Heart Disease/ Cardiovascular

Question 1

SS of CHF

Answer 1

SOB, fatigue, BLE, edema, dysrhythmia, persistent cough/wheeze

Question 2

SS of Arrhythmia

Answer 2

fluttering in the chest, tachycardia/bradycardia, chest pain, SOB, dizziness/fainting

Question 3

SS of Stroke

Answer 3

numbness, difficulty with balance, speech, understanding, blurred vision, facial drop, difficulty swallowing

Question 4

SS of MI

Answer 4

chest pain, numbness, pain in the left arm, jaw, back

Question 5

SS of Cardiac Arrest

Answer 5

heart completely stop working

Question 6

SS of HTN

Answer 6

headache, fatigue, blurred vision, chest pain, dyspnea, dysrhythmia

Question 7

What are Cardiac glycoside used for?

Answer 7

increase cardiac contractility, decrease HR

Question 8

What are Nitrates used for?

Answer 8

pain

Question 9

What are Antilipids (statin) used for?

Answer 9

decrease cholesterol

Question 10

What are Diuretics used for?

Answer 10

reduce fluid volume

Question 11

Which two precordial leads do not have an absolute anatomical landmark?

Answer 11

V3 & V5

Question 12

What intercostal spaces are landmarks when placing EKG pads?

Answer 12

4th and 5th

Question 13

Which wave is Atrial depolarization

Answer 13

P Wave

Question 14

Which wave: Ventricular depolarization

Answer 14

QRS wave

Question 15

Which wave: Complete depolarization

Answer 15

ST segment

Question 16

Which wave: Ventricular repolarization

Answer 16

T wave

Question 17

How is telemetry different from an EKG?

Answer 17

an EKG is just a snapshot of the heart at that particular moment - telemetry is a continuous

Question 18

Nursing interventoins to promote car of the cardiovascular system

Answer 18

• EKG and telemetry placement and monitoring
• Assist with leg exercises
• Prophylactic application (TEDs and SCDs)
• Medication
• Assessment and education

Question 19

What are TEDs?

Answer 19

thromboembolic deterrent stockings - prophylactically to prevent DVT

Question 20

What are SCDs?

Answer 20

sequential compression device - prophylactically to prevent DVT

Question 21

What is a Duplex ultrasound?

Answer 21

test to assess how blood moves through arteries and veins

Question 22

What is an angiography/ angioplasty?

Answer 22

injection of the radiopaque dye to outline vessels of the cardiovascular system looking for blockages and/or narrowing of vessels - pt remains awake

Question 23

What is a PTCA - percutaneous transluminal coronary angioplasty?

Answer 23

IV is placed in the neck, arm, or groin to allow insertion of a balloon-tipped catheter to open the blocked artery - pt remains awake

Question 24

What is a Coronary artery stent?

Answer 24

tube-shaped device placed in a coronary artery to keep it open - pt is then placed on anticoagulants - pt is aware during placement

Question 25

The patient has returned from PTCA - what are the nursing responsibilities upon return to the unit?

Answer 25

- check vital signs - assess pain - assess for bleeding or hematoma formation at the insertion site - maintain pressure dressing and immobilize limb for approx 6 hrs - monitor for urination within 6 hrs - administer fluids - document

Question 26

What is a CABG; which vessel can be used for this procedure?

Answer 26

a vessel is used to bypass a blocked vessel during this procedure; Greater saphenous vein or LIMA (left internal mammary artery

Question 27

What is a stress test?

Answer 27

Recording of the physiological response of the heart when stressed (during exercise) - looking for chest pain, irregular heart rhythm, etc

Question 28

What is an Echocardiogram?

Answer 28

A procedure that can be performed at the bedside using ultrasonic waves to detect structural defects of the heart - noninvasive

Question 29

How are DNR and DNI different from a MOLST?

Answer 29

MOLST needs to be signed by a physician - not DNR or DNI

Question 30

What is MOLST?

Answer 30

medical/Maryland order for life-sustaining treatment - medical order signed by a physician

Question 31

Is a Double Lumen Hickman Catheter short-term or long-term?

Answer 31

long term - months or years

Question 32

What is a Dacron Sheath?

Answer 32

a part of the Hickman catheter that acts like an anchor (tissue grows around it and helps keep the catheter in place) and protection barrier to keep bacteria from entering the body and causing infection

Question 33

Name of the central catheter that enters from the arm

Answer 33

PICC - peripherally inserted central catheter into a vein in the arm (cephalic, basilic, brachial, or medial cubital -- terminating in the SVC)

Question 34

What is a Mediport?

Answer 34

a central catheter placed in the subcutaneous chest tissue in the OR by a physician and terminates in the SVC; long-term; confirmed by Xray

Question 35

How is a Mediport accessed?

Answer 35

accessed with a huber needle, esp designed for a mediport

Question 36

What team members are involved in Code Blue?

Answer 36

first responder, bedside nurse, charge nurse, team/code leader, recorder, runner, respiratory/anesthesia, nurse on code cart, nursing supervisor, security

Question 37

What is an RRT?

Answer 37

Rapid response team

Question 38

What is an OPA?

Answer 38

Oropharyngeal airway - Maintains airway to keep the tongue from covering epiglottis in an unconscious patient

Question 39

What would cause a ventricular dysrhythmia? How does it affect cardiac output? What is the intrinsic ventricular rate?

Answer 39

- Cause: ectopic foci in the wall of the ventricles - Cardiac output: decrease - Rate: 20-40 bpm

Question 40

What is PVC? Is it a medical emergency?

Answer 40

premature ventricular contraction - false, many people have occasional PVC due to stress or too much coffee

Question 41

PVC is a beat, not a rhythm, true or false?

Answer 41

true

Question 42

What pulse point is the best place to count a V-tach? How do you treat this?

Answer 42

too fast to count - CPR/defibrillation, antiarrhythmic, medication, implantable device

Question 43

How well is the heart pumping during V-Fib? How many bpm? Treatment?

Answer 43

nothing is being pumped - there's no coordination between the atria and ventricles - 0 bpm; no palpable pulse - CPR/defibrillation, antiarrhythmic, medication, implantable device

Question 44

What is a STEMI?

Answer 44

- most severe MI - coronary artery becomes blocked - lack of perfusion to tissues

Question 45

What is a PEA? Is this a shockable rhythm? Is there cardiac output?

Answer 45

Pulseless Electrical Activity - there's electrical activity but no contraction; there's no palpable pulse (no bpm); not a shockable rhythm instead have to continue compressions; no cardiac output

Question 46

Do you shock a patient in Asystole?

Answer 46

NO

Question 47

What is a Holter Monitor?

Answer 47

records activity of the heart - worn for a few days or a few weeks