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BSN: 3rd Quarter > MED/SURG EXAM #1 > Flashcards

MED/SURG EXAM #1 Flashcards

1
Q

Differentiate the anatomic location and function of the following structures of the heart: pericardial layers, atria, ventricles, and valves.
_______________
Objective #1

A

Pericardial layers:
Atria layers:
Ventricles:
Valves:

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2
Q

Stages of development in atherosclerosis

A

Chronic endothelial injury which leads to…
1) Fatty streak
2) Fibrous plaque
3) Complicated lesion

NOTE: when the patient becomes symptomatic, the disease process usually is well advanced

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3
Q

Relate the coronary circulation to the areas of heart muscle supplied by the major coronary arteries.
_____________
Objective #2

A
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4
Q

Differentiate the structure and function of arteries, veins, capillaries, and endothelium.
__________
Objective #3

A
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5
Q

Describe the mechanism involved in the regulation of blood pressure
_________
Objective #4

A
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6
Q

Relate the various waveforms on a normal electrocardiogram to the associated cardiac events
_________
Objective #5

A
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7
Q

Obtain significant subjective and objective assessment data related to the cardiovascular system from a patient and/or caregiver
________
Objective #6

A
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8
Q

Perform a physical assessment of the cardiovascular system using the appropriate techniques
___________
Objective #7

A
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9
Q

Differentiate normal from abnormal finding s of a physical assessment of the cardiovascular system
_______
Objective #8

A
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10
Q

Link the age-related changes of the cardiovascular system to the differences in assessment findings
________
Objective #9

A
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11
Q

Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of the cardiovascular system
________
Objective #10

A
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12
Q
  1. Relate the pathophysiologic mechanisms associated with primary hypertension to the clinical manifestations and complications
A
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13
Q
  1. Select appropriate strategies for the prevention of primary hypertension
A
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14
Q
  1. Describe the interprofessional care for primary hypertension, including drug therapy and lifestyle modification.
A
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15
Q
  1. Explain the interprofessional care of the older adult with primary hypertension.
A
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16
Q
  1. Prioritize the nursing management of the patient with primary hypertension
A
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17
Q
  1. Describe the nursing and interprofessional care of a patient with a hypertensive crisis.
A
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18
Q
  1. Relate the etiology and pathophysiology of coronary artery disease (CAD) and acute coronary syndrome (ACS) to the clinical manifestations of each disorder.
A
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19
Q
  1. Describe the nursing role in the promotion of therapeutic lifestyle changes in patients at risk for CAD
A
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20
Q
  1. Differentiate the precipitating factors, clinical manifestations, interprofessional care, and nursing management of the patient with CAD and chronic stable angina
A
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21
Q
  1. Explain the clinical manifestations, diagnostic studies, complications, and interprofessional care of the patient with ACS
A
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22
Q
  1. Evaluate commonly used drug therapy in treating patients with CAD and ACS
A
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23
Q
  1. Prioritize key components to include in the rehabilitation of patients recovering from ACS and coronary revascularization procedures
A
24
Q
  1. Differentiate the precipitating factors, clinical presentation, and interprofessional care of patients who are at risk for or have experienced sudden cardiac death.
A
25
Q
  1. Compare the pathophysiology of systolic and diastolic heart failure (HF).
A
26
Q
  1. Relate the compensatory mechanisms involved in HF to the development of acute decompensated heart failure (ADHF) and chronic HF.
A
27
Q
  1. Select appropriate nursing and interprofessional care to manage the patient with ADHF.
A
28
Q
  1. Select appropriate nursing and interprofessional care to manage the patient with HF.
A
29
Q
  1. Describe the indications for heart transplantation and the nursing care of transplant recipients.
A
30
Q

Verapamil:
Class
Adverse effects
What to monitor?

A

Class: Calcium Channel Blockers (CCB)
Adverse effects: atrial fibrillation
What to monitor?: NO GRAPEFRUIT JUICE

31
Q

HCTZ:
Class
Adverse effects:
What to monitor?

A

Class: Thiazides (ends in -ides)
Adverse effects: Orthostatic hypotension, hypovolemia, HYPONa, HYPERglycemia
What to monitor?: decrease in K+ (leg cramps, fatigue, tachycardia), K+-rich foods (dark leafy greens)

32
Q

Beta Adrenergic Blockers
Class
Adverse effects
What to monitor?

A

Class:
Adverse effects: masked HYPOglycemia effects (e.g. Metoprolol); Bradycardia
What to monitor?:

33
Q

Teaching for a patient newly Dx’d with heart failure

A

— exercise
— watch changes in sleep patterns
— Check fluid volume for overload (HYPONa+ & NSAIDS can cause weight gain)

34
Q

Purpose of taking Warfarin + what to monitor? + Antidote?

A

Prevent blood clots (anticoagulants)
— Labs: PT, INR
Antidote = Vitamin K

35
Q

Purpose of taking Heparin + what to monitor? + Antidote?

A

Purpose: does NOT dissolve the clot, but prevents
— Labs: PTT
Antidote = Protamine Sulfate

36
Q

Identify Iron (Fe) rich foods

A

— Nuts
— Dried fruits: apricots, raisins
— Legumes: lentils, mixed/baked beans, chickpeas
— Dark leafy greens: spinach, silver beet, broccoli
— Oats
— Tofu
— Fortified cereals, breads and pastas
— Red meat, pork, poultry
— Peas

37
Q

How to read an ECG + determine interval durations

A

P-wave: atrial depolarization
PR segment:
QRS complex:
ST segment:
T-wave:

38
Q

Troponins + difference b/w L/R-sided heart failure

A
39
Q

Difference in a pacemaker when spiked at the Q/P

A

— When spiked @ the Q —> V-paced (ventricular)
— When spiked @ before the P-wave —> A-paced (atrial)

40
Q

The purpose of determining capillary refill?

A

To determine arterial sufficiency

41
Q

What are the shockable rhythms?

A

— Pulseless VTach
— VFIB

42
Q

ABCs related to Cardiovascular

A
43
Q

What is the proper treatment for the S/Sx’s of severe bradycardia?

A

ATROPINE
Dosage:

44
Q

Interventions/Teaching when taking Nitroglycerine (NTG)

A

1 dose, wait 5 minutes. If doesn’t work, do another dose
Max dose: 3 within a 15 minute time period; If that doesn’t work, GO TO THE HOSPITAL!!
—If a patch, make sure to place on in the AM, and take OFF at night/bedtime (stays on for no more than 12-14 hours)

45
Q

Teaching when taking Digoxin

A

DO NOT TAKE IF HR <60bpm
— HYPOkalemia
— Increase risk for Digoxin toxicity (0.8-2)

46
Q

MEDS TO STUDY: Heparin, Lisinopril, Warfarin, NTG, Digoxin, Dobutamin, ASA, Atenolol, Aloe Vera

A
47
Q

Herbals that impact someone with CAD

A

— Feverfew:
— Aloe vera
— Flax seed

48
Q

Right-sided heart failure vs. Left-sided heart failure

A

RSHF:

LSHF:

49
Q

Non-modifiable risk factors of coronary artery disease (CAD)

A

— age
— gender: 45+ for men, 55+ for women (highest incidence among white middle-aged men)
— ethnicity (women are more likely to die after 1st MI, but is most prevalent in black women)
— genetics: predisposed = key factor

50
Q

Modifiable risks factors of coronary artery disease

A

LIPIDS:
— cholesterol >200mg/dL
— triglycerides >150mg/dL
— LDL cholesterol >130mg/dL (think: “lethal”; low down dirty shame)
— HDL cholesterol <40mg/dL (men), <50mg/dL (women) (think: “healthy”)
— DM
— Tobacco use
— Physical inactivity
— Obesity: weight circumference >102cm or >40 in (men), >88cm/>35in (women)
— Psychosocial risk factors (e.g. depression, hostility)
— HIGH homocysteine levels
— Substance abuse

51
Q

Stage differences with hypertension

A

Normal: <120/80
PreHTN: 120-139/80-89
Stage 1: 140-159/90-99
Stage 2:>160/>100

52
Q

Differences between systolic vs. diastolic pressure

A

Systolic (top #): pressure when the heart contracts blood to pump to the rest of the body
Diastolic (bottom #): pressure when the heart relaxes b/w beats

53
Q

Amount of protein needed for someone with cardiac conditions

A

— 5-6oz/day

54
Q

NG Question about difference between STABLE vs UNSTABLE angina

A
55
Q

Differences between NSTEM vs. STEMI on the EKG

A

BSN: 3rd Quarter (13 decks)

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