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NCM 118: Life Threatening Conditions > PRELIM: 2ND QUIZ > Flashcards

PRELIM: 2ND QUIZ Flashcards

1
Q

The common causes of both top 1 and top 2 are

A

arterial blockage or arteriosclerosis, smoking

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2
Q

This sudden increase in the mortality rate is the target of the DOH campaign: “ Healthy Lifestyle to the Max.”

A

HEART DISEASE

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3
Q

Common illnesses which may require treatment in Intensive Care Unit

A

HEART DISEASE

VASCULAR DISEASE

RENAL DISEASE

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4
Q

Most Common cause of cardiovascular disability and death.

A

Coronary Heart Disease

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5
Q

A client with chest pain and shortness of breathing arrived in ER. You are about to perform a physical assessment on this patient. Data obtained in the nursing history of relevance to heart disease MUST include?

A

D. Drowning feeling at night

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6
Q

Modifiable Risk Factors

A

Hyperlipidemia- enhances atherosclerosis
Diabetes Mellitus
Obesity- result to increase cardiac workload
Personality type or behavioral factors
Contraceptive pills

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7
Q

This is information patients give concerning how they feel, what symptoms they are experiencing, their fears, and concerns.

A

Subjective Data

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8
Q

Nurse Lea is assessing a client who is previously diagnosed with Myocardial Ischemia, it is most important to ask which of the following?

A

A. “ What medications are you currently taking?”

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9
Q

is an ISCHEMIA
Lack of blood supply due to occlusion of coronary artery and its branches

A

MYOCARDIAL INFARCTION

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10
Q

MYOCARDIAL INFARCTION Most case are due to

A

ATHEROSCLEROSIS (90%)
Other causes- spasm, embolism,trauma ( 5%)

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11
Q

Decreased tissue perfusion and oxygenation may cause

A

anaerobic metabolism causes production of lactic acid

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12
Q

Nurse assess PQRST
in chest pain

A

P-rovoke
Q- uality
R- egion/ R-adiation
S- everity
T- iming

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13
Q

(dark red = most typical area,
light red = other possible areas).

A

Rough diagram of pain zones in myocardial infarction

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14
Q

DM- differences in pain threshold, autonomic neuropathy and psychological factors
After heart transplantation.

A

Silent MI

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15
Q

CARDIOVASCULAR ASSESSMENT

A

EBRILE IF:
Cardiovascular infection,
Heightened cardiac workload,
MI , Acute Pericarditis,
Ineffective Endocarditis

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16
Q

IF.. Assessing BP for the 1st time, take measurements in both arms
ALERT: a difference of more than 10mmhg in both arms may indicate

A

THORACIC OUTLET SYNDROME

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17
Q

difference between systolic and diastolic pressure normal: 40 mmHg

A

Pulse Pressure

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18
Q

Rising pulse pressure is seen with

A

Increased stroke volume
Declined Peripheral vascular resistance

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19
Q

Mitral or Aortic stenosis
Constricted peripheral vessels
Declined stroke volume

A

Diminishing pulse pressure is seen with

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20
Q

ESPIRATION EVALUATION

A

Observe for EUPNEA
Note for
Tachypnea with low cardiac output
Dyspnea
Cheyne Stokes
Shallow Breathing

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21
Q

ubjective feeling (inability to get enough air)

A

Dyspnea

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22
Q

Dyspnea on exertion is due to increased

A

O2 myocardial demand.

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23
Q

related to blood pooling in the pulmonary bed; suspect Pulmonary Edema

A

Orthopnea

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24
Q

Any sudden or acute dyspnea may be a sign of

A

Pulmonary Embolism

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25
Q

Myocrdial Infarction- sputum is none specific but any changes in

A

patient’s secretion may signifies infection

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26
Q

Mucoid and foamy sputum can be a sign of

A

CHF

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27
Q

Pink-tinged frothy appearance may signal

A

Pulmonary Edema

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28
Q

Whitish,

A

viral infection

29
Q

Change in color other than the above mentioned may signify

A

Bacterial infection.

30
Q

Awareness of rapid or irregular heartbeat
Autonomic Nervous System and Adrenal Glands response (stress)

A

Palpitations

31
Q

Transient loss of consciousness
Due to decreased cerebral tissue perfusion

A

Syncope

32
Q

no pitting edema

A

0

33
Q

mild pitting edema, 2mm depression that disappears rapidly

A

+1

34
Q

moderate pitting edema, 4mm depression that disappears 10-15 sec

A

+2

35
Q

moderately severe pitting edema, 6mm depression that may last for more than 1 minute

A

+3

36
Q

severe pitting edema, 8 mm depression that may last for more than 2 minutes

A

+4

37
Q

Types of edema
CHF or Renal Failure

A

Bilateral edema

38
Q

Types of edema caused by Vascular or Lymphatic obstruction

A

Unilateral edema

39
Q

Types of edema caused by inflammatory

A

Non pitting edema

40
Q

Types of edema caused by HP and COP derangement

A

Pitting edema

41
Q

Abnormal Findings
Skin Color-

A

Cyanosis, pallor, jaundice, ugular vein distention Skin Temperature- cool, moist or clammy

42
Q

most often noted in heart and lung diseases that cause a lower than normal amount of oxygen in the blood

A

Clubbing

43
Q

Pathophysiology
CLUBBING OF FINGERS

A

Blood vessel dilation in distal circulation
↓
Hypertrophy of the nail beds
↓
CLUBBING OF FINGERS

44
Q

used to monitor dehydration and the amount of blood flow to tissue.

A

CAPILLARY REFILL

45
Q

defined as the time taken for color to return to an

A

external capillary bed after pressure is applied to cause blanching.

46
Q

n newborn infants, capillary refill time can be measured by pressing on the _____________ for five seconds with a finger or thumb.

A

Sternum

47
Q

INSPECTION OF CHEST- exposed the anterior chest wall
NURSE assess for the presence of the following findings

A

Pulsations
Symmetry of movement
Retractions
Heave- strong outward thrust of the chest wall

48
Q

CHEST IRREGULARITIES THAT INHIBITS CHEST EXPANSION

A

Barrel Chest
Pectus Excavatum- depressed sternum
Pectus Carinatum– protruding sternum

49
Q

Affected patients tend to have lung volumes that are mildly decreased but within the normal range and they are often associated with

A

mild air-trapping.

50
Q

The deformity may be classified as either “chicken breast” (chondrogladiolar) or
“Pouter pigeon breast”

A

PECTUS CARINATUM

51
Q

Cardiovascular Normal Findings

A

Normal Heart rate – 60-100
Rhythm – regular or irregular
HEART SOUNDS- S1 AND S2- normal heart sounds
S3- “ Protodiastolic Gallop” or “Ventricular Gallop” lab-dub-ta
S4-” Presystolic gallop” Ta-lab-dub- or “ atrial gallop” which is pathologic.

52
Q

A sound heard over an artery or vascular channel, reflecting turbulence of flow. Most commonly, a bruit is caused by abnormal narrowing of an artery.

A

BRUIT

53
Q

A vibration caused by the movement of fluid felt by the NURSE on palpation.

A

THRILL

54
Q

Created by turbulence in a fluid column passing through an incompetent valve, or from a vessel of smaller caliber to a larger vessel

A

THRILL

55
Q

Nurse Mabel assessed bruit over the ABDOMINAL AORTA, aware that this is life threatening signals AORTIC ANEURYSM. What is the nursing action at this point?

A

Avoid deep palpation to prevent aneurysm to rupture

56
Q

During assessment palpated carotid bruit may signal

A

( TIA or CVA).

57
Q

KILLIP CLASSIFICATION OF AMI WITH EXPECTED MORTALITY RATE

NO SIGNS OF PULMONARY OR VENOUS CONGESTION

A

EXPECTED HOSPITAL MORTALITY
0-5%
CLASS 1

58
Q

KILLIP CLASSIFICATION OF AMI WITH EXPECTED MORTALITY RATE

MODERATE HF OR PRESENCE OF BIBASAL RALES

A

EXPECTED HOSPITAL MORTALITY
10-20%
CLASS 2

59
Q

KILLIP CLASSIFICATION OF AMI WITH EXPECTED MORTALITY RATE

SEVERE HF, RALES ≥ 50% of THE LUNG FIELD

A

EXPECTED HOSPITAL MORTALITY
35-45 %

CLASS 3

60
Q

SHOCK WITH SYSTOLIC BP
≤ 90MMHG

A

EXPECTED HOSPITAL MORTALITY
85-95%
CLASS IV

60
Q

indicating ischemia in ECG

A

T wave inversion

61
Q

injury and the acuteness of MI

A

S-T segment elevation

62
Q

Abnormal Q wave

A

indicaating tissue death

63
Q

Myocardial infarct in ECG

A

ST elevation

64
Q

In order for a patient to be diagnosed with a myocardial infarction, they must have at least two of the following three criteria

A

Clinical history of chest discomfort consistent with ischemia, such as crushing chest pain
An elevation of cardiac markers in blood (Troponin-I, CK-MB, Myoglobin)
Characteristic changes on electrocardiographic tracings taken serially

65
Q

cardiac markers: CK-MB at what hours

A

0-20 hours

66
Q

Cardiac markers: Myoglobin

A

first mins

67
Q
A

NCM 118: Life Threatening Conditions (12 decks)

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