Perfusion

Question 1

Cardiomyopathy: S/S:

Answer 1

SOB, congestion of lungs, dependent edema, palpitations, syncope, angina, tiredness, light-headedness, fatigue

Question 2

Cardiomyopathy:Meds:

Answer 2

Cardiomyopathy:Meds: 
o	ACE inhibitors
o	Beta blockers
o	Diuretics
o	Anticoagulants
o	CCBs

Question 3

Cardiomyopathy: Dx:

Answer 3

Echocardiogram, abnormal EKG, Holter monitoring, stress test

Question 4

Cardiomyopathy:Surgery:

Answer 4

Surgery: Cardioversion, heart transplant, pacemaker insertion, implantable defibrillator, myectomy

Question 5

Cardiomyopathy: Interventions:

Answer 5

Cardiac catheterization, biopsy of heart tissue, radioactive studies, electrical studies of the heart

Question 6

Cardiomyopathy: Teaching:

Answer 6

Weight loss
o Limit ETOH
o Avoid overexertion, hot showers, water immersion, and syncope episodes
o Flu vaccine annually

Question 7

Left-Sided Heart Failure:

• S/S:

Answer 7

SOB; palpitations; tachycardia; cough with frothy, blood tinged sputum; fatigue; fluid retention, weight gain; dysrhythmic heart rate; oliguria; lung crackles

Question 8

Left-Sided Heart Failure: Nursing Education:

Answer 8

Low Na+ diet. Fluid restriction as prescribed. Report weight gain of more than 2 pounds over 24 hours

Question 9

Left-Sided Heart Failure:

• Dx:

Answer 9

BNP (diagnose and grade severity of HF); CBC, CRP, echocardiogram (ultrasound); EKG (dysrhythmias, heart thickening), Troponin (MI check 3 times)

Question 10

Left-Sided Heart Failure: Serum Inflammatory markers:

Answer 10

IL-6, CRP, and TNF are associated with increased risk of CHF
• Left ventricle is the powerhouse of the heart

Question 11

Left-Sided Heart Failure: Meds:

Answer 11

ACE inhibitors, ARBs, vasodilators, nitrates, beta blockers, diuretics, digitalis, aspirin, hormones

Question 12

Right-Sided Heart Failure:S/S:

Answer 12

JVD, weight gain, peripheral edema, increased ICP, LOC issues, spleen and liver enlargement, palpable and auscultated dysrhythmias

Question 13

Right-Sided Heart Failure: Risk For:

Answer 13

Liver congestion, hepatomegaly, portal hypotension, DVT, stasis

Question 14

Right-Sided Heart Failure: Nursing Education:

Answer 14

Low Na+ diet. Fluid restriction as prescribed. Report weight gain of more than 2 pounds over 24 hours

Question 15

Right-Sided Heart Failure: Dx:

Answer 15

BNP (diagnose and grade severity of HF); CBC, CRP, echocardiogram (ultrasound); EKG (dysrhythmias, heart thickening), Troponin (MI check 3 times)

Question 16

Right-Sided Heart Failure: Serum Inflammatory markers:

Answer 16

IL-6, CRP, and TNF are associated with increased risk of CHF

Question 17

Right-Sided Heart Failure: Meds:

Answer 17

ACE inhibitors, ARBs, vasodilators, nitrates, beta blockers, diuretics, digitalis, aspirin, hormones

Question 18

Pulmonary Edema:S/S:

Answer 18

Apprehension, restlessness, chest pain, blood-tinged sputum, crackles and wheezes on auscultation, tachypnea, tachycardia, sense of impending doom

Question 19

Pulmonary Edema:Interventions:

Answer 19

Notify rapid response team, reassure patient, elevate HOB, administer oxygen, obtain VS and check lung sounds, obtain ABGs, prepare to administer heparin or other therapy

Question 20

Pulmonary Edema: Pharmacology:

Answer 20

IV Nitroglycerin: Reduce preload. Side effects: Headache, orthostatic hypotension, dizziness, weakness. Monitor for hypotension.
o IV Lasix: Decrease preload and pulmonary congestion, which decreases cardiac work and increases CO. Carefully monitor potassium levels for hypokalemia. Administer slowly because hearing loss can occur if infused too rapidly. Monitor electrolyte levels carefully. Monitor weight, VS, and urine output.

Question 21

Triamterene-Hydrochlorothiazide:

• S/E:

Answer 21

Hyperkalemia, N/V/D, dry mouth, photosensitivity, anemia, thrombocytopenia, dizziness, weakness
• Monitor for s/s of hyperkalemia (nausea, diarrhea, abdominal cramps, tachycardia followed by bradycardia, tall peaked T waves on the EKG, and oliguria).

Question 22

Triamterene-Hydrochlorothiazide:Teach:

Answer 22

Avoid exposure to direct sunlight. Monitor for signs of hypokalemia. Avoid salt substitutes. Take med with or without meals to decrease GI irritation.

Question 23

Furosemide (Lasix): Nursing Consideration:

Answer 23

Decrease preload and pulmonary congestion, which decreases cardiac work and increases CO. Carefully monitor potassium levels for hypokalemia. Monitor electrolyte levels carefully. Monitor weight, VS, and urine output.
• IV: Administer slowly because hearing loss can occur if infused too rapidly.

Question 24

Simvastatin (Zocor):

• Side Effects:

Answer 24

Nausea, diarrhea or constipation, abdominal pain or cramps, flatulence, headache, rash, blurred vision, pruritus, elevated liver enzymes

Question 25

Simvastatin (Zocor):

• Nursing Considerations:

Answer 25

Monitor serum liver enzyme levels. Annual eye exams because cataract formation is possible. Report unexplained muscular pain to HCP immediately.

Question 26

Hypertension Pharmacology:

• Meds:

Answer 26

Diuretics, vasodilators, central acting adrenergics, ACE inhibitors, CCBs, Beta-Adrenergic blockers

Question 27

Hypertension Pharmacology:

• Side Effects:

Answer 27

Hypotension, orthostatic hypotension, headache, nonproductive cough (ACE inhibitors), hypokalemia or hyperkalemia, dehydration (diuretics)

Question 28

Hypertension Pharmacology:

• Nursing Consideration:

Answer 28

Monitor heart and lungs, monitor renal labs, monitor calcium levels

Question 29

Hypertension Pharmacology:

• Teach:

Answer 29

BP diary at home, continue taking meds as prescribed, change positions slowly

Question 30

Hypertension Pharmacology:

• Lifestyle changes:

Answer 30

Diet, exercise, stop smoking, limit alcohol, reduce stress, reduce caffeine intake, reduce Na+

Question 31

Triple A’s (abdominal aortic aneurysm)

Answer 31

Auscultation of bruit= high pitched swooshing sound

If rupture occurs= tearing feeling, back pain, and heart beat in the gut