI and ARB
a normal sinus rhythm is
60-100 bpm
normal rate in the Bundle of His is
40-60 bpm
normal rate of the Purkinje fibers is
20-40 bpm
what are the 4 steps of analyzing an ECG?
(1) assess rhythm
(2) assess rate
(3) identify waveforms
(4) interpret rhythm
R-R interval represents the ___ rhythm
ventricular
p-p interval represents the ___ rhythm
atrial
all strips are __ seconds
6
when assessing the rate of an ECG, count what?
the QRS intervals (because they are larger typically)
if you have 8 QRS intervals in a 6-second strip, what is the heart rate?
80 (8 * 10)
compare the ST segment to ___ to assess for elevation / depression
isoelectric line
always assess if a patient is taking ED meds before giving ___
nitroglycerin
hold additional doses of nitroglycerin if _____
BP < 100 mmHg
sildenafil is an example of what type of med?
ED medication
pain occurs due to decreased oxygen supply to your leg muscles. what does this describe?
PAD
which intervention is most appropriate for venous insufficiency?
a. keep legs in a dependent position when sitting
b. encourage frequent walking with legs elevated when resting
c. apply warm compresses to both legs
d. limit fluid intake to reduce swelling
encourage frequent walking with legs elevated when resting
the valsalva maneuver can cause
bradycardia
name 3 causes of bradycardia
(1) being healthy / athletic
(2) valsalva maneuver
(3) drugs
(4) vomiting / suctioning
the 4 hypos can cause tachycardia. what are they?
hypovolemia
hypotension
hypoxia
hypoglycemia
widened QRS
regular rhythm
fast rate (140-180)
no P wave
what is this describing?
V Tach
chaotic
no discernible PQRST
rapid rate
V Fib
side effects of albuterol are ___ and ___
tachycardia and tremor
name the 5 nursing priorities for chest tube care:
(1) Measure drainage q1h for the first 24 hours
(2) Get baseline drainage amount at the beginning of the shift
(3) <30 mL/24 hours
(4) Monitor for infection
(5) Keep the chest tubes / drainage bags below heart level
Before and after the chest tube drainage, what are the nursing actions? (3)
(1) give morphine before and after
(2) do a repeat CXR to see if the placement is correct
(3) do not manipulate the dressing
If the chest tube becomes dislodged, what is the immediate nursing intervention?
Apply pressure with sterile gauze
for HTN, limit salt intake to ___
<1.5g/day
what are the safety precautions for thiazide diuretics?
(1) monitor for hypokalemia
(2) monitor BP
(3) encourage potassium-rich foods
(4) take in the morning
weight gain, edema, and ascites are key characteristics of ___
right-sided heart failure
an extra S3 gallop sound can be a sign of ___
heart failure
what are the 4 secondary causes of hypertension?
(1) Kidney disease
(2) Cushing’s
(2) Immunosuppressant
(4) Corticosteroids
what is the main cause of secondary hypertension?
kidney disease
What is the significance of monitoring drainage amount from a chest tube?
To assess respiratory status and lung re-expansion
___ can impact glucose control
thiazide diuretics
fatigue, weakness, bradycardia, and loss of P wave are a sign of ____
digoxin toxicity
do not take ____ with antacids
digoxin
do not stop ____ abruptly
beta blockers
fluid intake for heart failure is ____ L/day
2-3
name at least 3 risk factors for V tach
(1) heart disease
(2) history of MI
(3) hypokalemia
(4) hypomagnesemia
(5) HF
(6) cocaine use
cardioversion is used for ____
V tach
hypokalemia and hypomagnesemia can both lead to ___ and ___
V tach and V fib
name at least 3 risk factors for V Fib
(1) CAD
(2) MI
(3) hypokalemia
(4) hypomagnesemia
(5) hemorrhage
(6) rapid supraventricular tachycardia
(7) shock
(8) surgery
the three causes of ventricular asystole are
myocardial hypoxia, severe hyperkalemia, and acidosis
ventilate at what rate for CPR?
10-12 breaths per minute or
30 compressions to 2 breaths
the purpose of _____ is to measure clot breakdown, indicating a thromboembolic event
D-dimer test
the nurse should provide ____ lighting when talking to patients with vision loss
indirect
which 2 drugs can cause hyperkalemia?
ACEI and ARB
which 2 drugs can cause hypokalemia?
HCTZ, Furosemide
how long should you wait between eye drops for glaucoma?
5-10 minutes
name at least 3 reasons for reduced blood flow
(1) AFib
(2) Long distance travel
(3) bedrest / immobility
(4) venous obstruction
(5) venous insufficiency
name at least 3 reasons for blood vessel injury
(1) trauma
(2) surgery
(3) HTN
name at least 3 reasons for increased coagulability
(1) sepsis
(2) smoking
(3) coagulation disorders
(4) malignancy / cancer
facial flushing can be a sign of ____
hypertension
name at least 3 s/s of anemia
(1) fatigue
(2) cold intolerance
(3) spoon-shaped nails
(4) irritability
(5) N/T of extremities
(6) pallor
