Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURSING 220 > TEST 1 > Flashcards

TEST 1 Flashcards

1
Q

Shock Symptoms

A

Restlessness & Anxiety
Pulse weak & rapid
*Skin cold & clammy
*Diaphoresis
*Respirations *ShallowLaboredRapid
*Thirst, *Oliguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is shock?

A

physiologic condition in
which there is inadequate
blood flow to tissues and cells of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of shock?

A

*Failure of blood vessels
*Failure of the pump
*Loss of volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types/ Stages of Shock?

A

Early, Compensatory, Progressive and Irreversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Early Shock

A

-Physiologic Triggers
* Baroreceptors detect MAP decrease
of 10 mmHg or less
* Decrease in circulating blood
volume (less than 500 ml)
-Physiologic response (ANS)
* Increased HR
* Increased force of contraction
* Peripheral vasoconstriction
-Assessment findings
* Change in mental status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Compensatory Shock

A

-Physiologic Triggers
* Baroreceptors detect MAP decrease
of 10-15 mmHg
* Decrease in circulating blood
volume (1000ml or more)
-Physiologic response (ANS)
* Increased HR
* Increased force of contraction
* Peripheral vasoconstriction
* Increased venous return
* Water and Na conservation
-Assessment findings
* Restlessness, anxiety,
irritability, apprehension
* Slightly increased heart rate
* Normal or slightly increased
blood pressure
* Pale, cool skin
* Slightly increased respiratory
rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Progressive Shock

A
  • Triggers
  • Compensatory mechanisms have failed Causing change from aerobic to
    anaerobic metabolism
  • Organ function deteriorates
  • Physiologic Changes
  • Ischemia
  • Respiratory acidosis
  • GI/Liver
  • Neuro
  • Renal
  • Skin & Temperature
  • Assessment findings
  • Tachycardia
  • Signs of poor perfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Irreversible Shock

A

-Physiologic Triggers
* Tissue and cellular death is
widespread that treatment
CANNOT reverse damage!
-Physiologic changes
* Multi-system organ failure
* Kidneys
* Lungs
* Liver
* Brain
* Heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What will there be an absence of with an LVAD?

A

Absence of palpable pulse and blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the only anticoag medication approved from someone with a mechanical valve replacement?

A

coumadin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment for hypovolemic shock

A

restore intravascular volume with WARM FLUIDS, packed RBC’s, plasma & platelets, reverse events leading to poor perfusion and correct underlying cause of volume loss ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment for a STEMI

A

to go to the cath lab to remove the blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

STEMI/NSTEMI medication management

A

*Analgesics(nitro & morphine)
*Antidysrhythmic(amio & lidocaine)
*Beta-Blockers
*Dopamine
*Fibrinolytics(breaks up clots)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Does placenta previa cause DIC?

A

No, it is caused by placental abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of DIC?

A

NOT A DISEASE* Tissue damage
* Trauma
* Frostbite
* Burns
* GSW
* Head injury
* OB complications
* Septic abortion
* Abruptio placenta
* Amniotic fluid embolus
* Infection
* Sepsis
* Bacterial
* Parasitic
* Rickettsial
* Vessel damage
* Aortic aneurysm
* Acute glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you diagnose DIC?

A
  • CBC
  • Platelet count
  • PT, PTT
  • Fibrinogen level
  • Fibrin degradation
    products
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Symptoms of DIC?

A
  • Bleeding (From IV sites, Mucus membranes, GI, GU)
  • Petechia
  • Joint pain
  • Signs and Symptoms of shock
  • Prolonged PT, PTT, Thrombin times
  • Elevated D-Dimer
  • Thrombocytopenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of DIC

A
  • Treat underlying cause
  • Replace volume
  • Clotting factors
  • Cryoprecipitate- Fibrinogen, Factor V and Factor VII
  • Fresh Frozen Plasma- other factors
  • Platelets
  • Electrolytes
  • Fluid
  • Prevent secondary tissue ischemia
  • Heparin
  • LMWH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cardiomyopathy Symptoms

A
  • Range from none to symptoms
    of HF
  • Shortness of breath on exertion
  • Fatigue
  • Cough/ orthopnea
  • Fluid retention/ peripheral
    edema
  • Angina
  • Palpitations
  • JVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cardiomyopathy Treatment

A
  • Medical management
  • Treat cause
  • Medications
  • Diet/ fluid restriction/ Exercise
  • Temporary management
  • Intra-aortic balloon pump
  • LV assist device- or long term
  • Surgical management
  • Pacemaker
  • ICD
  • Heart transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ischemic Cardiomyopathy

A
  • Caused by CAD
  • Ventricular remodeling
    post MI
  • Decreased LV size with
    thickened intraventricular
    septum
  • Betablocker therapy post
    STEMI prevents remodeling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dilated Cardiomyopathy

A
  • Most common
  • Dilation of ventricles
  • Thin myocardium
  • Cause-
  • > 75% medical condition/ disease
    -Genetic
    -Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do all cardiomyopathies result in?

A

Impaired cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two classifications of cardiomyopathy?

A

Structural abnormalities and ischemic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What does cardiomyopathy lead to?
* Increased workload * Severe heart failure * Lethal dysrhythmias * Death
26
What are the two types of valvular heart disease?
stenosis and insufficiency
27
What is stenosis?
narrow opening- impedes blood moving forward and creates a straining or squeak
28
What is insufficiency? (r/t valvular heart disease)
improper closure- causes blood to flow backwards (regurgitation) and creates a swishing sound
29
What are causes of valvular heart disease?
Congenital- malformation or connective tissue disorders (ex. Ehler's Danlos or Marfan syndrome) Acquired- rheumatic heart disease, infective endocarditis, degenerative (from HTN)
30
S/S of valvular heart disease?
May start suddenly or develop over time Shortness of breath Weakness Lightheadedness Chest discomfort Edema of lower extremities Palpitations Rapid weight gain
31
What other assessment findings might you see with valvular disease?
murmur, orthopnea, dyspnea on exertion, paroxysmal nocturnal dyspnea
32
meds for tx of valvular heart disease?
diuretics, ACE inhibitors, inotropic agents, anticoagulants, prophylactic antibiotics NO NITRO for aortic stenosis - decreased CO, makes pt dizzy
33
surgical intervention for tx of valvular heart disease?
percutaneous transluminal balloon valvuloplasty (repairs valve for aortic or mitral stenosis), valve replacement, annuloplasty (ring insertion), TAVR
34
What is acute coronary syndrome?
any condition resulting in reduced blood flow to the heart ex. angina (stable and unstable), MI (NSTEMI and STEMI)
35
acute tx for ACS (angina)?
nitro sublingual
35
tx for chronic ACS (angina)
long acting nitrate patches and ointment, long-acting nitrate (isosorbide), beta blockers (decrease afterload), calcium channel blockers (increase myocardial blood and O2 supply which decreases O2 demand), aspirin (reduces risk of platelet aggregation in narrowing arteries
36
What is the electrical circuit of the heart?
SA node - AV node - Bundle of His - Right and Left Bundle Branches - Purkinje fibers
37
What is the electrical action of the heart?
A. SA node impulse causes atrial depolarization -P Wave results in atrial contraction (once all cells depolarized) pushes blood into ventricles B. AV node receives the impulse and slows it, results in PR interval C. Impulse sent to Bundle of His beginning ventricular depolarization- R wave upstroke C. Impulse continues to Right and Left Bundle branches causing depolarization of ventricles -R wave down stroke & S wave C. Impulse enters Purkinje Fibers results in ventricular contraction- ST segment, pushes blood to lungs &body D. Ventricle repolarization seen by T wave
38
what is polarization?
when the inside of a cell is more negative than the outside
39
What is depolarization?
the movement of charged particles across a cell membrane causing the inside of the cell to become positive
40
what is repolarization?
Resting phase; movement of charged particles in which the inside of the cell is restored to its negative charge
41
what is the refractory period?
the cells will not respond to further stimulation: cells cannot contract (Onset of QRS)
42
causes of sinus bradycardia?
Hypoglycemia Hypothermia Hypothyroidism Previous cardiac history Medication Toxic exposure Inferior wall MI
43
s/s of sinus bradycardia?
Syncope Dizziness Chest pain Shortness of breath Exercise intolerance Cool, clammy skin beta blockers
44
tx of sinus bradycardia?
stable- atropine unstable- pacing (transcutaneous or temporary pacemaker)
45
causes of sinus tachycardia?
Damage to heart due to heart disease Hypertension Fever Stress Drugs Alcohol Caffeine Nicotine Recreational drugs such as cocaine Medication side effect Pain response Imbalance of electrolytes Hyperthyroidism
46
s/s of sinus tachycardia
Dizziness, Lightheadedness Syncope, Shortness of breath Rapid pulse rate Heart palpitations Chest pain albuterol, synthroid, epi
47
tx for sinus tachycardia?
identify and treat cause
48
symptoms of SVT?
May be asymptomatic Palpitations (Most common) Dizziness (Most common) Shortness of breath Syncope Chest pain Fatigue Diaphoresis Nausea
49
patients at risk for SVT?
Previous MI Mitral valve prolapse Rheumatic heart disease Pericarditis Pneumonia Chronic Lung disease Acute alcohol intoxication
50
tx for SVT?
tx depends on stable vs unstable Short term -Vagal Maneuvers -Adenosine -Cardioversion Long Term -Rate control -Ablation Adenosine: 6mg RAPID IVP followed with 20 cc Nacl bolus; repeat with 12 in 2 minutes - for unstable
51
risk factors for Afib?
Nonmodifiable Age- 55+ Genetics- 40% increase with familial history Ethnicity- European descent Gender- higher prevalence in men Modifiable Obesity Hypertension Obstructive Sleep Apnea Diabetes Smoking Alcohol consumption Caffeine intake Surgery- 20-50% post cardiac surgery
52
causes of afib?
Hypoxia Hypertension Congestive heart failure Coronary artery disease Sinus node dysfunction Mitral valve disorders Rheumatic heart disease Pericarditis Hyperthyroidism Excessive alcohol or caffeine consumption
53
s/s of afib?
Heart palpitations Irregular pulse rapid, slow, racing, pounding or fluttering Dizziness or light-headedness Fainting, confusion Fatigue Trouble breathing Difficulty breathing lying down Sensation of chest tightness
54
tx for afib?
Medical Treatment- Rate control (slow ventricular rate to 80-100 beats/minute) Antiarrhythmic medications Digoxin Beta-adrenergic blockers Calcium channel blockers Clot prevention Anticoagulant therapy Surgical Treatment- Chemical or electrical cardioversion Watchman procedure
55
what happens in 3rd degree heart block?
Atria and ventricles are completely dissociated Total block at AV node None of the impulses are conducted Pathology is at the AV node NEEDS INTERVENTION- medical emergency
56
s/s of ventricular tachycardia?
Chest discomfort (angina) Syncope ,Light-headedness or dizziness Palpitations Shortness of breath Absent or rapid pulse Loss of consciousness Hypotension
57
tx for v tach?
stable (has pulse) - meds (amiodarone) unstable (no pulse, just electrical activity) - defibrillation
58
s/s of v fib?
Loss of consciousness Absent pulse Death
59
causes of v fib?
Acute Myocardial Infarction Untreated VT Electrolyte imbalance Hypothermia Myocardial ischemia Drug toxicity or overdose Trauma
60
tx for v fib?
defibrillation
61
what is agonal rhythm?
Idioventricular rhythm is 20 bpm or less Often the last-ordered heart rhythm seen when resuscitation efforts are unsuccessful
62
s/s of agonal rhythm?
Loss of consciousness No palpable pulse No measurable BP Management- Continue resuscitation efforts Confirm death with lack of cardiac muscle activity
63
causes of PEA (pulseless electrical activity)?
H’s and T’s Hypovolemia #1 cause Hypoxia Hydrogen ions (acidosis) Hypo / Hyperkalemia Hypothermia Toxins Tamponade (cardiac) Tension pneumothorax Thrombosis (coronary or pulmonary) Trauma Massive MI Overdose of tricyclic antidepressant
64
s/s of PEA?
Pulselessness Loss of consciousness No palpable BP
65
tx of PEA?
Determine cause & treat CPR Initiate ACLS protocol
66
s/s of asystole?
No palpable pulse ▪No measurable BP ▪Loss of consciousness
67
what does cardiac output measure?
CO measures amount of blood pumped out of left ventricle in 60 seconds normal CO is 4-8 L/min
68
CO equation?
CO= SV*HR
69
what is stroke volume?
MLs of blood pumped out LV per contraction Normal 60-130 ml/beat SV= end diastolic volume - end systolic blood volume
70
what is ejection fraction?
% of end-diastolic volume ejected from LV Normal EF 50-70% EF= SV/end diastolic volume
71
pulse pressure equation
Pulse pressure = Systolic blood pressure – Diastolic blood pressure
72
mean arterial pressure equation
MAP = 1/3(systolic blood pressure + 2/3(diastolic blood pressure)
73
What is preload?
Ventricular filling Influenced by venous return Influenced by ventricular contractility
74
What is afterload?
Pressure of the arterial system ahead of the ventricle Pressure LV overcomes to eject blood volume -ex. pressure in ventricle has to be higher than aorta to open the aortic valve
75
Tort: Negligence (unintentional)
*Carelessness or failure to act as an ordinary prudent person *Action contrary to what reasonable person would do *Neglected to use education as would be expected by peers *Injury must come from the breach of duty *Gross negligence is the intentional omission of proper care *When it involves a nurse or MD it is considered malpractice
76
Tort: Malpractice (unintentional)
Failure of a medical professional to follow accepted standards of practice for profession *Resulting in harm patient *Requires expert testimony *More specific than negligence
77
What is the nursing scope of practice based on?
The states nurse practice act
78
proximal cause
needs to be directly related- "a leads to b which lead to c"
79
Abandonment
When a nurse accepts an assignment and terminates it without an appropriate cause, don't hand off your patients, leave without notifying your supervisor,
80
what happens to the pH and PCO2 with respiratory acidosis
decreased pH and increased PCO2
81
what happens to the pH and HCO3 with metabolic acidosis
decreased pH and decreased HCO3
82
what happens to the pH and PCO2 with respiratory alkalosis
increased pH decreased PCO2
83
what happens to the pH and HCO3 with metabolic alkalosis
increased pH and increased HCO3
84
how does someone with hypoglycemia present
headache hungry rapid onset of altered mental status tachycardia cool moist skin anxious/restless seizure combative behavior
85
management of mild to moderate hypoglycemia
15g of rapid acting sugar(OJ glucose tabs honey marshmallows) 15/15 rule
86
severe hypoglycemia management
know facilities policy iv glucose(D10 iv drip or D50 IVP 10 ml over 1 min)
87
onset and action time of glucagon for severe hypoglycemia management
onset 8-10 min action 12-27 min may repeat in 15 min
88
how does hyperglycemia present
polyphagia polyuria polydipsia headache difficulty concentrating blurred vision weak and feeling tired
89
treatment for hyperglycemia
diet exercise medication (metformin) rehydration determine cause & correct/prevent
90
DKA presentation
tachycardic hypotension tachypnea fever(if infection) polydipsia polyuria polyohagia ill appearing dry skin labored respirations acetone breath dry mucus membranes N/V decreased skin turgor
91
HHS presentation
tachycardia orthostatis hypotension tachypnea hyperthermia (if infection) ill appearing Altered mental status Lethargy (Yes you can use it) Dry mucus membranes Sunken eyes Decreased skin turgor Decreased urine output Increased cap refill time Weak thready pulse Anhidrosis Coma
92
main differences between DKA and HHS
DKA-Type I diabetes Blood glucose > 300mg/dL Develops fast (days) Moderate dehydration Serum and urine ketones present Acidosis present Kussmaul’s respirations Abdominal pain HHS-Type II diabetes Blood glucose > 600mg/dL Develops over time (days to weeks) Profound dehydration Minimal to no ketones present Normal blood pH Normal respirations Lethargy/ confusion
93
signs and symptoms of DKA & HHS
Hyperglycemia Flushed, warm dry skin Increased thirst Decreased blood pressure Increased pulse Nausea & Vomiting Decreasing LOC Weakness Abnormal electrolytes(K, Na) Increased urine glucose Stupor or coma
94
DKA & HHS management
rehydration restore electrolytes insulin administration determination and treatment of underlying cause
95
why do we use insulin for DKA
stop ketosis
96
why do we use insulin for HHS
reduce blood sugar
97
H&H ranges
12-17 and 36-50
98
WBC range
4,500-11,000
99
Platelet range
150-450
100
PCO2 range
35-45
101
HCO3 range
22-28

NURSING 220 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions