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Medical Nursing > Q2 > Flashcards

Q2 Flashcards

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1
Q

Anemia

A

Low supply of RBCs
Result: transportation of o2 & co2 to organs & tissue will be insufficient
Function of organs will decrease

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2
Q

Where is S1 fit in based on an EKG?

A

Top of QRS

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3
Q

Where does S2 fit in based on EKG?

A

T wave

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4
Q

Age-Related Considerations - Aging on CVS

A

Chest wall - kyphosis
Heart
Blood vessels - arterial stiffening

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5
Q

Cardiac biomarkers

A

Troponin
CK-MB
Myoglobin

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6
Q

Troponin

A

Detected 4-6 hrs after MI and lasts for 14 hours

S: chest pain

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7
Q

CK-MB

A

MB - Specific to the heart

Elevated during injury within myocardium

Starts to Rise 3-6 hours and peaks at 12-24 hours and returns to baseline between 12-48 hours - must be caught

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8
Q

Myoglobin

A

Protein; comes from skeletal muscle

Note: Just checking on myoglobin will not indicate that there is a heart problem

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9
Q

C-reactive protein

A

Used for inflammation in general

If pt has history of MI or chest pain, they will have this protein elevated

If CRP increases = risk of cardiac problems

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10
Q

Homocysteine

A

Released with protein breakdown - if this is present, it indicates cardiovascular disease, peripheral vascular

Should be monitored; family history, MI, chest pain

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11
Q

Cardiac Natriuretic Peptide Markers

A

Released from atrium and ventricles - distinguish if SOB is respiratory or cardiac

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12
Q

Silent Killer

A

Hypertension = Risk of MI = Risk of Heart Failure = Risk of Stroke = Renal Disease

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13
Q

Why is it called a silent killer?

A

Creeps up on you, and symptoms are not apparent and you can catch it too late

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14
Q

Cardiac output

A

Total blood flow through circulatory system per minute

Affects: Renal fluids volume control, renin angiotensin II

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15
Q

Primary Hypertension

A

Majority of adults related to increased sodium intake, increased BMI, diabetes, alcohol consumption, increased SNS activity

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16
Q

Secondary Hypertension

A

Unprovoked
Hypokalemia
Family history of renal disease

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17
Q

Isolated systolic hypertension

A

Older Adults’

Related to loss of elasticity in large arteries

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18
Q

Urinalysis

A

Testing urine

If “it” affects our kidney, we will see protein in our urine

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19
Q

Age-Related Consideration: Hypertension

A

Loss of tissue elasticity
Increased collagen content and stiffness of myocardium
Increased peripheral vascular resistance
Decreased kidney function
Blunting of baroreceptor reflexes

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20
Q

Medications for Hypertension

A

Diuretic
Adrenergic inhibitors
Angiotensin inhibitors

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21
Q

What should you eat to increase potassium?

A

Bananas

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22
Q

Side Effects with Diuretics

A

Increased voiding

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23
Q

Nursing Intervention: Knowing that hypertension is modifiable, what can you do as a nurse to educate patient?

A

Lifestyle changes;
Proper diet
Exercise

Medications
Such as; thiazide diuretic
ACE-I
ARB
Long-acting CCB
Beta-blocker
Single pill combination

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24
Q

What is preferred over shorter acting diuretics?

A

Long-acting (indapamide and chlorthalidone

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25
Q

Vascular Disorders

A

Includes disorders of the arteries, veins and lymphatic vessels

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26
Q

Peripheral Arterial Disease

A

Progressive narrowing & degeneration of arteries of neck, abdomen & extremities

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27
Q

Why are sections of arteries narrowed?

A

Thickening of vessel wall

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28
Q

Atherosclerosis

A

Narrowing, hardening & “pieces” that break off (thrombus become embolus)

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29
Q

Common locations of atherosclerotic lesions

A

Abdominal aorta and lower extremities

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30
Q

PAD of lower extremities

A

Aortoiliac, femoral, popliteal, tibial, & peroneal arteries

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31
Q

Hyperemia

A

When foot becomes “redder”

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32
Q

PAD complications

A

Atrophy of muscles
Increased damage from minor trauma
*Slowed wound healing (important complication)
Increases risk of infection - because of poor circulation
Nonhealing arterial ulcers
Gangrene (blood flow to large area is cut off - need to improve circulation)
Amputation

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33
Q

Treatment of PAD - To help

A

Get a proper diagnosis
Pressure checks; thigh, below knee, and foot

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34
Q

Nursing Intervention; PAD

A

Help decrease the risk; education regarding tobacco
Anti-platelets side effects; aspirin

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35
Q

What are the 6 P’s?

A

Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermic (inability to maintain core temperature)

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36
Q

Virchow’s Triad

A

Venous stasis
Damage to endothelium
Hypercoagulability of blood

LEAD TO - thrombus formation

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37
Q

Venous stasis

A

Dysfunctional vein valves
Change in unidirectional blood flow

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38
Q

Endothelial

A

Release of clotting factors
Activation of platelets

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39
Q

Blood hypercoagulability

A

Imbalance in clotting mechanisms

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40
Q

What does CWCM mean?

A

Colour
Warmth
Circulation
Movement

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41
Q

What can be used to treat DVT or PE?

A

Anticoagulants - help reduce clots from developing

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42
Q

Types of Shock

A

Cardiogenic
Hypovolemic
Neurogenic
Anaphylactic
Septic

43
Q

Low Volume Shock

A

Cariogenic
Hypovolemic

44
Q

Distributive

A

Neurogenic
Anaphylactic
Septic

45
Q

What are the three components of defining shock?

A

Cellular oxygen supply
Decrease tissue perfusion
Impaired cellular metabolism

46
Q

Neurogenic Shock

A

Clinical Manifestations
- hypotension
- bradycardia
- temperature
- dry skin

47
Q

Septic Shock

A

Systemic inflammatory response to documented or suspected infection

48
Q

Clinical Manifestations of Septic Shock

A

Increased coagulation and inflammation
No single symptom or group of symptoms is specific to diagnosis
Hyperdynamic state ; increased CO and creased SVR

49
Q

What is the cornerstone of therapy for septic, hypovolemic, and anaphylactic shock?

A

Volume Expansion
- Crystalloids
- PRBC

50
Q

What is vital to decreasing morbidity from shock?

A

Nutrition
- monitor weight, protein, nitrogen balance, BUN, glucose and electrolytes

51
Q

What is hematology

A

Study of blood and blood-forming tissues

52
Q

Why is it important to have an understanding of hematology?

A

Useful to evaluate a patient’s ability to transport oxygen and carbon dioxide - combat infections

53
Q

Where does blood cell production occur?

A

Bone marrow

54
Q

What is the THREE major function of blood?

A

Protection
Regulation
Transportation

55
Q

Major Components of blood

A

Plasma and blood cells

56
Q

The term serum refers to what?

A

Plasma without its clotting factors

57
Q

Composition of Blood

A

Plasma 55%
Blood Cells 45%

58
Q

Erythrocytes (RBC)

A

Transport of gases and assistance in maintaining acid-base balance

59
Q

Leukocytes (WBC)

A

Primary purpose is to treat infections; low WBC - more susceptible to infections

60
Q

Primary function of granulocytes

A

Phagocytosis

61
Q

What is phagocytosis? (think of: criminals)

A

WBCs engulf unwanted organisms, digest, and kill it

62
Q

Where does absorption take place?

A

Duodenum and upper jejunum

63
Q

What is hemostasis? Why is it important?

A

Stopping of blood flow. Important because it minimizes blood loss when structures are injured

64
Q

What is thrombocytopenia? Why is this a big deal?

A

Low platelets - A big deal because it can cause bleeding in the brain (fatal)

Prolonged bleeding from minor trauma to spontaneous bleeding without injury3
.

65
Q

What do platelets do?

A

Stop bleeding

66
Q

T/F number of platelets is unaffected by the aging process

A

True

67
Q

What is Neutropenia? How does it occur?

A

Occurs when bone marrow does not produce enough neutrophils

This leads to an increase of infection and death from sepsis

68
Q

An anticoagulant such as warfarin that interferes with prothrombin production will alter the clotting mechanism during what process?

A

Activation of thrombin

69
Q

What is anemia?

A

Deficiency in erythrocytes (not enough RBCs)

70
Q

What is leukemia

A

Malignant diseases affecting the blood and blood forming tissues of bone marrow

71
Q

What are the two major types of Lymphomas

A

Hodgkin’s and Non-Hodgkin’s

72
Q

What is Hodgkin’s Lymphoma?

A

Abnormal, giant, multinucleated cells

Cause is unknown

Affects lungs, spleen, liver

Onset of symptoms is gradual; enlargement of cervical, axillary or inguinal lymph nodes

Patient may notice: weight loss, fatigue, weakness, fever, tachycardia

73
Q
A
74
Q

What is multiple myeloma?

A

A cancer of the blood

75
Q

Where do lymphomas originate from?

A

Bone marrow and lymphatic structures

76
Q

How does iron deficiency develop?

A

Dietary intake, malabsorption, blood loss or hemolysis

77
Q

What is the major cause of iron deficiency in adults?

A

Blood loss

78
Q

What is the most common nutritional disorder in the world?

A

Iron-deficiency anemia (caused by decreased RBC production)

79
Q

Electrocardiography

A

Used to assess cardiac function; P, QRS, T

Anything abnormal can indicate problems with heart functions

80
Q

What blood serum component will be included in a lipid profile?

A

Cholesterol
Triglycerides
Lipoproteins (HDL, LDL)

81
Q

What is atherosclerosis sometimes referred to?

A

Hardening of arteries

82
Q

What is a major cause of CAD?

A

Atherosclerosis

83
Q

What is a fatty streak an indication of? What can we do to treat it?

A

Atherosclerosis

LAB work - can show how it can be treated / make it go away

84
Q

Nonmodifiable Risk of CAD

A

Age, gender, ethnicity, family history

85
Q

Cholesterol-lowering drug therapy - Management of CAD

A

Restrict lipoprotein production
Increase lipoprotein removal
Decrease cholesterol absorption

86
Q

Antiplatelet therapy

A

ASA
Clopidogrel

87
Q

Increased demand for oxygen is?

A

Myocardial ischemia

88
Q

Chronic Stable Angina Indicators

A

Chest, occurs intermittently over a long period with same pattern of onset
Rarely sharp or stabbing
Pain usually lasts 3-5 minutes

89
Q

Silent Ischemia

A

No subjective symptoms
Places client at higher risk for adverse outcomes and death

90
Q

Nocturnal angina

A

Occurs only at NIGHT but not during sleep

91
Q

Prinzmental angina

A

Occurs at rest
Seen in clients w/ migraine, headaches, Raynaud’s phenomenon

92
Q

Microvascular angina

A

Common in women
Occur in absence of significant coronary atherosclerosis

93
Q

Angina - Treatment

A

Nitrates
B-adrenergic Blockers
Calcium Channel Blockers

94
Q

What can develop if ischemia does not get treated?

A

acute coronary syndrome

95
Q

Most common complication of Myocardial Infarction?

A

Dysrhythmias

96
Q

Automaticity

A

Ability to initiate an impulse and continue

97
Q

Contractility

A

Heart responds to impulse by contracting

98
Q

Conductivity

A

Transmission of that impulse

99
Q

Excitability

A

Electrically stimulated

100
Q

What’s the most commonly used diagnostic tool?

A

Electrocardiogram

101
Q

Cardiac Arrhythmias

A

Flutter

Contracting rapidly in flutter waves
RATE IS 250-350 beats/min

102
Q

What’s a common dyrhythmia?

A

Atrial Fibrillation

Must do APICAL pulse

103
Q

Junctional Dysrhythmias

A

When SA failed to fire, or impulse has been blocked - so heart beat starts at AV node instead of the usual, SA node

104
Q

Ventricular Tachycardia

A

Life-threatening b/c of decreased CO

Very rapid heart rate

Medical Nursing (3 decks)

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