Health and Illness 2, Exam 1
S/S of hypomagnesemia
(High and fast) Tachycardia Dysrhythmias Chest pain Diarrhea Confusion Irritability Insomnia Numbness/seizures
normal lab value of potassium
3.5-5.0 mEq/L
What is Mitral valve regurgitation
A backflow of blood caused by failure of the heart's mitral valve to close tightly.
Mitral Valve Regurgitation
A backflow of blood caused by failure of the heart's mitral valve to close tightly. Back towards left atrium
What is DVT
A blood clot forms in a deep vein
What is aortic dissection?
A tear in the inner layer of the large blood vessel branching off the heart (aorta).
Which prescribed action would the nurse QUESTION when caring for a patient who has HF, with BP of 102/70, pulse 106, and lung crackles? A. Infuse normal saline B. Give furosemide IV C. administer potassium D. titrate oxygen by mask
A. Infuse normal saline
Anti-hypertensive drugs
Act on heart=Beta blocker, ACE, ARBS Reduce blood pressure, control rhythm
S/S of hypercalemia
Bone pain Arrhythmias Cardiac arrest Kidney stones Muscle weakness Excessive urination
S/S of digoxin toxicity
Bradycardia/tachycardia Anorexia Diarrhea Visual disturbances (yellow) Abdominal Cramps Nausea and vomiting
What specific labs are ordered for patients with mechanical heart valves? A) CBC and Blood Glucose Levels B) Platelet Count and Hgb C) PT/INR D) HCT and Potassium
C) PT/INR
Which concern when caring for a client prescibed furosemide 40mg every day in conjunction with dixogin would prompt the nurse to ask the health care provider about potassium supplement? A. Digoxin causes significant potassium depletion B. the liver destroys potassium as digoxin is detoxified C. lasix requires adequate serum potassium to promote diuresis D. digoxin toxicity occurs rapidly in the presence of hypokalemia
D. digoxin toxicity occurs rapidly in the presence of hypokalemia
which type of shock would the nurse monitor for a client with a ruptured AAA? A. obstructive B. neurogenic C. cardiogenic D. hypovolemic
D. hypovolemic
S/S of left-sided heart failure
Dyspnea (shortness of breath) Orthopnea (difficulty breathing when lying down) Cough Hemoptysis (pink or red sputum may be produced) Adventitious breath sounds (crackles) Pulmonary congestion
Sinus Bradycardia signs and symptoms
Fainting easily fatigued dizziness difficulty breathing confusion chest pain hypotension
S/S of hypernatremia
Flushed skin Restlessness Increased blood pressure Edema Dry mouth and less kidney output Skin flushed Agitation Low-grade fever Thirst
What causes inflammation of the pericarditis?
Heart attack Renal failure Virus
What does sodium do?
Increases the amount of fluid in the heart
What is atrial fibrillation?
Irregular, rapid heart beat
What is AAA rupture?
Is a bulge or swelling in the aorta
What is an LVAD?
Left ventricle assist device
What is Amlodipine
Lowers blood pressure by relaxing the muscles decreased SVR and arterial BP
What does vitamin K do for the heart?
Reduce arterial stiffness, slow progression of vascular and valvular calcification
What are ACE inhibitors?
Relax the blood vessels (dilate them) Reduce blood pressure
What is hydralazine?
Treat high blood pressure by widening the blood vessles
What is ventricular fibrillation?
Uncoordinated contraction of ventricular muscle fibers
Furosemide
Used to treat high blood pressure Helps excrete fluid from the kidneys Increase excretion of Na+ and Cl−
Angina
a condition of episodes of severe chest pain due to inadequate blood flow to the myocardium
What is CVD (Cardiovascular Disease)?
a disease of the heart and blood vessels
S/S of beta blockers
bradycardia hypotension wheezing GI effects weight gain depression fatigue sexual dysfunction
What does calcium do?
contribute to the electrical signal that coordinates the heart's function
What is CAD?
coronary artery disease
What do beta blockers do?
decrease activity of the heart Reduce adrenaline
What is dyspnea?
difficulty breathing
Hypermagnesemia
excess of magnesium in the extracellular fluid
hypercalemia
excessive calcium in the blood
What is hyperlipidemia?
high cholesterol
What is hyperkalemia
high potassium
Hypernatremia
high sodium
Endocarditis
inflammation of the inner lining of the heart
What is hematocrit?
the ratio of the volume of red blood cells to the total volume of blood
Reasons hypertension drug therapy may not be working
veractive renal nerve
What is mitral valve prolapse?
when the mitral valve doesn't close right Causes regurgitation
Medications for hyperlipidemia
Statins, nican
What is creatinine kinase?
See if there is muscle damage
What is digoxin toxicity
Take too much medication for heart conditions
Ventricular fibrillation pathophysiology and patient signs/symptoms
No rate, no p wave, no PR interval, no discernible rhythm, no QRS. Dizziness, dyspnea, and hypotension because of decreased CO, increase heart rate
What is metoprolol tartrate
Beta-blockers Reduce blood pressure Slows down the heart beat Reduces ischemia (blood flow) Decreases afterload
what is CVI caused by?
Caused by -DVT -valve deficiency/varicose veins -lack of muscular pump (sedentary/bed rest)
Which cardiac valve disorder causes a sudden onset of cardiovascular collapse A) Mitral valve stenosis B) Tricuspid valve disease C) Pulmonic valve stenosis D) Acute aortic regurgitation
D) Acute aortic regurgitation
Patients with mechanical heart valves require anticoagulation for.......? A) 6-months B) 2-years C) 90 days D) Indefinitely
D) Indefinitely
Which autoimmune disease can result in damage to the heart? A. uveitis B. rheumatic fever C. myasthenia gravis D. graves disease
B. rheumatic fever
The nurse provides education for a client who has recieved a prescription for spironolactone. The nurse concludes that the teaching is effective when the client plans to consume which type of juice? A. prune juice B. orange juice C. tomato juice D. cranberry juice
D. Cranberry
S/S of hyponatremia
Stupor/coma Anorexia Lethargic Tendon reflexes decreased Limp muscles Orthostatic hypotension Seizure Stomach cramping
Stage two hypertension
Systolic 140 or higher and diastolic 90 or higher
Stage one hypertension
Systolic between 130-139 and diastolic between 80-89
Furosemide side effects
1. hypotension 2. hypokalemia 3. gastrointestinal upset 4. weakness lithium gets too much, gets rid of gas
normal lab value of magnesium
1.3-2.1 mEq/L
Normal lab value of sodium
135-145 mEq/L
What is nitroglycerin?
A drug that helps dilate the blood(coronary) vessels that supply the heart with blood it decreases Angina, heart failure, and acute MI
Which action would the nurse implement first for a client whose serum potassium level has increased to 5.8? A. assess vitals B. call lab to repeat test' C. inform cardiac arrest team D. perform electrocardiogram
A. assess vitals
Which lab test is important for a nurse to monitor when a patient is admitted with acute coronary syndrome? A. troponin B. myoglobin C. homocysteine D. creatinine kinase
A. troponin
S/S of right-sided heart failure
Anorexia and Nausea Weight gain Hepatomegaly (enlarged liver) Edema in extremities Ascites (fluid in abdomen) Distended neck vein
Are patients with Aortic Stenosis-S.A.D A) Stenosis, ACE-Inhibitors, Diuretics B) Syncope, Angina, Dyspnea C) Systolic, Anginal, Dysrhythmias D) Syncope, Amlodipine, Dilation
B) Syncope, Angina, Dyspnea
The reversal agent for warfarin is? A) Protamine Sulfate B) Vitamin K C) Vitamin D D) Enoxaparin
B) Vitamin K
Which signs of hypokalemia would the nurse monitor in the postop surgical client with a nasogastric tube attached to continuous low suction? A. irritability B. dysrythmias C. muscle weakness D. abdominal cramps E. acidosis
B. Dysrhythmias and C. muscle weakness
When the nurse is auscultating a client's heart, where would S1 be loudest? A. base B. apex C. left lateral border D. right lateral border
B. apex
Which nursing action has the highest priority when providing care for a client who has had an acute MI? A. prevent nausea and vomiting B. monitor for cardiac dysrhythmias C. use prescribed medication to lower fever D. teach about the phases of cardiac rehab
B. monitor for cardiac dysrhythmias
Lab values to watch in patients with heart failure
BNP, metabolic panel, CBC, BUN, Creatinine, Glucose, Thyroid function
What is VTE
Blood clot forms in a vein
What is acidosis caused by?
Buildup of carbon dioxide in the blood that results from poor lung function or depressed breathing
Which drug would the nurse expect to be prescribed for a patient with a mechanical heart valve? A) Oral nitrates B) Atrial Anti-dysrhythmias C) Anticoagulants D) ACE inhibitors
C) Anticoagulants
Which statement accurately describes mitral valve prolapse? A) Rapid onset prevents left chamber dilation B) May be caused by pulmonary hypertension C) Buckling of the valve into the left atrium during ventricular systole D) Rapid development of pulmonary edema and cardiogenic shock
C) Buckling of the valve into the left atrium during ventricular systole
Which explanation would the nurse give about the purpose of the procedure when a client with angina is scheduled to have cardiac catheterization? A. to obtain the pressures in the heart chambers B. to determine the existence of congenital heart disease C. to visualize the disease process in the coronary arteries D. to measure the oxygen content of various heart chambers
C. to visualize the disease process
High blood pressure...
Can lead to higher chance of developing cardiovascular disease
What are MI signs and symptoms
Chest pain Upset stomach Lightheadedness Short of breath Excessive sweating
The nurse is reviewing the data of clients with prehypertension. Which client is at risk of stage 1 hypertension based on the data? A. normal cardiac output, increased hematocrit B. increased cardiac output, increased hematocrit C. decreased cardiac output, normal hematocrit D. normal cardiac output, normal hematocrit
Client B
S/S of hypocalcemia
Convulsions Arrhythmias (irregular heartbeat/rhythms) Tetany (muscle spasms) Stridor/spasms (wheezing sounds) tingling around the mouth and chovstek sign
Which medication would a nurse conclude is the cause of a decreased HR in a client receiving a cardiac glycoside, a diuretic, an angiotensin enzyme inhibitor, and a vasodilator? A. diuretic B. vasodilator C. ACE inhibitor D. cardiac glycoside
D. cardiac glycoside
What is syncope?
Fainting; passing out
Blood Sugar - Normal parameters
Fasting 74-106 mg/dL (4.1-5.9 mmol/L)Casual ≤200 mg/dL (<11.1 mmol/L)
S/S of hypertension
Fatigue Dizziness Nosebleeds Confusion SOB Palpitations
What is MI?
Heart attacked caused by a clogged artery
What affects O2 supply?
Heart rate, Contractility Wall tension
What does potassium do?
Helps trigger the heart to squeeze blood through the body "muscles"
What is Aortic Aneurysm caused by
High blood pressure or injury
M.O.N.A.
M- morphine O- oxygen N- nitrates A- aspirin
ESR and CRP
Markers in the blood that are a better indication of inflammatory
ADHF
New or worsening signs of heart failure
Atrial fibrillation pathophysiology
No P wave No PR interval But QRS wave is normal
Antibiotics
Non-steroid anti-inflammatory never give for virus
What is right sided heart failure?
Occurs when the right ventricle does not pump effectively (ineffective contractility) Other organs are affected by right sided heart failure
6 P's of acute arterial ischemia
Pain Pallor Paralysis Pulse deficit Paresthesia Poikilothermia
What is spironolactone?
Permotes extra sodium secretion edema of HF, hypertension, HF
What is a PVC?
Premature ventricular contraction P and QRS waves a bit odd
Anticoagulants
Prevent blood clot formation
Difference between Primary and Secondary HTN
Primary-unknown cause-usually due to lifestyle issue Secondary- specific cause, sudden development
Cardiomyopathy
Reduced amount of blood that goes to the rest of the body Ventricles aren't pumping enough
What is left sided heart failure?
Resulted from the LV unable to properly empty during the systole or fill properly during diastole *Pulmonary, lungs*
Indications for a pacemaker
Sinus node dysfunction (SND) High-grade atrioventricular (AV) block
S/S of hypermagnesemia
Slow and low (hypo, resps, and brady) EKC dysrhythmias hypoactive bowel sounds drowsiness and lethargy weakness
What is bradycardia?
Slow heart rate
What are Oral nitrates?
Vasodilators Dilated blood vessels for a better blood flow
Warfarin is...........
Vitamin K
Drug therapies of DVT and VTE
Warfarin, Analgesia
Diuretics
Water pill Help get rid of sodium and water
What is troponin?
cardiac marker used to detect an MI
What is CVI
disorder caused by damage to the parts of the brain that process vision
Assessment findings for infective endocarditis
elevated ESR and CRP
What is homocysteine?
elevated homocysteine increases your risks for dementia, heart disease and stroke
What is cardiac glycoside?
increase the output force of the heart decrease its rate of contractions acting on the cellular sodium-potassium ATPase pump.
Myocarditis
inflammation of the heart muscle Middle of the heart
pericarditis
inflammation of the sac surrounding the heart
Hypomagnesemia
insufficient amount of magnesium in the extracellular fluid
What is hypovolemic shock?
loss of too much blood/fluid in the body
hypokalemia
low potassium
Hyponatremia
low sodium in the blood
What does enalapril do?
lowers blood pressure and increases the supply of blood and oxygen to the heart. HF, left ventricular dysfunction
What does magnesium do?
modulating neuronal excitation, intracardiac conduction, and myocardial contraction
What is stenosis?
narrowing of a valve
Aortic Valve Stenosis
narrowing of the aortic valve
mitral valve stenosis
narrowing of the mitral valve from scarring, usually caused by episodes of rheumatic fever
What is post-thrombotic syndrome?
painful extremities, edema, stasis dermatitis, and skin ulcers Bein wall and vein valve damage
What is PAD?
peripheral artery disease thickening of the intima which reduces blood flow
What is myoglobin?
red pigment that stores oxygen