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Adult Nursing I (NUR 240) > Final Exam > Flashcards

Final Exam Flashcards

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1
Q

Explain Coronary Atherosclerosis

Include signs & symtoms, risk factors & pathology

A

Signs & Symptoms:
* Angina (most common)
* Weakness
* Lightheadedness
* Nausea
* Epigastric, arm, or shoulder pain
* Dyspnea (SOB)

Risk Factors:
Non-Modifiable: family history, gender, race
Modifiable: cholesterol, HTN, DM, tobacco use

Pathology:
* accumulation of lipids (as well as blood components, Ca+, carbs, & fibrous tissue) in the arteries that decreases blood flow

  • affects medium & large arteries
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2
Q

Coronary Atherosclerosis

  • What is it?
  • What are the unique symptoms?
  • What are the risk factors associated with it?
  • What kind of vessels are impacted & what size are they?
A

Accumulation of plaque in arteries that decreases blood flow

  • Non-Modifiable Risks: family hx, gender, race
  • Modifiable Risks: cholesterol, HTN, DM, tobacco

Medium & Large ARTERIES are impacted

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3
Q

What is the most common symptom of coronary atherosclerosis?

A

Angina

weakness, light-headed, epigastric / shoulder / arm pain, SOB

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4
Q

What is ateriosclerosis?

A

Hardening / scarring of small arteries & arterioles

  • due to thickening of muscle fiber & endothelial lining
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5
Q

What is angina?

Types, causes, pathology, & treatment

A

Crushing pain in the chest, neck, upper back, shoulders, arms

Types:
* Stable
* Unstable
* Intractable

Causes:
* Acute coronary syndrome
* Myocardial infarction (MI)
* Arrhythmias
* Cardiac arrest
* Heart failures
* Cardiogenic Shock

Pathology: Low blood supply to the heart (muslces don’t receive enough O2)

Treatments: stop & rest, high fiber / low fat diet

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6
Q

What is Coronary Atherosclerosis & what are the defining characteristics?

A

accumulation of plaque in arteries that decreases blood flow

Defining Characteristics:
* Angina
* Pre-MI

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7
Q

What is Acute Coronary Symdrome (ACS = Acute MI Onset)?

Types, Signs & Symptoms, Risk Factors, & Pathology

A

Sudden, reduced blood flow to the heart

Types:
* Unstable angina
* STEMI (ST-elevated myocardial infarction)
* NSTEMI (non-ST elevated myocardial infarction)

Signs & Symptoms:
* Sudden chest pain (not aleviated w/ rest or meds)
* Dyspnea (SOB)
* Indigestion / nausea
* Anxiety
* Pale, cool skin
* Increased HR / RR / BP
* New murmur
* S3 & S4
* Arrhythmia

Risk Factors:
* Smoking
* Hypertension
* Diabetes
* Hyperlipidemia
* Being male
* Physical inactivity
* Diet / Exercise

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8
Q

What is Acute Coronary Syndrome & what are defining characteristics?

A

Acute loss of blood to the heart

  • Sudden Chest Pain
  • New Murmur

Types = unstable angina, STEMI, & NSTEMI

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9
Q

What is Heart Failure? What is the difference in systolic & diastolic heart failure? What is one of the main causes?

Risk Factors, R & L sided HF symptoms, Treatments

A

Heart can’t pump enough blood to meet metabolic demands

R-Sided HF:
* Visceral & peripheral congestion
* JVD
* Dependent edema
* Hepatomegaly
* Ascites
* Weight Gain

L-Sided HF:
* Pulmonary congestion
* Crackles
* S3
* Dyspnea
* Low O2
* Dry cough
* Oliguria

Risk Factors: smoking, obesity, diabetes, metabolic syndrome

  • Systolic HF: problems with heart contraction
  • Diastolic HF: problems with hear filling
  • Main Causes = atherosclerosis in coronary arteries

Treatment: ACE inhibitors

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10
Q

Key Differences in R-sided & L-sided Heart Failure

A

R-Sided: weight gain, JVD, edema, hepatomegaly, ascites, visceral & peripheral congestion

L-Sided: pulmonary congestion, crackles, S3, dyspnea, low O2, dry cough, oliguria

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11
Q

What is the difference in systolic & diastolic heart failure?

A

Systolic = issue with heart contraction

Diastolic = issue with heart fillling

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12
Q

What is one of the main causes of heart failure?

A

Atherosclerosis in coronary arteries

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13
Q

What do ace inhibitors do to help with heart failure?

A

Vasodilation = decreases afterload

important for systolic HF

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14
Q

Explain each part of the EKG

A
  • P = Atrial Depolarization (atria contract)
  • QRS = Ventricular Depolarization (ventricular contraction)
  • T = Ventricular Repolarization (ventricular contraction)
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15
Q

Explain the electrical conduction pathway through the heart

A
  • SA Node - main pacemaker
  • AV Node - back up pacemaker
  • His Budnle - (Bundle of His)
  • Bundle Branches
  • Purkinje Fibers

Sweet Apples Have A Big Price

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16
Q

What is the difference in ST elevation & ST depression?

A
  • ST Elevation = NO O2
  • ST Depression = LOW O2
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17
Q

Describe the following types of infections:

  • Nosicomial
  • Iatrogenic
A

Nosicomial = hospital acquired infection
* Catheter-associated UTI (CAUTI)
* Surgical site infection (SSI)
* Methicillin-resistant Staph aureus (MRSA)
* C. diff infection (CDI)
* Central line-associated bloodstream infection (CLABSI)

Iatrogenic = infection acquired after a procedure or treatment

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18
Q

Explain the stages of sleep. How long is a sleep cycle & how many sleep cycles does a person have in one night?

A

Non-REM Sleep: Stage I –> Stage II –> Stage III –> Stage IV –> Stage III –> Stage II –> REM –> Stage II –> ETC.

1 Cycle = 90 minutes

  • Person has about 6 cycles per night
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19
Q

Explain the nursing process.

A
  • Assess
  • Diagnose
  • Plan
  • Implement
  • Evaluate
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20
Q

What step of ADPIE are SMART goals used & what are SMART goals?

A

Used in planning phase

  • Specific
  • Measurable
  • Attainable
  • Realistic
  • Timely
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21
Q

What are the four phases of the nursing interview?

A

1.) Preparatory -
2.) Introduction -
3.) Working - longest phase
4.) Termination -

Per Book: (1.) Orientation; (2.) Work; (3.) Termination

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22
Q

What is ISBAR?

A
  • Introduction
  • Situation
  • Background
  • Assessment
  • Recommendations
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23
Q

What are Maslow’s Hierarchy of Human Needs?

highest to lowest priority

A

1.) Physiological needs
2.) Safety needs
3.) Love & belonging
4.) Self-esteem needs
5.) Self-actualization needs

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24
Q

What is the difference in Nociceptive & Neuropathic Pain?

A
  • Nociceptive = aching, throbbing

Neuropathic = tingling, burning, shooting, pins & needles

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25
Q

What are the 5 Rights of Delegation?

A

Right:

  • Task
  • Circumstances
  • Person
  • Directions / communication
  • Supervision / evaluation
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26
Q

Explain primary, secondary, & tertiary prevention in nursing

A
  • Primary: Prevention & education
  • Secondary: Screening
  • Tertiary: Patient already has diagnosis, how do you prevent it from coming back / treatment
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27
Q

What is the difference in a contusion, abrasion, laceration, & avulsion?

A
  • Contusion: bruising
  • Abrasion: rubbing or scraping of epidermal layers / some tissue is removed
  • Laceration: cut / tearing of skin
  • Avulsion: structures are removed from normal anatomical position
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28
Q

What is the difference in dehisence & evisceration?

A

**Dehisence = ** wound pulls apart at the edges

Evisceration: intraabdominal contents protrudes from the wound

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29
Q

Describe the stages of pressure injuries

A

Stage I: non-blanchable, erythema, skin is intact

Stage II: partial-thickness skin loss with exposed epidermis; errosion

Stage III: full-thickness skin loss; visible adipose tissue (no underlying tissue seen)

Stage IV: bone, muscle, tendon, etc. (other underlying structures) are visible

Unstageable: obscured view (usually obscured by eschar

Deep Pressure Injury: nonblancable; red, purple, or maroon color

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30
Q

Explain the different types of wound drainage: serous, sanguineous, serosanguineous, purulent.

A

Serous: mainly clear & thin (hint of yellow)

Sanguineous: bright red & slightly thick

Serosanguineous: pink

Purulent: thick, viscous pus, yellow or green

31
Q

What is tidaling in terms of a chest tube?

A

Fluid level in the chamber moves up & down with the patients respirations

32
Q

What does it mean if there is continuous bubbling in a water seal chamber?

A

leak in chest tube

Bubbling is expected in suction control chamber

33
Q

Which Oxygen Delivery Device provides the most precise amount of oxygen to be delivered to a patient?

A

Venturi Mask

34
Q

What does peak flow meter measure?

A

Forced expiration / highest airflow during forced expiraiton

35
Q

What signs & symptoms are the primary indicators of an asthma diagnosis?

A
  • Cough
  • Chest tightness
  • Wheezing
  • Dyspnea
36
Q

What is the difference in cardioversion & defibrillation?

A

Cardioversion is synchronized delivery of energy

Defibrillation is asynchronous delivery of energy

37
Q

Explain Pulmonary Edema (caused by HF)

Include risk factors, s&s, & pathology

A

Signs & Symptoms:
* Severe hypoxemia
* Restlessness / anxiety
* Tachypnea
* Dyspnea
* Cool, clammy skin
* Cyanosis
* weak / rapid pulse
* Cough (moist / noisy respirations)
* Increased pink frothy sputum (blood-tinge)
* Fluid overload
* S3 (blood rushing into L ventricle)
* Wheezes / Crackles

Risk Factors: Heart failure, specifically L ventricle failure

Pathology: blood backs up, pushes with pressure through vessels into alveoli

38
Q

What are the unique signs & symptoms of Pulmonary Edema (from HF)?

A
  • Weak / rapid pulse
  • Pink, frothy sputum (blood-tinged)
  • Crackles / Wheezes
39
Q

What kind of oxygen should be given to a patient with Pulmonary Edema from heart failure? What prescriptions can be used & waht should be monitored?

A

Use a Non-Rebreather Mask (100% O2 concentration)

Rx: diuretics & vasodilators

Monitor: I/O & weight

40
Q

Explain Hypertension

S&S, Risk factors, & pathology

A

Signs & Symptoms:
* Absent or weak pulses (esp. distal)
* S3 or S4 heart sounds
* Reginal hemorrhages
* JVD
* Renal artery bruit

Risk Factors: African American Men, older age, smoking, obesity, sedentary, dyslipidemia, DM, family hx, microalbuminuria or GFR < 60

Pathology:
* increased cardiac output (hypervolemia), peripheral resistance, or both
* Dysfunction of ANS (increased RAAS)
* Insulin resistance
* Activates immune system
* 95% of cases have no known cause

41
Q

What are unique defining characteristics of Hypertension?

S&S, risk factors, & pathology

A

Signs & Symptoms: Retinal Hemorrages, Renal artery bruit

Risk Factors: African American Men

95% of HTN has no known cause

In HTN, you must protect vital organs including the brain, heart, & kidneys

42
Q

Explain Cardiogenic Shock

S&S, Risk Factors, & Pathology

A

Signs & Symptoms:
* Tachypnea
* Dyspnea
* Tachycardia
* Weak pulse
* Diaphoresis
* Pale skin
* Hypotension

Risk Factors: pericardial effusion, cardiac tamponade, MI, PE, End stage HF, cardiomyopathy, arrhythmia

Patho: Heart can’t pump as much blood as the body needs, decreased CO

43
Q

What is Cardiogenic Shock & what are signs / symptoms?

A

Heart can’t pump enough blood throughout the body; decreased CO

Signs & Symptoms:
* Tachycardia
* Hypotension

44
Q

What is Virchow’s Triad and what disease does it deal with?

A
  • Intravascular vessel wall damage
  • Stasis of flow
  • Presence of a hypercoagulable state

Deals with Thromboembolism

45
Q

What are signs & symptoms of DVT / Thromboembolism?

A
  • Leg Pain
  • Swelling
  • Erythema
  • Warmth
46
Q

Explain a thromboembolism

S&S, RF, & Patho

A

Signs & Symptoms: (DVT)
* Leg pain
* Swelling
* Arrythmia
* Warmth

Risk Factors: cardiovascular disorder, decreased mobility

Patho:
* Virchow’s Triad: intravascular vessel wall damage, stasis of flow, & presence of a hypercoagulable state

47
Q

Explain Pericardial Effusion

S&S, RF, Patho

A

Signs & Symptoms:
* Elevated pressure in all chambers
* Dyspnea
* Discomfort breathing when lying down
* Chest pain
* Lightheadedness

Risk Factors:
* Heart Failure
* Pericarditis
* Metastatic Carcinoma
* Cardiac Surgery
Trauma

Patho: Increase in fluid in the pericardial sac
* may occur over time or suddenly

48
Q

What is a pericardial effusion & what are unique characteristics?

A

Increase in fluid in pericardial sac that can occur suddenly or over time

  • Discomfort when lying down
49
Q

What is Pulsus Paradoxus?

A

BP decreases with inhalation

50
Q

Explain Cardiac Tamponade

S&S, RF, Patho

A

Signs & Symptoms:
* Chest pain
* Pulsus paradoxus (BP decreases with inhalation)
* Tachypnea
* Dyspnea
* Tachycardia
* JVD
* Hypotension
* Muted Heart Sounds

Risk Factors: Heart surgery, injury to the heart, tumors in the heart, MI, HF

Patho: compression of heart by accumulated fluid in the pericardial sac

  • related to PE & Cardiogenic shock
51
Q

What is Cardiac Tamponade & what is unique about it?

A

Commpression of heart by fluid in pericardial sac

  • Related to PE & Cardiogenic Shock
  • Muted heart sounds
52
Q

Explain Cardiomyopathy

S&S, RF, Patho

A

Signs & Symptoms:
* Dyspnea
* Fatigue
* Dizziness
* Arrhythmias
* Murmurs
* Pulsus paradoxus
* Weight changes
* JVD
* Edema
* S3 / S4 heart sounds
* Crackles in lungs

Risk Factors: Family history, HF, long-term HTN, prior MI, CAD, heart infection, obesity

Patho: Series of progressive events that lead to impaired cardiac output

Na+ is major electrolyte involved

53
Q

What is cardiomyopathy & waht is unique about it?

A

Damage to the heart muscle that causes impaired cardiac output

S&S: murmur, pulsus paradoxus, weight changes, S3 / S4, crackles

Risk Factors: Long-term HTN

Sodium = major electrolyte involved

54
Q

What is the main electrolyte involved in cardiomyopathy?

A

Sodium

55
Q

Explain Infectious Diseases of the Heart

S&S, RF, Patho

A

Signs & Symptoms:
* Fever
* New heart murmur
* Olser nodes (fingers/toes, painful)
* Janeway lesions (palms/soles, no pain)
* Roth spots (eyes)
* Cardiomegaly
* HF
* Tachycardia
* Splenomegaly
* Fatigue
* Dyspnea
* Syncope
* Palpitations

Risk Factors: bacteria & viruses

Named for layer of heart that’s affected:

56
Q

List the layers of the heart from outside to inside

A
  • Pericardial Sac
  • Epicardium
  • Myocardium
  • Endocardium
57
Q

What is rheumatic endocarditis?

S&S, who gets it, & what’s the cause?

A

Bacterial Endocarditis

  • Most common in School aged kids

Cause = Group A beta-hemolytic strep

Unique S/S: hemolytic nail beds

58
Q

What are common complications of pericarditis?

A

Pericardial effusion: fluid filling sac around the heart

Cardiac tamponade: pressure from fluid build-up

59
Q

What is the cause of Infective Endocarditis? What are common reasons for getting it / associated with?

A

Caused by Bacteria

Associated with: prosthetic heart valve or structural cardiac defects, IV drug abuse, catheters, prolonged IV therapy

60
Q

What is the common cause of myocarditis?

A

Virus

61
Q

What is the difference in these valve disorders:

  • Regurgitation
  • Stenosis
  • Prolapse
A
  • Regurgitation = Backflow
  • Stenosis = Narrowing
  • Prolapse = Relaxes into atrium
62
Q

Explain Aneurysms

S&S, RF, Patho

A

Signs & Symptoms:
* Nausea / Vomiting
* Stiff neck
* Blurred vision
* Sensitivity to light
* Seizures
* Drooping eyelid
* LOC

Risk Factors:
* Triple A: atherosclerosis in aorta
* Congenital
* Infection
* Inflammation
* Pregnancy-related
* Trauma

Patho: Abnormal Dilation of Blood Vessels

63
Q

What is the difference in Saccular & Fusiform aneurysms? What are unique signs & symptoms?

A

S&S:
* Stiff Neck
* Seizures

Saccular: balloon on ONE side

Fusiform: balloon on BOTH sides

64
Q

What is the difference in a STEMI & NSTEMI myocardial infarction?

A

STEMI: total occlusion (Serious)

NSTEMI: partial occlusion (blood flow is restricted, not stopped)

65
Q

Explain Reynaud’s Phenomenon

A

Intermittent arterial vasoocclusion of fingers & toes (vasospasm)

  • color changes in fingers & toes
  • numbness, tingling, burning
66
Q

Explain Peripheral Artery Disease (PAD)

S&S, RF, Patho

A

Signs & Symptoms:
* Intermittent Claudication - aching, cramping, inducing fatigue or weakness with exercise of distal occlusion; relief with rest
* rest pain is due to ischemia
* Elevation increases pain
* Unequal pulses in limbs

Risk Factors: Atherosclerosis

Patho:Mainly caused by buildup of fatty plaque in arteries (atherosclerosis)

Extremities are cold / numb
Round, punched-out wound ulcer

67
Q

Explain Venous Stasis

A

Stasis = blood stays in legs

Signs & Symptoms:
* Tan legs
* Ulcers with clean edges, but odorous
* Higher risk for DVT

68
Q

What is the difference in Lymphagitis, Lymphadenitis, & Lymphedema?

A
  • Lymphagitis - inflammation or infection of lymph channels
  • Lymphadenitis - inflammation or infection of lymph nodes
  • Lymphedema - swelling related to obstruction of lymphatic flow
69
Q

What is the main function of the following electrolytes?

  • Potassium
  • Sodium
  • Calcium
  • Magnesium
  • Phosphate
A
  • K+ = Heart
  • Na+ = dehydration (Cl+ = same as Na+)
    • maintain BP, blood volume, & pH
  • Ca+ = bones, blood, (clotting factors** & beats** (heart beats)
  • Mg+ = muscles
    * torsades de pointe
  • P+ = bone & teeth formation; regulates Ca+

P+ & Ca+ are inverse

70
Q

What occurs with hyperkalemia & hypokalemia?

A

Hyper = irregular heartbeat, hypotension, bradycardia, muscle & GI contraction

Hypo =
* Low & slow GI & muscles

71
Q

What occurs with hypernatremia & hyponatremia?

A

Hypernatremia = red skin, edema, low grade fever, polydipsia(excessive thirst)

Hyponatremia
* seizures & coma
* tachycardia & weak, thready pulses
* respiratory arrest

Late Hyper Sings = N/V, swollen dry tongue, increased muscle tone

72
Q

What occurs with hypermagnesemia & hypomagnesemia?

A

Hyermagnesemia = CALM & QUIET
* bradycardia, hypotension, hyporeflexia, depressed / shallow respirations, hypoactive bowel sounds

Hypomagnesemia
* tachycardia, V-fib, torsades de pointe
* hyporeflexia (increased DTR)
* abnormal eye movements
* diarrhea

73
Q

What occurs with hypercalcemia & hypocalcemia??

A

Hypercalcemia = swollen & slow (moans, groans, & stones)
* constipation
* bone pains
* kidney stones
* decreased dtr

Hypocalcemia
* Trousseau’s signs
* Chvostek’s sign (cheek)
* diarrhea
* tingling around mouth
* weak bones
* risk for bleeding
* cardiac dysrhythmias

Adult Nursing I (NUR 240) (6 decks)

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