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Med Surg I > Quiz #3 Cardiac > Flashcards

Quiz #3 Cardiac Flashcards

1
Q

What to do for epistaxis

A

Can occur during hypertensive crisis
Priority is to administer IV to lower decrease BP by 20%
Blood pressure and ECG monitoring
Neurological assessment

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2
Q

What is heart healthy diet

A

Low sodium <2.3 g/day, low fat, low cholesterol, high fiber
DASH - high in fruit, high in vegetables, low fat dairy foods
Consume foods rich in calcium
Increase potassium consumption - apricots, bananas, tomatoes, potatoes

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3
Q

Teachings on hydrochlorothiazide

A

Diuretic
- take med first thing in the morning
- be sure med is taken by 1400 to prevent nocturia
- consume food high in K+
- take med with food if GI upset
- report significant weight loss, lightheadedness, dizziness, GI upset

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4
Q

Primary prevention for hypertension

A

Eat a heart healthy diet
Exercise
No smoking
Limit alcohol
Get enough sleep

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5
Q

Secondary prevention for hypertension

A

Obtain blood cholesterol levels
- this is aimed to screen at risk community members
- focus on further illness or injury

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6
Q

Tertiary prevention for hypertension

A

Anti hypertensive therapies
Ex: medication adherence programs
Walking program for those with hypertension

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7
Q

Adverse effects of digoxin toxicity

A

Hypokalemia —> can increase toxicity

Anorexia [usually the first sign]
N/V, diarrhea
Blurred vision and halo lights

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8
Q

Digoxin toxicity reversal agent

A

Digoxin immune fab (digibind) or DIGIFAB

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9
Q

Left side heart failure manifestations

A

Occurs due to inadequate tissue perfusion

  • dyspnea
  • pulmonary congestion (cough, crackles)
  • frothy sputum
  • S3 heart sound
  • decreased o2
  • altered LOC
  • nocturia
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10
Q

Right sided heart failure manifestations

A

Systemic congestion due to fluid outside lungs

  • dependent edema
  • ascites
  • anorexia, vomiting
  • jugular vein distention
  • weakness
  • weight gain
  • Fatigue
  • hepatomegaly
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11
Q

Patient teaching for heart failure

A

Consume a diet low in sodium
Continue to take meds even if feeling better
Measure weight daily at the same time
- more than 2 lbs in a day or 5 lbs in a week
Report swelling of feet

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12
Q

Metabolic syndrome risk factors

A

Inactive
Obesity
Not having a proper diet
Triglycerides > 150 mg/dL
Low HDL
High fasting glucose level

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13
Q

Nitroglycerin

A

A vasodilator
Can be used to open up coronary artery in the heart
Helps deliver oxygen to heart muscle
- used for angina, which is chest pain occurs with decreased perfusion or atherosclerosis

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14
Q

Chronic stable angina

A

Precipitated by exertion or stress
Relieved by rest or nitroglycerin
Manifestations last less than 15 min
Not associated by nausea or, anxiety, diaphoresis

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15
Q

Chronic unstable angina

A

Occurs with exercise or at rest but increases in occurrence, severity, and duration over time

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16
Q

Risk factors for coronary artery disease

A

No modifiable
- age, gender, ethnicity
- family history
Modifiable
- increase serum lipids
- cholesterol > 200 mg/dL
- triglycerides > 150 mg/dL
- increase LDL decrease HDL
- hypertension

Others
-obesity, diabetes, metabolic syndrome, substance abuse tobacco use

17
Q

Example of low cholesterol diet

A

Oats
Barely
Whole grain
Beans
Skim milk
Veggies
Pears and apples

18
Q

Nitroglycerin tablet

A

Can be sublingual tab or spray
S for STABLE
S for STRESS induced

  • will stop when activity stops
19
Q

Nitroglycerin patch

A

U for UNSTABLE
U for UNPREDICTABLE

Take nitro before stressful activity
Can be used for first indication of chest pain

20
Q

Client teaching for sublingual nitroglycerin (stable angina)

A

Take first tablet (let dissolve under tongue)
Call 911 if pain not relieved by first tablet, then take 2nd tablet
Make take up to 3 doses and must be 5 min apart

Store NTG away from light and heat source
Replace every six months
Take acetaminophen for headache

21
Q

Adverse effects of simvastatin

A

Hepatotoxicity
- anorexia, N/V, jaundice
Myopathy
- muscle aches, pain, tenderness

Drinking grapefruit juice can lead to rhabdomyolysis which can further damage heart and kidneys

22
Q

Propranolol adverse effects that need immediate action

A

Bradycardia (hold medication if HR is less than 60)
Orthostatic hypotension
Bronchoconstriction
Heart failure
Sexual dysfunction

23
Q

Captopril

A

Drug of choice for hypertensive clients with heart failure
Vasodilator to help lower BP

24
Q

Captopril adverse effects

A

C- Cough
A- Angioedema
P- pregnancy problems
T- taste changes
O- orthostatic hypotension (monitor BP for several hours after treatment)
P- proteinuria
R- rash
I- increased potassium
L- low neutrophil count

25
Q

Captopril client teaching

A

TAKE ON AN EMPTY STOMACH (at least 1 hour before meals)
Stop taking diuretic 2-3 days before
NOTIFY HCP IF COUGH DEVELOPS
Monitor blood pressure and heart rate
Do not double up on doses
Do not stop medication abruptly (can get rebound hypertensive crisis—> stroke)
Change positions slowly

26
Q

What to do if BP meds aren’t working

A

Maybe ask provider for different medication.

27
Q

Stress test

A

Patient walks on treadmill, exercising the cardiac muscle
Provides info regarding workload of the heart
Test discontinued once heart reaches a certain rate

28
Q

Nurse is monitoring a client who is undergoing exercise stress test. Which of the following assessment findings require most rapid action by the nurse?

A

Electrocardiographic changes indicating coronary ischemia (can be shown as newly inverted Twaves)

29
Q

Cardiac catheterization

A

Also known as angiography
Used to evaluate presence and degree of coronary artery blockage
The groin is the most common site used inserted through femoral artery
Injection of contrast media

30
Q

Cardiac catheterization post procedure

A

After procedure pressure will be held on access site
Extremity must be keep straight for a prescribed amount to prevent bleeding
Assess vital signs every 15 min x 4

ASSESS FOR BLEEDING AND HEMATOMA FORMATION AT THE INSERTION SITE
*THROMBOSIS (document pedal pulse, color, and temp)

31
Q

Cardiac catheterization and what do we need to be concerned about

A

Bleeding and hematoma formation at insertion site
Assess for thrombosis (document pedal pulse, color, and temp)
Cardiac tamponade
- fluid in the pericardium (which is sac surrounding heart)
Artery dissection
- puncture on arterial wall

32
Q

A nurse is reinforcing teaching with a client who has a prescription for simvastatin. Which of the following instructions should the nurse provide?

A

Take medication in evening hours

33
Q

Normal cholesterol

A

Total cholesterol <200 mg/dL
LDL <100 mg/dL
HDL >60

34
Q

For someone who had coronary artery bypass

A

**Low cholesterol
Low sodium, low fat
High fiber

35
Q

Cholesterol and warfarin

A

Using garlic to help lower cholesterol can potentiate effects of warfarin

36
Q

Warfarin adverse effects

A

Hemorrhage
-bruising, Petechiae, hematoma, and black tarry stools
Hepatitis
Toxicity

Med Surg I (12 decks)

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