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aa Orgo > Medsurg hesi 4 cardiac > Flashcards

Medsurg hesi 4 cardiac Flashcards

1
Q

Left-sided heart (ventricular) failure results in inadequate left ventricle (cardiac) output and
consequently in inadequate

A

tissue perfusion

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2
Q

Right-sided heart (ventricular) failure results in inadequate right ventricle output and systemic

A

venous congestion (peripheral edema)

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3
Q

Pulmonary problems (COPD, pulmonary fibrosis) are risk factors for __ sided HF

A

right sided

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4
Q

orthopnea is symptom of __ sided HF

A

left

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5
Q

left or right HF: Displaced apical pulse (hypertrophy)

A

left

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6
Q

left or right HF: S3 heart sound (gallop)

A

left

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7
Q

left or right HF: Pulmonary congestion (dyspnea, cough, bibasilar crackles)

A

left

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8
Q

left or right HF: Frothy sputum (can be blood-tinged)

A

left

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9
Q

left or right HF: Manifestations of organ failure, such as oliguria

A

left

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10
Q

left or right HF: Jugular vein distention

A

right

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11
Q

left or right HF: Abdominal distention, ascites

A

right

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12
Q

left or right HF: Nausea and anorexia

A

right

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13
Q

left or right HF: Polyuria at rest (nocturnal)

A

right

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14
Q

left or right HF: Liver enlargement (hepatomegaly) and tenderness

A

right

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15
Q

Human B-type natriuretic peptides (hBNP): Elevated in ___ ___

A

heart failure

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16
Q

In clients who have dyspnea, elevated ___ confirms a diagnosis of heart failure rather than a problem originating in the respiratory system

A

hBNP

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17
Q

uses a transducer placed in the esophagus behind the heart to obtain a detailed view of cardiac structures

A

Transesophageal echocardiography (TEE)

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18
Q

Administer furosemide IV no faster than __ mg/min.

A

20

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19
Q

Monitor clients taking ACE inhibitors for ____ following the initial dose.

A

hypotension

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20
Q

ACE inhibitors: Monitor for increased levels of _____

A

potassium

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21
Q

Inotropic agents, such as digoxin are used to

A

increase contractility and thereby improve cardiac output

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22
Q

For a client taking digoxin, take the apical heart rate for 1 min. Hold the medication if apical pulse is less than

A

60/min

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23
Q

Teach clients who are self-administering digoxin to: count

A

pulse for 1 min (if it’s irregular or anything, don’t take the meds)

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24
Q

Do not take digoxin at the same time as ___

A

antacids

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25
Q

Vasodilators: Remind the client that a ____ is a common side effect of this medication

A

headache

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26
Q

hBNPs, such as nesiritide (Natrecor), are used to treat acute heart failure by causing

A

natriuresis (loss of sodium and vasodilation)

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27
Q

a mechanical pump that assists a heart that is too weak to pump blood through the body

A

Ventricular assist device (VAD)

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28
Q

Heart ____ is the treatment of choice for clients who have severe dilated cardiomyopathy

A

transplant

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29
Q

pink, frothy sputum (cardinal sign of ___ ___)

A

pulmonary Edemamama

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30
Q

Finding of pulmonary edema patient: __ heart sound (gallop)

A

S3 heart sound (gallop)

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31
Q

pulmonary edema: Position the client in high-Fowler’s position with

A

feet and legs dependent or sitting on the side of the bed to decrease preload.

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32
Q

pulmonary edema: Administer oxygen using a high-flow ___ mask

A

rebreather (bipap or intubation may become necessary too)

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33
Q

This is a serious complication of pump failure that occurs commonly following an MI and injury to greater than 40% of the left ventricle.

A

Cardiogenic shock

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34
Q

Valvular heart disease: Narrowed opening that impedes blood moving forward

A

Stenosis

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35
Q

Valvular heart disease: Improper closure

A

regurgitation – some blood flows backward

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36
Q

Acquired valvular heart disease: Due to damage over time from mechanical stress. The most common cause is hypertension.

A

Degenerative disease

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37
Q

Acquired valvular heart disease: Gradual fibrotic changes, calcification of valve cusps. The mitral valve is most commonly affected.

A

Rheumatic disease

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38
Q

Acquired valvular heart disease: Infectious organisms destroy the valve. Streptococcal infections are a common cause.

A

Infective endocarditis

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39
Q

heard with turbulent blood flow

A

murmur

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40
Q

_____ therapy is used for clients who have a mechanical valve replacement, atrial fibrillation, or severe left ventricle dysfunction.

A

Anticoagulation

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41
Q

This procedure can open aortic or mitral valves affected by stenosis

A

Percutaneous balloon valvuloplasty

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42
Q

Prosthetic valves: Mechanical valves last longer but require ____

A

anticoagulation

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43
Q

Valvular heart disease: biggest complication

A

HF

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44
Q

inflammatory disorder: Can be due to a myocardial infarction

A

Pericarditis

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45
Q

inflammatory disorder: Findings include chest pressure/pain, friction rub auscultated in the lungs, shortness of breath, and pain relieved when sitting and leaning forward

A

Pericarditis

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46
Q

inflammatory disorder: Can be due to a viral, fungal, or bacterial infection, or a systemic inflammatory disease (Crohn’s disease

A

Myocarditis

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47
Q

inflammatory disorder: Findings include tachycardia, murmur, friction rub auscultated in the lungs, cardiomegaly, chest pain, and dysrhythmias

A

Myocarditis

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48
Q

inflammatory disorder: An infection of the endocardium due to streptococcal bacteria

A

Rheumatic endocarditis

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49
Q

inflammatory disorder: Produces lesions in the heart

A

Rheumatic endocarditis

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50
Q

inflammatory disorder: Also known as bacterial endocarditis

A

Infective endocarditis

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51
Q

inflammatory disorder: Most common in IV drug users or clients who have cardiac malformations

A

Infective endocarditis

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52
Q

Valve debridement, draining of abscess, and repairing congenital shunts are procedures
involved with infective _____

A

endocarditis

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53
Q

PAD results from _____ that occurs in the arteries

A

atherosclerosis

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54
Q

PAD results from atherosclerosis that usually occurs in the arteries of the

A

lower extremities and is characterized by inadequate flow of blood.

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55
Q

Buerger’s disease, subclavian steal syndrome, thoracic outlet syndrome, Raynaud’s disease and Raynaud’s phenomenon, and popliteal entrapment are examples of

A

PADs

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56
Q

PAD pain is relieved by placing legs at rest in

A

a dependent position

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57
Q

Numbness or burning pain primarily in the feet when in bed

A

PAD

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58
Q

PAD bruit over ___ and ___ arteries

A

femoral and aortic arteries

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59
Q

PAD color of leg

A

pallor when elevated, red when dependent

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60
Q

involves arterial injection of contrast medium to visualize areas of decreased arterial flow on an x-ray

A

Arteriography

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61
Q

PAD test: It is usually done only to determine isolated areas of occlusion that can be treated during the procedure with percutaneous transluminal angioplasty and possible stent placement

A

Arteriography

62
Q

used to determine the variations of blood passing through an artery, thus identifying abnormal arterial flow in the affected limb.

A

Plethysmography

63
Q

In the absence of peripheral arterial disease, pressures in the lower extremities are ____ than those of the upper extremities.

A

higher

64
Q

With arterial disease, the pressures in the thigh, calf, and ankle are

A

lower

65
Q

PAD: tell the client to refrain from wearing

A

restrictive garments

66
Q

PAD: Tell the client to elevate the legs to reduce swelling, but not to

A

elevate them above the level of the heart (that’s too high)

67
Q

PAD: Have the client wear insulated ___

A

socks

68
Q

PAD: best way to prevent vasoconstriction

A

stop smoking

69
Q

may be given to specifically treat intermittent claudication experienced by clients who have PAD.

A

Pentoxifylline (Pento)

70
Q

besides Pentoxifylline (Pento), medication that can relieve intermittent claudication

A

statins

71
Q

Invasive intra-arterial procedure using a balloon and stent to open and help maintain the patency of the vessel

A

Percutaneous transluminal angioplasty

72
Q

Surgical intervention for PAD: Anticoagulant therapy is used during the operative procedure, followed by

A

antiplatelet therapy for 1 to 3 months

73
Q

used with clients who have severe claudication and/or limb pain at rest, or with clients who are at risk for losing a limb due to poor arterial circulation

A

Arterial revascularization surgery

74
Q

After PAD bypass surgery, Hypotension may result in an increased risk of

A

clotting or graft collapse

75
Q

After PAD bypass surgery, hypertension increases the risk for

A

bleeding from sutures

76
Q

After PAD bypass surgery, Instruct the client to limit bending of the

A

hip and knee to decrease the risk of clot formation

77
Q

a brown discoloration along the ankles that extends up the calf relative to
the level of insufficiency.

A

Stasis dermatitis (finding of venous insufficiency)

78
Q

finding of venous insufficiency: stasis ulcers found on the

A

ankles

79
Q

What kind of venous problem: Clients often report muscle cramping and aches, pain after sitting, and pruritus.

A

Varicose veins

80
Q

Varicose veins: Clients often report pain after

A

sitting, and pruritus

81
Q

____ test measures fibrin degradation products present in the blood produced from fibrinolysis. A positive test indicates that thrombus formation has possibly occurred.

A

D-dimer

82
Q

Impedance plethysmography can be used to determine the variations of

A

blood passing through a vein

83
Q

Place the client in a supine position with legs elevated. When the client sits up, the veins will fill from the proximal end if varicosities are present
(veins normally fill from the distal end).

A

Trendenlenburg Test for varicose veins

84
Q

DVT and thrombophlebitis tx: Administer intermittent or continuous

A

warm moist compresses

85
Q

DVT and thrombophlebitis tx: provide

A

thigh-high compression or antiembolism stockings

86
Q

Venous insufficiency: Elevate feet approximately 6 inches at

A

night

87
Q

Venous insufficiency: Instruct client to wear elastic compression stockings and apply them after

A

the legs have been elevated and when swelling is at a minimum

88
Q

heparin has significant adverse effects and must be given in the

A

facility

89
Q

Warfarin effect takes

A

3 to 4 days

90
Q

Warfarin is started while

A

client is still on heparin (because it takes a little while to start working)

91
Q

Warfarin antidote

A

vitamin K

92
Q

Thrombolytic therapy must be started within _ days after the development of the clot for the therapy to be effective

A

5

93
Q

irritating chemical solution is injected into the varicose vein to produce localized inflammation, which will, close the lumen of the vessel over time

A

sclerotherapy for Varicose veins

94
Q

sclerotherapy: Pressure dressings are applied for approximately 1 week after each procedure to keep the vessel

A

free of blood

95
Q

the removal of large varicose veins that cannot be treated with less-invasive procedures.

A

Vein stripping

96
Q

Vein stripping, post op: Instruct the client to elevate the legs when sitting, and avoid

A

dangling them over the side of the bed

97
Q

Venous stasis ulcers: Apply oxygen-permeable ____ films to superficial ulcers.

A

polyethylene

98
Q

Venous stasis ulcers: Apply occlusive, ____ dressings on deeper ulcers

A

hydrocolloid

99
Q

Venous stasis ulcers: Apply occlusive, hydrocolloid dressings on deeper ulcers to promote

A

granulation tissue and reepithelialization.

100
Q

sudden onset dyspnea

A

PE

101
Q

HTN tx: Instruct the client to avoid grapefruit juice, which ____ the medication’s effects

A

increases

102
Q

ACE inhibitors should be stopped if client has

A

persistant cough

103
Q

HTN: amount of alcohol that’s OK

A

2 drinks for men, 1 for women

104
Q

Risk Factors for ___ shock: cardiac pump failure due to MI, heart failure, cardiomyopathy, dysrhythmias, and valvular rupture or stenosis

A

Cardiogenic

105
Q

Risk Factors for ___ shock: excessive fluid loss from diuresis or vomiting/diarrhea, or blood loss secondary to
surgery, trauma, gynecologic/obstetric causes, burns, and diabetic ketoacidosis.

A

Hypovolemic

106
Q

Risk Factors for ___ shock: blockage of great vessels, pulmonary artery stenosis, pulmonary embolism, cardiac tamponade, tension pneumothorax, and aortic dissection are among the causes

A

Obstructive

107
Q

serum glucose can ____ during shock

A

increase

108
Q

Cardiogenic and obstructive shock: Assess for ECG changes associated with

A

MI and dysrhythmias

109
Q

Shock: Place the client on high-flow oxygen, such as a 100% _____ face mask.

A

nonrebreather

110
Q

Shock: If the client has COPD, insert a

A

2 L/min nasal cannula and increase the oxygen flow as needed.

111
Q

INOTROPIC actions

A

Strengthens cardiac contraction and increases cardiac output

112
Q

VASOPRESSORS (like dobu) should be given through a

A

central line to prevent irritation

113
Q

Epinephrine can cause ___ if infiltrates tissue.

A

sloughing

114
Q

what IV fluids are given for hypovolemic shock

A

NS or LR

115
Q

Vasodilators are used to treat ___ shock

A

cardiogenic

116
Q

Vasodilators need to be protected from

A

light

117
Q

DIC

A

Disseminated Intravascular Coagulation

118
Q

Disseminated Intravascular Coagulation (DIC) is a complication of ___ shock

A

septic

119
Q

Thousands of small clots form within organ capillaries (liver, kidney, heart, brain), creating hypoxia and anaerobic metabolism

A

Disseminated Intravascular Coagulation (DIC)

120
Q

Disseminated Intravascular Coagulation (DIC): As a result of multiple clot formation, platelets and other clotting factors such as fibrinogen are depleted and the client is at increased risk for

A

hemorrhage

121
Q

Disseminated Intravascular Coagulation (DIC): risk for

A

hemorrhage

122
Q

A weakness in a section of a dilated artery that causes a widening or ballooning in the wall of the blood vessel is called an

A

aneurysm

123
Q

Seventy-five percent of aneurysms are ___ ___ aneurysms.

A

abdominal aortic

124
Q

can occur when blood accumulates within the artery wall (hematoma) following a tear in the lining of the artery

A

Dissecting aneurysm

125
Q

Dissecting aneurysm can occur when blood accumulates within the artery wall (hematoma) following a tear in the lining of the artery. It’s usually due to

A

HTN

126
Q

Abdominal aortic aneurysm: subjective

A

Constant gnawing feeling in abdomen; flank or back pain

127
Q

Aortic dissections (often associated with ___ syndrome)

A

Marfan’s

128
Q

the priority in an emergency aneurysm

A

decrease BP

129
Q

Hematologic assessment and diagnostic procedures evaluate _____ function

A

blood function

130
Q

Bone marrow Biopsy: Postprocedure discomfort is usually relieved by __ analgesics.

A

mild (but avoid aspirin since it causes bleeding)

131
Q

Bone marrow Biopsy: Teach the client to check the biopsy site

A

daily

132
Q

Autologous transfusions: Clients may donate blood 5 weeks in advance up to

A

72 hr prior to surgery.

133
Q

blood tx of Coagulation factor deficiencies such as hemophilia

A

– fresh frozen plasma

134
Q

blood tx of Anemia or Kidney failure

A

packed RBCs

135
Q

Obtain blood products from the blood bank. Inspect the blood for excessive

A

bubbles

136
Q

transfusion: Prime the blood administration set with

A

NS

137
Q

transfusion: Never add ____ to blood products.

A

medications

138
Q

Dispose of the blood-administration in

A

biohazard bags

139
Q

Hgb levels should rise by approximately __ g/dL with each unit transfused.

A

1

140
Q

transfusion reaction: onset: Acute hemolytic

A

immediately

141
Q

transfusion reaction: onset: Febrile

A

30minto6hr after transfusion

142
Q

transfusion reaction: onset: Mild allergic

A

During or up to 24 hr after transfusion

143
Q

transfusion reaction: onset: Anaphylactic

A

immediately

144
Q

transfusion reaction: Use WBC filter. Administer antipyretics.

A

Febrile reaction

145
Q

transfusion reaction: This reaction may cause cardiovascular collapse, kidney failure, disseminated intravascular coagulation, shock, and death.

A

Acute hemolytic

146
Q

Mild allergic transfusion reaction: Administer

A

antihistamines

147
Q

transfusion reaction: Maintain airway; administer oxygen, IV fluids, antihistamines, corticosteroids, and vasopressors.

A

Anaphylactic

148
Q

transfusion reaction: stop the infusion and Initiate an infusion of NS. The infusion should be

A

initiated with a separate line, so as not to infuse more blood from the transfusion tubing.

149
Q

After a transfusion reaction: save the

A

Save the blood bag with the remaining blood (for testing)

150
Q

If disseminated intravascular coagulation (DIC) occurs: Administer ___ in the early phase

A

anticoagulants

151
Q

If disseminated intravascular coagulation (DIC) occurs: Administer ___ ___ and ___ ___ during the late phase

A

clotting factors and blood products

aa Orgo (196 decks)

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