Gallbreath Study Guide Flashcards

1
Q

Hypotension may be reversed with…

A

1

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2
Q

Would you give atropine to a patient with bradycardia and heart blocks?

A

No, it could send them into cardiac arrest.

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3
Q

What pulse do you monitor with digoxin and for how long?

A

Apical for 1 min before administering medicine. If pulse is less than 60, hold it.

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4
Q

What can be used to treat tachydysrhythmias?

A

Vagal Maneuvers. They induce vagal stimulation of the SA and AV nodes. This is usually a temporary intervention.

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5
Q

Define pulse pressure

A

The difference between the systolic and diastolic. It is an indirect method of measuring cardiac output.

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6
Q

What is used to assess the vascular status of the lower extremities?

A

Ankle-brachial index

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7
Q

When attempting to get an ankle-brachial index, where is the BP cuff placed?

A

To the lower extremity just above the malleolus.

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8
Q

What are the normal values for the ankle-brachial index?

A

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.

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9
Q

How do you assess the toe-brachial index?

A

You get the toe systolic pressure and divide it by the brachial systolic pressure.

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10
Q

What is a toe-brachial index used for?

A

It is used to assess arterial perfusion to the feet and toes.

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11
Q

What position would you assess jvd in?

A

1

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12
Q

When you listen to a carotid pulse, what are you listening for?

A

A bruit. This can indicate turbulent blood flow from narrow arteries.

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13
Q

Where do you listen for S1 sounds?

A

Lower left sternal border or APEX of the heart.

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14
Q

Where do you listen for S2 sounds?

A

At the base of the heart.

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15
Q

Where can S3 and S4 sounds be heard?

A

At the lower left sternal border or Apex of the heart with the patient lying on the left side.

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16
Q

What is a grade 1 murmur?

A

Very faint

17
Q

Grade 2 murmur?

A

Faint but recognizable

18
Q

Grade 3 murmur?

A

Loud but moderate in intensity

19
Q

Grade 4 murmur?

A

Loud and accompanied by a palpable thrill

20
Q

Grade 5 murmur?

A

Very loud with thrill and can be heard with the stethoscope slightly off the patient’s chest.

21
Q

Grade 6 murmur?

A

Extremely loud with thrill and can also be heard with stethoscope slightly off patient’s chest.

22
Q

What should a person with diabetes and hard disease have for bp?

A

less than 130/90

23
Q

How do you find out if the kidneys have been damaged by hypertension?

A

BUN and Creatinine test

24
Q

What do you have to watch out for if a patient is on loop diuretics?

A

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

25
Q

What time of day should a patient take a diuretic?

A

In the morning.

26
Q

How is orthostatic hypotension defined?

A

A decrease in bp 20/10

27
Q

How is malignant hypertension defined?

A

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).

28
Q

Why is a bp of 200/150 a concern?

A

It is malignant hypertension. It can lead to renal failure, left ventricular failure or stroke.

29
Q

What are some important things to know about digoxin toxicity?

A

s/s nausea, double vision, decreased hr, measure apical, if below 60 withold medicine.