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NCLEX > module 2 > Flashcards

module 2 Flashcards

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1
Q

preload

A

right heart blood return - muscle stretch *think volume

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2
Q

afterload

A

pressure in the l ventricles pump against- resistance in the peripheral pulses

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3
Q

heart failure

A 
muscle is weak 
Co decreases 
kidney perfusion decreases
UO decreases 
volume stays in the vascular space
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4
Q

renal glomerularnephritis

A

patho: inflammatory disease (STREP), antibodies lodge in the kidneys which causes scarring and decrease filtering
s/s: sore throat, malaise, headache
increase BUN and creatinine
urine: sediment, blood, protein
flank pain, increase BP and facial edema, decrease UO, increase SG, FVE

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5
Q

glomer tx

A 
treat strep 
I&O
daily weight 
activity/rest
check VS
diuretics 
restrict fluids 
diet: increase carbs, decrease na and protein
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6
Q

with a kidney client

A

decrease protein

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7
Q

nephrotic syndrome

A

excreting too much protein in the urine
s/s: massive proteinuria, hypoalbuminemia, edema, (anasarca), hyperlipidemia
tx: diuretics, ace inhibitor, prednisone, cyclophosphamide to shrink holes in the kidneys, daily weight, io

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8
Q

problems associated with protein loss

A

blood clots since losing protein normally prevents their blood from clotting so the blood starts clotting
high cholesterol and triglycerides

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9
Q

AKI

A

sudden episode of renal damage
pre renal: blood cant get to kidneys (hypotension, decrease hr, hypovolemia, shock)
intra renal: damage has occurred inside kidneys (glomerulonephritis, nephrotic syndrome, malignant HTN, dyes for tests, drugs/NSAIDS,
post renal: urine cant get out of the kidneys (enlarged prostate, kidney stone, tumors, uretral obstruction

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10
Q

hemodialysis

A

the machine works as the filter
3-4 times per week
usually on anticoagulants such a heparin
monitor blood pressure and electrolytes

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11
Q

peritoneal dialysis

A

peritoneum is the filter
filled with fluid then the fluid dwells and then its removed with all the toxins
if all the fluid doesnt come out- turn and reposition

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12
Q

2 types of peritoneal dialysis

A

CAPD done 4 times a day, 7 days a week
must have the desire and energy to be active in their treatment

APD happens at night and their exchange is done automatically while they sleep

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13
Q

nephrolithiasis/kidney stone

A

s/s: pain, nausea and vomiting, wbc in urine, hematuria

tx: increase fluids, ondansteron, NSAIDS or opiates, maybe surgery

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14
Q

chronic stable angina

A

intermittent decreased blood flow to the myocardium leads to ischemia
pain is from low oxygen due to exertion
rest relives the pain
tx: nitro, beta blockers, CCB, acetylsalicylic acid

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15
Q

cardiac cath

A

allergies to iodine and shellfish
check kidney function
acetylcysteine is usually given to help protect kidneys

post: monitor BLEEDING, lay flat for 4-6 hours after, report pain asap, pain, pallor, paresthesia, pulselessness, paralysis

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16
Q

unstable angina

A

decrease blood flow to myocardium which leads to ischemia and necrosis
rest does not relieve it
s/s: pain, crushing on their chest, pressure radiating to the left arm and left raw, cold/clammy, BP drops, SOB*

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17
Q

lab work for unstable angina

tx?

A

CPK-MB
Troponin
myoglobin

oxygen, aspirin, nitro, morphine

18
Q

major arrhythmias

A

pulseless v tach, v fib, asystole.
defib, epi, amiodarone/lidocaine. lidocaine toxic- neuro changes.
amiodarone can lead to hypotension

19
Q

what do thrombolytics end in

A

lase

20
Q

dissolves the clot that is blocking blood flow to the heart muscle to decrease the size of the infarction

A

thrombolytics

21
Q

PCI

A

stent placed with a balloon. given acetylsalicyclic acid or clopidogrel. think bleeding

22
Q

CABG

A

bypass graft with vessel. usually done on the coronary artery occlusion. think bleeding

23
Q

left sided HF

A

blood is not moving forward into the aorta and out of the body. if it doesnt move forward its going backward into the lungs
s/s: pulmonary congestions, dyspnea, orthopnea, tachy, crackles
*left=Lungs

24
Q

right sided HF

A

blood is not moving forward into the lungs. so its moving backward into the venous system
s/s: jvd, edema, enlarged organs, weight gain, ascites

25
Q

pacemakers

A

always worry if the heart rate drops below the set rate

26
Q

post packemaker

A

monitor incision
immobilize arm
assist in passion ROM to prevent frozen shoulder
keep the client from raising the arm higher than shoulder height

27
Q

pulmonary edema

A

fluid is backing up into the lungs. the heart is unable to move the volume forward
s/s: sudden onset, breathless, restless, severe hypoxia
tx: o2, morphine, furosemide/bumetanide, nitro
prevent: check lung sounds

28
Q

cardiac tampanade

A

blood, fluid, or exudates have leaked into the pericardial sac resulting in compression of the heart
s/s: jvd, narrowed pulse pressure, increase CVP, decrease bp, muffled heart sounds

29
Q

arterial disorders

A

arterial occulsion
intermittent claudication, cold extremity, decreased pulses
tx: surgery or lower the arteries

30
Q

venous disorders

A

brown pigmentation around the ankle, edema, temperature is normal, ulcers if present on the ankles

31
Q

another name for right sided heart failure

A

cor pulmonale

32
Q

interventions to decrease preload

A 
vasodilators
elevate HOB
low salt diet
dangle the legs
diuretics
33
Q

vasodilators

A

ace inhibitors
arbs
nitro

these help with decreasing preload and afterload

34
Q

chronic stable angina

A

decreased blood flow- ischemia
occurence? predictable
pain occurs because of decreased o2, usually from exertion
relieved with rest and nitro

35
Q

unstable angina or mi

A

decreased blood flow - necrosis/ischemia
occurence? not predictable
pain occurs because of poor blood flow through the myocardial vessels
not relieved with rest and nitro

36
Q

patient experiencing hypotension or myocardial shock

A

dopamine

37
Q

compare and contrast glome and nephrotic

A

compare: inflammatory response within the glomerulus. toxins and malasie. increase BP. decrease UO. can lead to RF

g: strep. protein loss. hematuria. facial edema
n: idiopathic. massive protein loss. anasarca. hyperlipidemia. clotting problems

38
Q

IF KIDNEYS ARE DAMAGED..RBC

A

will decrease because kidneys are not making erythropoietin

39
Q

s/s of renal failure

A

anemia- decrease erythropoietin
HTN- retaining fluids, increase workload on the heart
itching frost- urea excess is surfacing to the skin
FVE/HR-kidneys arent working so fluid in the vascular space will continue to increase

40
Q

interventions for increased toxins and metabolic waste

A

bedrest, diet low in protein and high in carbs and fats

41
Q

interventions for fve

A

bedrest, I o , daily weight, vs q2 hours, cvp, assess lung sounds, restrict fluids, administer iv meds in the smallest amount possible

42
Q

interventions for hyperkalemia

A 
iv glucose and insulin
polystyrene sulfonate 
loop diuretics 
low K diet 
calcium gluconate at bedside

NCLEX (17 decks)

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