cardiac
Anm urgent care nurse is treating a pt that has a rapid heart rate. What type of dysrythmia do they have?
Atrial fibrilation
Digoxin
- 0.5-2 mg/ml - Positive inotropic effect increases heart's contractions - Negatve chronotropic causes heart to beat slower - Allows heart to rest and pump more efficiently - Not first line: Used with ACE, diuretics - Toxicity: Increased with hypokalemia: N&V, vision
A pt is on telemetry with unstable angina, pain 7/10. How does the nurse administer nitroglycerin?
-Sublingually -3x every 5 minutes -It's a vasodilator -After 5 min and the pain is at a 3 you can still give it to them
A nurse plans to perform a blood transfusion. What do they need to have? (Select all that apply)
-Vital signs -18 gauge needle -Primary blood tubing with 5% dextrose -transfusing within 5 hours -Expiration date -name, DOB
What is the mean priority goal when lowering a bp percent when treating a pt for hypertensive emergency?
20-25%
What percentage of people on statins stop taking them within the first year?
50%
What is a risk factor for metabolic syndrome?
A large waist size or central obesity due to excessive abdominal fat is a risk factor for metabolic syndrome and increases the risk for developing diabetes and coronary artery disease.
A nurse is caring for a client with HTN and develops epistaxis. Which of the following actions should the nurse take? (Select all that apply) A. Apply pressure to the nares B. Place ice to the bridge of the client's nose C. Instruct the client to blow his nose D. Tilt the client's head backward E. Move the client into high-Fowler's position
A. Apply pressure to the nares B. Place ice to the bridge of the client's nose E. Move the client into high-Fowler's position
A nurse is providing teaching about a heart healthy diet to a group of clients with HTN. Which of the following statements by one of the clients indicates a need for further teaching? A. I may eat 10 ounces of lean protein each day B. Fresh fruits make a good snack option C. I will replace table salt with dried herbs D. I may thicken gravies with cornstarch as I cook
A. I may eat 10 ounces of lean protein each day
A nurse is providing teaching about the Mediterranean diet to a pt who has a new diagnosis of hypertension. Which of the following statements by the pt indicates a need for further teaching? A. I will limit my intake of red meat to twice weekly B. I can have dairy in moderate portions daily C. I can have fish two times a week D. I can drink wine in moderation
A. I will limit my intake of red meat to twice weekly
A nurse is caring for a pt who has PAD. Which of the following symptoms should the nurse expect to find in the early stage of the disease? A. Intermittent claudication B. Dependent rubor C. Rest pain D. Foot ulcers
A. Intermittent claudication
For uncomplicated hypertension and no specific indications for another medication, what is the initial medication? A. Thiazide diuretic B. Calcium channel blockers C. Vasodilators D. Angiotensin-converting enzyme inhibitors
A. Thiazide diuretic
A nurse is caring for a client who has a new diagnosis of essential hypertension. The nurse should monitor the client for which of the following findings that is consistent with this diagnosis? A. Vertigo B. Uremia C. Blurred Vision D. Dyspnea
A. Vertigo
A nurse is caring for a client who has HTN and is afraid to take his bp medication. Which of the following nursing statements is an example of the therapeutic communication response of reflection? A. You seem upset about taking your bp medication B. Why do you feel afraid to take your medication? C. You won't get better until you take your medication D. Did your symptoms occur before or after you took the medication?
A. You seem upset about taking your bp medication
Which term refers to chest pain brought on by physical or emotional stress?
Angina pectoris
A pt had a valve replacement and needs long term therapy. What medication will they be on?
Anticoagulant
Why would aspirin be prescribed for a pt with history if MI what is the action of this medication?
Antiplatelet aggregate
The nurse is preparing a male pt to have a 12-lead ECG preformed. When prepping the skin the nurse notices hat the pt has abundant chest hair. What is the most appropriate nursing intervention to improve adhesion of the ECG leads? A. Use alcohol swabs to clean the skin before applying the leads B. Clip the chest hair with the patient's permission before applying the leads C. Apply the leads to the arms and legs only D. Reschedule the ECG
B. Clip the chest hair with the patient's permission before applying the leads
A nurse is teaching a middle aged client about HTN. Which of the following information should the nurse include in the teaching? A. Reaching your goal bp will occur within two months B. Diuretics are the first type of medication to control HTN C. Limit your alcohol consumption to 3 drinks a day D. Plan to lower saturated fats to 10% of your daily calorie intake
B. Diuretics are the first type of medication to control HTN
What is a priority nursing assessment when caring for a pt in a hypertensive crisis receiving intravenous vasodilators? A. pain B. I&O C. vision D. family history
B. I&O
A nurse is caring for a client who is scheduled for an exercise stress test. Which of the following statements made by the client indicates to the nurse that the client requires further teaching? A. I will not smoke before my test B. I'll take my heart medications the morning of my test C. I'll get eight hours of sleep the night before the test D. I'll skip my coffee the morning of my test.
B. I'll take my heart medications the morning of my test
A nurse is assessing a male pt who has advanced peripheral artery disease (PAD). Which of the following findings should the nurse expect? A. Thin, pliable toenails B. Leg pain at rest C. Hairy legs D. Flushed, warm legs
B. Leg pain at rest
A nurse is teaching a client who has a new prescription for hydrochlorotiazide for management of HTN. Which of the following instructions should the nurse include? A. Take this medication before bed time B. Monitor for leg cramps C. Avoid grapefruit juice D. Reduce intake of potassium rich foods
B. Monitor for leg cramps
A nurse is caring for a client who has HTN and a potassium level of 6.8. Which of the following actions should the nurse take? A. Suggest that the client use a salt substitute B. Obtain a 12-lead ECG C. Advise the pt to add citrus juices and bananas to her diet D. Obtain a blood sample for a serum sodium level
B. Obtain a 12-lead ECG
A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his bp of 124/84 places him in which of the following categories? A. Within the expected range B. Pre-hypertension C. Stage 1 hypertension D. Stage 2 hypertension
B. Pre-hypertension
Hypertensive emergency
BP greater than 180/120 mm hg and must be lowered immediately to prevent damage to target organs -severe headache -blurred vission, dizziness, disorientation
A pt with multiple myeloma presents symptoms of?
Bone pain in the back of the ribs
Manifestations of left sided heart failure
Breathlessness due to pulmonary congestion
The nurse is providing education for a pt diagnosed with mitral valve prolapse (MVP). What should be included in the teaching plan? (select all that apply). A. MVP is not hereditary B. caffeine is tolerated in small amounts C. Avoid alcohol D. stop use of tobacco products E. Prophylactic antibiotics are not prescribed before dental procedures
C, D, E
A pt with a history of MI's is prescribed aspirin 325 mg. The nurse knows the aspirin was given due to which of the following actions of the medication? A. Analgesic B. Anti-Inflammatory C. Antiplatelet aggregate D. Antipyretic
C. Antiplatelet aggregate
A nurse is teaching an older adult pt who is post op following insertion of a permanent pacemaker. The nurse should instruct the pt to notify the provider about which of the following manifestations? A. Increased urine output B. Rapid pulse C. Fatigue D. Sneezing
C. Fatigue
A nurse is performing an ECG on a pt who is experiencing chest pain. Which of the following statements should the nurse make? A. You might feel a slight tingling while the test is being done B. the test will be complete in 30-60 minutes C. I will need to apply electrodes to your chest and extremities D. Te radioactivity from the dye only lasts a few hours
C. I will need to apply electrodes to your chest and extremities
A nurse in a clinic is caring for a pt who has a prescription for digoxin. Which of the following statements indicates the pt is experiencing digoxin toxicity? A. I am gaining weight B. I am constipated C. My vision seems yellow D. My tongue is red and beefy
C. My vision is yellow
A nurse is reviewing bp classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for development of HTN? A. High density lipoprotein (HDL) level of 70 mg B. A diet high in potassium C. Obstructive sleep apnea (OBA) D. Taking benazepril
C. Obstructive sleep apnea (OBA)
A nurse is caring for a pt with a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the pt is experiencing a MI? A. Check the pt's bp B. Auscultate heart tones C. Perform a 12-lead ECG Determine if pain radiates to the left arm
C. Perform a 12-lead ECG
A nurse is caring for a pt who came to the ED reporting chest pain. The provider suspects a MI. While waiting for the troponin levels report, the pt asks what this blood test will show. Which of the following explanations should the nurse provide the client? A. Troponin is an enzyme that indicates damage to brain, heart, and skeletal muscle B. Troponin is a lipid whose levels reflect the risk for CAD C. Troponin is a heart muscle protein that appears in the blood stream when there is damage to the heart D. Troponin is a protein that helps transport oxygen through out the body
C. Troponin is a heart muscle protein that appears in the blood stream when there is damage to the heart
When a pt is experiencing ventricular asystole...
Call a code and start CPR Ventricular asystole is characterized by no heart beat, no palpable pulse, and no respiration
A pt in the ER reports pain and swelling in lower legs, redness and rubor, fever, chills, and is sweating. e hit his leg ona care door a few days ago and it has gotten worse. History of chronic venous insufficiency. What do they have?
Cellulitus, treat with antibiotics
Disseminated intravascular coagulation (DIC) as result of septic shock, what would the nurse expect to see?
Excessive thrombosis and bleeding
What are the characteristics of atherosclerosis?
Fatty deposits in the arteries
Apical pulse area
Fifth intercostal space, left midclavicular line
If a pt complains of chest asprin after taking a sublingual nitroglycerin what action would the nurse take?
Give another nitroglycerin 5 minutes later
A pt develops V-Fib and is unresponsive, what should the nurse do?
Grab the defibrilator
Expected findings of right ventricle failure
Hepatomegally
A pts bp is 160/100 the physician diagnoses htn after reviewing these readings. The pt asks why it is important to treat htn since he doesn't have symptoms. What is the nurse's best response?
Htn increases your risk for stroke and heart disease
What disease increases your risk for a stroke?
Hypertension
What is the most common chronic disease among US adults?
Hypertension
A nurse is educating a pt on mitral valve prolapse. Which statement by the client indicates understanding?
I should avoid alcohol, tobacco, and caffeine
A pt having symptoms of unstable angina, which discomfort is associated with angina?
Ineffective cardiopulmonary tissue perfusion related to CAD
Pt with a pacemaker is not feeling good and isn't sleeping well. Nurse assesses Janeway lesions and splinter hemorrhages. What are these symptoms of?
Infective endocarditis
Which refers to muscle cramping like pain in extremities consistently reproduced with exercise and relieved with rest?
Intermittent clottication
A nurse is caring for a young pt with weakness, fatigue, and heavy periods. Their hemoglobin is 8. What do you suspect?
Iron deficient anemia
A nurse is teaching a pt about valve replacement surgery. Which statement indicates understanding of autograft replacement?
It is made of their own valve
The nurse is providing care for a pt that has high cholesterol dn triglyceride values. The appropriate teaching and goals would include LDL and HDL values which are?
LDL: 100 or 100-129 HDL 200 or 200-239
A nurse is assessing a man with PAD (peripheral arterial disease), what are some expected findings?
Leg pain at rest
PAD which of the following findings should the nurse expect?
Leg pain with rest
The nurse is caring for a pt who is scheduled for a mechanical valve replacement. The education that the nurse teaches the pt includes?
Long term anticoagulant therapy
A home health nurse is assessing a pt dx with lymphedema. The nurse includes the following at the visit:
Meticulous skin care, passive exercise, external compression devices, custom fitted graduated compression stockings or sleeves
When monitoring a pt on an ECG what would the nurse do if it starts beeping?
Monitor the pt
Digoxin
Must take apical pulse for 60 seconds, always call doctor if it is under 60 bpm
The nurse is planning care for a pt following a femoral artery cardiac catheterization which of the following actions should the nurse plan to take?
Neurovascular checks with vital signs
QT interval
Represents the total time for ventricular depolarization and repolarization, is measured from the beginning of the QRS complex to the end of the T wave. The QT interval varies with heart rate, gender, and age.
What is the universal blood type?
O
Pt enters the hospital with bleeding from a gastric ulcer and needs a blood transfusion. He has type O blood. What type of blood would he get?
O-
Pt enters the ED with symptoms of a MI. What do you first give them?
Oxygen
Depolarization
Process by which cardiac muscle cells change from a more negatively charged to a more positively charged intracellular state
Repolarization
Process by which cardiac muscle cells return to a more negatively charged intracellular condition, their resting state
Back flow of blood
Regurgitation
ST segment
Represents early ventricular repolarization, lasts from the end of the QRS complex to the beginning of the T wave
U wave
Represents repolarization of purkinje fibers (Appears with hypokalemia, hypertension, or heart disease)
P wave
Represents the electrical impulse starting in the SA node and spreading through the atria (atrial depolarization)
Raynauds dx
Result from reduced blood flow to the extreme with complaints of pale blue ajd painful suymppt when exposed to cold
Recognizing and promptly treating strep infections help prevent?
Rheumatic endocarditis
When we are reviewing the conduction system of the heart it usually originates where?
SA node
Electrical conduction of the heart
SA node, AV node, Bundle of His, Purkinje fibers
A 47 yo has a bp reading of 140/92 which classification or stage of htn are they in?
Stage 1 HTN
Pt complains of chest pain while shoveling snow and has history of smoking. What should the nurse educate this patient?
Stop smoking
A pt has dyspnea, chills, and back pain while receiving blood. What is the priority?
Stopping the transfusion
Most effective way to prevent Rheumatic heart disease
Strep test/preventing strep
Stroke volume
The blood ejected with each heart beat
What is the reason for heart failure?
The heart can't pump sufficient blood to meet the body's metabolic needs
A pt with an MI is diagnosed with having damage to a layer of their heart. What layer related to pumping action was damaged?
The myocardium
A pt with restricted cardiomyopathy taking digoxin has: anorexia, fatigue, nausea, headache, and is vomiting. What will happen?
Their dose will be decreased
Arterial insufficiency in elderly pts may cause which characteristics to the lower extremities?
Ulcers on pressure areas that are painful
atrial fibrillation
Uncoordinated atrial electrical activation that causes a rapid, disorganized twitching of atrial musculature
A pt is seen in the ED for severe pain related to sickle cell disease. What is occurring with this pt?
Vascular occlusion
What are the symptoms of sickle cell crisis?
Vascular occlusion in small vessels which cause severe pain
When the nurse is assessing a pt that is admitted with CVD which symptoms correlate with the pts diagnosis?
Weight gain, fatigue, chest pain
A pt with a history of an MI during his first visit to the cardiac unit says, "I don't know why I'm here, the damage is already done." What should the nurse say?
You're right, you can't undo the damage, but with rehab we can get you back to the activity level you were at before
A nurse is educating a pt diagnosed with heart failure. The nurse should teach about taking....
daily weights, same time every day
A nurse is caring for a pt who has infective endocarditis. Which of the following manifestations is the priority for the nurse to monitor for?
dyspnea
A pt that is dx with hypertension ask s the nurse what they can do to decrease the risk for cardiovascular problems the nurse states that age is a modifiable risk factor. True or false
false
PR interval
measured from beginning of P wave to beginning of QRS complex and represents the time needed for sinus node stimulation, atrial depolarization, and conduction through the AV node before ventricular depolarization
Syncope
passing out
SA node
primary pacemaker of the heart
when taking thiazide diuretics...
pt typically needs to be on potassium replacements
Valvular heart disorders
pts with valvular heart disorders must be on prophylactic antibiotics before invasive dental or respiratory procedures
QRS complex
represents ventricular depolarization
A pt with uncomplicated htn and no other health issues had made changes to their lifestyle and has seen no changes in lowering bp, what medication is likely to be prescribed?
thiazide diuretics
T wave
ventricular repolarization, when the cell regains a negative state, resting period