Gallbreath Study Guide Flashcards
Hypotension may be reversed with…
1
Would you give atropine to a patient with bradycardia and heart blocks?
No, it could send them into cardiac arrest.
What pulse do you monitor with digoxin and for how long?
Apical for 1 min before administering medicine. If pulse is less than 60, hold it.
What can be used to treat tachydysrhythmias?
Vagal Maneuvers. They induce vagal stimulation of the SA and AV nodes. This is usually a temporary intervention.
Define pulse pressure
The difference between the systolic and diastolic. It is an indirect method of measuring cardiac output.
What is used to assess the vascular status of the lower extremities?
Ankle-brachial index
When attempting to get an ankle-brachial index, where is the BP cuff placed?
To the lower extremity just above the malleolus.
What are the normal values for the ankle-brachial index?
1.0 is normal. If less than 0.80 the patient has moderate vascular disease. If less than 0.50, the patient has severe vascular disease.
How do you assess the toe-brachial index?
You get the toe systolic pressure and divide it by the brachial systolic pressure.
What is a toe-brachial index used for?
It is used to assess arterial perfusion to the feet and toes.
What position would you assess jvd in?
1
When you listen to a carotid pulse, what are you listening for?
A bruit. This can indicate turbulent blood flow from narrow arteries.
Where do you listen for S1 sounds?
Lower left sternal border or APEX of the heart.
Where do you listen for S2 sounds?
At the base of the heart.
Where can S3 and S4 sounds be heard?
At the lower left sternal border or Apex of the heart with the patient lying on the left side.
What is a grade 1 murmur?
Very faint
Grade 2 murmur?
Faint but recognizable
Grade 3 murmur?
Loud but moderate in intensity
Grade 4 murmur?
Loud and accompanied by a palpable thrill
Grade 5 murmur?
Very loud with thrill and can be heard with the stethoscope slightly off the patient’s chest.
Grade 6 murmur?
Extremely loud with thrill and can also be heard with stethoscope slightly off patient’s chest.
What should a person with diabetes and hard disease have for bp?
less than 130/90
How do you find out if the kidneys have been damaged by hypertension?
BUN and Creatinine test
What do you have to watch out for if a patient is on loop diuretics?
You’ll have to monitor their potassium. If they are low, encourage them to eat therapy bannanas, kiwi, strawberries, greens, yogurt, Kdur (drug) or orange juice
What time of day should a patient take a diuretic?
In the morning.
How is orthostatic hypotension defined?
A decrease in bp 20/10
How is malignant hypertension defined?
When a person has a bp greater than 200/150 or a diastolic greater than 130 if they have other complications. Symptoms include morning headache, blurred vision, dyspnea and/or symptoms of uremia (accumulation in the blood of substances normally excreted by urine).
Why is a bp of 200/150 a concern?
It is malignant hypertension. It can lead to renal failure, left ventricular failure or stroke.
What are some important things to know about digoxin toxicity?
s/s nausea, double vision, decreased hr, measure apical, if below 60 withold medicine.
