Exam 2 Tutoring Notes Flashcards
alpha
vasoconstriction of peripheral arterioles
beta 1
increased heart rate, conduction and contractility
beta 2
vasodilation of peripheral arteries and brohcnodilation
dopaminergic
dilation of renal and mesenteric arteries
class 1
blocks sodium channels
class 1A
may prolong QT and cause arrhythmia
class 2
blocks beta adrenergic receptor
class 3
slows repolarization and increase duration of action potential
class 4
blocks calcium channels
preload
volume in ventricles at end of diastole
preload
- decrease in
hemorrhagic shock
preload
- increase
fluid bolus
afterload
pressure in the ventricle has to generate to overcome resistance
afterload
- decreased
septic shock
nipride
nitro
lasix
morphine
acei
afterload
- increase
vasopressor (levophed)
will ACEI have reflex tachycardia
NO
what will ACEI delay/inhibit
ventricular remodeling
reflect tachycardia
due to a lowered BP, body tries to compensate by increasing heart rate
contractility
- increased in
dobutamine (vasopressor, beta 1)
fluid bolus
contractility
- decreased in
acidosis
beta blockers
stroke volume
preload + contractility + afterload
end diastolic volume
how much blood is in the ventricles before contraction
LVEF
left ventricular ejection fraction
ratio of stroke volume to end diastolic volume
normal EF
over 55%
reduced/systolic
- EF
under 40%
reduced/systolic
- treatment
hydralazine (lower BP)
nitrates (vasodilation)
- both reduce afterload
persevered/diastolic EF
over 40%
left sided
pulomonary symptoms such as cough, crackles, shortness of breath
right sided HF
peripheral symptoms such as edema, JVD, weight gain
MAP formula
(DBP x2) + SBP
________________
3
inotrope
contractility
positive inotropic
dobutamine
epinephrine
dopamine
dig
negative inotrope meds
verapamil
atenolol
clondaine
positive chronotropic medications
epinephrine
atropine
dopamine
negative chrono meds
metoprolol
dig
pulmonary edema
too much fluid in the lungs
causes of pulmonary edema
heronin overdose
head injury
anterior wall MI
cardiomyopathy
pulmonary capillary wedge pressure, central venous pressure pulmonary edema
25mgHg
treatment of pulmonary edema
lasix
morphine
CPAP
What rhythms are epinephrine used in?
V-Fib, PEA and asystole
- pulsless Vtach
adenosine used in what rhythm
PSVT
adenosine works
slows condition through AV node
adenosine half life
very short
monitor adenosine for
bradycardi
A patient is diagnosed with heart failure and is prescribed digoxin (Lanoxin) and furosemide (Lasix). Before administering the furosemide to the patient, which laboratory result should the healthcare provider review?
potassium
A patient who has a history of pulmonary valve stenosis tells the healthcare provider, “I don’t have a lot of energy anymore, and both of my feet get swollen in the late afternoon.” Which of these problems does the healthcare provider conclude is the likely cause of these clinical findings?
Right ventricular failure
causes of tension pneumothorax
trauma
central line placement
trachea will be deviated to what side
tension pneumo
opposite side of the injury
breath sounds tension pneumothorax
absent on side of injury
cheyne stokes respirations
CHF
advanced neuro issues
advanced pulmonary issues
pulmonary embolism causes
hypoxia
tachycardia
chest pain
HF in pulmonary embolism
right
how to diagnose pulmonary embolism
CT
saddle embolism
clot in bifurcation of the pulmonary artery
what can be inserted for pulmonary embolism
IVC filter inserted through groin can catch future clots
atelectasis
Alveolar collapse
encourage what for atelectasis
encourage patients to sue incentive spirometer
The patient with acute respiratory distress syndrome (ARDS) would exhibit which of the following symptoms?
Decreasing PaO2 levels despite increased FiO2 administration
mild oral yeast infection
rinse mouth with normal saline
erythema following radiaiton
avoid using soap on area
platelets under what should avoid invasive procedure
20,000
filgrastim/neupogen how is it given
IV or SQ
Filgrastim/Neupogen can be given at home?
yes SQ
what does Filgrastim/Neupogen do
stimulates WBC production
when to start Filgrastim/Neupogen
24 hour after chemo
continue Filgrastim/Neupogen how long after starting
2 weeks after chemo induced nadir
nadir
lowest neutrophil count
ANC
absolute neutropenic count
ANC under what are neutropenic precautions
500
neutropenia
low neutrophils
neutropenic precautions
no fresh fruit or flowers
private room
paraneoplastic syndromes
different ways that immune system may react to the tumor
SIADH
body is making too much ADHSI
SIADH does what to soidum
low because body retains water
SIADH symptoms
subtule mental changes, nausea, vomiting
hypercalemai in what cander
lung
venous thrombosis prevention
SCD and ambulation
tumor lysis syndrome
cancerous cells are getting released into the bloodstream
tumorlysis syndrome can cause
increase uric acid, potassium, phosphorus which can be hard on kidneys
top priorities of tumor lysis syndrome
renal function and hydration status
what is the pressure point for nausea
P6
manitol does what
decreases ICP
what do we need to do while giving mannitol
use filter
factors that increase ICP
headaches
suctioning
coughing
sneezing
ICP should not be what for extended peroid of time
20
normal ICP
0-15
earlier sign of increasing ICP is
change LOC
later sign of Increase ICP
change in pupils
what do we do for increase ICP
elevate HOB
issue where half of the vision is reduced
homonymous hemianopsia
What is the most probable cause of decreased level of consciousness related to a metabolic disorder?
HHS
cushings triad
widened pulse pressure (systolic hypertension)
bradycardia
irregular respirations
uncle herination
medical part of temporal lobe protrudes over the tensorial edge as a result of increased ICP
uncal herianation leads to
cushings triad
diffuse axonal injury
rotational injury resulting in severe brain injury
leads to coma
testing for responsiveness
no sternal rub
* use trapezius squeeze
tell tale signs of basilar skull fracture
raccoon eyes
battle sign
halo
Autonomic dysreflexia
-Occurs in spinal cord injury patients
-Could be due to pain, distended bladder or rectum
-Causes sweating and high blood pressure
Autonomic dysreflexia TX
Sit the patient up, evaluate possible causes (Do a bladder scan, ask about last BM, any tight clothing, maybe they just need to be repositioned)
keep assessing/evaluating BP
A white female client is admitted to an acute care facility with a diagnosis of cerebrovascular accident (CVA). Her history reveals bronchial asthma, exogenous obesity, and iron deficiency anemia. Which history finding is a risk factor for CVA?
Obesity
modifiable vs nonmodifable
A male client is having a tonic-clonic seizures. What should the nurse do first?
take measure to prevent injury
A female client with a suspected brain tumor is scheduled for computed tomography (CT). What should the nurse do when preparing the client for this test?
determine allergies
a fib
heparin or diltiazem
cardioversion for afib
depends on time
pneumonia
good side down
