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test bank Flashcards

1
Q

S3 heart sounds are normal in who? (3 children)

A

normal in children and adults up to 30 or 40

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2
Q

CAD - with exercise has an increase in HR - means what?

A

Myocardial ischemia

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3
Q

The nurse is caring for an 82-year-old patient. The nurse knows that changes in cardiac structure and function occur in older adults. What is a normal change expected in the aging heart of an older adult? Just one thing (old, wide aorta)

A

widening of the aorta

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4
Q

connective tissue with age (this is collagen)

A

increases with age

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5
Q

increased CVP is (think water)

A

hypervolemia

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6
Q

The critical care nurse is caring for a patient who has had an MI. The nurse should expect to assist with establishing what hemodynamic monitoring procedure to assess the patients left ventricular function? (left gets pampers)

A

Pulmonary artery pressure monitoring (PAPM)

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7
Q

Central venous pressure (CVP) monitoring is left or right ventricle? (RIGHT in the center)

A

right

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8
Q

The nurse is caring for an acutely ill patient who has central venous pressure monitoring in place. What intervention should be included in the care plan of a patient with CVP in place?

A

Change the site dressing whenever it becomes visibly soiled. NOT ROM.

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9
Q

A patient is brought into the ED by family members who tell the nurse the patient grabbed his chest and complained of substernal chest pain. The care team recognizes the need to monitor the patients cardiac function closely while interventions are performed. What form of monitoring should the nurse anticipate?

A

Hardwire continuous ECG monitoring

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10
Q

The nurse is performing an intake assessment on a patient with a new diagnosis of coronary artery disease. What would be the most important determination to make during this intake assessment?

A

NOT DIET. Whether the patient and involved family members are able to recognize symptoms of an acute cardiac problem and respond appropriately

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11
Q

The nurse is relating the deficits in a patients synchronization of the atrial and ventricular events to his diagnosis. What are the physiologic characteristics of the nodal and Purkinje cells that provide this synchronization? Select all that apply.

A

automacticity, conductivity, and excitability

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12
Q

A lipid profile has been ordered for a patient who has been experiencing cardiac symptoms. When should a lipid profile be drawn in order to maximize the accuracy of results? (fat after 12)

A

After a 12-hour fast

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13
Q

When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who has such a device in place, the nurse should check which of the following components? Select all that apply.

A

tranducer, a flush system, a pressure bag.

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14
Q

Pulmonary artery pressure monitoring (PAPM) is to assess which ventricle?

A

the left

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15
Q

all types of angina on ECG

A

transient T-wave inversion

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16
Q

STEMI - what is the pain like?

A

unrelenting pain

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17
Q

troponin - how soon is it detected after an MI?

A

MI, detected 3-4 hrs after onset of chest pain. normal 0 - .1

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18
Q

Door to Balloon time

A

< 90 minutes

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19
Q

Fibrinolytic: door to drug time (fiber after 30)

A

less than 30 min for STEMI patients

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20
Q

PCI (balloon angioplasty) pre-op care - how long to fast? And what about allergies?

A

Fasting/NPO for 6-12 hrs
-Baseline assessment: VS, O2 sat, Heart and lung sounds, neurovascular assessment of extremities.
Assess all distal pulse, mark them for indicator for post op care
Stop meds like Aspirin/blood thinners
Assess labs
Allergies; contrast dye
Pt education: flush feeling when dye injected; fluttering of heart

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21
Q

PCI post op care - check for signs of..

A

-Baseline assessment: compare to preprocedural; note hypotension or HTN; Signs of PE

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22
Q

What is a Holter monitor? (holt continously watches me)

A

Continuous cardiac monitoring portable device.

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23
Q

transthoracic echocardiogram - invasive or not?

A

non-invasive

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24
Q

A critical care nurse is caring for a patient with a hemodynamic monitoring system in place. For what complications should the nurse assess? Select all that apply.

A

pneumothorax, air embolism, and infection

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25
Q

weight gain - what is too much?

A

over 3 lbs in 1 day, or 5 lbs in 7 days

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26
Q

HF - is there chest pain?

A

usually NOT.

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27
Q

left-sided HF - #1 treatment (the body is drIED)

A

IDE ending drugs, furosemide, bume

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28
Q

HOPE (for HF)

A

head of bed, oxygen, push furosemide and morphine, ending all sodium and fluids

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29
Q

how to know if HF treatment is working?

A

clearer lungs and decreased HR

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30
Q

always question any dr order that

A

wants to give fluids, even IV maintanence fluids

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31
Q

what part of heart is damaged with left-sided HF?

A

the myocardium, usually an MI

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32
Q

sleep apnea causes right or left sided HF?

A

right

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33
Q

aldosterone (AL)

A

Adds sodium and water to the body
Lets potassium out of the body

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34
Q

Pril drugs (P for potassium)

A

spare potassium

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35
Q

Ejection fraction - what % is HF?

A

less than 40% is BAD

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36
Q

what machine to monitor HF?

A

hemodynamic monitor (swan) also called PAC (pulmonary artery catheter), measures central venous pressure. anything over 8 is not great

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37
Q

PAC measures what?

A

PAC (pulmonary artery catheter), measures central venous pressure. anything over 8 is not great

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38
Q

can you take OTCs if you have HF?

A

no, even ibprofen

39
Q

if pt is in immediate HF, pink froth, do what?

A

IV drugs - butanmide or furosimide

40
Q

drugs for HF - ABC DDD

A

ace inhibitors and arbs, beta blockers, calcium channel blockers, digoxin, dilators, diuretics

41
Q

digoxin doesn’t do what?

A

decrease BP, only HR. SO it doesn’t cause orthostatic hypotension

42
Q

ACE and ARBS only lower BP, so

A

we can give if HR is lower than 60

43
Q

which drug does not cause orthostatic hypotension?

A

digoxin BC it doesn’t drop BP

44
Q

3 conditions that result from acute coronary syndrome (ACS)

A

unstable angina, NSTEMI, STEMI

45
Q

if heart attack, how fast will you see troponin in blood test?

A

within 6 hours

46
Q

unstable angina ECG (depressing angina)

A

normal or transient ST depression

47
Q

NSTEMI - which part of the heart? (nystemi in my ventricle)

A

inner layer of ventricular wall

48
Q

NSTEMI - is there ST elevation?

A

NO. T wave inversion or ST depression or both.

49
Q

STEMI

A

complete occulusion of blood flow

50
Q

STEMI - ECG?

A

ST elevation

51
Q

if you have ACS (angina, STEMI, NSTEMI), what meds?

A

same ones used for angina

52
Q

what procedure is best for STEMI? (stemi gets a balloon)

A

PCI - percutaneous coronary intervention - the balloon

53
Q

if PCI treatment is not available for STEMI, then what?

A

fibrinolytics

54
Q

treatment for unstable angina or NSTEMI (no stemi gets angie in 24 hrs)

A

angiography within 24 to 48 hrs. (uncomplicated)
immediate angiography for complicated

55
Q

what about fibrinolytics for angina and NSTEMI?

A

NO, NOT GOOD FOR THEM

56
Q

acute decompensated HF - right or left side? (the left can’t even compensate)

A

left

57
Q

PCI post op - how often to observe for bleeding? (very serious)

A

Complication
Observe for q 15min- 1 hr bleeding:

58
Q

PCI post op - watch for

A

hypotension, tachycardia, hematoma.
Myocardial ischemia
Arterial occlusion- check distal pulse again.
AKI

59
Q

PCI post op - bedrest for how long?

A

Bed Rest for 6 hr
Monitor ECG, chest pain, Intake/output

60
Q

angina after PCI?

A

*There should be no angina s/p PCI, stent should provide 100% flow to coronary artery

61
Q

cath lab with acute MI within

A

60 min

62
Q

2nd degree (Mobitz type 1) heart block

A

longer, longer, longer drop, that is a winkebach

63
Q

1st degree heart block

A

just a PR interval that is longer than .20 (or 5 small boxes)

64
Q

type II - mobitz type 2

A

PR interval is constant, and then you drop a beat. It doesn’t keep getting longer.

65
Q

3rd degree AV block

A

low low HR, brady

66
Q

treatment for blocks

A

stop meds that are slowing it down- ie beta blockers.
if that doesn’t work, atropine, dopamine, epinephrine.
if that doesn’t work, pacemaker

67
Q

An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?

A

Fewer QRS complexes than P waves

68
Q

The nurse is caring for a patient who has just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurses assessment?

A

Vigilant monitoring of the patients ECG

69
Q

who gets cardiac conduction treatment?

A

Atrial and ventricular tachycardias not responsive to other treatments

70
Q

The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was defibrillated unsuccessfully and the patient remains in VF. According to national standards, the nurse should anticipate the administration of what medication?

A

Epinephrine 1 mg IV push

71
Q

signs of heart block - COLLAPSED

A

chest pain, oxygen, low bp, lethargy, anxiety, palpitations, SOB, elevated HR, dizziness

72
Q

ST depression - causes

A

hypokalemia, cardiac ischemia, and medications such as digitalis

73
Q

STEMI - thrombolylic therapy - how fast? (throw bombs within 12 hours)

A

Thrombolytic therapy is within 12 hours from onset of pain/sx

74
Q

PCI - pre op care - how long to fast?

A

Fasting/NPO for 6-12 hrs
-Baseline assessment: VS, O2 sat, Heart and lung sounds, neurovascular assessment of extremities.
Assess all distal pulse, mark them for indicator for post op care
Stop meds like Aspirin/blood thinners
Assess labs
Allergies; contrast dye
Pt education: flush feeling when dye injected; fluttering of heart

75
Q

PCI - post op care

A

-Baseline assessment: compare to preprocedural; note hypotension or HTN; Sings of PE
Complication
Observe for q 15min- 1 hr bleeding: hypotension, tachycardia, hematoma.
Myocardial ischemia
Arterial occlusion- check distal pulse again.
AKI
Bed Rest for 6 hr
Monitor ECG, chest pain, Intake/output
*There should be no angina s/p PCI, stent should provide 100% flow to coronary artery

76
Q

Variant or Prinzmetals:

A

***Variant angina (prinzmetal’s angina or atypical): Occurs at rest, caused by coronary artery vasospasm with or w/o CAD. Reversible ST segment elevation · Unrelieved by NGT or rest
· We treat with calcium channel blockers
· Associated with migraines

77
Q

on ECG,

A

1-4 is left, the others are right coronary artery

78
Q

5 lead - what intercostals?

A

2nd, 4th, and 8th intercostal spaces

79
Q

phases of polarization

A

P4 (baseline)
Depolarization:
P0
Platea:
P2
Repolarization:
P3

80
Q

what percent is blocked for claudation? (Claud only got 50%)

A

about 50% of the arterial lumen or 75% the cross-sectional area

81
Q

what test can diaganose pericarditis? (Peri echos)

A

Echocardiography

82
Q

Which symptom occurs in the client diagnosed with mitral regurgitation when pulmonary congestion occurs? (mitral regurg is an SOB)

A

SOB

83
Q

cardiac output = colorado sveet heart

A

CO = SV x HR

84
Q

baroreceptors as we age?

A

decrease in sensitivity

85
Q

CK-MB

A

this is a subtype of CK. It is more sensitive for finding heart damage from a heart attack. CK-MB rises 4 to 6 hours after a heart attack. goes back to normal in a day or 2, so not helpful if time has passed.

86
Q

BNP detects what type of HF?

A

ventricular

87
Q

homocysteine (homo will work around lipids)

A

detects CAD even when lipids are normal

88
Q

wide QRS

A

hyperkalemia, vfib

89
Q

12 lead (12 monkeys for 12 heart attacks)

A

differentiates between myocardial ischemia and infarction

90
Q

magnetic or tomography is

A

radionucleotide

91
Q

what test measures ejection fraction? (the ejact echos)

A

echocardiography

92
Q

catheter - how often to assess?

A

assessed every 15 minutes for an hour, every 30 minutes for an hour, and then every hour for 4 hours until pulses are stable

93
Q

AV carries to which bundle branch?

A

RBB

XIO (372 decks)

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