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Funds II Theory > Module 1: Perfusion and Teaching & Counseling > Flashcards

Module 1: Perfusion and Teaching & Counseling Flashcards

1
Q

Red Blood Cells Normal Range

A

3.6-6.1 million/mcL

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2
Q

S/S of Low RBC Count

A

anemia, paleness, cyanosis, weakness, fatigue, poor circulation

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3
Q

What causes low RBC count?

A

iron deficiency anemia

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4
Q

What does Hemoglobin levels measure?

A

hemoglobin measures the protein (called hemoglobin) that carries oxygen in red blood cells

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5
Q

Hemoglobin Normal Range

A

11.1 - 15.3 g/dL

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6
Q

S/S of Low Hemoglobin Count

A

excessive bruising in pts with low platelets, cyanosis, tired, pale, increased HR, SOB, weakness

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7
Q

Causes of low hemoglobin

A

anemia or blood loss

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8
Q

Hematocrit Normal Levels

A

33.7 - 46%

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9
Q

What does Hematocrit measure?

A

portion of RBCs in blood

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10
Q

S/S of low level of hematocrit

A

cyanosis, tired, pale, increased irregular HR, SOB, weakness

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11
Q

S/S of high level of hematocrit

A

dehydration (leads to increase Hct)

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12
Q

What causes changes in hematocrit?

A

fluid balance

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13
Q

Platelets Normal Range

A

150-450 billion/L

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14
Q

S/S of low value platelets

A

BLEEDING, fatigue, nose bleeds, bl in stool, BRUISING, pallor, low blood pressure, tachycardia, weak pulse

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15
Q

S/S of high value platelets

A

more likely to clot

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16
Q

What causes changes in platelet count?

A

iron deficiency, cancer, trauma

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17
Q

Prothrombin Time Normal Range

A

11-13.5 sec

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18
Q

low level of prothrombin time

A

more likely to clot

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19
Q

high level of prothrombin time

A

more likely to bleed

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20
Q

What causes changes in prothrombin time?

A

vitamin K, drug and herb interactions

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21
Q

International Normalized Ratio Normal Range

A

0.8 - 1.3 sec

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22
Q

What do both INR and PT and PTT measure?

A

how long bl takes to clot

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23
Q

Low levels of INR

A

more likely to clot

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24
Q

High levels of INR

A

more likely to bleed

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25
Q

What causes changes in INR?

A

vitamin K, drug and herb interactions

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26
Q

Partial Prothrombin Time Normal Range

A

25-35 sec

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27
Q

Low value PTT

A

more likely to clot

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28
Q

High value PTT

A

more likely to bleed

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29
Q

What causes changes of PTT?

A

vitamin K deficiency, liver disease

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30
Q

Ejection Fraction Normal Range

A

50-70%

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31
Q

Low value ejection fraction

A

fatigue, weakness

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32
Q

What causes low ejection fraction

A

heart failure

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33
Q

Brain Natriuretic Peptide (BNP) normal range

A

less than 100 pg/mL

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34
Q

What does BNP measure?

A

levels of BNP protein made by heart and bl vessels

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35
Q

low BNP

A

know they don’t have heart failure

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36
Q

high BNP

A

worse severity of heart failure

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37
Q

Total Cholesterol normal range

A

less than 200 mg/ dL

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38
Q

HDL normal range

A

more than 40 mg/dL

GOOD CHOLESTEROL

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39
Q

LDL normal range

A

less than 100 mg/dL

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40
Q

S/S of low ranges of cholesterol

A

no s/s but increase risk of CV disease (HDL)
no s/s for other two

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41
Q

s/s of high ranges of cholesterol

A

cardiac disease
decreased circulation
increased BP
atherosclerosis

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42
Q

Erythrocyte Sedimentation Rate (ESR) normal range

A

0-20 mm/hr

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43
Q

What does ESR measure

A

detects inflammation

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44
Q

high levels of ESR

A

infection
heart attack

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45
Q

Albumin Normal Range

A

3.4 - 5.4 g/dL

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46
Q

What does albumin measure?

A

protein in bl plasma, keeps bl in vasculature

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47
Q

low levels of albumin

A

swelling (increased protein diet needed)

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48
Q

White Blood Cell normal range

A

5-10 billion/L

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49
Q

low and high level of WBC

A

s/s of infection

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50
Q

Electrical conduction pathway of the heart

A

SA node (pacemaker) (atria charge)
AV node (atria contract)
Bundle of HIS (ventricles charge)
Purkinje fibers (ventricles contract)

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51
Q

How do you assess the adequacy of circulation and perfusion?

A

skin color assessment
pulse strength
cap refill

52
Q

S/S of poor tissue perfusion/poor circulation

A

pallor
weak pulses
slow cap refill >3 sec

53
Q

S/S of Anemia

A

tachycardia
fatigue
pallor
confusion
diminished pulses

54
Q

Left-sided heart failure interventions

A

assess lung sounds for crackles
daily weight checks
fluid restriction
assess the patient for confusion
allow for frequent breaks and rest periods
check SPO2
raise HOB (high fowlers)
ambulating
decrease Na diet (heart healthy diet)
deep breathing exercises (incentive spirometer)
I & O
elevate/compress legs
diuretic

55
Q

Hypertension complications

A

glaucoma
kidney disease
cardiomyopathy
aortic aneurysm (weakening in lining of blood vessel)
heart failure
myocardial infarction

56
Q

Heart Failure S/S

A

dyspnea
anasarca (swelling of the whole body)
heart murmur
confusion
fatigue

57
Q

Factors that affect cardiovascular function

A

age
stress
allergic reaction
altitude
pregnancy
nutrition
obesity
exercise
tobacco
substance abuse
medications

58
Q

Cardiac Arrest vs MI

A

cessation of cardiac function

blood supply to the heart muscle is blocked

59
Q

Dysrhythmia/arrhythmia

A

alterations in heart rate or rhythm; arrhythmia

60
Q

Cardiomyopathy

A

heart enlargement; impaired cardiac contractility

61
Q

Valve stenosis

A

narrowing; blood flows through a narrow, constricted opening

62
Q

Unstable angina

A

ischemic chest pain that has worsened and isn’t relieved by usual measures; if untreated can lead to MI

63
Q

Cardiac Ischemia

A

oxygen requirements of the heart aren’t met; if prolonged, leads to MI as the heart begins to necrose from inadequate O2

64
Q

Coronary Artery Disease (CAD)

A

plaque builds up inside coronary arteries; reduces blood flow to the heart muscle; clots can form

65
Q

Valve incompetence

A

incomplete closure of a valve resulting in regurgitation of blood into the chamber from which it came

66
Q

Angina Pectoris

A

transient chest pain due to myocardial ischemia; tissue becomes injured but doesn’t necrose

67
Q

Stable Angina

A

a predictable pattern of ischemic chest pain that is precipitated by know triggers; alleviated by rest and medication

68
Q

Main Risk Factors of Heart Failure

A

uncontrolled hypertension and myocardial infarctions

69
Q

Right-Sided Heart Failure S/S

A

peripheral edema/ jugular vein distension (JVD)
abdominal distension/pain
murmurs
full feeling in stomach
urgency to urinate
nausea/vomiting
increased BP
anorexia

70
Q

Right-Sided Heart Failure Interventions

A

diuretic
measure urine output
check edema
ambulate
increase protein diet and decrease Na intake (heart healthy diet)
raise HOB
I & O (output should be the same as or greater than input)

71
Q

Priorities and Nursing Considerations for Right-Sided Heart Failure

A

ABCs
heart sounds (S3 and murmurs)
peripheral assessment/cap refill
skin assessment
A & O x4

72
Q

Left-Sided Heart Failure S/S

A

crackles
SOB
productive cough (frothy/pink)
PE
dyspnea
decreased SPO2
increased RR, HR, BP
cardiomyopathy
edema
weight gain
cyanosis/pallor
confusion
bounding pulses
fatigue
cool to touch/wet skin

73
Q

Priorities and Nursing Considerations for Left-Sided Heart Failure

A

ABCs (especially breathing)/ lung sounds
heart sounds (S3/murmurs)
peripheral assessment / cap refill
skin assessment
A & O x4

74
Q

S/S for both types of Heart Failure

A

cardiomyopathy
decreased CO (cardiac output)
increased BNP (over 100)
S3 sounds
decreased Ejection Fraction (30% = heart failure)

75
Q

Causes of venous insufficiency

A

obstruction
valves not working
calf muscle dysfunction

76
Q

S/S for Venous Insufficiency

A

erythema/ “ruddy”
swelling/edema/oozy
warmth
painful (esp when extremity is dependent [hanging down])
wounds w/ drainage

77
Q

Interventions for Venous Insufficiency

A

elevate legs
compression socks
IPCs
ice therapy
wound cleaning and keep them dry
encourage ambulation
leg exercises

78
Q

S/S of Arterial Insufficiency

A

pallor/cyanotic/necrotic (black)
cool to touch
diminished/weak/absent pulses
slow cap refill
wounds (dry/necrotic)
loss of hair
pain upon activity (intermittent claudication)

79
Q

Interventions for Arterial Insufficiency

A

heat therapy
legs down
frequent breaks w/ ambulation
short activity sessions
keep wounds moist

80
Q

Assessments for both venous and arterial insufficiency

A

peripheral vascular assessment (cap refill/pulses)
skin assessment
neurovascular assessment (pain and sensations)

81
Q

Vasodilator action

A

dilate blood vessels and ease cardiac workload

82
Q

What do vasodilators end in?

A

-pril

83
Q

Example of vasodilator

A

nitroglycerin

84
Q

Assessment for vasodilators

A

systolic above 100
AP above 60

85
Q

Beta-Adrenergic blockers action

A

reduce workload of heart and reduce oxygen consumption

relax heart

86
Q

What do beta-adrenergic blockers end in?

A

-olol

87
Q

Assessment for beta-adrenergic blockers

A

systolic above 100
AP above 60

88
Q

Positive inotropic agents action

A

improve effectiveness of heart’s pumping action without excess workload or oxygen demands

decreases heart rate

for heart failure

89
Q

Example of a Positive inotropic agent

A

digoxin

90
Q

Assessment for Positive inotropic agents

A

AP above 60
systolic above 100

91
Q

Diuretic action

A

reduce the volume of circulating blood

prevent accumulation of fluid in pulmonary circulation and body tissues

give to pts in heart failure

92
Q

Example of diuretic

A

furosemide

93
Q

Assessment for diuretics

A

AP above 60
systolic above 100
Potassium level (DO NOT GIVE WHEN K = LOW)

94
Q

Anticoagulants action

A

blood thinner (prevents clots)

95
Q

Examples of anticoagulants

A

heparin, enoxaparin

DO NOT GIVE WITH ASPIRIN

96
Q

What do you need to monitor for pt on anticoagulant?

A

bleeding
RBCs
Hgb/Hct
PLATELETS (hold if less than 100)

97
Q

Cholesterol / Lipid Profile

A

indicates risk for cardiovascular disease in the long term

98
Q

Echocardiogram

A

ultrasound evaluation of the heart that examines function and blood flow

determines ejection fraction

99
Q

Hemoglobin

A

measures oxygen carrying capacity of the blood

100
Q

Electrocardiogram

A

electrode placed to evaluate electrical activity of the heart

checks electrical pathway in heart

101
Q

Doppler Ultrasound

A

detects abnormalities of blood flow in vessels (DVT)

102
Q

Venography

A

dye and x-rays used to identify blood clots or narrowing of the blood flow (DVT)

103
Q

MI: pathophysiology, etiology, S/S, complications

A

caused by lack of oxygen-rich blood to the heart muscles

could be caused by hypertension, high cholesterol, atherosclerosis

chest pain, SOB; pain in arm, neck, back, shoulder; nausea, light-headedness, fatigue

arrhythmias, mechanical errors, inflammatory response, heart failure

104
Q

HTN: etiology, S/S, complications

A

unhealthy lifestyle (exercise, smoking, diet), diabetes, obesity

blurry or double vision, dizziness, fatigue, headache, heart palpitations, nosebleeds, SOB, N/V

arterial stiffness, MI, stroke, aneurysm, heart failure, kidney problems, eye problems, dementia, changes with memory or understanding

105
Q

PAD: etiology, S/S, complications

A

buildup of fatty, cholesterol-containing deposits (plaques) on artery walls [atherosclerosis]

coldness in lower leg or foot, leg numbness or weakness, no pulse or weak pulse, cramping after activities (walking, climbing stairs), shiny skin on leg

MI, stroke, death, coronary artery disease, cerebrovascular disease

106
Q

Anemia/blood loss: etiology, S/S, complications

A

decrease in # of RBCs/blood loss, lack of RBC production, high rates of RBC destruction

fatigue, weakness, confusion, pallor, irregular heartbeat, SOB, dizziness, chest pain, cold hands and feet (drop in Hgb, drop in RBCs)

fatigue, pregnancy complications, heart problems, death

107
Q

S/S of poor tissue perfusion/poor circulation

A

pallor, weak pulses, slow cap refill

108
Q

Assessments for adequate circulation and perfusion

A

skin color, warmth, pulse strength, cap refill

109
Q

TEACH acronym

A

tune into the pt
edit pt info
act on every teaching moment
clarify often
honor the pt as partner in education process

110
Q

Steps of teaching-learning process

A

summary of learning needed
plan
implementation of plan
evaluation of results

111
Q

Factors that affect pt learning

A

age and developmental level
family support networks
financial resources
cultural influences
language deficits
health literacy level

112
Q

Teaching Strategies

A

lecture
discussion
panel discussion
demonstration
discovery
role playing
audiovisual materials
printed materials
programmed instruction
web-based instruction and technology

LET THEM KNOW WHAT IS IN IT FOR THEM

113
Q

Cognitive domain for learning

A

storing and recalling of new knowledge in the brain

lecture, panel, discovery, written materials

114
Q

Psychomotor domain for learning

A

learning a physical skill

demonstration, discovery, printed materials

115
Q

Affective domain for learning

A

changing attitudes, values, and feelings; encouraging

role modeling, discussion, audiovisual materials

116
Q

Common Teaching Mistakes

A

ignoring restrictions of the pt’s environment
failing to accept that pt’s have the right to change their mind
using medical jargon
failing to negotiate goals
duplicating teaching that other team members have done
overloading the pt with information
choosing the wrong time for teaching
not evaluating what the pt has learned
not reviewing educational media, or relying exclusively on media
failing to document pt teaching and plan for follow up or teaching reinforcement

117
Q

What VS and mineral can diuretics affect?

A

can drop blood pressure
drop potassium

118
Q

Should you give a diuretic to a pt with low blood pressure and low potassium level?

A

no

119
Q

Anticoagulant labs to watch

A

PLATELETS!!!!!
RBC count
PTT (heparin)
PT and INR (non-heparin meds)

120
Q

If there is blockage in the electrical conduction of the heart what would happen?

A

an irregular rhythm

121
Q

If a heart valve isn’t working correctly, what could happen?

A

enlarged ventricles, murmur

122
Q

If the SA node was damaged, then what node would become the start of electrical conduction?

A

AV node

123
Q

What does vasoconstriction do to your blood pressure

A

increases it

124
Q

Promoting circulation and decrease the risk of thromboemboli

A

ambulation
exercise
move legs
elevating legs
TED hose
IPCs

125
Q

What medication do you give for edema?

A

diuretic

126
Q

What OTC med would you question giving to a pt who is taking an anticoagulant?

A

aspirin

Funds II Theory (7 decks)

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