exam 4 HF

Question 1

Most often caused by CAD, HTN, or valve disorders

Answer 1

Heart failure

Question 2

Pulmonary congestion- dyspnea, cough, crackles, ↓ O2 saturation, S3 heart sound

Answer 2

left sided heart failure

Question 3

Dyspnea on exertion (DOE)
Orthopnea
Paroxysmal nocturnal dyspnea (PND)
Oliguria
Confusion, anxiety, restlessness
are for what?

Answer 3

left sided HF

Question 4

if a patient has pink frothy sputum what might they have?

Answer 4

left sided HF

Question 5

a patient with left sided HF might become

Answer 5

confused, altered LOC, because they are not getting enough oxygen

Question 6

Recognition of early stages:
Dry, hacking cough
Fatigue
Weight gain
Worsening edema
Degree of dyspnea

in what?

Answer 6

pulmonary edema

Question 7

patients with left sided HF - intervetions

Answer 7

• daily weights
• check skin - esp feet/ankles
• watch level of SOB

Question 8

a patient with right sided HF will have

Answer 8

• JVD
• dependent edema
• enlarged liver and spleen
• ascites
• weakness, anorexia, weight gain

Question 9

what labs do we need to watch in patients with HF

Answer 9

• BNP, electrolytes, BUN, creatinine

Question 10

what diagnostic test can we use for HF patients?

Answer 10

• CXR
• EKG
• echocardiogram

Question 11

echocardiogram measures what?

Answer 11

ejection infarction

Question 12

what is really important to monitor in HF patients

Answer 12

intake and output

Question 13

what medications can we give to HF patients

Answer 13

• beta blockers
• alpha/beta blockers
• diuretics
• anticoagulants

Question 14

A patient with heart failure is beginning therapy with captopril, an ACE inhibitor. What nursing intervention is indicated prior to giving the first dose?

A. Provide the medication 1 hour before meals
B. Offer the medication with food
C. Review recent lab values for hypokalemia
D. Instruct the patient to call for assistance when getting out of bed

Answer 14

D. can cause dizziness so call before getting out of bed

Question 15

cardiac glycoside used for systolic heart failure, a-fib & flutter

Answer 15

digoxin

Question 16

what is the antidote for digoxin toxicity

Answer 16

digibind

Question 17

Fatigue
Depression
Malaise
N/V, anorexia
Changes in heart rhythm – PVCs

Answer 17

digoxin toxicity

Question 18

check apical pulse and hold this med if its less then 60

Answer 18

digoxin

Question 19

what foods do patients with HF need to avoid

Answer 19

processed foods / canned foods

Question 20

A heart failure client is being discharged home. How should the nurse instruct the client to assess fluid balance?

Monitor daily weight
Monitor blood pressure
Assess radial pulses
Monitor bowel movements

Answer 20

A

Question 21

A patient is experiencing fluid volume excess with dependent edema. The health care provider places the patient on a 1,500ml/day fluid restriction. Which nursing intervention is most important?

Provide frequent oral care

Assess amount of edema each shift

Weigh patient every Monday

D. Keep the legs lower than the heart

Answer 21

B

Question 22

Which of the following are symptoms of left heart failure? Select all that apply

Paroxysmal nocturnal dyspnea (PND)

Peripheral edema

Jugular venous distention (JVD)

Crackles in the lungs

Shortness of breath upon exertion

Answer 22

A,B,D,E

Question 23

Which of the following are symptoms of right heart failure? Select all that apply.

Jugular venous distention (JVD)
Hepatomegaly
Wheezing
Ascites
Shortness of breath on exertion

Answer 23

ABD

Question 24

:)