Exam 2 - Summary Set Flashcards

1
Q

____ is a loss of lung elastic tissue, leading to hyperinflation and air trapping

A

emphysema

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2
Q

___ is inflammation of the bronchi and bronchioles

A

chronic bronchitis

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3
Q

mucus plugs, inflammation, hypoxemia, and respiratory acidosis are associated with ____

A

chronic bronchitis

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4
Q

____ is the #1 risk factor for COPD

A

smoking

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5
Q

name at least 4 s/s of COPD

A

(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

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6
Q

barrel chest and pursed lip breathing is associated with

A

emphysema

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7
Q

name s/s of early hypoxia

A

(1) tachycardia
(2) tachypnea
(3) elevated BP
(4) pale skin
(5) O2 <90
(6) confusion

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8
Q

name s/s of late hypoxia

A

(1) stupor
(2) cyanosis
(3) bradycardia
(4) bradypnea
(5) hypotension
(6) dysrhythmias

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9
Q

name s/s of chronic hypoxia

A

(1) nail clubbing
(2) cyanosis
(3) delayed cap refill
(4) barrel chest
(5) pursed lip breathing

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10
Q

describe 4 components of a COPD exacerbation

A

(1) RR 40-50
(2) SpO2 80-85%
(3) Accessory muscle use
(4) Abnormal lung sounds (wheezing, crackles)

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11
Q

___-sided heart failure is a complication of COPD

A

right

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12
Q

how do you diagnose COPD? (5)

A

(1) History
(2) Peak flow expiratory flow
(3) ABGs
(4) Chest x-ray
(5) Sputum & WBC

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13
Q

____ is the #1 priority for COPD

A

impaired gas exchange

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14
Q

the 5 priorities r/t COPD are

A

(1) gas exchange
(2) anxiety
(3) weight loss
(4) fatigue
(5) preventing infection

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15
Q

name at least 3 nursing interventions for impaired gas exchange

A

(1) raise HOB
(2) give O2 to get SaO2 88-92%
(3) Hydration to thin secretions
(4) medication
(5) smoking cessation
(6) suctioning

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16
Q

name 3 nursing interventions for anxiety r/t COPD

A

(1) breathing exercises
(2) relaxation techniques
(3) anti-anxiety meds

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17
Q

pts with COPD should eat _____ type of meals to avoid weight loss

A

protein / calorie-dense meals; frequent and small

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18
Q

use ____ 30 minutes before meals

A

bronchodilator

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19
Q

what are the 5 main medications for COPD?

A

(1) short-acting b2 agonists
(2) long-acting b2 agonists
(3) inhaled corticosteroids
(4) inhaled anticholingergics
(5) mucolytics

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20
Q

____ is an example of a SABA

A

albuterol

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21
Q

____ is an example of a LABA

A

salmeterol

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22
Q

____ is an example of an inhaled anticholinergic

A

tiotropium

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23
Q

____ is an example of an inhaled corticosteroid

A

fluticasone

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24
Q

____ is the rescue inhaler

A

albuterol / SABA

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25
Q

which medication do you take first (before other meds)?

A

SABA / albuterol

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26
Q

what is the purpose of Tiotropium?

A

bronchodilator

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27
Q

___ is a side effect of inhaled anticholinergics / tiotropium

A

dry mouth

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28
Q

what is the purpose of Fluticasone?

A

reduce airway inflammation

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29
Q

teach pts to ____ when taking inhaled corticosteroids to decrease risk of thrush

A

rinse their mouth

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30
Q

____ is an example of a mucolytic

A

acetylcysteine

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31
Q

what is the action of mucolytics?

A

thin secretions

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32
Q

the main side effect of mucolytics is _____

A

hepatotoxicity

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33
Q

which medication can smell like rotten eggs?

A

acetylcysteine / mucolytics

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34
Q

explain the steps of MDI use:

A

(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

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35
Q

in a COPD action plan, when do you call 911?

A

when the pt is in the red zone

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36
Q

___ is a lung infection that causes airway inflammation and fluid buildup

A

pneumonia

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37
Q

is the biggest risk factor for pneumonia

A

underlying lung condition

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38
Q

name at least 3 s/s of pneumonia

A

(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

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39
Q

WBC will be ___ in pneumonia

A

elevated

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40
Q

what are the 4 nursing priorities for pneumonia?

A

(1) gas exchange
(2) airway obstruction
(3) possible sepsis
(4) anxiety

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41
Q

encourage _____ L/day of ____ to thin secretions

A

2-3; fluids

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42
Q

what are the 2 main medications for pneumonia?

A

(1) cephalosporin (ceftriaxone)
(2) fluoroquinolone (levofloxacin)

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43
Q

___ is one of the safest antibiotics

A

ceftriaxone

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44
Q

name the 4 main side effects of levofloxacin

A

(1) N/V
(2) swelling of tendon
(3) C. diff
(4) yeast infections

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45
Q

the 3 things you should teach pts when taking levofloxacin are…

A

(1) take with food
(2) avoid sun exposure
(3) complete the course

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46
Q

multiple rapid impulses from the atria that are disorganized is ____

A

atrial fibrillation

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47
Q

chaotic rhythm, no atrial contraction, loss of atrial kick, and irregular ventricular response can all be used to describe

A

A Fib

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48
Q

the two biggest risk factors for A Fib are

A

HTN and CV disease

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49
Q

name at least 3 other risk factors for A Fib (besides HTN and CV disease)

A

(1) obesity
(2) DM
(3) advanced age
(4) smoking
(5) excessive alcohol use
(6) OSA
(7) hyperthyroidism

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50
Q

if CO is impacted by AFib, ___ is affected

A

perfusion

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51
Q

what are the key characteristics of A Fib on an ECG?

A

(1) heart rate can vary (normal 60-100 or rapid 100-200)
(2) irregular R to R rhythm
(3) no clear P wave

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52
Q

the 3 main nursing priorities for A Fib are

A

(1) risk for embolus formation
(2) risk for heart failure
(3) potential knowledge deficit

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53
Q

embolus formation can lead to ___, ___, and ___

A

stroke, DVT, and PE

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54
Q

the two main drug classes for A Fib are

A

antidysrhythmics and anticoagulants

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55
Q

___, ___, and ___ are antidysrhythmics

A

diltiazem, metoprolol, and digoxin

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56
Q

diltiazem class

A

Ca channel blocker

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57
Q

diltiazem action

A

slow conduction

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58
Q

diltiazem monitoring & ed

A

(1) monitor HR and BP
(2) slow position changes
(3) monitor s/s HF

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59
Q

metoprolol class

A

beta blocker

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60
Q

metoprolol action

A

slow ventricular response

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61
Q

metoprolol monitoring & ed

A

(1) monitor HR and BP
(2) slow position changes
(3) can cause bronchospasm

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62
Q

if HR<60 bpm hold _____ and call the provider

A

diltiazem, metoprolol, and digoxin

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63
Q

____ drugs are a high fall risk

A

antidysrhythmics

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64
Q

___ and ___ are the two anticoagulants used for A Fib

A

Coumadin / Warfarin, Apixaban / Rivaroxaban

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65
Q

Coumadin class

A

anticoagulant

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66
Q

Coumadin action

A

thin blood and prevent clot

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67
Q

Coumadin monitoring & ed

A

(1) INR testing required
(2) avoid / limit vit K
(3) herbals can interfere (ginseng, ginger)
(4) monitor for bleeding

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68
Q

Apixaban / Rivaroxaban class

A

DOAC

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69
Q

Apixaban / Rivaroxaban action

A

thin blood and prevent clots

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70
Q

Apixaban / Rivaroxaban monitoring & ed

A

(1) No INR testing
(2) Monitor for bleeding

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71
Q

name 5 ways to prevent bleeding when on anticoagulants

A

(1) electric razors
(2) no aspirin
(3) small gauge needles
(4) limit needles sticks
(5) protect from injury (falls, trauma, etc.)

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72
Q

3 lifestyle recommendations the nurse can provide for pts with A Fib include:

A

(1) 210 minutes of moderate to vigorous exercise
(2) smoking cessation
(3) weight reduction
(4) alcohol reduction to <3 drinks/week
(5) control HTN

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73
Q

____ is an increase in HR

A

sinus tachycardia

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74
Q

name at least 3 causes of sinus tachycardia

A

(1) anemia
(2) normal response to physical activity, stress, or pain
(3) hypoxia
(4) hyperthyroidism
(5) drugs
(6) compensation for decreased CO and BP

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75
Q

name at least 3 s/s of sinus tachycardia

A

(1) fatigue
(2) weakness
(3) SOB
(4) orthopnea
(5) decreased O2 sat
(6) decreased BP

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76
Q

the 2 nursing priorities with sinus tachycardia are

A

(1) avoid drugs that increase HR
(2) help with stress management

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77
Q

partial or total arterial occlusion

A

peripheral arterial disease (PAD)

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78
Q

___ can lead to decreased perfusion of the extremities / lower extremities

A

PAD

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79
Q

___ usually occurs on the toes and has well-defined edges

A

PAD

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80
Q

what is the main cause of PAD?

A

systemic atherosclerosis

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81
Q

name at least 3 s/s of PAD

A

(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

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82
Q

the #1 priority for treatment of PAD is to ___

A

improve perfusion

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83
Q

why should people with PAD avoid smoking, caffeine, and nicotine?

A

b/c they are vasoconstrictors and can worsen poor perfusion

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84
Q

____ agents are used to treat PAD

A

antiplatelet

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85
Q

the 2 main meds used in PAD are ___ and ___

A

aspirin, clopidogrel

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86
Q

elevating the legs in _____ injuries will cause more pain

A

arterial

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87
Q

one key different between PAD and Venous insufficiency is that ____ has present pedal pulses and ____ does not

A

venous insufficiency; PAD

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88
Q

prolonged venous hypertension stretches the veins and damages the valves

A

venous insufficiency

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89
Q

venous insufficiency often occurs in the ____

A

malleolus medialis

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90
Q

venous insufficiency general cause is ____

A

anything that impacts venous return

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91
Q

what are 4 things that impact venous return?

A

(1) DVT
(2) decreased skeletal muscle pump
(3) increased ABD pressure
(4) sedentary lifestyle

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92
Q

name at least 3 s/s of venous insufficiency

A

(1) pitting edema
(2) eczema / dermatitis
(3) ulcers
(4) hyperpigmentation
(5) pedal pulses present and palpable
(6) ABI WNL

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93
Q

what are 3 things we can do to decrease edema (non-pharm)?

A

(1) avoid prolonged sitting
(2) compression stockings (Teds, Jobst)
(3) SCDs

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94
Q

which compression stocking requires a prescription?

A

Jobst

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95
Q

compression of 8-18 mmHg and can be worn in bed is which type of compression sock?

A

Teds

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96
Q

___ has a compression of 15-20 mmHg

A

Jobst

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97
Q

what is the most important thing about compression stockings?

A

Making sure they are the right size so they don’t fall down

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98
Q

name 3 ways to protect the skin and avoid infection

A

(1) use mild soap
(2) limit sun exposure
(3) avoid skin irritants
(4) wear shoes

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99
Q

patients with _____ should not wear constrictive clothing or cross their legs

A

venous insufficiency

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100
Q

____ are dressings with zinc oxide that are covered in a wrap that hardens

A

Unna boot

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101
Q

what is the difference between PR segment and PR interval?

A

PR segment starts AFTER the P wave; PR interval INCLUDES the P wave

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102
Q

on an ECG strip, each small square represents ___ seconds

A

0.04

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103
Q

on an ECG strip, each large square represents ____ seconds

A

0.20 seconds

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104
Q

____ represents atrial depolarization

A

P wave

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105
Q

P waves should measure ___ seconds

A

<0.12; no more than 3 small squares

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106
Q

____ demonstrates the delay of the AV node

A

PR segment

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107
Q

___ can help determine if there is a heart block

A

PR interval

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108
Q

if PR interval is ____, it can indicate a potential heart block

A

too long

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109
Q

PR interval should be ____ in duration

A

0.12-0.20 seconds; 3-5 small squares

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110
Q

___ represents ventricular depolarization

A

QRS complex

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111
Q

QRS interval should be ____ in duration

A

<0.12 seconds (no more than 3 small squares)

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112
Q

____ is where the QRS complex meets the ST segment

A

J point

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113
Q

____ represents the completion of ventricular depolarization and the beginning of ventricular repolarization

A

ST segment

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114
Q

what shape should the ST segment be?

A

flat / isoelectric

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115
Q

____ represents the beginning of ventricular repolarization

A

T wave

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116
Q

what shape should the T wave be?

A

round and upright (in most leads)

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117
Q

after the T wave we see ___

A

the flat line

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118
Q

which wave may be caused by hypokalemia and is not seen in all patients?

A

U wave

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119
Q

____ represents the time it takes for for electrical signals to cause ventricles to contract and then rest

A

QT interval

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120
Q

QT interval duration should be ___

A

0.35-0.44 seconds

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121
Q

who has shorter QT intervals - males or females?

122
Q

a prolonged QT interval can indicate what?

A

increased risk of ventricular dysrhythmias, like Torsades de Pointes

123
Q

what are the 3 Rs of ECG analysis?

A

(1) Regularity
(2) Rate
(3) Resemblance

124
Q

Regularity in ECG readings means

A

making sure the waves / segments are the same distance from one another

125
Q

Rate in ECG readings means

A

the number in a certain duration (like a 6-second strip)

126
Q

Resemblance in ECG readings means

A

do the waves / segments resemble one another? are the measurements similar / normal?

127
Q

which type of glaucoma is a medical emergency?

A

angle-closure glaucoma (ACG)

128
Q

____ is the most common form of glaucoma

A

open-angle glaucoma (OAG)

129
Q

what measures elevated intraocular pressure (IOP)?

130
Q

___ determines if glaucoma is open or closed-angle

A

gonioscopy

131
Q

the 2 nursing priorities for glaucoma are:

A

(1) impaired visual sensory perception
(2) health teaching d/t treatment regimen

132
Q

name at least 4 tips when communicating with someone with hearing loss

A

(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

133
Q

every ECG rhythm strip is ____ seconds long

134
Q

which arrhythmia is highlighted as life-threatening?

A

ventricular fibrillation (V Fib)

135
Q

_____ is full cardiac arrest

A

ventricular asystole

136
Q

_____ is not a shockable rhythm

137
Q

Brief, temporary moment of imbalance of O2 supply and demand can cause

A

stable angina

138
Q

stable angina is usually resolved by

A

rest, nitroglycerin, and stopping the activity that triggered it

139
Q

____ lasts <15 minutes

A

stable angina

140
Q

name 4 key characteristics of unstable angina

A

(1) lasts >15 minutes
(2) not relieved by nitro
(3) may have ST segment changes
(4) no changes in troponin levels

141
Q

normal troponin T levels are

A

<0.01 ng/mL

142
Q

normal troponin I levels are

A

<0.03 ng/mL

143
Q

name 3 non-modifiable risk factors for ACS

A

(1) increased age
(2) male sex
(3) family history

144
Q

the biggest risk factor for ACS and MI is

A

atherosclerosis

145
Q

silent ischemia is ____

A

ischemia without pain

146
Q

silent ischemia is more common in ____

147
Q

vasospasm, dissection, and narrowing of arteries are all causes of

148
Q

describe the ECG changes associated with NSTEMI

A

(1) ST depression
(2) T inversion

149
Q

initial troponin levels will be normal and eventually elevate in ____

150
Q

rupture of atherosclerotic plaque is the main cause of ____

151
Q

what are the ECG changes associated with STEMI?

A

ST segment elevation on 2 contiguous leads

152
Q

elevated troponin levels indicate which type of ACS?

153
Q

which type of ACS occurs without cause, usually in the morning?

154
Q

name at least 4 associated s/s of NSTEMI/STEMI

A

(1) N/V
(2) diaphoresis
(3) dyspnea
(4) anxiety, fear, impending doom
(5) dysrhythmias
(6) fatigue
(7) dizziness
(8) disorientation
(9) feeling SOB

155
Q

name at least 3 distinct s/s of NSTEMI/STEMI for females

A

(1) indigestion
(2) pain b/t shoulders
(3) aching jaw
(4) flu-like symptoms

156
Q

____ may experience indigestion, SOB, and confusion during an MI

A

older adults

157
Q

name the initial steps a nurse should take if they learn the pt has chest pain / symptoms of ACS (6)

A

(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

158
Q

only use O2 with ____ during possible MI

159
Q

What is the optimal positioning during a possible MI?

A

semi-fowler’s

160
Q

the two meds for pain relief of MI initially are

A

(1) IV morphine
(2) Nitroglycerin sublingual

161
Q

___ needs to be managed within 4-6 hours of symptoms

162
Q

___ needs to be managed within 90 minutes of symptoms

163
Q

which type of MI requires PCI?

164
Q

percutaneous coronary intervention (PCI) should be performed within ___ of onset of symptoms

A

90 minutes

165
Q

if a patient can’t receive PCI, what is the next therapy choice?

A

fibrinolytics

166
Q

on arrival to the ED with possible MI, what is given to pts?

A

aspirin, chewable 325 mg

167
Q

___ is given 1-2 hours after MI and stable BP and HR

A

beta blocker

168
Q

what is given within 24 hours of MI?

A

ACEIs or ARBs

169
Q

what med do you give for MI pts with abnormal lipid panel?

A

Statin therapy

170
Q

when should a MI pt stop walking therapy?

A

if they experience dyspnea, angina, or exceed their target pulse

171
Q

when should MI pts resume sexual activity?

A

(1) after exercise tolerance test is completed
(2) when they can climb 2 flights of stairs without symptoms

172
Q

avoid taking ____ with aspirin

173
Q

teach patients to monitor ___ and ____ on beta blockers

174
Q

take ___ in the evening to be most effective

175
Q

what are 4 things to teach pts about Nitro?

A

(1) sun-resistant container
(2) carry at all times
(3) replace every 3-5 months
(4) if no relief after 5 mins, call 911

176
Q

after a pt experiences an MI, when should they call the provider? (4)

A

(1) HR <50
(2) Dyspnea
(3) Weight gain 3 lbs/week or 1-2 lbs/day
(4) Activity intolerance

177
Q

when should MI pts call 911?

A

(1) no relief with 1 dose of Nitro
(2) severe chest pain + associated symptoms

178
Q

what is the medication management during a COPD exacerbation?

A

(1) nebulizer (albuterol / ipratropium)
(2) IV / oral corticosteroids
(3) monitor BG
(4) antibiotics if infection

179
Q

what are the two diagnostic tests for PE?

A

D-dimer and CTPA

180
Q

what D-dimer result indicates a positive test for PE?

A

> 250 ng/mL

181
Q

what lab test can help differentiate if a cause is respiratory or cardiac?

182
Q

asymmetric chest expansion and decreased or absent breath sounds are s/s of ____

A

pneumothorax

183
Q

T/F: The three-way dressing for a chest tube will have one side open for air to exit during exhalation

184
Q

atropine is used to treat ____

A

bradycardia

185
Q

long-term A Fib leads to decreased CO and poor perfusion. This is associated with which s/s?

A

fatigue, dizziness, hypotension, chest discomfort

186
Q

what do you give for MI pain?

A

IV morphine
Nitroglycerin

187
Q

What other drugs do you give for the treatment of MI (in general)?

A

(1) aspirin chewable 325 mg
(2) platelet inhibitor (clopidogrel)
(3) Beta blocker
(4) ACEI or ARB
(5) statin therapy

188
Q

give beta blocker ____ after MI and when pt is stabilized

189
Q

when do you give ACEI or ARB for MI?

A

within 24 hours of MI and when pt is stable

190
Q

who should receive statin therapy for MI?

A

those with abnormal lipid panel

191
Q

treat a STEMI within ___ of onset of symptoms

A

90 minutes

192
Q

which type of MI receives PCI?

193
Q

if a patient can’t receive a PCI in time, what should they receive instead?

A

fibrinolytics within 30 minutes

194
Q

treat NSTEMI within ____ of symptoms

195
Q

when do you give alteplase for PE?

A

patient deterioration and shock

196
Q

excessive bubbling of a chest tube can indicate ___

197
Q

what are the main causes of A Fib? (5)

A

(1) HTN
(2) CV disease
(3) ACS
(4) CAD
(5) HF

198
Q

which antidysrhythmic is good for A Fib and HF?

199
Q

amlodipine will do what to heart rate?

200
Q

when is the EF concerning in heart failure?

A

If EF <50%

201
Q

which drug causes a dry cough?

202
Q

what tool can be used to diagnose heart failure?

A

echocardiography

203
Q

how do you treat pulmonary edema?

A

(1) high Fowler’s
(2) give O2
(3) IV push Furosemide over 1-2 minutes
(4) reassess respiratory

204
Q

the three nursing interventions for a hypertensive crisis are:

A

(1) semi-fowler’s
(2) give O2
(3) call a rapid

205
Q

avoid grapefruit juice with what med?

A

Ca channel blockers

206
Q

the main risk factor for MI is

A

atherosclerosis

207
Q

within 10 minutes of chest pain, what should happen?

A

a 12-lead ECG should be hooked up

208
Q

name at least 4 pieces of discharge teaching for a MI

A

(1) risk factor modification
(2) diet
(3) exercise
(4) sexual activity
(5) medications

209
Q

hypertensive crisis is defined as…

A

Systolic >180 and/or Diastolic >120

210
Q

s/s of hypertensive crisis include

A

(1) severe headache
(2) blurred vision
(3) dyspnea
(4) anxiety
(5) uremia

211
Q

____ glaucoma is slow vision loss over time

A

open-angle

212
Q

what are the goals of medication for glaucoma?

A

(1) decrease pressure
(2) maintain vision

213
Q

Holding pressure after eye drops to ensure the drop doesn’t go to the whole body via the lacrimal duct is called?

A

punctal occlusion

214
Q

Name at least 3 guidelines for talking to patients with vision loss in the hospital

A

(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

215
Q

name at least 4 things for hearing aid care

A

(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

216
Q

name 4 risk factors for OSA

A

(1) obesity
(2) male sex
(3) genetics
(4) older age

217
Q

name at least 3 s/s of OSA

A

(1) daytime sleepiness
(2) waking up gasping
(3) overweight
(4) irritability
(5) memory problems

218
Q

ability to perceive stimulation through sensory organs

219
Q

process of receiving, organizing, and interpreting sensation

A

perception

220
Q

ability to receive inputs and translate into meaningful information

A

sensory perception

221
Q

CN II controls ___

A

visual acuity and visual field

222
Q

CN III is the ____ nerve

A

oculomotor

223
Q

CN IV

224
Q

____ controls downward and inward eye movement

225
Q

____ controls the sensation of the eye

A

CN V / trigeminal

226
Q

CN V

A

trigeminal

227
Q

CN VI

228
Q

___ controls lateral eye movement

A

abducens / CN VI

229
Q

what are the 3 CN involved in taste?

A

CN VII, IX, and X

230
Q

stage 1 of sleep is ____ sleep

231
Q

during ___ (stage of sleep), eye movement stops and brain waves slow

232
Q

during stage 2 sleep, RR, HR, and temp will ____

233
Q

___ takes 90-110 minutes to achieve (sleep type)

234
Q

deep sleep and little muscle activity is associated with which stage of sleep?

235
Q

Describe characteristics of REM sleep

A

(1) increased RR and HR
(2) brain is active
(3) muscle paralysis
(4) active dreaming

236
Q

tissue degeneration, muscle / bone development, immune enhancement, and hormone regulation occur during ___

A

deep sleep

237
Q

recurring or chronic insufficient sleep time, poor quality of sleep despite adequate time, or problems falling or staying asleep

A

sleep disorders

238
Q

3 primary sleep disorders are

A

(1) insomnia
(2) OSA
(3) RLS

239
Q

name at least 3 physiological consequences of inadequate sleep

A

(1) HTN
(2) heart disease
(3) HF
(4) stroke
(5) obesity

240
Q

what is the most important intervention for impaired sleep?

A

sleep hygiene

241
Q

what are the 2 risks of sleep aids?

A

(1) make people drowsy
(2) increase risk of falls

242
Q

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

243
Q

when might we place a pacemaker?

A

if someone with sinus bradycardia can’t regain normal HR

244
Q

we give ___ for sinus bradycardia (medication)

245
Q

we give ___ for v tach with a pulse (medication)

A

amiodarone

246
Q

always pulseless, apneic, absent heart sounds – what is this describing?

247
Q

___ is the arrhythmia that typically precedes V fib

248
Q

complete absence of any ventricular rhythm

A

ventricular asystole

249
Q

____ is not a shockable rhythm

A

ventricular asystole

250
Q

idarucizumab is the antidote for ____

A

dabigatran

251
Q

____ can cause bronchospasm (medication)

A

metoprolol

252
Q

____ is a useful drug for both A fib and HF

253
Q

what is Virchow’s Triad?

A

(1) decreased blood flow
(2) endothelial / vessel injury
(3) hypercoaguable state

254
Q

Virchow’s Triad is a risk for ___ and ___.

A

DVT and PE

255
Q

beta blockers, carbonic anhydrase inhibitors, and alpha agonists all treat ___

256
Q

never give which two drugs together?

A

ACEI and ARB

257
Q

a normal sinus rhythm is

A

60-100 bpm

258
Q

normal rate in the Bundle of His is

259
Q

normal rate of the Purkinje fibers is

260
Q

what are the 4 steps of analyzing an ECG?

A

(1) assess rhythm
(2) assess rate
(3) identify waveforms
(4) interpret rhythm

261
Q

R-R interval represents the ___ rhythm

A

ventricular

262
Q

p-p interval represents the ___ rhythm

263
Q

all strips are __ seconds

264
Q

when assessing the rate of an ECG, count what?

A

the QRS intervals (because they are larger typically)

265
Q

if you have 8 QRS intervals in a 6-second strip, what is the heart rate?

A

80 (8 * 10)

266
Q

compare the ST segment to ___ to assess for elevation / depression

A

isoelectric line

267
Q

always assess if a patient is taking ED meds before giving ___

A

nitroglycerin

268
Q

hold additional doses of nitroglycerin if _____

A

BP < 100 mmHg

269
Q

sildenafil is an example of what type of med?

A

ED medication

270
Q

pain occurs due to decreased oxygen supply to your leg muscles. what does this describe?

271
Q

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

A

encourage frequent walking with legs elevated when resting

272
Q

the valsalva maneuver can cause

A

bradycardia

273
Q

name 3 causes of bradycardia

A

(1) being healthy / athletic
(2) valsalva maneuver
(3) drugs
(4) vomiting / suctioning

274
Q

the 4 hypos can cause tachycardia. what are they?

A

hypovolemia
hypotension
hypoxia
hypoglycemia

275
Q

widened QRS
regular rhythm
fast rate (140-180)
no P wave

what is this describing?

276
Q

chaotic
no discernible PQRST
rapid rate

277
Q

side effects of albuterol are ___ and ___

A

tachycardia and tremor

278
Q

name the 5 nursing priorities for chest tube care:

A

(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

279
Q

Before and after the chest tube drainage, what are the nursing actions? (3)

A

(1) give morphine before and after
(2) do a repeat CXR to see if the placement is correct
(3) do not manipulate the dressing

280
Q

If the chest tube becomes dislodged, what is the immediate nursing intervention?

A

Apply pressure with sterile gauze

281
Q

for HTN, limit salt intake to ___

282
Q

what are the safety precautions for thiazide diuretics?

A

(1) monitor for hypokalemia
(2) monitor BP
(3) encourage potassium-rich foods
(4) take in the morning

283
Q

weight gain, edema, and ascites are key characteristics of ___

A

right-sided heart failure

284
Q

an extra S3 gallop sound can be a sign of ___

A

heart failure

285
Q

what are the 4 secondary causes of hypertension?

A

(1) Kidney disease
(2) Cushing’s
(2) Immunosuppressant
(4) Corticosteroids

286
Q

what is the main cause of secondary hypertension?

A

kidney disease

287
Q

What is the significance of monitoring drainage amount from a chest tube?

A

To assess respiratory status and lung re-expansion

288
Q

___ can impact glucose control

A

thiazide diuretics

289
Q

fatigue, weakness, bradycardia, and loss of P wave are a sign of ____

A

digoxin toxicity

290
Q

do not take ____ with antacids

291
Q

do not stop ____ abruptly

A

beta blockers

292
Q

fluid intake for heart failure is ____ L/day

293
Q

name at least 3 risk factors for V tach

A

(1) heart disease
(2) history of MI
(3) hypokalemia
(4) hypomagnesemia
(5) HF
(6) cocaine use

294
Q

cardioversion is used for ____

295
Q

hypokalemia and hypomagnesemia can both lead to ___ and ___

A

V tach and V fib

296
Q

name at least 3 risk factors for V Fib

A

(1) CAD
(2) MI
(3) hypokalemia
(4) hypomagnesemia
(5) hemorrhage
(6) rapid supraventricular tachycardia
(7) shock
(8) surgery

297
Q

the three causes of ventricular asystole are

A

myocardial hypoxia, severe hyperkalemia, and acidosis

298
Q

ventilate at what rate for CPR?

A

10-12 breaths per minute or
30 compressions to 2 breaths

299
Q

the purpose of _____ is to measure clot breakdown, indicating a thromboembolic event

A

D-dimer test