EXAM 2 B One min nurse questions

what is heparin antidote

protamine sulfate

How do antiplatelets work?

they prevent platelets from sticking to stents , "make blood less sticky"

What is an example of anticoagulant?

warfarin and heperin

A nurse is administering a beta blocker to a patient who has heart failure. Which statement may be part of the nurse's patient education?

"This medication will improve your survival and symptoms of heart failure." Beta blockers improve symptoms of heart failure and extend survival. Beta blockers lower heart rates and help do more than managing symptoms. Diuretics may be used to get rid of extra fluid in the body.

medications for HF

- ARBS, BBs, diuretics, digoxin

what value suggest HF?

BNP over 100

Which factors should be assessed prior to administering a loop diuretic? Select all that apply.

Blood pressure, Potassium level (hypotension, hypokalemia)

Which serum lab value can assist in diagnosing heart failure?

Brain natriuretic peptide (BNP); A BNP level over 100 suggests heart failure. BUN is not specific to heart failure, and blood pressure and cardiac catheterization are not serum lab values.

Which medication is an example of an antiplatelet?

Clopidogrel and apirin

How does digoxin work?

Digoxin increases cardiac contractility, making the heart pump more effectively.

Loop Diuretics

Furosemide (Lasix), bumetanide, torsemide, ehtocrynic acid treats fluid volume overload (first line option) --> specifically in heart failure, hypertension, and fluid overload potassium wasting (need baseline) get recent BP do not administer near the evening!

What is digoxin used to treat?

Heart failure and certain arrhytmias

A patient is ordered furosemide. What is a potential complication of this medication?

Hypotension (r/t volume loss) could cause the patient to become tachycardic

Which is not a common cause of heart failure?

Hypothyroidism CAD, MI, and hypertension can all lead to heart failure.

How does nitroglycerin work?

It vasodilates veins, arteries, and capillaries. improves blood flow to the heart

A patient is receiving nitroglycerin sublingually. How should the nurse instruct the patient to take this medication?

Let the pill dissolve under the tongue;

do you give digoxin if the HR is below 60

NO, could be digoxin toxicity check HR and electrolytes

Which lab value is used for warfarin

PT and INR (warfarin takes days to kick in)

How does the nurse assess the heart rate prior to administering digoxin?

The nurse must listen to the apical heart rate for 60 seconds. Digoxin should not be administered if the heart rate is less than 60 bpm.

A patient has an ejection fraction (EF) of 35%. What does this indicate?

The patient is in systolic heart failure An EF less than 40% indicates decreased cardiac output and pump failure, which means they have systolic heart failure. EF is preserved in diastolic heart failure. The heart is not optimally functioning, and the patient has already developed heart failure.

Upon assessment, the nurse notes a patient has crackles and dyspnea. What does this indicate?

The patient's left side of the heart is affected. Crackles and dyspnea result from a poorly functioning left side of the heart. If the right side is affected, fluid will back up into the rest of the body leading to an enlarged liver and spleen, ascites, and dependent edema. Crackles and dyspnea do not indicate if heart failure is systolic or diastolic.

1How do anticoagulants work?

Thin the blood to prevent clots and stop clots from getting bigger.

Which are key findings of digoxin toxicity?

Visual disturbances such as halos and nausea are signs of digoxin toxicity.

what is warfarin antidote?

Vitamin K

A patient is on a heparin infusion, which lab value is used to tritrate this medication

aPTT

what is an example of a thrombolytic

alterplase

what is magnesium toxicity antidote

calcium glucontate

What condition indicates the need to administer nitroglycerin?

chest pain Chest pain is an indication that there is a lack of oxygen in the coronary arteries. Nitroglycerin is administered to dilate the vessels to promote better blood flow. It is not indicated for headache, dizziness, or palpitations

How do thrombolytics work?

clot busters, dissolve clots

Which finding is not an adverse effect of nitroglycerin?

constipation hypotension, headache, weakness are all adverse effects associated with it

what is the digoxinantidote

digoxin immune fab bind to digoxin

Nitroglycerin

dilates the veins, arteries, and capillaries improving blood flow to the heart (get 02 where it needs to go) decreased pre load first lime choice for angina pectoris administered in many ways

what symptoms do we see with right sided HF?

fluid backing up into tissues and organs, edema in the legs, increased weight gain, JVD, fatigue, hypertension, hepatomegaly BACK UP INTO REST OF BODY (jugular vein distention-- BAD) right side-- rest of body

Systolic heart failure

heart failure with reduced ejection fraction; decreased blood from left ventricle with an increase in fluid overload EF is less than 40% which = decreased cardiac output and pump failure

digoxin

helps the heart pump harder used for patients with heart failure, and or cardiac arrhythmias

which intervention should be implemented for patients on any medications that increase the risk of bleeding?

monitor for dark stools (bleed gums, bruising, dark stools) other interventions include maintaining fall precautions, avoiding IM injections, and using electric razors

Which factor is an absolute contradiction to recieving thrombolytic

pregnancy also recent GI bleed, hemorrhagic stroke, a bleeding disorder, recent major surgery or trauma, intracranial vessel malformation, and uncontrolled hypertension

Diastolic heart failure

preserved ejection fraction; stiff ventricles resist filling which = the heart working harder EF > 50%= ventricles are unable to relax without proper filling

A nurse is administering nitroglycerin to a patient. What is the priority intervention?

stay with patient; It is important to stay with the patient to frequently monitor their vital signs and ensure safety. Monitoring vital signs every 15 minutes is too infrequent. There is no indication to send the patient to the cardiac catheterization lab, and incentive spirometry is not a priority for this patient.

heart failure

when structural or functional cardiac disorders lead the heart to not sufficiently pump everything to the rest of the body at first the body will try to compensate, and pump faster, but then the heart will reshape itself and just not function properly

Why do loop diuretics need to be pushed slowly when administered via intravenous (IV) push?

To prevent ototoxicity

what symptoms do we see with left sided HF?

pulmonary symptoms: congestion, edema/crackles, impaired gas exchange dyspnea, anxiety, orthopnea, dry hacking cough, S3 heart sound, fatigue THINK LEFT LUNG SYMPTOMS fluid will back up into lungs