Exam 3 Flashcards
What is the risk associated with Parkinson’s disease and bradykinesia?
Risk for falls due to impaired movement and balance.
What is the primary concern in a myasthenic crisis?
Respiratory failure due to muscle weakness affecting breathing.
What pattern is seen in atrial flutter on EKG strips?
‘Saw-tooth’ pattern.
What characterizes ventricular tachycardia on an EKG?
Wide, bizarre QRS complexes, regular rhythm.
How is atrial fibrillation identified on an EKG?
Irregularly irregular rhythm with no distinct P waves.
What does sinus bradycardia look like on an EKG?
Slow rate but normal PQRST complexes.
List the primary manifestations of Parkinson’s disease.
- Tremors
- Rigidity
- Bradykinesia
- Postural instability
What are common signs of right-sided heart failure?
- Peripheral edema
- Jugular venous distension
- Ascites
- Hepatomegaly
What type of medications are used in Parkinson’s disease?
Medications that act on the dopaminergic system, particularly in the brain’s basal ganglia.
What do elevated ANP and BNP levels indicate?
Heart failure severity, especially concerning ventricular stretch and pressure.
Is there a genetic link to Alzheimer’s disease?
Yes, especially with familial Alzheimer’s and specific mutations like APOE4.
Name three types of progressive dementia diagnoses.
- Alzheimer’s disease
- Vascular dementia
- Lewy body dementia
What is a key differentiator of Alzheimer’s disease from vascular dementia?
Memory loss and cognitive decline.
What does a CT scan show in a patient with Alzheimer’s disease?
Brain atrophy, including enlarged ventricles and shrinkage of the hippocampus.
What are muscle fasciculations?
Involuntary muscle twitches seen in ALS or motor neuron disorders.
What is the underlying issue in multiple sclerosis?
Immune-mediated destruction of the myelin sheath in the CNS.
What urine output indicates inadequate renal perfusion?
Less than 30 ml/hr.
List symptoms of left-sided heart failure.
- Pulmonary symptoms (e.g., dyspnea, orthopnea)
- Crackles
- Fatigue
What is the primary symptom of Parkinson’s disease?
Tremor, especially resting tremor.
What is thrombocytopenia?
Low thrombocyte count, leading to a risk for bleeding.
What should be explained to an Alzheimer’s patient neglecting things?
Memory loss is part of the disease, and routines can help.
What causes Wernicke-Korsakoff syndrome?
Thiamine (Vitamin B1) deficiency, often due to chronic alcohol use.
What type of shock typically requires antibiotics?
Septic shock.
How do ACE inhibitors help in chronic heart failure?
Reduce afterload by preventing the conversion of angiotensin I to angiotensin II, lowering blood pressure.
What is the oxygen saturation range for moderate hypoxemia?
86-90%.
What is the role of cholinesterase inhibitors in Alzheimer’s?
Slow cognitive decline by increasing acetylcholine in the brain.
What routine is beneficial for an Alzheimer’s patient?
Establish a consistent daily routine to help manage memory loss.
Describe the manifestations of delirium.
Acute confusion, fluctuating consciousness.
Describe the manifestations of dementia.
Progressive memory and cognitive loss.
What does dysphagia refer to?
Difficulty swallowing.
What characterizes depression?
Persistent sadness, withdrawal, changes in appetite/sleep.
What is an intervention for a confused, agitated dementia patient?
Reorient and calm the patient with a familiar object or routine.
What do pinpoint hemorrhages and bruising indicate?
Petechiae and purpura, often indicating thrombocytopenia.
What is the purpose of compression stockings post-hip repair?
Prevent deep vein thrombosis (DVT).
What should be assessed in a thrombocytopenia patient with bleeding gums?
Recent infections, medication history (e.g., aspirin), or blood clotting disorders.
List risk factors for atherosclerosis.
- Smoking
- Hypertension
- Hyperlipidemia
- Diabetes
What are common causes of thrombocytopenia?
- Decreased production
- Increased destruction of platelets (e.g., bone marrow disease, medications)
What do red pinpoint hemorrhages likely indicate?
Petechiae due to low platelet count.
How does liver cancer affect bleeding risk?
Damage can lead to coagulopathy due to the liver producing clotting factors.
What is a complication of heparin therapy?
Heparin-induced thrombocytopenia (HIT), leading to increased risk of clotting.
What is a key intervention in circulatory shock?
Administer fluids, vasopressors, oxygen.
What should be done if a patient develops heparin-induced thrombocytopenia?
Stop heparin, use non-heparin anticoagulants.
What is the firing rate of the AV node if the SA node fails?
40-60 beats per minute.
What is known as the natural pacemaker of the heart?
SA node.
Why is primary hypertension management important?
It prevents complications like stroke, heart attack, and kidney damage.
What is a non-modifiable factor for hypertension?
Genetics or age.
How do you calculate pulse pressure?
Systolic pressure minus diastolic pressure.
What are risks for venous thrombosis?
- Immobility
- Pregnancy
- Prolonged bed rest
- Surgery
How is hypertension diagnosed?
Repeated elevated blood pressure readings on different occasions.
What is heart failure?
Inability of the heart to meet the body’s oxygen demands.
What are the DASH diet restrictions?
Avoid high sodium, processed foods, and excessive sweets.
What is the primary cause of coronary artery disease?
Atherosclerosis.
What should older adults be educated about regarding cardiac health?
Encourage regular exercise, low-sodium diet, and monitoring blood pressure.
What are signs of a true myocardial infarction?
- Chest pain unrelieved by rest or nitroglycerin
- ST-elevation on EKG
- Positive troponins
