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Nursing School > NUR 133 - Exam 2; Craig Hint-Hint > Flashcards

NUR 133 - Exam 2; Craig Hint-Hint Flashcards

1
Q

Which layer of the heart is most susceptible to ischemia?

A

Endocardium.

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2
Q

Which medication is typically used to treat atrial fibrillation alongside CHF?

A

Digoxin.

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3
Q

What is the effect of Digoxin?

A
  • Slows HR

- Strengthens contractility

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4
Q

Which component of the heart’s conduction system is the pacemaker?

A

SA Node.

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5
Q

What are the intrinsic rates of conduction for all the components?

A
  • SA Node (pacemaker) - 60-100 bpm
  • AV Node (backup) - 40-60 bpm
  • Bundles of HIS - 20-40 bpm
  • Perkinje fibers - 20 bpm
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6
Q

What is the general function of beta-blockers?

A
  • Slow HR

- Vasodilate

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7
Q

When are beta-blockers contraindicated?

A
  • Respiratory disease due to bronchoconstriction

- Asthma, COPD, etc.

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8
Q

What does right-sided heart failure lead to?

A
  • Peripheral edema
  • JVD
  • Hepatomeglia (enlargement of liver)
  • Portal hypertension
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9
Q

What does left-sided heart failure lead to?

A
  • Pulmonary edema

- Crackles, rales, pink-frothy sputum

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10
Q

How is stroke volume measured?

A

By the amount of blood moved per single contraction.

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11
Q

What is the average stroke volume?

A

70mL.

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12
Q

How is cardiac output measured?

A

Amount of blood moved over 1 minute.

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13
Q

What is the average cardiac output?

A

4-6 litres.

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14
Q

What value of diastolic BP is considered pre-hypertensive?

A

80’s.

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15
Q

What is afterload?

A

The pressure that the heart must work against to eject blood during systole (ventricular contraction).

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16
Q

Where is renin released from?

A

Kidneys.

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17
Q

What does renin do?

A
  • Converts angiotensin I to angiotensin II

- Vasoconstriction (increases BP)

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18
Q

What does aldosterone do?

A

Holds on to sodium (increases BP).

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19
Q

What does anti-diuretic hormone (ADH) do?

A

Holds on to water (increases BP).

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20
Q

Which receptors initiate the release of renin, aldosterone, and ADH?

A

Baroreceptors (detect a pressure drop).

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21
Q

How do palpitations occur?

A

Increase in HR (sympathetic).

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22
Q

How does syncope occur?

A

Decrease in HR.

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23
Q

Why does syncope occur?

A

The SA node does not receive enough acetylcholine for contraction.

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24
Q

What are all the proper values for the lipid panel?

A
  • Total cholesterol = <200
  • HDL = >40
  • LDL = <100
  • Triglycerides = <150
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25
Q

What are all the proper values for blood chemistry?

A
  • Sodium = 135-145
  • Potassium = 3.5-5
  • Magnesium = 1.3-2.1
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26
Q

What are all the proper values for hematology panels?

A
  • RBC = 4.5-6
  • WBC = 5,000-10,000
  • Hct = (m)42-52%, (f)37-47%
  • Hgb = 12-18
  • Platelets = 150,000-400,000
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27
Q

How many leads to you use to identify the origin of ischemia?

A

12-lead EKG.

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28
Q

When is the best time to administer diuretics?

A

In the morning.

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29
Q

What is claudication indicative of?

A

Peripheral Arterial Disease (PAD).

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30
Q

How will a patient with PVD present with venous issues?

A
  • Red
  • Warm
  • Edema
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31
Q

How will a patient with PAD present with arterial issues?

A
  • Cool
  • No blood
  • No pulse
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32
Q

What should a patient on diuretics do every morning?

A
  • Weigh themselves every morning

- Monitor electrolytes (K+, Na+, etc.)

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33
Q

What is Artherosclerosis?

A

Build up of plaque, more commonly affects medium-large arteries.

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34
Q

What is Arteriosclerosis?

A

Narrowing of the arteries/vessels.

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35
Q

What position do you place a patient with an air embolism?

A

Left-lateral trendelenburg position.

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36
Q

What can uncontrolled cardiovascular disease or hypertension lead to?

A
  • Retinopathy
  • Thicker arteries
  • Renal failure
  • Stroke
37
Q

What are the mercury values for prehypertension?

A

120-139/80-89 mmHg.

38
Q

What are the mercury values for Stage 1 hypertension?

A

140-159/90-99 mmHg.

39
Q

What are the mercury values for Stage 2 hypertension?

A

> 160/>100 mmHg.

40
Q

What are the symptoms of hypertension?

A
  • Retinal damage
  • Renal damage
  • Myocardial infarction
  • Cardiac infarction
  • Stroke
41
Q

What is the the number one cause of hemorrhagic stroke?

A

Hypertension.

42
Q

What do loop diuretics do?

A

Inhibit sodium reabsorption.

43
Q

Typical nursing suggestions for patients with hypertension.

A
  • Walk 30 minutes a day

- Limit alcohol consumption to 2 drinks/day

44
Q

What are the mercury values for Hypertensive crisis?

A

180/120 mmHg.

45
Q

What are the nursing procedures for caring for patients with hypertensive crisis?

A
  • Treat w/ nitroprusside
  • Reduce BP by 20-25% in first hour
  • Administer IV slowly
  • Monitor BP every 5-15 minutes
46
Q

What is the general function for ACE-Inhibitors?

A

Block the conversion of angiotensin I into angiotensin II.

47
Q

What are the side-effects of ACEI’s?

A
  • Angioedema
  • Dry cough
  • Hyperkalemia
  • Rash
  • Neutropenia
  • Heart failure
  • Altered taste
  • Renal impairment
48
Q

What is the premise behind the DASH diet?

A
  • Having a healthy diet

- Reducing sodium intake

49
Q

What are the 5 conditions where you must have 3 in order to have metabolic syndrome?

A
  • Abdominal obesity
  • Hypertension
  • Increase triglycerides
  • Increase blood glucose
  • Decrease in HDL’s
50
Q

What do you administer first and second when a patient has a heart attack?

A
  • Aspirin first

- Nitroglyceride

51
Q

What is the purpose of administering a statin?

A
  • To prevent further complication from claudication/PAD

- Increase HDL’s

52
Q

What do you monitor when you’re on statins?

A
  • Muscle pain
  • Abdominal pain
  • Jaundice
53
Q

What do you not ingest when you’re on statins?

A

Grapefruit juice.

54
Q

What are the side effects of statins?

A
  • Myopathy
  • Rhabdomyolysis (break down of protein in muscles, which lead to kidney failure)
  • Liver toxicity
55
Q

What are the ranges for Hemoglobin A1C?

A
  • 5.7-6.4 is predisposed/pre-diabetic
  • > 6.4 is diabetic
  • If they have diabetes, anything <6 is compliant with their diet
56
Q

What are the pre-disposed factors for Type I Diabetes?

A
  • Genetic
  • Usually diagnosed at a young age
  • Fasting hyperglycemia (no insulin)
57
Q

What are the pre-disposed factors for Type II Diabetes?

A
  • Onset over 30 y/o
  • R/T obesity, poor diet, sedentary lifestyle
  • Insulin resistant/impaired
58
Q

What are the 3 P’s for Hyperglycemia?

A
  • Polyuria
  • Polydipsia
  • Polyphagia
59
Q

What are the other manifestations for hyperglycemia?

A
  • Weakness/Fatigue
  • Wounds slow to heal
  • Tingling in extremities
  • Dry skin
  • Stomach pain
60
Q

What are typical blood sugar levels for an individual with hypoglycemia?

61
Q

What are some manifestations for hypoglycemia?

A
  • Cool, pale, diaphoretic
  • Anxiety/Irritability
  • Tachycardia
  • shakiness
  • Blurred vision
  • Unconsciousness
62
Q

How many carbohydrates should a diabetic consume before exercising?

63
Q

What do you typically administer to treat hypoglycemia?

A
  • Sugar & water

- Dextrose IV/Glucagon IM

64
Q

Which glucose medication won’t work with alcoholics?

A

Glucagon IM.

65
Q

What is the primary treatment for yhperglycemia?

66
Q

Patients with DKA (diabetic ketoacidosis) will present with what?

A
  • Type I
  • Blood glucose: 300-1,000 (hyperglycemia)
  • Fruity breath
  • Dehydration
67
Q

What is the typical treatment for DKA?

A
  • Fluids first (normal saline)
  • Electrolyte replacement (K+)
  • Regular insulin (slowly)
68
Q

What is the important patient education for a Type II Diabetic?

A
  • How to give insulin

- Side effects

69
Q

What are the general insulin mixing rules?

A
  • Draw up short-acting (clear)
  • Then draw up long-acting (cloudy)
  • Clear over cloudy
70
Q

Short-acting insulin facts.

A
  • Onset: 30-60min
  • Peak: 1-5 hours
  • Duration: 6-10 hours
71
Q

Intermediate-acting insulin facts.

A
  • Onset: 1-2 hours
  • Peak: 6-14 hours
  • Duration: 16-24 hours
72
Q

Long-acting insulin facts.

A
  • Onset: 70 min
  • Peak: None
  • Duration: 24 hours
  • Long-acting cannot be mixed
73
Q

Injectable hypoglycemics treat which type of diabetes?

A

Both type I and type II.

74
Q

Oral hypoglycemics treat which type of diabetes?

A

Only type II.

75
Q

How long do you have to feed patients when you’ve administered insulin?

A

30 minutes.

76
Q

What are cataracts?

A

Cloudiness forming over the clear lens in the eye.

77
Q

What causes cataracts?

A
  • Exposure to UV
  • Toxicity from corticosteroids/beta-blockers
  • Diabetes
  • Thyroid disorders
  • Smoking
78
Q

What is the treatment for cataracts?

A
  • Sunglasses
  • Increase available room light
  • Snellen chart
  • Adaptive devices
  • Anticholinergics (atropine)
79
Q

What is glaucoma?

A

Functional disturbance of the optic nerve.

80
Q

What is glaucoma caused by?

A
  • Infection
  • Tumors
  • Diabetes
  • HT
  • Myopia
  • Retinal damage
81
Q

What is the treatment for glaucoma?

A
  • Medication
  • Eye drops every 12 hours
  • 5-10 minutes between drops
  • Apply pressure with punctual occlusion
82
Q

What is meniere’s disease?

A
  • Episodic vertigo
  • Tinnitus
  • Hearing loss
  • Vomiting
  • Imbalance
  • Nystagmus
83
Q

What is the treatment for meniere’s disease?

A
  • Fall risk precautions
  • Home safety
  • Assistive devices
  • Monitor ototoxic blood levels
  • Antivertigo/Antiemetics
84
Q

What is macular degeneration?

A

Age-related loss of vision.

85
Q

What are the treatments for macular degeneration?

A
  • Laser therapy
  • Ocular injections (-zumabs)
  • Assistive devices
86
Q

What is myopia?

A
  • Near-sighted

- Blurred distance vision

87
Q

What is hyperopia?

A

Having farsightedness.

88
Q

What manifestations should you watch for with patients who have undergone LASIK?

A
  • Halos

- Glare

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