(3) All Cardiac

Question 0

Hypertension

💊 What common Diuretic used for the treatment of Hypertension is Potassium sparing?

Answer 0

Amiloride (Midamor)

Question 1

Hypertension

🚬 What are the causes of Secondary Hypertension?

Answer 1

▪️Cirrhosis
▪️Oral Contraceptives 
▪️Corticosteroids
▪️NSAID's
▪️Cushing Syndrome
▪️Hyperthroidism
▪️Renal Disease / Renal Artery Stenosis
▪️Hormone Replacement Therapy
▪️Sleep Apnea
▪️Brain Tumor or Brain Injuries
▪️Cocaine

Question 2

Hypertension

🍓 What eating plan is recommended to patients with Hypertension?

Answer 2

DASH Eating Plan

Question 3

Hypertension

What is the chemical term for Sympathetic?

Answer 3

Adrenergic

Question 4

Hypertension

🚬 What is the most common cause of Secondary Hypertension?

Answer 4

Cirrhosis

Question 5

Hypertension

💊 What is usually the initial medication used for the treatment of Hypertension?

Answer 5

Thiazide Diuretic (Diuril)

Question 6

Hypertension

😰💥 Hypertension Stage 1 is classified as?

Answer 6

SBP 140–159 or DBP 90–99

Question 7

Hypertension

🚨 Hypertensive Emergency is when BP rises rapidly and occurs over what time period?

Answer 7

Hours to Days

Question 8

Hypertension

🚨 Hypertensive Urgency is when the BP rises at a slower rate over what time period?

Answer 8

Days to Weeks

Question 9

Hypertension
♿️ Hypertension has a direct relationship with Cardiovascular Disease because it does what to the blood vessels that allow lipids into the lining of the vessels and cause plaque formation?

Answer 9

Inflames Blood Vessels

Question 10

Hypertension
🚬 If a patient has Atherosclerosis and their Hypertension goes away when the Atherosclerosis is treated, what kind of Hypertension do they have?

Answer 10

Secondary Hypertension

Question 11

Hypertension

📚 What should patients with Hypertension be taught about Hydrocholorothiazide (HCTZ) and Anti-Hypertensives?

Answer 11

▪️Take in the AM (Especially Diuretics)
▪️Eat Potassium rich foods
▪️Avoid NSAIDS because they↓effectiveness
▪️Rise slowly & sit for a few minutes before standing
▪️Sodium Restrictions

Question 12

Hypertension

😷 How do you determine which arm to take a BP in?

Answer 12

Take in both arms initially and use the arm that had the higher BP after

Question 13

Hypertension
😷 Because organs wont get enough blood flow if decreased too fast, the initial goal is to decrease the MAP by how much of the starting MAP?

Answer 13

25%

Question 14

Hypertension

💊 What drugs used for the treatment of Hypertension are powerful, usually IV drip, and is reserved for emergencies?

Answer 14

Direct Vasodilators

Question 15

Hypertension

💊 What common ACE Inhibitors are used for the treatment of Hypertension?

Answer 15

▪️Captopril (Capoten)

▪️Enalapril (Vasotec)

Question 16

Hypertension

📚 Weight loss of how many pounds may decrease SBP by approximately 5-20 mmHg?

Answer 16

22 lbs.

Question 17

Hypertension

😰 Why is Hypertension known as the “Silent Killer”?

Answer 17

Because in and of itself it has no S/S

Question 18

Hypertension
🚬 Men before the age of 45 have a higher risk for Hypertension than woman, but woman over what age have a higher risk than men?

Answer 18

> 64

Question 19

Hypertension

💊 What would cause rebound hypertension?

Answer 19

Stopping drugs abruptly

Question 20

Hypertension

🍓 What food does the DASH Eating Plan consist of?

Answer 20

▪️Fruits
▪️Vegetables
▪️Fat-Free or Low-Fat Milk
▪️While Grains
▪️Fatty Fish (Salmon)
▪️Poultry
▪️Beans
▪️Seeds & Nuts
▪️Low Sodium
▪️High Potassium

Question 21

Hypertension

💊 When a patient is hospitalized with Hypertensive Crisis, what IV drug therapy is titrated in an ICU setting?

Answer 21

Nitroprusside

Question 22

Hypertension

💊 How often is the BP monitored in patients being administered Direct Vasodilators?

Answer 22

Q5 Mins

Question 23

Hypertension

🚨 Besides the rate of rise, what is the difference between Hypertensive Emergency and Hypertensive Urgency?

Answer 23

Target organ disease is happening as the BP rises with Hypertensive Emergency. There is no clinical evidence of target organ disease with Hypertensive Urgency

Question 24

Hypertension

😰 What is more important than the absolute value of the BP in a Hypertensive Crisis?

Answer 24

Rate of rise

Question 25

Hypertension

📚 What lifestyle modifications are recommended to patients with Hypertension?

Answer 25

▪️Regular Physical Exercise
▪️Weight Reduction
▪️Avoidance of Tobacco Products
▪️Psychosocial Risk Factors

Question 26

Hypertension

😰💥 Prehypertension is defined as?

Answer 26

• Systolic BP: 120 to 139 mm Hg
OR
• Diastolic BP: 80 to 89 mm Hg

Question 27

Hypertension

💊 What are two common Adrenergic Inhibitors are used for the treatment of Hypertension?

Answer 27

▪️Clonidine (Catapress)

▪️Doxazosin (Cardura)

Question 28

Hypertension

💊 What common Angiotensin II receptor Blocker is used for the treatment of Hypertension?

Answer 28

Losartan (Cozaar)

Question 29

Hypertension

😰 What BP will Patients in a Hypertensive Emergency have?

Answer 29

> 220/140

Question 30

Hypertension
😰 Although Hypertension doesn’t have symptoms in and of itself, what type of Hypertension has symptoms, not because of Hypertension directly, but because it is affecting the hearts function?

Answer 30

Severe Hypertension

Question 31

Hypertension

😰 What are the clinical manifestations of a patient in a Hypertensive Emergency?

Answer 31

▪️Hypertensive Encephalopathy- Brain Damage (Headache, N/V, Seizures, Confusion, Coma)

▪️Renal Insufficiency

▪️Cardiac Decompensation (MI, HF, Pulmonary Edema)

▪️Aortic Dissection

Question 32

Hypertension

💊 What drugs used for the treatment of Hypertension have side effects that may be a reason for noncompliance?

Answer 32

▪️ACE Inhibitors - Dry hacking cough → Needs to be discontinued

▪️Beta Blockers- Impotence

Question 33

Hypertension

🚬 What is a common reason for a Hypertensive Crisis?

Answer 33

Medications were stopped abruptly

Question 34

Hypertension

💊 What are two common Beta Adrenergic Blockers given for the treatment of Hypertension?

Answer 34

▪️Metoprolol (Lopressor)

▪️Labetalol (Normodyne)

Question 35

Hypertension

🚬 What are the risk factors for Primary Hypertension?

Answer 35

▪️Age (Systolic rises with age)
▪️Alcohol
▪️Tobacco Use 
▪️Diabetes 
▪️Elevated Serum Lipid
▪️Excess Dietary Sodium
▪️Family History
▪️Obesity
▪️Sedentary Lifestyle 
▪️Socioeconomic Status
▪️Sustained Stress
▪️Gender
▪️Ethnicity

Question 36

Hypertension

🚬 What ethnicity is at greater risk for Hypertension?

Answer 36

African Americans

Question 37

Hypertension

🍓 What foods are high in Potassium?

Answer 37

▪️Bananas
▪️Citrus Fruit
▪️Dried Fruit
▪️Green Leafy Vegetables

Question 38

Hypertension

💊 What high risk OTC medications should patients with Hypertension be taught to avoid?

Answer 38

▪️Cold Medications / Decongestants
▪️Antacids that have a lot of sodium in them
▪️Appetite Suppressants (Raise BP)

Question 39

Hypertension

😷 What are the reasons for noncompliance in patients on medications to control Hypertension?

Answer 39

▪️Inadequate Teaching
▪️Side Effects
▪️Return to normal BP
▪️Lack of Motivation
▪️Financial 
▪️Lack of Trust in the Healthcare System

Question 40

Hypertension

What is the chemical term for Parasympathetic?

Answer 40

Cholinergic

Question 41

Hypertension

💊 When should patients take HCTZ and Anti-Hypertensives?

Answer 41

In the morning

Question 42

Hypertension

♿️ What organs are most frequently affected by Hypertension?

Answer 42

▪️Heart (Heart Attack)

▪️Brain (Stroke)

▪️Kidney (Renal Failure)

▪️Eyes (Blindness)

▪️Peripheral Vascular Disease

Question 43

Hypertension

😰💊 What two Diuretics are Potassium wasting and need a Potassium supplement or high potassium diet?

Answer 43

▪️HCTZ (Diuril)

▪️Furosemide (Lasix)

Question 44

Hypertension

😷 When should the nurse take a BP if the patient has “White Coat Syndrome”?

Answer 44

It means the patient gets anxious in healthcare settings so wait a little while and take the BP when they’re calmer.

Question 45

Hypertension

📚 What do you want to teach patients about Hypertension and how to manage it at home?

Answer 45

▪️Monitor BP at home & report elevations
▪️Lifestyle Modifications
▪️HTN may not have symptoms but its not curable
▪️Never stop drugs abruptly
▪️Never double up for missed doses
▪️High risk OTC medication

Question 46

Hypertension

💊 What common Calcium Channel Blocker is used for the treatment of Hypertension?

Answer 46

Amlodipine (Norvasc)

Question 47

Hypertension

💊 What is the treatment for Prehypertension?

Answer 47

Lifestyle Modifications

Question 48

Hypertension

🚬 If you stop smoking, the risk for Hypertension goes down after how long?

Answer 48

About a year

Question 49

Hypertension

😰💥 Hypertension is the persistent elevation of what?

Answer 49

○ Systolic blood pressure ≥140 mm Hg
	  OR
○ Diastolic blood pressure ≥90 mm Hg
     OR
○ Current use of antihypertensive drug(s)

▪️
▪️

Question 50

Hypertension

😰 What BP with Patients in a Hypertensive Urgency have?

Answer 50

> 180/110

Question 51

Hypertension

😰💥 Hypertension Stage 2 is classified as?

Answer 51

SBP ≥160 or DBP ≥100

Question 52

Hypertension
📈 Hypertension is persistent, so for it to be properly diagnosed, what else has to occur besides BP measurements within a certain range?

Answer 52

Average of 2 or more BP readings on 2 different office visits

Question 53

Hypertension
🚬 90% to 95% of patients with Hypertension have an elevated BP without an identifiable cause which is also known as what?

Answer 53

Primary Hypertension

Question 54

Hypertension

😰 What symptoms occur with Severe Hypertension?

Answer 54

▪️Fatigue
▪️Dizziness
▪️Palpitations
▪️Angina
▪️Dyspnea

Question 55

Hypertension

💊 What common Direct Vasodilator is used for the treatment of Hypertension in emergency situations?

Answer 55

Sodium Nitroprusside (Nipride)

Question 56

Hypertension

📈 What is the only way to diagnose Hypertension?

Answer 56

BP taken 2 or more times on 2 different occasions

Question 57

Abdominal Aortic Aneurysms

🚬 What can cause an Abdominal Aortic Aneurysm?

Answer 57

▪️Congenital Weakness of the Aorta
▪️Atherosclerosis in the Aorta
▪️Infection (Syphilis)
▪️Inflammation
▪️Trauma (Twisting motion causes tear)

Question 58

Venous Thromboembolism (VTE)
📈 A Duplex Ultrasound looks at what and will be positive with VTE?

Answer 58

Looks at blood flow through the veins

Question 59

Venous Thromboembolism (VTE)
🚬 Endothelial Damage, Venous Stasis, and Altered Coagulation are the risk factors for VTE and also known as what?

Answer 59

Virchow’s Triad

Question 60

Abdominal Aortic Aneurysms
♿️ What complication of an Abdominal Aortic Aneurysms is caused by embolized plaque or blood clot that travels down to the feet?

Answer 60

“Blue Toe Syndrome”

Question 61

Venous Thromboembolism (VTE)
💊 LMWH, UH, and Factor X Inhibitors are medications that prevent what?

Answer 61

Coagulation / Clotting of blood

Question 62

Abdominal Aortic Aneurysms

😰 What is the most common site for an Abdominal Aorta?

Answer 62

Below the renal artery

Question 63

Venous Stasis Ulcers

♿️ What complications could occur with Venous Stasis Ulcers?

Answer 63

▪️Infection
▪️Failure to Heal
▪️Lifelong Compression with Therapy Required

Question 64

Abdominal Aortic Aneurysms

💊 What medications are given to patients with Abdominal Aortic Aneurysms?

Answer 64

▪️Beta Blockers

▪️Antibiotics (Slows growth if theres an infection)

Question 65

Abdominal Aortic Aneurysms
😷 To avoid bending / flexion of the graft after surgical repair of AAA, elevation of the HOB should be limited to what degree?

Answer 65

45 degrees or less

Question 66

Venous Thromboembolism (VTE)
😷 Veins are squeezed / pushed by what when walking to get blood to the next valve and back to the heart?

Answer 66

Muscle

Question 67

Venous Thromboembolism (VTE)
🚬 What are examples of risk factors that could cause Venous Stasis?

Answer 67

▪️Dysfunctional Valves

▪️Inactive Muscles

Question 68

Venous Thromboembolism (VTE)
💉 What serologic study for VTE will be positive if there is a blood clot present in the body?

Answer 68

D-Dimer Blood Test

Question 69

Abdominal Aortic Aneurysms
😷 An Abdominal Aortic Aneurysm will continue to enlarge throughout the patients life, but what is the main way to keep it from getting bigger?

Answer 69

Keep BP down to a low range

Question 70

Venous Stasis Ulcers

😰 What S/S occur with Venous Stasis Ulcers?

Answer 70

▪️Aching Fatigue, Heaviness, & Swelling of Lower Extremities
▪️Irregular Shaped, Shallow, Open Sore Drainage
▪️Yellow Slough or Red Granulation
▪️Pigmentation Changes
▪️Itching, Cracking
▪️Pain
▪️Chronic Edema

Question 71

Venous Stasis Ulcers

🚬 What causes Venous Stasis Ulcers?

Answer 71

▪️Venous Insufficiency
▪️Venous Stasis
▪️Chronic Edema

Question 72

Venous Thromboembolism (VTE)
📚 What should patients with VTE be taught about Oral Contraceptive and Hormone use?

Answer 72

Stop taking them

Question 73

Venous Thromboembolism (VTE)
📚 How long should you recommend patients with VTE to wear stockings?

Answer 73

2 years

Question 74

Abdominal Aortic Aneurysms

😷 Post-op assessment for surgical repair of AAA includes monitoring for what?

Answer 74

▪️Change in pulses
▪️Cool / Cold Extremities
▪️White or Blue Extremities of Flank
▪️Severe Pain
▪️Abdominal Distention
▪️Decreased Urine Output

Question 75

Abdominal Aortic Aneurysms

💊 Surgery is not usually performed if an Abdominal Aortic Aneurysms is less than what size?

Answer 75

< 5.5 cm

Question 76

Venous Thromboembolism (VTE)
😷 The patient should walk for how long every 1-2 hours as a preventative measure for VTE?

Answer 76

10 minutes every 1-2 hours

Question 77

Venous Thromboembolism (VTE)
♿️ What is a complication of VTE?

Answer 77

▪️Pulmonary Embolism

▪️Postthrombotic Syndrome

Question 78

Venous Stasis Ulcers

😰 Where do Venous Stasis Ulcers often occur?

Answer 78

Medial aspect of the Ankle

Question 79

Venous Thromboembolism (VTE)
🚬 Patients with the combination of what risk factors are most likely to have strokes and blood clots in their veins?

Answer 79

Smoking + Oral Contraceptives

Question 80

Abdominal Aortic Aneurysms

😰 Abdominal Aortic Aneurysms may compress other organs resulting in what clinical manifestations?

Answer 80

▪️Back Pain
▪️Epigastric Pain
▪️Altered Bowel Elimination

Question 81

Venous Stasis Ulcers

😰 What pigment changes occur due to the breakdown of RBC’s?

Answer 81

Brownish Discoloration

Question 82

Abdominal Aortic Aneurysms

💊 At what size will surgery be performed on an Abdominal Aortic Aneurysms?

Answer 82

Usually at 6 cm

Question 83

Abdominal Aortic Aneurysms

😷 What occurs if BP is not maintained and gets too low or too high after surgical repair of AAA?

Answer 83

▪️Too Low = Clots

▪️Too High = Leaking in the graft

Question 84

Abdominal Aortic Aneurysms

😰 What signs of hemorrhage occur with rupture of Abdominal Aortic Aneurysms?

Answer 84

▪️Hypotension
▪️Tachycardia
▪️Pallor
▪️Confusion

Question 85

Abdominal Aortic Aneurysms

💊 What surgical treatment is most commonly used for larger or symptomatic Abdominal Aortic Aneurysms?

Answer 85

Open Aneurysm Repair w/ Graft

Question 86

Venous Thromboembolism (VTE)
💊 What can be used to prevent clots from going into the lungs if anticoagulation is contraindicated and should be removed once the danger is over?

Answer 86

Vena Cava Interruption (Filter)

Question 87

Venous Stasis Ulcers

😰 What causes a separation between the capillaries and the tissues and the tissues start to die?

Answer 87

Edema

Question 88

Venous Stasis Ulcers

🍓 What diet is recommended in patients with Venous Stasis Ulcers?

Answer 88

↑Protein, Zinc, Vitamin C, Iron

Question 89

Venous Thromboembolism (VTE)
🚬 What are examples of risk factors that could cause Endothelial Damage?

Answer 89

▪️Surgery
▪️Trauma
▪️Sepsis

Question 90

Venous Stasis Ulcers
😷 An Unna boot should not be applied too tight because it shrinks as it dries and takes some of the edema out and is left on for how long?

Answer 90

About a week

Question 91

Abdominal Aortic Aneurysms

♿️ What complications can occur after surgical repair of AAA?

Answer 91

▪️MI
▪️Hemorrhage
▪️Hypovolemia
▪️Renal Failure
▪️Respiratory Distress
▪️Paralytic Ileus

Question 92

Venous Thromboembolism (VTE)
💉 Oral Warfarin (Coumadin) should be taken for 3 months and the INR should be within what range?

Answer 92

2-3

Question 93

Venous Thromboembolism (VTE)
♿️ What is Postthrombotic Syndrome?

Answer 93

Persistent Venous Obstruction

Question 94

Abdominal Aortic Aneurysms

😰 What clinical manifestations occur with rupture of Abdominal Aortic Aneurysms?

Answer 94

▪️Severe Back Pain
▪️Ecchymosis
▪️Signs of Hemorrhage

Question 95

Venous Stasis Ulcers

😷 After debriding a Venous Stasis Ulcers, what is wrapped over the dressing?

Answer 95

Unna Boot

Question 96

Venous Thromboembolism (VTE)
🚬 What are the risk factors for VTE?

Answer 96

▪️Endothelial Damage
▪️Venous Stasis
▪️Altered Coagulation

Question 97

Venous Stasis Ulcers
😰 Venous Stasis Ulcers location differs from Arterial Ulcers because Arterial Ulcers are usually on the outside of the leg and over a bone and Venous StasisUlcers are usually located where?

Answer 97

Inner leg above the medial malleolus

Question 98

Venous Thromboembolism (VTE)
📚 What type of clothing should patients with VTE be taught not to wear?

Answer 98

Constrictive

Question 99

Abdominal Aortic Aneurysms

😷 How often is the size of the Abdominal Aortic Aneurysms monitored using US, CT, or MRI?

Answer 99

Once a year (Annually)

Question 100

Venous Thromboembolism (VTE)
💉 Patients with VTE should be taught to apply pressure for how long if bleeding occurs?

Answer 100

10-15 minutes

Question 101

Venous Thromboembolism (VTE)
💊 Thrombolytic Therapy, Angioplasty, Stents, and Mechanical Thrombectomy are used to dissolve or remove what type of clot?

Answer 101

Massive Clots

Question 102

Venous Thromboembolism (VTE)
😷 What are measures to prevent VTE?

Answer 102

▪️Early Ambulation (4-6x Daily)
▪️Elastic Compression Stockings
▪️Sequential Compression Devices (SCD’s)
▪️SubQ Heparin / LMWH or Warfarin (Coumadin) for extended therapy
▪️Periodic elevation of lower extremities above heart
▪️Active & Passive Exercises Q2 hr
▪️Avoid sitting or standing prolonged periods

Question 103

Venous Thromboembolism (VTE)
😰 Manifestations of lower extremity VTE are asymptomatic in many cases, but what clinical manifestations occur if the patient is symptomatic?

Answer 103

▪️Unilateral 
▪️Leg Edema - Sense of fullness in thigh or calf
▪️Pain / Tenderness when Palpating
▪️Dilated Superficial Veins
▪️Paresthesia 
▪️Warm Skin
▪️Erythema 
▪️Mild Fever

Question 104

Venous Thromboembolism (VTE)
🚬 What are examples of risk factors that could cause altered coagulation?

Answer 104

▪️Severe Anemia

▪️Smoking + Oral Contraceptives

Question 105

Abdominal Aortic Aneurysms

💊 Instead of performing surgery on an Abdominal Aortic Aneurysms < 5.5 cm, what risk factors are reduced?

Answer 105

▪️Maintain low / normal BP

▪️Annual Monitoring

Question 106

Venous Stasis Ulcers

😷 What type of dressing is used to promote healing in a moist environment for Venous Stasis Ulcers?

Answer 106

Hydrocolloid Dressing

Question 107

Buerger’s Disease / Thromboangitis Obliterans
Buerger’s Disease / Thromboangitis Obliterans is an autoimmune disorder where there is reoccurring inflammation of what vessels?

Answer 107

Arteries and Veins

Question 108

Cardiomyopathy

💊 What is the only cure for Cardiomyopathy if it is a permanent condition?

Answer 108

Cardiac Transplantation (Heart Transplant)

Question 109

Cardiomyopathy
♿️ Because the heart is too weak to generate a stroke volume, anyone with Cardiomyopathy also has what other cardiac dysfunction?

Answer 109

HF

Question 110

Cardiomyopathy

💊 What medication is used for the treatment of Cardiomyopathy?

Answer 110

Dobutamine Drip

Question 111

Raynaud’s Phenomenon

🚬 Raynaud’s Phenomenon is usually triggered by what?

Answer 111

Cold and Stress

Question 112

Buerger’s Disease / Thromboangitis Obliterans

🚬 What is a risk / aggravating factor of Buerger’s Disease / Thromboangitis Obliterans?

Answer 112

Tobacco

Question 113

Raynaud’s Phenomenon

📚 What do you want to teach patients with Raynaud’s Phenomenon?

Answer 113

▪️Avoid Triggers (Cold & Stress)
▪️Avoid Injury & Sharp Objects
▪️No Smoking
▪️Avoid Caffeine
▪️Warm Clothing (Glovers & Layer Clothes)

Question 114

Buerger’s Disease / Thromboangitis Obliterans

😰 Progressive occlusion of vessels in extremities results in what clinical manifestations?

Answer 114

▪️Pain
▪️Ischemic Changes
▪️Ulcerations
▪️Gangrene

Question 115

Raynaud’s Phenomenon
Raynaud’s Phenomenon
😰 Raynaud’s Phenomenon is a phenomenon not a disease but is also known as what syndrome due to its appearance?

Answer 115

White, Blue, Red Syndrome

Question 116

Cardiomyopathy

🚬 Cardiomyopathy may be primary (unknown) or secondary related to what?

Answer 116

▪️CHF
▪️Viral Infections
▪️Alcohol / Drug Abuse (Lg. Quantities over many years)
▪️Pregnancy
▪️Chronic Ischemia from CAD

Question 117

Raynaud’s Phenomenon

😰 Why is Raynaud’s Phenomenon described as White, Blue, Red Syndrome?

Answer 117

Color changes of extremities:
▪️Vasoconstriction (White)

▪️Cyanosis (Blue)

▪️Vasodilation (Red)

Question 118

Buerger’s Disease / Thromboangitis Obliterans

💊 What drugs are used for the treatment of Buerger’s Disease / Thromboangitis Obliterans?

Answer 118

▪️Vasodilators

▪️Anti-Platelets

Question 119

Buerger’s Disease / Thromboangitis Obliterans

🚬 Buerger’s Disease / Thromboangitis Obliterans most often occurs at what age in men?

Answer 119

20-35

Question 120

Raynaud’s Phenomenon
😰 Raynaud’s Phenomenon is intermittent arterial vaso-occlusion, usually of the fingertips or toes that usually last how long?

Answer 120

Episodes usually last about 20 mins

Question 121

Raynaud’s Phenomenon

💊 What Calcium Channel Blocker may be given to patients with Raynaud’s Phenomenon?

Answer 121

Nifedipine

Question 122

Raynaud’s Phenomenon

📚 What do you want to teach patients with Raynaud’s Phenomenon to do to decrease spasms?

Answer 122

Immerse hands in warm water

Question 123

Raynaud’s Phenomenon

😰 Sudden vasoconstriction of the vessels in the extremities results in what clinical manifestations?

Answer 123

▪️Color Changes
▪️Numbness
▪️Tingling
▪️Burning Pain

Question 124

Peripheral Artery Disease
💊 What is used to dissolve the clot when using Percutaneous Catheter-Directed Thrombolytic Therapy for the treatment of Acute Arterial Ischemia?

Answer 124

tPA or Urokinase

Question 125

Peripheral Artery Disease

😰 A build up of what causes PAD pain?

Answer 125

Lactic Acid

Question 126

Peripheral Artery Disease

😷 What risk factor modifications can be made to prevent PAD?

Answer 126

▪️Tobacco Cessation
▪️Aggressive treatment of Hyperlipidemia
▪️BP maintained < 140/90
▪️Glycosylated Hemoglobin < 7% - Control Diabetes

Question 127

Peripheral Artery Disease

💊 What drug therapy is used for patients with PAD?

Answer 127

▪️ACE Inhibitors

▪️Anti-platelet Agents

Question 128

Peripheral Artery Disease

😰 What may develop between the toes or on bony prominences on the top of the feet in patients with PAD?

Answer 128

Ischemic Arterial Ulcers

Question 129

Peripheral Artery Disease

💊 If Heparin is used during procedures, what reversal agent must be kept at the bedside?

Answer 129

Protamine Sulfate

Question 130

Peripheral Artery Disease

What are the two common sites for Atherosclerotic Lesions?

Answer 130

▪️Bifurcations (Branch / Fork in iliac crest area)

▪️Femoral Area (Behind the knee at the Popliteal Artery)

Question 131

Peripheral Artery Disease

📚 What do you want to teach patients with Intermittent Claudication about exercise?

Answer 131

Exercise to the point that it hurts and then rest but should continue to exercise.

Question 132

Peripheral Artery Disease

🚬 What are the risk factors for PAD?

Answer 132

▪️Smoking
▪️HTN
▪️Hyperlipidemia
▪️Diabetes

Question 133

Peripheral Artery Disease

😰 What position may decrease PAD pain?

Answer 133

Dangling

Question 134

Peripheral Artery Disease

📚 What should patients with PAD be encouraged to do to improve peripheral arterial circulation?

Answer 134

▪️Exercise (Walking & Graded Isometric Exercises

▪️Don’t bend at the groin

▪️Temperature considerations

▪️Stop Smoking

▪️Stress Reduction

Question 135

Peripheral Artery Disease

💊 What drug therapy is used for the treatment of Intermittent Claudication?

Answer 135

▪️Cilostazol (Pletal) -↑Vasodilation

▪️Pentoxifylline (Trental)

Question 136

Peripheral Artery Disease

💊 What is often a long term need after surgical treatment for Acute Arterial Ischemia?

Answer 136

Oral Anticoagulation

Question 137

Peripheral Artery Disease

📚 What should the patient be taught NOT to do after bypass surgery for the treatment of PAD?

Answer 137

▪️Bending
▪️Sitting in a Chair
▪️Cross legs at ankles or knees

Question 138

Peripheral Artery Disease

😰 How does the skin appear in patients with PAD due to decreased oxygen and nutrients?

Answer 138

▪️Shiny
▪️Thin
▪️Taut
▪️Loss of Hair

Question 139

Peripheral Artery Disease

😷 How long after bypass surgery for treatment of PAD should the patient ambulate?

Answer 139

Out of bed on the first day to promote blood flow through the graft

Question 140

Peripheral Artery Disease

😰 How does pain of Arterial Ulcers compare to Venous Ulcers?

Answer 140

Arterial Ulcers are more painful

Question 141

Peripheral Artery Disease
💊 What non-surgical procedure used for the treatment of PAD uses a cutting disc, laser, or rotating diamond tip device to cut or grind down plaque?

Answer 141

Atherectomy

Question 142

Peripheral Artery Disease
😰 What is the patient experiencing if they have pain in the calf / major muscle during exercise (even walking) which subsides with rest?

Answer 142

Intermittent Claudication

Question 143

Peripheral Artery Disease

💊 What ACE Inhibitor is used for the treatment of PAD?

Answer 143

Ramipril (Altace)
↓Cardiovascular Morbidity & Mortality
↑Peripheral Blood flow, ABI, & Walking Distance

Question 144

Peripheral Artery Disease

💊 Besides bypass surgery, what other surgical therapy can be used for the treatment of PAD?

Answer 144

▪️Endarterectomy- Scalpel removes inner lining of artery

▪️Patch Graft Angioplasty- Tissue lining the vessel is missing

▪️Amputation- Last effort. Severe pain at rest & infection

Question 145

Peripheral Artery Disease

😰 Lack of blood flow and oxygen may cause what S/S in patients with PAD?

Answer 145

Numbness and Tingling - Nerve endings are being damaged

Question 146

Peripheral Artery Disease

💊 What is the only drug that actually thins the blood by making RBC’s more flexible and slippery?

Answer 146

Pentoxifylline (Trental)

Question 147

Peripheral Artery Disease
📚 Because patients with PAD may not have full feeling in their feet, what should they be instructed to do to warm their feet?

Answer 147

Use a couple of blankets

Question 148

Peripheral Artery Disease

💊 What non-surgical interventional Radiology Procedures can be used on patients with PAD?

Answer 148

▪️Percutaneous Transluminal Balloon Angioplasty (PTA)
▪️Atherectomy
▪️Cryoplasty

Question 149

Peripheral Artery Disease

😷 What are the 6 P’s?

Answer 149

▪️Pain
▪️Pallor
▪️Pulselessness
▪️Paresthsia (Pins & Needles feeling)
▪️Paralysis
▪️Poikilothermia / Cold (Polar)

Question 150

Peripheral Artery Disease
💊 What is the most common surgical approach used for treatment of PAD which uses a vein or synthetic graft to bypass blood around the lesion and may be used in combination with PTA?

Answer 150

Peripheral Artery Bypass with Autogenous (their own vein)

Question 151

Peripheral Artery Disease

📈 What common test used for PAD is a noninvasive ultrasound sensor to view arterial blood flow?

Answer 151

Doppler

Question 152

Peripheral Artery Disease

😷 What areas should be checked for good circulation on patients with PAD after bypass surgery?

Answer 152

6 P’s distal to surgical site

Question 153

Peripheral Artery Disease

🚬 Patients with what advanced disease are likely to have PAD?

Answer 153

CAD

Question 154

Peripheral Artery Disease

📚 What type of footwear should patients with PAD use to protect their feet?

Answer 154

▪️Cotton or Wool Socks
▪️Round Toe Shoes
▪️Shoes Tied Loosely

Question 155

Peripheral Artery Disease

🍓 What diet modifications should be made for patients with PAD?

Answer 155

↓Fat

↓Cholesterol

Question 156

Peripheral Artery Disease

📚 What should patients with PAD be taught about proper care of feet?

Answer 156

▪️Check feet daily
▪️Protect extremities
▪️Never soak the feet
▪️Contact HCP with any injury or inflammation to the feet

Question 157

Peripheral Artery Disease

😰 If patients with Intermittent Claudication sit down and rest, how long will it take for the pain to go away?

Answer 157

About 10 mins

Question 158

Peripheral Artery Disease

🚬 PAD is a slow progressive disease that usually affects men over what age?

Answer 158

> 50

Question 159

Peripheral Artery Disease

😰 PAD pain is usually bilateral and distal to what?

Answer 159

Obstruction

Question 160

Peripheral Artery Disease

♿️ Without immediate intervention, Acute Arterial Ischemia may progress to necrosis and gangrene within how long?

Answer 160

A few hours

Question 161

Peripheral Artery Disease
💊 Besides Surgical Thrombectomy which is recommended, what other surgical procedures can be used for the treatment of Acute Arterial Ischemia?

Answer 161

▪️Percutaneous catheter with direct Thrombolytic Therapy

▪️Percutaneous Mechanical Thrombectomy (Pull thrombus out)

▪️Surgical Bypass

Question 162

Peripheral Artery Disease

💊 What anti-platelet drugs are given for PAD?

Answer 162

▪️Aspirin (1 per day)

▪️Clopidogrel (Plavix)

Question 163

Peripheral Artery Disease

😰 What skin changes occur in patients with PAD when their extremity is dependent?

Answer 163

Rubor & Cyanotic

Question 164

Peripheral Artery Disease
♿️ Embolism, Thrombosis of Plaque, and trauma can cause Acute Arterial Ischemia in patients with PAD but the most frequent cause of Acute Arterial Ischemia is embolization of thrombus from what area?

Answer 164

Heart

Question 165

Peripheral Artery Disease

💊 What anticoagulant is administered in patients with Acute Arterial Ischemia?

Answer 165

Lovanox SubQ

Question 166

Peripheral Artery Disease
💊 What non-surgical procedure used for the treatment of PAD involves the insertion of a catheter through the femoral artery that presses plaque back into the lining of the vessel and a stent is usually placed?

Answer 166

Percutaneous Transluminal Balloon Angioplasty (PTA)

Question 167

Peripheral Artery Disease
💊 What non-surgical procedure used for the treatment of PAD uses liquid nitrous oxide and a balloon to freeze anything it touches and causes plaque to disintegrate?

Answer 167

Cryoplasty

Question 168

Peripheral Artery Disease

😰 PAD pain is usually described as what type of pain?

Answer 168

Ischemic Pain in the legs
▪️Aching
▪️Cramping
▪️Burning

Question 169

Peripheral Artery Disease

💊 What are the indications for non-surgical interventional Radiology procedures in patients with PAD?

Answer 169

▪️Intermittent Claudication symptoms become incapacitating
▪️Pain at rest
▪️Ulcerations or Gangrene severe enough to threaten viability of the limb

Question 170

Peripheral Artery Disease

😰 What skin changes occur in patients with PAD when their extremity is elevated?

Answer 170

Cold and Pale

Question 171

Peripheral Artery Disease

💊 To prevent the breakdown which will cause the patient to bleed out, how should Protamine Sulfate be stored?

Answer 171

Must be kept refrigerated

Question 172

Peripheral Artery Disease

💊 What surgical therapy is used to redirect blood from the Femoral Artery to the Popliteal Artery?

Answer 172

Fempop Bypass

Question 173

Peripheral Artery Disease

😰 When auscultating, the Peripheral Pulses may be decreased, absent, or what sound may be heard?

Answer 173

Bruit

Question 174

Peripheral Artery Disease

The biggest problem for people with PAD is getting blood to what area of the body?

Answer 174

Feet because theres a blockage in the way

Question 175

Peripheral Artery Disease

💊 What treatment is recommended for Acute Arterial Ischemia?

Answer 175

Surgical Thrombectomy

Question 176

Peripheral Artery Disease

😰 In advanced PAD, what placement of the lower extremities may aggravate the pain?

Answer 176

Elevation or Horizontal

Question 177

Valvular Disorders

🚨 What occurs if a patient with Aortic Valve Stenosis is given Nitroglycerin?

Answer 177

Blood vessels coming off aorta are dilated and theres very little blood volume so the patient will bottom out and likely die because they have no BP

Question 178

Valvular Disorders

💊 Where does Autograft come from?

Answer 178

Patients own tissue

Question 179

Valvular Disorders

📈 What is the gold standard for diagnosing Valvular Disorders except Aortic Valve Disease?

Answer 179

Transesophageal Echocardiogram (TEE)

Question 180

Valvular Disorders
💊 What type of replacement valve does not deteriorate or become infected as easily but are thrombogenic and require life-long anticoagulation therapy?

Answer 180

Mechanical Valves

Question 181

Valvular Disorders

♿️ Calcification causes stenosis or regurgitation of what Valve?

Answer 181

Mitral - Mitral Stenosis & Mitral Regurgitation

Question 182

Valvular Disorders

💊 What surgical procedure inflates a balloon on a catheter to stretch the valve opening?

Answer 182

Percutaneous Transluminal Balloon Valvuloplasty (PTBV)

Question 183

Valvular Disorders

💊 Xenograft, Homograft, and Autograft are what type of replacement valves?

Answer 183

Tissue / Biologic Valves

Question 184

Valvular Disorders

💊 How long do Mechanical Valves last?

Answer 184

20-30 years

Question 185

Valvular Disorders

📈 Why is a TEE the gold standard for diagnosing Valvular Disorders?

Answer 185

Esophagus is a better view of valves than from the front of the chest where do an Echocardiogram.

Question 186

Valvular Disorders

💊 Where does Xenograft come from?

Answer 186

Pig or cow valve

Question 187

Valvular Disorders

What valve disorder occurs when the valve does not OPEN completely and blood flow through the valve is reduced?

Answer 187

Stenosis

Question 188

Valvular Disorders

💊 What type of replacement valve is used for patients > 65 years old?

Answer 188

Tissue / Biologic Valves

Question 189

Valvular Disorders

💊 Surgical Interventions such as Valvuloplasy or Valve Replacement may be used if patient is what?

Answer 189

Symptomatic

Question 190

Valvular Disorders

💊 What type of drugs may be used for patients with Valvular Disorders before invasive procedures?

Answer 190

▪️Antibiotics

▪️Anticoagulants (Especially with Mitral Stenosis)

Question 191

Valvular Disorders

📈 What diagnostic study can be used to identify the degree of the disease by measuring pressures?

Answer 191

Cardiac Catheterization

Question 192

Valvular Disorders

📈 What is the gold standard for diagnosing Aortic Valve Disease?

Answer 192

CT with Contrast

Question 193

Valvular Disorders

💊 What medication should be used with caution in patients with Aortic Valve Stenosis?

Answer 193

Nitroglycerin

Question 194

Valvular Disorders

📈 What is a common heart rhythm in patients with valve disorders?

Answer 194

Atrial Fibrillation w/ irregular pulse (Quiver)

Question 195

Valvular Disorders
😰 The prognosis for Aortic Valve Stanosis is very poor because the valves narrow over time so symptoms do not occur until the valve is how much of its normal size?

Answer 195

1/3

Question 196

Valvular Disorders

♿️ With what valve disorder does the blood come back into the left ventricle when going into the Aorta?

Answer 196

Aortic Valve Regurgitation

Question 197

Valvular Disorders

Where leaflets come together is called what?

Answer 197

Commissures

Question 198

Valvular Disorders
♿️ With what valve disorder does blood get pumped back up into the L. Atrium when the Ventricle is trying to pump blood into the Aorta?

Answer 198

Mitral Regurgitation

Question 199

Valvular Disorders

😰 What is a common sound heard over the heart with valve disorders?

Answer 199

Murmur

Question 200

Valvular Disorders

🚬 What are common causes of valve disorders in older adults?

Answer 200

▪️Cardiovascular Disease
▪️Rheumatic Heart Disease (Strep Infection)
▪️Ruptured Papillary Muscle (From a MI)
▪️Syphilis

Question 201

Valvular Disorders
💊 What surgical procedure forces the valve leaflets to open by tearing them apart from each other using an instrument and can be used on any kind of stanotic valve?

Answer 201

Commissurotomy

Question 202

Valvular Disorders

♿️ What complication occurs in acute situations of Aortic Valve Regurgitation?

Answer 202

They start having HF and eventually go into shock

Question 203

Valvular Disorders

😰 When valves aren’t working efficiently, S/S of what dysfunction may appear?

Answer 203

L. Sided HF

Chronic Valve problems = May see S/S of both L & R Sided HF

Question 204

Valvular Disorders
♿️ With what valve disorder does pressure build in the L. Ventricle, L. Atrium and Lungs causing Pulmonary Edema and L. Sided HF?

Answer 204

Aortic Valve Stenosis

Question 205

Valvular Disorders

😷 What is the major concern if Atrial Fibrillation develops?

Answer 205

Maintaining CO

Question 206

Valvular Disorders
♿️ With what valve disorder does the heart have to pump twice as hard to the same amount of CO causing the L. Ventricle to dilate and eventually Hypertrophy?

Answer 206

Aortic Valve Regurgitation

Question 207

Valvular Disorders
💊 What surgical procedure uses a catheter to push the valve aside to insert an artificial valve and is used in older adults or patients that are going to have post-op complications?

Answer 207

Transcatheter Heart Valve Replacement

Question 208

Valvular Disorders

💊 How long will patients with Mechanical Valves and Nonbiologic Valves be on anticoagulants?

Answer 208

The rest of their life

Question 209

Valvular Disorders

♿️ The goal for Valvular Disorders is to prevent, monitor for, and manage what complication?

Answer 209

HF

Question 210

Valvular Disorders

📚 What can the patient be taught to do so that HF does not rapidly get worse?

Answer 210

REST! The more they do, the worse the will go into HF

Question 211

Valvular Disorders

💊 What are the two types of replacement valves?

Answer 211

Mechanical and Tissue / Biologic Valves

Question 212

Valvular Disorders

What Valve disorder occurs when the valve does not CLOSE properly and back flows through the valve?

Answer 212

Regurgitation

Question 213

Valvular Disorders

💊 What drug therapy is used for patients with Valvular Disorders?

Answer 213

▪️Diuretics (To prevent HF)
▪️Vasodilators
▪️Beta Blockers
▪️Calcium Channel Blockers
▪️Antibiotics
▪️Anticoagulants

Question 214

Valvular Disorders

♿️ Mitral Stenosis, Mitral Regurgitation, and Mitral Valve Prolaspse causes blood to back up in what area of the heart?

Answer 214

Left Atrium

Question 215

Valvular Disorders
💊 What medication may be given prophylactically to patients with an irregularity inside their heart chambers if a foli catheter is being inserted?

Answer 215

Prophylactic Antibiotic Therapy - May be given with any invasive procedure because if any bacteria gets in the blood stream, its going to attach itself to the irregularities inside the heart

Question 216

Valvular Disorders
♿️ With what valve disorder does the L. Atrium fill with blood, becomes distended, blood backs up into the lungs and causes L. Sided HF?

Answer 216

Mitral Stenosis

Question 217

Valvular Disorders

💊 Where does Hemograft come from?

Answer 217

Human Valve

Question 218

Valvular Disorders

💊 How long do Tissue / Biologic Valves usually last before they start deteriorating?

Answer 218

10 years at the earliest

Question 219

Valvular Disorders

Valve disorders primarily occur on what side of the heart?

Answer 219

Left Side of the Heart

Question 220

Valvular Disorders
💊 What surgical therapy is used for the treatment of regurgitant valves by suturing and tightening the annulus so that leaflets are touching?

Answer 220

Annuloplasty

Question 221

Valvular Disorders

🚬 Regurgitation and Stenosis of the valves are usually found in children and adolescents due to what?

Answer 221

Congenital Defects

Question 222

Valvular Disorders

♿️ Aortic Valve Stenosis and Aortic Valve Regurgitation cause blood to back up in what area of the heart?

Answer 222

Left Ventricles

Question 223

Endocarditis

😰 What manifestation of Arterial Embolization causes tiny bleeding points in the nail bed?

Answer 223

Splinter Hemorrhage

Question 224

Endocarditis
😰 What manifestation of Arterial Embolization are superficial hemorrhages from embolization and are common in conjunctiva due to high pressure?

Answer 224

Petechiae & Purpura

Question 225

Pericarditis

📈 The heart should be no more than how much the width of the chest cavity?

Answer 225

1/2 the width of the chest cavity

Question 226

Pericarditis

😰 What is often heard at the lower left sternal boarder when auscultating the heart of a patient with Pericarditis?

Answer 226

Pericardial Friction Rub - Heard better when PT leans forward

Question 227

Endocarditis

😰 What is Purpura?

Answer 227

Large Petechiae

Question 228

Endocarditis
♿️ What precursor to Endocarditis is an infection that gets into the heart as a result of a strep infection and makes the heart prone to infection from that point on?

Answer 228

Rheumatic Carditis

Question 229

Pericarditis

💊 What medications are given for the treatment of Pericarditis?

Answer 229

▪️Antibacterial (If no MI occurred)
▪️NSAIDS or Steroids for pain
▪️Anti-Inflammatory (Indocin)

Question 230

Pericarditis
😰 Although there are often no symptoms with Pericardial Effusion, what symptoms occur once a large amount of fluid has collected over time?

Answer 230

They will show signs of↓CO
▪️Pallor / Cyanosis 
▪️Cold
▪️Clammy
▪️↓Urine Output
▪️Prolonged Capillary Refill
▪️Confusion
▪️↓BP
▪️↑HR
▪️Diaphoresis

Question 231

Pericarditis

😰 What clinical manifestation is the classic sign of Tamponade?

Answer 231

Muffled Heart Sounds - Cant hear through fluid

Question 232

Endocarditis

😰 Splenic Infarction that occurs with Endocarditis is sudden LUQ pain that radiates to what area?

Answer 232

Shoulder

Question 233

Pericarditis

😰 What are the findings of Cardiac Tamponade?

Answer 233

▪️Jugular Vein Distention
▪️↑Central Venous Pressure (CVP)
▪️Paradoxical Pulse
▪️Muffled Heart Sounds
▪️Circulatory Collapse - They go into HF
▪️↓CO

Question 234

Pericarditis

What are the different types / forms of Pericarditis?

Answer 234

▪️Fibrous (Scar Tissue & Debris)
▪️Serous (Fluid)
▪️Hemorrhagic (Inflamed blood vessels bleeding)
▪️Purulent (Puss)
▪️Neoplastic (Cancer on surface of Heart)

Question 235

Pericarditis

💊 Antibacterials are given to patients with Pericarditis unless the inflamed pericardium is a result of what?

Answer 235

MI

Question 236

Endocarditis

Endocarditis is a microbial infection of what organisms inside the endocardium (inner later of the heart)?

Answer 236

Virus, Bacteria, or Fungi

Question 237

Pericarditis

♿️ What can cause Chronic Pericarditis?

Answer 237

▪️TB
▪️Radiation Therapy
▪️Trauma
▪️Renal Failure
▪️Metastatic Cancer

Question 238

Pericarditis

😰 When does pain caused by Pericarditis get worse?

Answer 238

Taking a deep breath

Question 239

Pericarditis

😷 What is used to monitor patients with Cardiac Tamponade?

Answer 239

Hemodynamic Monitoring System

Question 240

Endocarditis
♿️ What is it called when vegetation on the left side of the heart breaks loose into the arterial system and gets caught in a barrow blood vessel?

Answer 240

Arterial Embolization

Question 241

Endocarditis

🚬 Who does Endocarditis commonly occurs in?

Answer 241

▪️Older adults w/ Aortic Stanosis (50%)
▪️History of Rheumatic Carditis (20%)
▪️IV Drug Users
▪️People w/ Prosthetic Heart Valves
▪️People who have Intravascular Procedures
▪️People on Renal Dialysis

Question 242

Pericarditis

😰 What Paradoxical Pulse changes occur with Cardiac Tamponade?

Answer 242

10 mm higher on expiration than on inspiration

Question 243

Pericarditis

💊 What treatment is used for Cardiac Tamponade?

Answer 243

Rapid Pericardiocentesis

Question 244

Endocarditis

💊 What medication is used for the treatment of Endocarditis?

Answer 244

Antimicrobials

Question 245

Pericarditis

Pericarditis is inflammation or alteration that occurs in what area of the heart?

Answer 245

Outside the Heart (Pericardial Membrane, Pericardial Sac, & Surface of the Heart)

Question 246

Pericarditis

😰 What is the main / primary symptom of Pericarditis?

Answer 246

Pain

Question 247

Endocarditis

😰 Arterial Embolization occurs in up to half of patients with Endocarditis and manifest as what?

Answer 247

▪️Petechiae
▪️Splinter Hemorrhages
▪️Janeway Lesions

Question 248

Pericarditis

📈 What diagnostic test is used with Pericardial Effusion because it can differentiate between muscle and fluid?

Answer 248

Echocardiogram

CT Scan or MRI may also be used

Question 249

Pericarditis
😰 What can be heard in Fibrous forms of Pericarditis due to scar tissue and debris that build up around the heart from chronic inflammation?

Answer 249

Friction Rub

Question 250

Endocarditis
😰 What manifestation of Arterial Embolization causes non-painful, red-blue macular lesions on the palms and soles of feet?

Answer 250

Janeway Lesion

Question 251

Pericarditis
🚨♿️ What complication of Pericardial Effusion is a medical emergency and occurs as a result of decreased CO due to fluid constricting / squeezing the heart?

Answer 251

Cardiac Tamponade

Question 252

Pericarditis

😰 What will the Central Venous Pressure be with Cardiac Tamponade?

Answer 252

> 8 mmHg

Question 253

Pericarditis

😰 Where is pain from Pericarditis located?

Answer 253

Radiates to left neck, shoulder, or the back

Question 254

Pericarditis

💊 What medication is used to relieve pain with Pericarditis?

Answer 254

NSAIDS or Steroids

Question 255

Endocarditis
♿️ Rheumatic Carditis is a sensitivity response that develops after an upper respiratory tract infection with what bacteria?

Answer 255

Group A Beta-Hemolytic Streptococci

Question 256

Endocarditis

♿️ What complications can occur with Endocarditis?

Answer 256

▪️HF
▪️Stroke
▪️Kidney Failure
▪️Spleen Failure

Question 257

Pericarditis

💊 What usually relieve Pericarditis pain after the first dose?

Answer 257

NSAIDS

Question 258

Endocarditis

🚬 Why does Endocarditis occur in people with prosthetic heart valves or who have intravascular procedures?

Answer 258

Causes valves to be damaged and/or no longer smooth so bacteria and viruses can easily attach to those areas

Question 259

Pericarditis

😰 What symptoms occur with Pericardial Effusion?

Answer 259

There are often no symptoms

Question 260

Pericarditis

😰 What serologic studies are elevated in patients with Pericarditis?

Answer 260

WBC, CRP, & ESR

Question 261

Pericarditis

📈 Although there are often no symptoms with Pericardial Effusion, it can be detected with what diagnostic studies?

Answer 261

X-Ray & Echo

Question 262

Endocarditis

😰 What manifestation of Arterial Embolization causes painful, purplish nodules on the pads of fingers and toes?

Answer 262

Oscler’s Nodules

Question 263

Endocarditis

😷 What is used for treatment in patients with Endocarditis?

Answer 263

▪️Antimicrobials
▪️Rest (They’re going into HF)
▪️Monitor for Complications
▪️Supportive Care (Rest, Fluids, Diet, Oxygen)

Question 264

Endocarditis

💉 What serologic studies are used to help diagnose Endocarditis?

Answer 264

▪️↑WBC, ESR, & CRP (Signs of Inflammation)

▪️Blood Cultures (To know what were fighting)

Question 265

Pericarditis

📈 How much serous fluid is normally between the sac and heart to keep it lubricated?

Answer 265

15 mL

Question 266

Endocarditis
♿️ Because the valves don’t close properly causing the heart not to work efficiently, what is a common complication of Endocarditis?

Answer 266

Heart Failure

Question 267

Endocarditis

💉 How should blood be drawn when using blood cultures to diagnose Endocarditis?

Answer 267

2 Blood Cultures from 2 different sites

Question 268

Pericarditis

♿️ What occurs with Pericardial Effusion if too much fluid from the heart leaks into the pericardial space?

Answer 268

Heart is compressed

Question 269

Endocarditis

📈 What diagnostic studies are used for Endocarditis?

Answer 269

▪️Echocardiogram (Will show malfunctioning valves)
▪️Chest X-Ray
▪️ECG (Dysrhythmias)

Question 270

Endocarditis

🚬 50% of Endocarditis occurs in older adults with what valve dysfunction that is caused by age?

Answer 270

Aortic Stenosis (Narrowing of the Aortic Valves)

Question 271

Pericarditis

😷 When relieve pain caused by Pericarditis?

Answer 271

Sitting up and leaning forward

Question 272

Pericarditis

📈 What diagnostic test isn’t used with Pericardial Effusion because fluid and muscle cant be differentiated?

Answer 272

X-Ray

Question 273

Endocarditis

What is the primary target for Endocarditis?

Answer 273

Valves

Question 274

Endocarditis

😰 What S/S occur in patients with Endocarditis?

Answer 274

▪️Anorexia
▪️Chills
▪️Diaphoresis 
▪️Bloody Urine
▪️Fatigue
▪️Cough
▪️Dyspnea, Orthopnea 
▪️Muscle & Bone Pain
▪️↑HR & RR
▪️Dysrhythmias 
▪️New Murmurs
▪️Retinal Hemorrhages

Question 275

Coronary Artery Disease

💊 Aggressive treatment for what problems are needed in older adults with CAD?

Answer 275

Hypertension and Hyperlipidemia

Question 276

Coronary Artery Disease

🚬 Waist circumference >40” in men, >35” in woman, or a BMI greater than what increases the risk for obesity?

Answer 276

BMI >30

Question 277

Coronary Artery Disease

📈 What is used to prevent overgrowth of new intima which is the primary cause of restenosis?

Answer 277

Drug Eluting Stents

Question 278

Coronary Artery Disease
📚 A physical fitness plan using the FITT formula recommends how many minutes of aerobic exercise most days of the week plus weight training 2 days per week for patients with CAD

Answer 278

30 mins

Question 279

Coronary Artery Disease
💊💥 What Cholesterol Absorption Inhibitor is commonly used for Lipid-Lowering Drug Therapy to prevent cholesterol absorption in the blood stream?

Answer 279

Zetia (ezetimibe)

Question 280

Coronary Artery Disease

😷 Respiratory distress after stent placement is usually associated with what complication?

Answer 280

Hemorrhage or chest pain

Question 281

Coronary Artery Disease

💊 How often does Nitroglycerin have to be replaced after it has been opened?

Answer 281

Q6 Months

Question 282

Coronary Artery Disease

💊 What are the methods of administration for Long-Acting Nitrates?

Answer 282

▪️Oral
▪️Ointment
▪️Transdermal Patch

Question 283

Coronary Artery Disease

🚬 Two or more of what problems will cause the development of CAD?

Answer 283

▪️Hypertension
▪️Tobacco Use
▪️Diabetes
▪️Infections
▪️Toxins

Question 284

Coronary Artery Disease

🍓 A decrease in what dietary changes should be recommended to patients with CAD?

Answer 284

↓Saturated fats & Cholesterol

Question 285

Coronary Artery Disease

💊 Besides Nitroglycerin, what other drugs are used to prevent angina in patients with CAD?

Answer 285

▪️ACE Inhibitors
▪️β- Adrenergic Blockers
▪️Calcium Channel Blockers
▪️Sodium Current Inhibitors

Question 286

Coronary Artery Disease

📈 What initial diagnostic studies are done when the patient has a history of CAD or CAD is suspected?

Answer 286

▪️Chest X-Ray
▪️Laboratory Studies
▪️12 Lead ECG
▪️Calcium-Score Screening Heart Scan

Question 287

Coronary Artery Disease

🚬 Because diabetes is a risk factor for CAD, A1C should not be greater than what percentage?

Answer 287

Don’t want it > 7%

Question 288

Coronary Artery Disease

💊 What surgical treatment is used for patients with Significant Left Main CAD?

Answer 288

Open Heart Surgery with Bypass

Question 289

Coronary Artery Disease

What occurs with oxygen demand and supply with angina?

Answer 289

O2 demand > O2 Supply

Question 290

Coronary Artery Disease
♿️ The artery has its own capillaries and blood supply so when there’s a tear in the lining it starts to bleed and develops a blood clot in the blood vessel that causes what complication due to the artery being locked?

Answer 290

Heart Attack

Question 291

Coronary Artery Disease

💊 Why is a Nitrate free period needed with Transdermal Nitroglycerin?

Answer 291

Body develops a tolerance. Usually removed at night and reapplied in the morning

Question 292

Coronary Artery Disease
🍓To increase complex carbohydrates in patients with CAD, complex carbs such as candy and maple syrup should be avoided and what foods containing starch should be suggested?

Answer 292

Potatoes and Beans

Question 293

Coronary Artery Disease

Cardiac cells can live for how long without adequate blood flow and oxygen?

Answer 293

20 mins

Question 294

Coronary Artery Disease

💊💥 What drug is used for Anti-Platelet Therapy in patients that cant take Aspirin?

Answer 294

Plavix (clopidogrel)

Question 295

Coronary Artery Disease

😷 After a stent is placed through cardiac catheterization, what areas are assessed Q15 x 1H for circulation?

Answer 295

Extremity used for insertion and distal to insertion site.

Question 296

Coronary Artery Disease

💊 Because Nitroglycerin will degrade and become less effective, how should tablets be stored?

Answer 296

Protect from light, air, and heat (including body heat)

Question 297

Coronary Artery Disease

What is Atheromas?

Answer 297

Fatty Deposits

Question 298

Coronary Artery Disease

🍓 Any fat that comes from an animal has what in it?

Answer 298

Cholesterol

Question 299

Coronary Artery Disease

📈 How much of the coronary arteries usually have to be blocked for a stent to be placed?

Answer 299

70-75%

Question 300

Coronary Artery Disease

😷💥 What do you do if the patient experiences chest pain after a stent placement?

Answer 300

Call HCP ASAP. If Nitroglycerin is ordered, it can be given.

Question 301

Coronary Artery Disease

📈 What is the most common entry for cardiac catheterization?

Answer 301

Femoral Artery

Question 302

Coronary Artery Disease

📈 A 12-lead ECG often shows what results that indicate ischemia

Answer 302

ST segment depression and/or T-Wave inversion

Question 303

Coronary Artery Disease

📈 What does ST elevation indicate?

Answer 303

Heart Damage

Question 304

Coronary Artery Disease
💊💥 What Lipid-Lowering Drug has side effects of Flushing, Pruritus, GI side effects, and Orthostatic Hypotension due to vasodilation?

Answer 304

Niacin (Niaspan)

Question 305

Coronary Artery Disease

When does myocardial ischemia occur?

Answer 305

When O2 demand > O2 supply

Question 306

Coronary Artery Disease

📈 Where is a cardiac catheter inserted to go into the right side of the heart?

Answer 306

Must go in a vein

Question 307

Coronary Artery Disease

💊 Why should patients be instructed to sit when taking Nitroglycerin?

Answer 307

Orthostatic Hypotension

Question 308

Coronary Artery Disease

🍓 Patients with CAD should decrease the consumption of what specific foods that come from animals?

Answer 308

↓Red Meat, Egg Yolk, & Whole Milk

Question 309

Coronary Artery Disease
💉 What is nonspecific marker of systemic inflammation that isn’t specific to the location of inflammation but tends to indicate CAD when the results are high?

Answer 309

C-Reactive Protein (CRP)

Question 310

Coronary Artery Disease

“Hardening of the Arteries” is another name for what disease?

Answer 310

CAD

Question 311

Coronary Artery Disease

💊💥 What Lipid-Lowering Drug↓LDL,↓Triglycerides, and↑HDL?

Answer 311

Niacin

Question 312

Coronary Artery Disease

💊💥 What Lipid-Lowering Drug increases conversion of cholesterol so that it can be excreted through the feces?

Answer 312

Bile Acid Sequestrans - WelChol (colesevelam)

Question 313

Coronary Artery Disease
📈 What diagnostic study looks at heart wall movement and valve movement and can be done with a stress test to determine if the heart can handle exercise?

Answer 313

Echocardiogram

Question 314

Coronary Artery Disease

What plays a major role in the development of fatty deposits that get under the endothelial and build up plaque?

Answer 314

Inflammation

Question 315

Coronary Artery Disease

🍓 In patients with CAD, most of the fat intake should be from what type of oils?

Answer 315

Vegetable Oils (olive, safflower, corn, soybean, flaxseed, cottonseed) or oils in nuts.

Question 316

Coronary Artery Disease

💊 If there is some relief with Nitroglycerin, how often may 3 additional doses be administered?

Answer 316

Every 5 minutes

Question 317

Coronary Artery Disease
😰 Squeezing, heavy, chocking, suffocating sensation, and the feeling of an elephant sitting on the chest is commonly described in what type of pain?

Answer 317

Angina

Question 318

Coronary Artery Disease
💊💥 Zocor is what type of drug given to patients with CAD to increase cholesterol synthesis, decrease LDL, and increase HDL?

Answer 318

Statin

Question 319

Coronary Artery Disease

🚬 What is not a high risk factor for CAD but tends to go along with physical inactivity?

Answer 319

Obesity

Question 320

Coronary Artery Disease

🚬 What are the top 4 modifiable risk factors for CAD?

Answer 320

1) Elevated Serum Lipids
2) Hypertension
3) Tobacco Use
4) Physical Inactivity

Question 321

Coronary Artery Disease

💊 What instructions should be given to patients that are prescribed Nitrolingual?

Answer 321

Spray directly on the tongue. Not underneath. Do not inhale

Question 322

Coronary Artery Disease

😰 Angina pain is usually described as what?

Answer 322

Pressure / Ache

Question 323

Coronary Artery Disease

📚 What guidelines for physical activity are necessary to modify in older adults?

Answer 323

▪️Longer warm-up
▪️Longer periods of low-level activity
▪️Longer rest periods
▪️Avoid extreme temperatures
▪️30 minutes most days minimum

Question 324

Coronary Artery Disease

🚬 African Americans have a higher mortality but what ethnicity has the highest incidence?

Answer 324

Caucasians

Question 325

Coronary Artery Disease
📈 To prevent clots the patient is put on an anticoagulant during cardiac catheterization and put on what two anti-platelet agents after the procedure?

Answer 325

Aspirin & ticagrelor (Brilinta)

Question 326

Coronary Artery Disease

📚 What discharge teaching related to CAD and PCI need to be provided to the patient?

Answer 326

▪️Stent is not a cure. Need to start lifestyle modifications

▪️Call HCP with any chest pain

Question 327

Coronary Artery Disease

🚬 Increased risk for CAD occur at what age for men and woman?

Answer 327

Men >45 years

Woman >55 years

Question 328

Coronary Artery Disease

💊💥 What Fibric Acid Derivative is commonly given as Lipid-Lowering Drug Therapy?

Answer 328

Lopid (gemfibrozil)

Question 329

Coronary Artery Disease

😰 What is angina?

Answer 329

Chest pain / discomfort above the waist

Question 330

Coronary Artery Disease

🚬 What ethnicity have a very low incidence of CAD and a low mortality rate?

Answer 330

Hispanics

Question 331

Coronary Artery Disease

💊 What are the side effects of Long-Acting Nitrates?

Answer 331

Headache & Orthostatic Hypotension

Question 332

Coronary Artery Disease
💊💥 Statins, Niacin, Fibric Acid, Bile Acid Sequestrants, and Cholesterol Absorption Inhibitors are what type of drugs used in patients with CAD?

Answer 332

Lipid-Lowering Drugs

Question 333

Coronary Artery Disease

💊 Nitroglycerin should not be combined with what other medication?

Answer 333

Erectile Dysfunction Medication (Viagra)

Question 334

Coronary Artery Disease

📈 Why is a Drug-Eluting Stent used with cardiac catheterization?

Answer 334

To prevent the build up of protein over the surface of the stent that could cause another blockage

Question 335

Coronary Artery Disease
💊 What type of drug is Ranolazine (Ranexa) which is used for the treatment of angina when other antianginals haven’t worked?

Answer 335

Sodium Current Inhibitor

Question 336

Coronary Artery Disease
When there is a slow build of plaque and not enough oxygen, what can develop that causes small blood vessels around the heart to incease their blood flow and the growth of new blood vessels to supply the ischemic area with blood flow?

Answer 336

Angiogenesis

Question 337

Coronary Artery Disease

💊 What kind of bottle is Nitroglycerin stored in?

Answer 337

Dark Glass Bottle

Question 338

Coronary Artery Disease
🍓 Patients with CAD should be taught to increase or add chia seeds, nuts, and what fatty fish in their diet to increase Omega 3-Fatty Acids?

Answer 338

Sardines
Salmon
Tuna
Mackerel

Question 339

Coronary Artery Disease

😷 What are you looking for when assessing for bleeding after a stent is placed through cardiac catheterization?

Answer 339

Hematoma (Raised blood clot)

Question 340

Coronary Artery Disease

💊 What medications end in “pril”?

Answer 340

ACE Inhibitors

Question 341

Coronary Artery Disease
📚 When planning a physical activity program for older adults, physical activity should be encouraged for how long on most days at minimum?

Answer 341

30 mins

Question 342

Coronary Artery Disease

💊 What medication achieves the goal to treat angina which is to↓O2 demand and↑O2 supply?

Answer 342

Nitroglycerin

Question 343

Coronary Artery Disease

In CAD, what happens to fatty deposits over time?

Answer 343

They harden

Question 344

Coronary Artery Disease

🚬 Men have more CAD until woman reach what age in which it becomes equal for both genders?

Answer 344

Woman reach age 55

Question 345

Coronary Artery Disease

💊💥 What type of drugs are initially started if diet and exercise doesn’t effectively lower lipid levels?

Answer 345

Statins

Question 346

Coronary Artery Disease

📈 What diagnostic study is diagnostic for CAD because it can be used to visualize and open blockages?

Answer 346

Cardiac Catheterization

Question 347

Coronary Artery Disease

💊 What medications end in “pines”, “zems”, and “mils”?

Answer 347

Calcium Channel Blockers

Question 348

Coronary Artery Disease

💊💥 What Lipid-Lowering Drug binds with other drugs so must be taken separately from other drugs?

Answer 348

Bile Acid Sequestrans - WelChol (colesevalam)

Question 349

Coronary Artery Disease

What in the heart muscle causes angina pain?

Answer 349

Acid

Question 350

Coronary Artery Disease

🚬 What BP puts someone at high risk for CAD?

Answer 350

140/90

Question 351

Coronary Artery Disease
🍓 Patients with CAD should reduce their fat intake to what percent with most from monounsaturated fats and less from saturated fats?

Answer 351

25-35%

Question 352

Coronary Artery Disease

🍓 What dietary changes should be increased in patients with CAD?

Answer 352

Complex Carbohydrates, Fiber, & Omega-3 Fatty Acids.

Question 353

Coronary Artery Disease

💊 What ACE Inhibitor is commonly used to prevent angina?

Answer 353

Captopril (Capoten)

Question 354

Coronary Artery Disease

😰 How long does chronic stable angina usually last?

Answer 354

5-15 mins

Question 355

Coronary Artery Disease
📈 What ECG results is seen with Prinzmetal (Varient) Angina indicates ischemia of the heart muscle and that the patient could be having a heart attack?

Answer 355

Significant elevation of ST segment

Question 356

Coronary Artery Disease

When may collateral circulation be inadequate causing a heart attack to occur?

Answer 356

Rapid onset of CAD. Blood clot develops rapidly

Question 357

Coronary Artery Disease

PCI (stent placement) is not used in patients with what specific CAD?

Answer 357

▪️3 Vessels CAD

▪️Significant Left Main CAD

Question 358

Coronary Artery Disease
😷 If external bleeding occurs after a stent is placed, nonstop manual pressure without lifting is to be applied for at least how long?

Answer 358

20 minutes

Question 359

Coronary Artery Disease

💊 Chronic Stable Angina is controlled with rest and what typical medication?

Answer 359

Nitroglycerin

Question 360

Coronary Artery Disease

🚬 What Triglyceride levels increase the risk for CAD?

Answer 360

> 150 mg/dL

Question 361

Coronary Artery Disease

📈 What does ST depression indicate?

Answer 361

Ischemia

Question 362

Coronary Artery Disease

💊💥 What Drug Therapy is started in patients with CAD so that clots don’t form as easily?

Answer 362

Anti-Platelet

Question 363

Coronary Artery Disease

🚬 What has a major contributing component and is the #1 modifiable risk factor for CAD

Answer 363

Elevated Serum Lipids

Question 364

Coronary Artery Disease

Because the vessels are narrowed and calcified they become ischemic which causes a build up of what in the heart muscle?

Answer 364

Acid

Question 365

Coronary Artery Disease
If there is a massive coronary artery blockage, what may protect from an infarction by still supplying adequate blood flow to the heart muscle?

Answer 365

Collateral Circulation

Question 366

Coronary Artery Disease
🚬 What 3rd highest risk factor for CAD↑HR BP due to vasoconstriction, ↑LDL, ↓HDL, ↑Oxygen Radicals, and ↑Carbon Monoxide?

Answer 366

Tobacco use

Question 367

Coronary Artery Disease

🚬 What is the #1 cause of chronic injury that results in fat and plaque build up over time to become a major blockage?

Answer 367

Hypertension

Question 368

Coronary Artery Disease

📈 Where can a cardiac catheter be inserted to go into the aorta?

Answer 368

▪️Femoral Artery
▪️Brachial Artery
▪️Radial Artery

Question 369

Coronary Artery Disease

😰 Angina doesn’t usually occur until how much of the arteries are blocked?

Answer 369

75%

Question 370

Coronary Artery Disease

📈 What is the patient at risk for when a stent is placed?

Answer 370

Clots

Question 371

Coronary Artery Disease
😰 Although most of the pain experienced by people with angina appears substernally, the sensation may also occur in what other regions?

Answer 371

Neck, Jaw, Shoulders, and down the Arms

Question 372

Coronary Artery Disease
💊 Nitroglycerin Ointment is usually given every 6 hours, is dosed by the inch, and is administered by putting it on a piece of paper and placed on what area of the body?

Answer 372

Upper body or arm, over a flat muscular area that is free of hair and scars

Question 373

Coronary Artery Disease

💊 What surgical treatment is needed for patients with 3 Vessel CAD?

Answer 373

Bypass Graft

Question 374

Coronary Artery Disease
😷 When encouraging lifestyle changes, what realistic goals do you want to set with the patient to achieve risk reduction?

Answer 374

Pick one of the big four modifiable risk factors for the patient to work on. Don’t be unrealistic and suggest multiple changes.

Question 375

Coronary Artery Disease

🚬 What HDL levels increase the risk for CAD in men and woman?

Answer 375

Men >40 mg/dL

Woman >50 mg/ dL

Question 376

Coronary Artery Disease
😰 What type of Angina can occur with or without CAD and is usually at rest in response to a spasm of the major coronary artery?

Answer 376

Prinzmetal

Question 377

Coronary Artery Disease

What is a major cause of CAD that is characterized by lipid deposits within intima (inner lining) of the artery?

Answer 377

Atherosclerosis

Question 378

Coronary Artery Disease
😰 What type of Angina is ischemia that occurs in the absence of any subjective symptoms, is often associated with diabetic neuropathy, and is confirmed by ECG?

Answer 378

Silent Angina / Ischemia

Question 379

Coronary Artery Disease

💊 What type of medication is Imdur (isoisorbide mononitrate)?

Answer 379

Long-Acting Nitrate

Question 380

Coronary Artery Disease

😰 What is it called when there ischemia of the heart under known circumstances?

Answer 380

Stable Angina

Question 381

Coronary Artery Disease

💊 What is treatment for patients with prehypertension?

Answer 381

Lifestyle changes?

Question 382

Coronary Artery Disease

📈 Why would pharmacologic nuclear imaging where IV medication is given be used to raise the patients HR?

Answer 382

When the patient is not able exercise for an exercise stress test

Question 383

Coronary Artery Disease

💊💥 The Lipid-Lowering Drugs Niacin, Fibric Acid, and Bile Acid Sequestrants all have what common side effect?

Answer 383

GI side effects

Question 384

Coronary Artery Disease

😰 Prinzmetal’s (varient) Angina occurs at rest due to what?

Answer 384

Spasm of a major coronary artery

Question 385

Coronary Artery Disease

💊 What aggressive treatment is used for patients with stage 1or 2 hypertension?

Answer 385

Medication and lifestyle modifications

Question 386

Coronary Artery Disease

📈 What diagnostic study is used when there is a positive stress test?

Answer 386

Cardiac Catheterization

Question 387

Coronary Artery Disease
😰 What type of angina affects the small, distal coronary arteries and cant be seen well during cardiac catheterization because it only looks that the major arteries?

Answer 387

Microvascular Angina

Question 388

Coronary Artery Disease

💊 What medications end in “lols”?

Answer 388

β-Adrenergic Blockers

Question 389

Coronary Artery Disease

😰 Many people with angina complain of what sensation in the epigastric region?

Answer 389

Indigestion or Burning

Question 390

Coronary Artery Disease

🚬 CAD is the leading cause of death in what gender?

Answer 390

Females

Question 391

Coronary Artery Disease

🚬 How do strategies to reduce the risk for CAD change when treating CAD in older adults?

Answer 391

It doesn’t. Reducing risk factors are still effective in older adults.

Question 392

Coronary Artery Disease

💊 In what ways can short acting Nitroglycerin be administered?

Answer 392

Sublingually tablet (Nitrostat) or translingual spray (Nitrolingual)

Question 393

Coronary Artery Disease

💊💥 What is the most common Bile Acid Sequestrant used for Lipid Lowering Drug Therapy?

Answer 393

WelChol (colesevelam)

Question 394

Coronary Artery Disease

💊💥 What Niacin drug is a high dose B Vitamin?

Answer 394

Niaspan

Question 395

Coronary Artery Disease

😷 After a stent is placed through cardiac cauterization, how often is the patient assessed for the first hour?

Answer 395

Q15 mins x 1 hour

Question 396

Coronary Artery Disease

💊💥 When the patient is prescribed Statin drugs, what is initially monitored and rechecked with any increase in dosage?

Answer 396

Liver enzymes

Question 397

Coronary Artery Disease
😰 What is described as intermittent chest pain that occurs over a long period with the same pattern of onset, duration, and intensity of symptoms?

Answer 397

Chronic Stable Angina

Question 398

Coronary Artery Disease

😰 What are the three types of Angina?

Answer 398

Silent, Prinzmetal (Variant), and Microvascular

Question 399

Coronary Artery Disease

😰 Chronic Stable Angina can turn into what cardiovascular disorder?

Answer 399

Acute Coronary Syndrome

Question 400

Coronary Artery Disease

🚬 What LDL levels increase the risk for CAD?

Answer 400

> 160 mg/dL

Question 401

Coronary Artery Disease
📈 When a cardiac catheter is inserted it goes against the flow and the tip of the catheter ends right above the aortic valve where what is located and dye is injected?

Answer 401

Coronary Ostia

Question 402

Coronary Artery Disease
💊💥 What Statin drugs is commonly given to patients with CAD when diet and exercise are not effectively lowering lipid levels?

Answer 402

Zocor (simvastatin)

Question 403

Coronary Artery Disease

😰 Are epigastric pain and intrascapular considered typical or atypical angina pain?

Answer 403

Atypical

Question 404

Coronary Artery Disease
📈 After cardiac catheterization, how long will the patient be on the two anti-platelet drugs (Aspirin & ticagrelor (Brilinta))?

Answer 404

12 months or more

Question 405

Coronary Artery Disease

💊 Angina is reversible ischemia with what treatment?

Answer 405

Rest or rest and medication

Question 406

Coronary Artery Disease
💊💥 In addition to lowering cholesterol and lipids and increasing HLD, what other therapy is started on patients with CAD?

Answer 406

Anti-platelet Therapy

Question 407

Coronary Artery Disease

😷 After a stent is placed through cardiac catheterization, what vital signs changes are indicative of internal bleeding?

Answer 407

↑Pulse & Respirations (↓BP is a later sign)

Question 408

Coronary Artery Disease

🚬 What ethnicity have heart attacks at a younger age and double the mortality compared to the rest of the population?

Answer 408

American Indians

Question 409

Coronary Artery Disease

🚬 What cholesterol levels increase the risk for CAD?

Answer 409

> 200 mg/dL

Question 410

Coronary Artery Disease

💊💥 What Lipid Lowering drug↓LDL, and↑HDL?

Answer 410

Statins

Question 411

Coronary Artery Disease

💊💥 What Lipid Lowering Drug↓triglycerides and↑HDL?

Answer 411

Fibric Acid

Question 412

Coronary Artery Disease
📈 When a patient has a history of CAD or CAD is suspected, what is the first diagnostic study done that will determine if the heart is enlarged?

Answer 412

Chest X-Ray

Question 413

Coronary Artery Disease

💊💥 For Anti-Platelet Therapy, how many mg of Aspirin is usually recommended for patients with CAD?

Answer 413

81 mg

Question 414

Coronary Artery Disease

How long after an occlusion do the cells start to suffer from the lack of oxygen?

Answer 414

10 seconds

Question 415

Coronary Artery Disease

💊💥 For Anti-Platelet Therapy in patients CAD, 81 mg of what type of Aspirin is prescribed daily?

Answer 415

Enteric Coated so it doesn’t cause GI upset

Question 416

Congestive Heart Failure
😷 Meticulous skin care is needed in patients with HF because the skin is fragile and susceptible to breakdown and tears due to what interfering with gas exchange in the skin?

Answer 416

Edema

Question 417

Congestive Heart Failure

HF usually occurs on what side of the heart first?

Answer 417

Left because it works harder

Question 418

Congestive Heart Failure

😰 What amount of weight gain in patients with HF does the HCP need to be notified?

Answer 418

Weight gain of 3 lbs in 2 days OR 3-5 lbs in a week

Question 419

Congestive Heart Failure
💊 What Positive Inotrope drug used for the treatment of HF is for short term use, usually given via IV in ICU, and is titrated up and down depending on the patients S/S?

Answer 419

Dobutamine

Question 420

Congestive Heart Failure

😰 What HF has peripheral S/S such as dependent edema, liver enlargement, and jugular vein distention?

Answer 420

Right Sided HF

Question 421

Congestive Heart Failure

😷 How should activity and rest be planned for patients with HF?

Answer 421

Separate activities and interventions because they need breaks between. Do as much for them as they will allow because they more they do, they harder their heart is having to work.

Question 422

Congestive Heart Failure

😰 What are the S/S of Left-Sided HF?

Answer 422

▪️Dyspnea
▪️Orthopnea
▪️Proxysmal Nocturnal Dyspnea
▪️Cough
▪️Tachycardia
▪️S3, crackles
▪️Fatigue
▪️Anxiety / Restlessness
▪️Chest Pain

Question 423

Congestive Heart Failure

😰 Edema is present when a sudden weight gain or loss of how much occurs within a 24 hr period?

Answer 423

2 kg = 4.4 lbs

Question 424

Congestive Heart Failure

💉 Stretching of the heart releases what amino acid that triggers the kidneys to release more sodium and water?

Answer 424

BNP

Question 425

Congestive Heart Failure

🚬 What are the risk factors for CHF?

Answer 425

▪️CAD
▪️HTN
▪️Diabetes
▪️Smoking
▪️Obesity
▪️High Cholesterol

Question 426

Congestive Heart Failure

🚬 What is the most common cause of R. Sided HF?

Answer 426

L. Sided HF

Question 427

Congestive Heart Failure

How does CAD affect the heart?

Answer 427

Heart becomes ischemic and cant pump very well

Question 428

Congestive Heart Failure

♿️ What HF occurs with a massive MI to the Right side or Cor Pulmonale?

Answer 428

R. Sided HF

Question 429

Congestive Heart Failure

😰 Besides weight gain, when should the HCP with HF?

Answer 429

▪️Shoes fitting tighter than usual
▪️Nausea & Anorexia
▪️↓Activity tolerance lasting > 2-3 days (Easily exhausted from usual activity)
▪️Awakening at night SOB or to urinate, dizziness, angina

Question 430

Congestive Heart Failure

💊 What type of pacemaker can be used for the treatment of HF?

Answer 430

Biventricular Pacemakers

Question 431

Congestive Heart Failure

💊 What medication can be used in small does to decrease anxiety in patients with Acute HF and SOB?

Answer 431

Morphine

Question 432

Congestive Heart Failure

📚 What do you want to teach patients with HF?

Answer 432

▪️Hidden sources of sodium
▪️How to take their pulse if on Digoxin
▪️Weigh Self Daily
▪️Medication Administration- If untreated leads to cardiogenic shock which leads to death.

Question 433

Congestive Heart Failure

💊 What medications can be given for the treatment of HF?

Answer 433

▪️Cardiac Glycosides (Digoxin)
▪️Diuretic Therapy
▪️Vasodilators (Nitroglycerin)
▪️ACE Inhibitors
▪️Beta Blockers
▪️Anticoagulants 
▪️Morphine Sulfate (Anxiety & Vasodilator)
▪️Positive Inotropes (Dobutamine)

Question 434

Congestive Heart Failure

📈 What diagnostic studies can be used to diagnose or help diagnose HF?

Answer 434

▪️Chest X-Ray (Infiltrates & Cardiomegaly)
▪️ECG (Ischemia)
▪️2-D Echocardiogram (Ejection Fraction)
▪️Cardiac Catheterization (CVP-Central Venous Pressure)
▪️Nuclear Imaging (Heart Function

Question 435

Congestive Heart Failure

😷 What position does the patient in the acute phase of HF and SOB need to be placed in?

Answer 435

High Fowlers

Question 436

Congestive Heart Failure

🍓 What diet is recommended for patients with HF?

Answer 436

Low Sodium (2 G Sodium) & Small frequent meals

Question 437

Congestive Heart Failure

😷 Nursing interventions for patients in Acute HF and SOB?

Answer 437

▪️Positioning 
▪️Decrease Anxiety
▪️Assess Lung & Heart Sounds
▪️Monitor VS, I&O, & Edema
▪️Daily Weights
▪️Progressive Ambulation
▪️Meticulous Skin Care

Question 438

Congestive Heart Failure
💊 What type of drug prevents Angiotensin 2 from causing vasoconstriction and prevent aldosterone from causing sodium and water retention?

Answer 438

ACE Inhibitors

Question 439

Congestive Heart Failure
😰 With L. Sided HF, crackles are heard because the lungs are filling with fluid, but what sound is heard because the airways are swollen and filling with fluid?

Answer 439

Wheezes

Question 440

Congestive Heart Failure

😰 When auscultating the lungs, when are crackles a sign that the patient may be having HF?

Answer 440

Crackles that doesn’t clear with a cough

Question 441

Congestive Heart Failure

How does smoking affect the heart?

Answer 441

Damages lining of the blood vessels by inflaming them and can also promote cell damage in the heart

Question 442

Congestive Heart Failure

📈 When using Cardiac Catheterization to diagnose HF, what does it mean if there is elevated left / right heart pressure?

Answer 442

▪️Elevated L. heart pressure = L. Sided HF

▪️Elevated R. heart pressure = R. Sided HF

Question 443

Congestive Heart Failure

😰 What are the S/S of R. Sided HF?

Answer 443

▪️Edema
▪️Hepatomegaly
▪️RUQ Pain
▪️Distended Neck Veins
▪️Anorexia / Nausea
▪️Fatigue

Question 444

Congestive Heart Failure

How does HTN affect the heart?

Answer 444

Causes damage to the coronary arteries and causes vasoconstriction

Question 445

Congestive Heart Failure

😰 With R. Sided HF the liver will be tender and can be palpated in what quadrant?

Answer 445

RUQ

Question 446

Congestive Heart Failure

🚬 What are the most common causes of HF?

Answer 446

▪️MI
▪️HTN
▪️Valvular Disease

Question 447

Congestive Heart Failure

♿️ If the patient has chronic R. Sided HF, hepatomegaly can lead to what complication?

Answer 447

Ascites

Question 448

Congestive Heart Failure

💊 When would revascularization and stent placement be considered for patients in HF?

Answer 448

CAD Blockage

Question 449

Congestive Heart Failure

😰 What is the long term sign of decreased CO?

Answer 449

Decreased Urinary Output

Question 450

Congestive Heart Failure

😰 What is the first sign of decreased CO?

Answer 450

Confusion

Question 451

Congestive Heart Failure

💉 What BNP value is considered abnormal and is suggestive of HF?

Answer 451

> 100

Question 452

Congestive Heart Failure

😰 A dry that is initially present with L. Sided HF may progress to what?

Answer 452

Frothy, blood-tinged sputum which is evidence of pulmonary edema

Question 453

Congestive Heart Failure

How does diabetes affect the heart?

Answer 453

Causes damage to the microvasculature of the heart and causes cells that are fed by the micovessels to die off in a small amount. Heart becomes weak

Question 454

Congestive Heart Failure

😰 What HF primarily has respiratory types of symptoms?

Answer 454

Left-Sided HF

Question 455

Assessment of Cardiovascular System

😰 When assessing for Jugular Vein Distention, the HOB should be at what degree?

Answer 455

35-40 degree angle

Question 456

Assessment of Cardiovascular System

S3 heard after S2 is associated with and usually indicates what CV disorder?

Answer 456

L. Sided Heart Failure

Question 457

Assessment of Cardiovascular System

If capillary refill is >2 seconds it could mean that there is massive vasoconstriction and that blood is trapped where?

Answer 457

Blood is trapped in that extremity

Question 458

Assessment of Cardiovascular System

😰 Jugular Vein Distention is an indication of what CV disorder?

Answer 458

R. Sided Heart Failure

Question 459

Assessment of Cardiovascular System

💊 What medication can cause erectile dysfunction?

Answer 459

Beta Blockers

Question 460

Assessment of Cardiovascular System

What pulse is auscultated at the left sternal border and fifth intercostal space?

Answer 460

Tricuspid

Question 461

Assessment of Cardiovascular System
🍓 What in a patients diet increases vascular volume which if increased too much can lead to heart failure because the heart is having a hard time pumping?

Answer 461

Salt

Question 462

Assessment of Cardiovascular System

📈 Troponin rises within how many hours after the injury?

Answer 462

4-6 hours

Question 463

Assessment of Cardiovascular System

What does the PPQRRST stand for when assessing pain?

Answer 463

Provocative 
Palliative
Quality
Region
Radiation
Severity
Timing

Question 464

Assessment of Cardiovascular System
The PMI (Point of Maximum Impulse) is located where what pulse is felt?

Answer 464

Where apical (mitral) pulse if felt (Midclavicular)

Question 465

Assessment of Cardiovascular System

After a heart attack, dead cells break open and release what protein?

Answer 465

troponin

Question 466

Assessment of Cardiovascular System

📈 What cardiac biomarker is known as the gold standard for heart attack diagnosis?

Answer 466

Troponin

Question 467

Assessment of Cardiovascular System

Hemorrhages under the finger nails caused by Endocarditis is known as what?

Answer 467

Splinter Hemorrhages

Question 468

Assessment of Cardiovascular System

😷 Because a Transeposphageal Echo (TEE) requires swallowing a tube, how long should a patient be NPO prior?

Answer 468

6 hours

Question 469

Assessment of Cardiovascular System

📈 What does BNP trigger the kidneys to do that reduces preload?

Answer 469

Excrete salt and water

Question 470

Assessment of Cardiovascular System
📈 What diagnostic imaging study uses contrast to identify and measure coronary artery blockages if the patient has a positive stress test?

Answer 470

Coronary Angiography

Question 471

Assessment of Cardiovascular System

What type of cyanosis tells about circulation to the whole body and is found in the mucus membranes?

Answer 471

Central Cyanosis

Question 472

Assessment of Cardiovascular System

Inspection of what veins can be an indication for the condition of valves?

Answer 472

Varicose Veins

Question 473

Assessment of Cardiovascular System

Where would dependent edema be found if a patient is on bed-rest?

Answer 473

Sacrum / back area.

Question 474

Assessment of Cardiovascular System

📈 Troponin levels can be detected for up to how many days?

Answer 474

10-14 days

Question 475

Assessment of Cardiovascular System

A swishy sound heard over any artery is known as what?

Answer 475

Bruit

Question 476

Assessment of Cardiovascular System

If the patient has a congenital anomaly, what sound may be auscultated?

Answer 476

Cardiac Murmur

Question 477

Assessment of Cardiovascular System

😷 How is Paroxysmal Nocturnal Dyspnea corrected?

Answer 477

Fixed when patient sits upright.

Question 478

Assessment of Cardiovascular System

🍓 What in the diet can increase Coronary Artery Disease or Peripheral Vascular Disease?

Answer 478

Fat

Question 479

Assessment of Cardiovascular System

📈 What lipoprotein is the main storage form for fat?

Answer 479

Triglycerides

Question 480

Assessment of Cardiovascular System

😷 What does the nurse want to assess for after a Transesophageal Echo (TEE)?

Answer 480

Gag reflex and that the patient can swallow

Question 481

Assessment of Cardiovascular System

Murmurs are commonly caused by what type of disorders?

Answer 481

Valve Disorders

Question 482

Assessment of Cardiovascular System

What pulse is auscultated at the left sternal border and second intercostal space?

Answer 482

Pulmonic

Question 483

Assessment of Cardiovascular System

🍓 Fiber in the diet is encouraged to prevent constipation but fiber also reduces what?

Answer 483

Cholesterol Levels

Question 484

Assessment of Cardiovascular System

What pulse is auscultated just below the pulmonic area at the left sternal boarder and third intercostal space?

Answer 484

Erb’s

Question 485

Assessment of Cardiovascular System

📈 What type of ECG monitoring is used for continuous recording to try and catch a dysrhythmia?

Answer 485

Holter

Question 486

Assessment of Cardiovascular System

📚 When using a Holter monitor, what is the patient instructed to do when symptoms occur?

Answer 486

Write down date and time in a journal

Question 487

Assessment of Cardiovascular System

Why shouldn’t Jugular Vein Distention be assessed when the patient is in the supine position?

Answer 487

Everyones Jugular Vein is distended when laying down.

Question 488

Assessment of Cardiovascular System

Pulse deficits are often caused by what CV disorder?

Answer 488

Dysrhythmias

Question 489

Assessment of Cardiovascular System

😰 Dizziness or fainting could be a sign of what CV disorder?

Answer 489

Dysrhythmias

Question 490

Assessment of Cardiovascular System

Waking suddenly with SOB can be a sign of what CV disorder?

Answer 490

L. Sided Heart Failure

Question 491

Assessment of Cardiovascular System

😰 With Dependent Rubor, what characteristic is present when the extremity is dependent / down?

Answer 491

Extremity is Red

Question 492

Assessment of Cardiovascular System
📈 What is usually indicated if a Chest X-Ray reveals that the diameter of the heart is greater than 1/2 of the distance of the diameter of the thorax?

Answer 492

Cardiac Enlargement

Question 493

Assessment of Cardiovascular System

📈 With a Electrophysiology Study the patient is sedated and a catheter is placed in the heart to look for what disorder?

Answer 493

Dysrhythmias

Question 494

Assessment of Cardiovascular System

When using the PPQRRST Method to assess pain, what does provocative mean?

Answer 494

What provokes or brings on the pain

Question 495

Assessment of Cardiovascular System

Dependent Rubor is usually caused by what disease due to build up of plaque?

Answer 495

Peripheral Artery Disease

Question 496

Assessment of Cardiovascular System

📈 What Cholesterol to HDL ratio increases the risk for CVD?

Answer 496

> 5

Question 497

Assessment of Cardiovascular System

Inspection for what type of cyanosis determines the circulation to a certain area or extremity?

Answer 497

Peripheral Cyanosis

Question 498

Assessment of Cardiovascular System

😰 With Dependent Rubor, what characteristic is present when the extremity is elevated?

Answer 498

Extremity is pale

Question 499

Assessment of Cardiovascular System

📈 An increase in what cholesterol is a risk factor for CVD?

Answer 499

LDL

Question 500

Assessment of Cardiovascular System

A combination of pallor and cyanosis is known as what?

Answer 500

Mottling

Question 501

Assessment of Cardiovascular System

📈 At what ejection fraction percentage is there an interference with adequate or effective ejection of blood.

Answer 501

< 50%

Question 502

Assessment of Cardiovascular System

📈 Elevated homocysteine blood levels increase the risk for CAD, PAD, and stroke and are related to what deficiencies?

Answer 502

Hereditary or Vitamin

Question 503

Assessment of Cardiovascular System
What sound is heard when there is inflammation of pericardium and heart muscle and is described as scratchy / fingernail file sound?

Answer 503

Pericardial Friction Rub

Question 504

Assessment of Cardiovascular System

What pulse is auscultated at the mid-clavicular line and fifth intercostal space?

Answer 504

Mitral (PMI)

Question 505

Assessment of Cardiovascular System

What sound should be heard when auscultating an artery?

Answer 505

Silent. Shouldn’t hear a sound

Question 506

Assessment of Cardiovascular System

S4 heard before S1 usually indicates what CV disorder?

Answer 506

L. Ventricular Hypertrophy

Question 507

Assessment of Cardiovascular System

📈 What test is done if a stress test is positive or if symptoms are suspicious with negative results?

Answer 507

Cardiac Catheterization

Question 508

Assessment of Cardiovascular System

Bearing down has what type of effect that↓the HR?

Answer 508

Parasympathetic effect

Question 509

Assessment of Cardiovascular System
📈 When diastolic pressure rises on the heart due to it being stretched, what cardiac natriuretic peptide marker is released to decrease the pressure?

Answer 509

BNP

Question 510

Assessment of Cardiovascular System

📈 What cardiac biomarker is specific to the heart muscle and can only be detected 3-48 hours after damage to the heart?

Answer 510

CK-MB

Question 511

Assessment of Cardiovascular System

What pulse is auscultated at the right sternal border and second intercostal space?

Answer 511

Aortic

Question 512

Assessment of Cardiovascular System
📈 What diagnostic study is an ultrasound of moving images of the structure of the heart that can be given with or without contrast?

Answer 512

Echocardiogram

Question 513

Assessment of Cardiovascular System
When blood is not being pushed out of the heart or circulating adequately, fluid from blood leaks out of what structure and into the lungs causing Paroxysmal Nocturnal Dyspnea?

Answer 513

Capillaries

Question 514

Assessment of Cardiovascular System

📈 What does an exercise or stress test screen for?

Answer 514

CAD

Question 515

Assessment of Cardiovascular System

📈 Elevated BNP levels signify what CV disorder?

Answer 515

Heart Failure

Question 516

Assessment of Cardiovascular System

What is Pulsus Alternans?

Answer 516

Strength of pulse alters

Question 517

Assessment of Cardiovascular System
📈 An Echocardiogram is an ultrasound that is normally a noninvasive diagnostic test that screens for CAD by measuring what?

Answer 517

Ejection Fraction

Question 518

Assessment of Cardiovascular System

📈 Ejection Fraction is similar to what measurement but instead of L/min, its measured in a percentage?

Answer 518

Cardiac Output

Question 519

Assessment of Cardiovascular System

📈 What do you generally want the total cholesterol to be less than?

Answer 519

< 200

Question 520

Assessment of Cardiovascular System

What is it called when a patient cant lay flat in a bed and breath comfortably?

Answer 520

Orthopnea

Question 521

Assessment of Cardiovascular System

Palpation of what is described as a vibration or feeling of bees under the skin?

Answer 521

Thrill

Question 522

Assessment of Cardiovascular System

♿️ What could it mean if PMI is shifted to the left instead of midclavicular?

Answer 522

Heart is enlarging

Question 523

Assessment of Cardiovascular System

What is PPQRRST Method used to assess?

Answer 523

Pain

Question 524

Assessment of Cardiovascular System
📈 Echocardiograms measure what which is the percent of blood that is ejected when the ventricles contract with each heartbeat?

Answer 524

Ejection Fraction

Question 525

Assessment of Cardiovascular System

Lipids must bind to what to circulate in the blood?

Answer 525

Protein

Question 526

Assessment of Cardiovascular System
📈 With what diagnostic study can you see the structure of the heart and if there are any blood clots in the chambers of the heart?

Answer 526

Transesophageal Echo (TEE)

Question 527

Assessment of Cardiovascular System

Cholesterol comes from the food we eat and is also made by what body organ?

Answer 527

Liver

Question 528

Assessment of Cardiovascular System

😰 Jugular Vein Distention greater than what size above the clavicle may be considered abnormal?

Answer 528

> 0.5 inches.

Question 529

Assessment of Cardiovascular System

😰 Orthopnea commonly goes along with what CV disorder?

Answer 529

Heart Failure

Question 530

Assessment of Cardiovascular System

📈 Elevated C-Reactive Protein is an indicator for inflammation and a risk factor for what CV disorder?

Answer 530

Coronary Artery Disease

Question 531

Assessment of Cardiovascular System
📈 With what diagnostic imaging study does a catheter go through the blood vessel to the heart and looked at through X-Ray technology to measure the pressure in the heart?

Answer 531

Cardiac Catheterization

Question 532

Assessment of Cardiovascular System

When using the PPQRRST Method to assess pain, what does palliative mean?

Answer 532

What makes the pain better or go away?

Question 533

Assessment of Cardiovascular System

📈 Cardiac Computed Tomography CT Angiography views the coronary arteries and is looking for what kind of deposits?

Answer 533

Calcium

Question 534

Assessment of Cardiovascular System

What is felt over a fistula?

Answer 534

A thrill

Question 535

Acute Coronary Syndrome

💊 What drug therapy is used for patients with ACS?

Answer 535

▪️IV Nitroglycerin Drip (Tridil)
▪️Morphine
▪️β-Adrenergic Blockers
▪️ACE Inhibitors
▪️Anti-Dysrhythmias
▪️Cholesterol-Lowering Drugs
▪️Stool Softener

Question 536

Acute Coronary Syndrome
♿️ Ventricular fibrillation, a common cause of sudden cardiac death (SCD), is a lethal dysrhythmia that often occurs within the first 4 hours after the onset of what?

Answer 536

Pain

Question 537

Acute Coronary Syndrome

♿️ What complication of MI occurs when the pumping power of the heart has diminished and causes decreased stroke volume?

Answer 537

Heart Failure

Question 538

Acute Coronary Syndrome

😷 What is the nurses role in reducing the patients anxiety?

Answer 538

Identify the source and alleviate it

Question 539

Acute Coronary Syndrome
😷 What interventions are needed for the ongoing and intensive monitoring of the hemodynamic status for patients after a CABG?

Answer 539

▪️ICU for first 24-36 hours
▪️Pulmonary Artery Catheter 
▪️Intra-arterial Line 
▪️Pleural/Mediastinal Chest Tubes 
▪️Continuous ECG Monitoring 
▪️ET Tube w/ Mechanical Ventilation 
▪️Epicardial Pacing Wire 
▪️Urinary Catheter 
▪️NG Tube

Question 540

Acute Coronary Syndrome
💊 Alteplase / t-PA is used to dissolve clots when using IV Thrombolytic Therapy on a patient with a MI, but what medication is used with it to keep new clots from forming?

Answer 540

IV Heparin

Question 541

Acute Coronary Syndrome

💥📈 What ST Segment changes occur if the patient is having a heart attack / injury to the cells?

Answer 541

ST Segment Elevation

Question 542

Acute Coronary Syndrome

😷 After a PCI, a neurovascular assessment should be done on what area of the body?

Answer 542

Check 6 P’s distal from where they did the procedure.

Question 543

Acute Coronary Syndrome

💊 What surgery is recommended for patients with a failed PCI or that isn’t a candidate for PCI?

Answer 543

Coronary Artery Bypass Graft (CABG)

Question 544

Acute Coronary Syndrome

😰 Crackles that persist for several hours to several days after a MI suggest what type of dysfunction?

Answer 544

Left Ventricular Dysfunction - Left Ventricle failing and starts to back up in lungs

Question 545

Acute Coronary Syndrome

😷 If a coronary revascularization with emergent PCI is not available, what would be done instead for patients with a MI?

Answer 545

Thrombolytic Agents

Question 546

Acute Coronary Syndrome

💊 Alteplase / t-PA is hard to reverse and should not be given to what patients?

Answer 546

Patients that have had:
▪️Recent Trauma
▪️Recent Surgery
▪️Recent Head Injury
▪️Prolonged CPR
▪️A Stroke

Question 547

Acute Coronary Syndrome

💉 How long after the onset of MI symptoms does CK-MB levels rise?

Answer 547

After about 3 hours

Question 548

Acute Coronary Syndrome

💉 How long after the onset of MI symptoms will Troponin start rising?

Answer 548

About 4 hours

Question 549

Acute Coronary Syndrome

😷 After a PCI, what is the patient instructed not to do for 4-6 hours because it could pop the clot that was formed?

Answer 549

No Bending

Question 550

Acute Coronary Syndrome
💊 What medication that calms the patient which reduces the work of the heart and also dilates the blood vessels is given if Nitroglycerin doesn’t relieve pain?

Answer 550

Morphine

Question 551

Acute Coronary Syndrome
💊 What procedure uses full or partial sternotomy to access all of the coronary vessels but is performed on a beating heart using mechanical stabilizers instead of CPB?

Answer 551

Off-Pump Coronary Artery Bypass (OPCAB)

Question 552

Acute Coronary Syndrome

🍓 What diet will the patient with an MI progress to once they are pain free and nausea is resolved?

Answer 552

↓Salt
↓Saturated Fats
↓Cholesterol

Question 553

Acute Coronary Syndrome

💊Drug therapy for Acute Coronary Syndrome tend to be the same drugs used for what other cardiovascular disorders?

Answer 553

CAD & Angina

Question 554

Acute Coronary Syndrome

Why do younger adults have more serious first MI than an older person with the same degree of blockage?

Answer 554

Individuals with a long history of CAD will develop collateral circulation

Question 555

Acute Coronary Syndrome

😰 What happens to the patients glucose when a MI occurs?

Answer 555

Goes up because adrenal glands release glycogen

Question 556

Acute Coronary Syndrome

😰 In what gender may symptoms of unstable angina be more vague because they do not have typical angina?

Answer 556

Woman

Question 557

Acute Coronary Syndrome
♿️ Electrolyte Imbalances and SNS stimulation affect the myocardial cell’s sensitivity to nerve impulses and can cause dysrhythmias, but what is the most common cause of dysrhythmias after a MI?

Answer 557

▪️Ischemia (Most Common)

▪️Electrolyte Imbalances (less likely)
▪️SNS Stimulation (Norepinephrine stressing the heart & making it more ischemic)

Question 558

Acute Coronary Syndrome

😷 After a CABG, the patient will have continuous ECG monitoring to detect for what complication?

Answer 558

Dysrhythmias

Question 559

Acute Coronary Syndrome
What is the process called when normal myocardium to hypertrophy and dilate in an attempt to compensate for the infarcted muscle after a MI occurs?

Answer 559

Ventricular Remodeling

Question 560

Acute Coronary Syndrome
♿️ When an acute MI occurs, cardiac cells can withstand sustained ischemic conditions for approximately how long before cellular death begins?

Answer 560

Approximately 20 minutes

Question 561

Acute Coronary Syndrome

💊 How are all Thrombolytics administered?

Answer 561

IV

Question 562

Acute Coronary Syndrome

♿️ Dysrhythmias vary with severity but what type occurs most often with anterior wall infarction, HF, or shock?

Answer 562

Life-Threatening

Question 563

Acute Coronary Syndrome

🍓 What diet will patients with an MI initially be on?

Answer 563

NPO with ice chips

Question 564

Acute Coronary Syndrome

💊 What is the treatment of choice for a confirmed MI whether ST elevation is present or not?

Answer 564

Balloon Angioplasty + Stent(s)

Question 565

Acute Coronary Syndrome

🚨 What type of angina is a medical emergency and the patient is likely to be hospitalized?

Answer 565

Unstable Angina

Question 566

Acute Coronary Syndrome

😷 After a PCI, why is it important to flush the kidneys to protect them from the contrast?

Answer 566

Contrast is toxic to kidneys

Question 567

Acute Coronary Syndrome
💊 What medication is used in the initial treatment of the patient with ACS that is having chest pain and ST Segment Elevation

Answer 567

IV Nitroglycerin (Tridil) Drip

Question 568

Acute Coronary Syndrome

💊 What is used so that the patients heart can be stopped with an open sternotomy?

Answer 568

Cardiopulmonary Bypass (CPB) Machine

Question 569

Acute Coronary Syndrome

😰 What abnormal heart sounds after a MI may suggest ventricular dysfunction?

Answer 569

S3 or S4 & A New Murmur

Question 570

Acute Coronary Syndrome
😷 When monitoring heart pressures using a Pulmonary Artery Catheter, what happens to the Left Ventricle pressures if the heart starts to fail?

Answer 570

L. Ventricle pressures will rise

Question 571

Acute Coronary Syndrome
😷 If a Sternotomy was done, what is often sutured to the surface of the heart that comes out of the chest cavity and can be connected to a pulse generator for emergency pacing of the heart?

Answer 571

Epicardial Pacing Wires

Question 572

Acute Coronary Syndrome
😷 A Pulmonary Artery Catheter is usually put in during a CABG procedure and is used to monitor what throughout the recovery phase?

Answer 572

Heart Pressures

Question 573

Acute Coronary Syndrome
💊 Until the patient is stable and can undergo a Coronary Angiography with PCI, what drug combination is recommended to prevent clots in patients with Unstable Angina or NSTEMI?

Answer 573

▪️Aspirin
▪️Heparin Drip
▪️Glycoprotein Inhibitor (Integrilin)

Question 574

Acute Coronary Syndrome

📈 What test is done on patients with a MI before they are discharged that will gauge their activity level?

Answer 574

Low-Level Stress Test

Question 575

Acute Coronary Syndrome

♿️ When ischemia is prolonged, Acute Coronary Syndrome develops and encompasses what disorders?

Answer 575

▪️Unstable Angina (UA)
▪️Non-ST Segment Elevation Myocardial Infarction (NSTEMI)
▪️ST Segment Elevation Myocardial Infarction (STEMI)

Question 576

Acute Coronary Syndrome

😰💥 The presence of what symptom after a PCI indicates that it was a failed attempt and CABG is needed?

Answer 576

Failed PCA with ongoing Chest Pain

Question 577

Acute Coronary Syndrome

♿️ What is a post-op concern for CABG that requires sternotomy?

Answer 577

Infection

Question 578

Acute Coronary Syndrome
😷 Dyspnea, Tachycardia, Pulmonary Congestion, and Distended Neck Veins are evidence of what complication that is monitored for in patients recovering from ACS by assessing heart & breath sounds and VS?

Answer 578

HF

Question 579

Acute Coronary Syndrome

📚 What is important to teach patients with ACS?

Answer 579

Explain why rest is important (Scar tissue hasn’t formed that well yet)

Question 580

Acute Coronary Syndrome
💊 How does the Saphenous Vein differ from the Internal Mammary Artery and what characteristic of the Saphenous Vein usually causes it to occlude sooner than the Internal Mammary Artery?

Answer 580

Saphenous Vein has valves so it has to be turned around and the valves cause it to occlude sooner.

Question 581

Acute Coronary Syndrome
😷 The goal in the treatment of a MI is to have the patient in the catheter laboratory within how long after coming to the ER?

Answer 581

90 minutes

Question 582

Acute Coronary Syndrome

😷 After a CABG, the patient will have an ET Tube with Mechanical Ventilation that usually stays in for how long?

Answer 582

Most patients will be extubated within 6 hours which is usually the next morning.

Question 583

Acute Coronary Syndrome
😷 The HCP should be notified if there are any neurovascular problems identified because there could be a clot forming at what part of the artery and preventing blood flow down to the foot.

Answer 583

Could mean there is a clot forming INSIDE the artery

Question 584

Acute Coronary Syndrome
😰 Pulmonary congestion on chest X-Ray, S3 or S4 heart sounds, crackles, & jugular vein distention are signs that indicate the onset of HF but initially it occurs with what subtle signs?

Answer 584

▪️Mild Dyspnea
▪️Restlessness
▪️Agitation
▪️Slight Tachycardia

Question 585

Acute Coronary Syndrome
💊 When a patient is having a MI, what medication is given to stop the enlargement of the clot and prevent new ones from starting?

Answer 585

Chewable Aspirin (ASA)

Question 586

Acute Coronary Syndrome
😰 What clinical manifestation occurs after a MI because the heart isn’t able to generate enough blood flow to the GI tract?

Answer 586

Nausea & Vomiting - Usually NPO except for ice chips

Question 587

Acute Coronary Syndrome

📈 How often is progression monitored if there are ECG changes?

Answer 587

Daily

Question 588

Acute Coronary Syndrome

When the patient has total occlusion of the coronary artery, they are on their to having what?

Answer 588

STEMI

Question 589

Acute Coronary Syndrome
♿️ What fatal complication of a MI can lead to HF & Dysrhythmias if a rupture occurs due to the myocardial wall becoming thinned and bulging out in the opposite direction during contractions?

Answer 589

Ventricular Aneurysm

Question 590

Acute Coronary Syndrome
♿️ The Papillary Muscles are finger like projections at the bottom of the ventricles that have Chordae Tendineae at the ends of them which attachment to valves and keep from allowing 2 way flow. When a MI causes a Pulmonary Muscles rupture, mitral valve regurgitation occurs and usually results in what serious complication?

Answer 590

Cardiogenic Shock

Question 591

Acute Coronary Syndrome
💊 With CABG surgery the patients own veins and arteries are commonly used for grafting. What vein in the leg is the most common used for bypass graft because of length?

Answer 591

Saphenous Vein

Question 592

Acute Coronary Syndrome

♿️ Blockage of what artery will result in anterior wall MI’s?

Answer 592

Left Anterior Descending Artery

Question 593

Acute Coronary Syndrome

♿️ What causes 80-90% of all acute MI’s?

Answer 593

Thrombus Formation

Question 594

Acute Coronary Syndrome

📚 When should patients with a MI be taught to avoid sex?

Answer 594

▪️After a heavy meal
▪️Tired or haven’t had a good nights rest
▪️If they’ve been drinking heavily
▪️With unfamiliar partners

Question 595

Acute Coronary Syndrome
💊 Alteplase / t-PA is ideally given within the first hour, but must be given within how long after the onset of MI symptoms?

Answer 595

6 hours

Question 596

Acute Coronary Syndrome

😷 Why should blood be draw and 2-3 IV’s be started to draw blood from first before starting Thrombolytic Therapy?

Answer 596

If blood is drawn or an IV is started after administering Alteplase, there will be prolonged bleeding.

Question 597

Acute Coronary Syndrome
♿️ What complication of a MI occurs when Heart Failure becomes so bad that the heart cant provide enough oxygen and blood flow to the body due to LV Failure?

Answer 597

Cardiogenic Shock

Question 598

Acute Coronary Syndrome

💊 What can be used to assist the surgeon when performing CABG or Mitral Valve Replacement?

Answer 598

Robot-Assisted Surgery (Da Vinci robot arms)

Question 599

Acute Coronary Syndrome

😷 Whether it is a STEMI or NSTEMI, Angioplasty with stent placement will be done if what cardiac markers are positive?

Answer 599

Troponin

Question 600

Acute Coronary Syndrome

Partial blockage of the coronary arteries with a thrombus usually results in what?

Answer 600

Unstable Angina or NSTEMI

Question 601

Acute Coronary Syndrome
😰 After a MI, the systemic inflammatory process caused by myocardial cell death can cause the patients temperature may be up to what temperature for the first 24 hours?

Answer 601

100.4

Question 602

Acute Coronary Syndrome
📚 Teach the patient to gradually increase activity after a MI because if the scar tissue has not had time to harden it could cause what complications?

Answer 602

▪️Ventricular Aneurism
▪️Hole in the Heart
▪️Extend their Heart Attack

Question 603

Acute Coronary Syndrome
💊 When PCI is not available, What “clot buster” IV medication is given to patients with a MI to stop the infarction process by dissolving thrombus?

Answer 603

Alteplase, t-PA

Question 604

Acute Coronary Syndrome

😷💥 When is IV Thrombolytic therapy used in patients with a MI?

Answer 604

When PCI is not available in STEMI

Question 605

Acute Coronary Syndrome
♿️ Ischemia starts in the subendocardium and then starts to move outward towards the entire thickness of the myocardium. If ischemia persists, it takes approximately how long for the entire thickness of the heart muscle to become necrosed?

Answer 605

4-6 hours

Question 606

Acute Coronary Syndrome
😰 During the initial phase of a MI, the ischemic myocardial cells release catecholamines (norepinephrine & epinephrine) and results in what clinical manifestations?

Answer 606

▪️Diaphoresis
▪️Skin: Ashen, Clammy, and/or cool to touch
▪️Vasoconstriction
▪️Release of glycogen

Question 607

Acute Coronary Syndrome

😰 What symptom should not occur after a PCI and is considered a medical emergency if it does?

Answer 607

Chest Pain

Question 608

Acute Coronary Syndrome
😷 After a CABG the patient has an Intra-Arterial Line that can be used to draw ABG’s but is primarily used for continuous monitoring of what?

Answer 608

BP

Question 609

Acute Coronary Syndrome

♿️ Blockage of what artery will result in an inferior wall MI?

Answer 609

Right Coronary Artery

Question 610

Acute Coronary Syndrome

😰 Jugular Vein distention, hepatic engorgement, and peripheral edema after an MI may indicate what dysfunction?

Answer 610

Right Ventricular Dysfunction - Right side of heart cant move blood through lungs to the Left side.

Question 611

Acute Coronary Syndrome

😷💥 What patients are not candidates for PCI and would need to have a CABG?

Answer 611

▪️Presence of Left Main Coronary Artery
▪️Presence of Three-Vessel Disease
▪️Lesions are long and difficult to assess
▪️History of Diabetes

Question 612

Acute Coronary Syndrome

💊 What surgical procedure is an alternative to the traditional CABG that does not involve a full sternotomy?

Answer 612

Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)

Question 613

Acute Coronary Syndrome

😰♿️ What is the most common complication after an MI which is life-threatening and present in 80-90% of patients?

Answer 613

Dysrhythmias

Question 614

Acute Coronary Syndrome
😷 When monitoring heart rhythms of a patient recovering from a MI, what would indicate that damage is still occurring or is reoccurring?

Answer 614

ST Segment Elevation

Question 615

Acute Coronary Syndrome
😷 After a PCI, VS are checked frequently because there is a risk for hemorrhage and cardiac rhythms are monitored because the procedure could have altered the heart rhythm or triggered what complication?

Answer 615

Dysrhythmia

Question 616

Acute Coronary Syndrome

😰♿️ What is the most common cause of death in the prehospital phase after a MI?

Answer 616

Dysrhythmias

Question 617

Acute Coronary Syndrome

😷 What intervention would you expect to prepare a patient to undergo within 90 minutes of arriving at the ED with a MI?

Answer 617

Angioplasty with stent placement

Question 618

Acute Coronary Syndrome

🍓 When can the diet be advanced from NPO in patients with an MI?

Answer 618

When stable - Pain free & Nausea is resolved

Question 619

Acute Coronary Syndrome

💊 What is used to treat pain in patients with ACS?

Answer 619

▪️Nitroglycerin
▪️Morphine
▪️Oxygen

Question 620

Acute Coronary Syndrome

🚬 At what time of day are MI’s more common?

Answer 620

In the morning

Question 621

Acute Coronary Syndrome

♿️ What complication of a MI occurs when inflammation radiates to the outside of the heart and the pericardium?

Answer 621

Acute Pericarditis

Question 622

Acute Coronary Syndrome

😰 What vital sign changes occur in response to the release of catecholamines due to a MI?

Answer 622

↑HR & BP, then↓BP later secondary to↓CO because adrenalin wears off

Question 623

Acute Coronary Syndrome

😷 What ongoing monitoring is done for patients that have had a MI?

Answer 623

▪️Treat Dysrhythmias
▪️Frequent VS Monitoring
▪️Bed Rest / Limit Activity for 12-24 hours

Question 624

Acute Coronary Syndrome

😷 How long are patient usually in ICU after CABG?

Answer 624

24-36 hours

Question 625

Acute Coronary Syndrome

Coronary Artery Bypass Graft is also know as what?

Answer 625

Open heart surgery

Question 626

Acute Coronary Syndrome
😰 MI pain in the typical person is severe immobilizing chest pain not relieved by rest, position changes, or nitrate administration and the patient usually describes what characteristics of pain?

Answer 626

▪️Heaviness
▪️Pressure
▪️Tightness
▪️Burning
▪️Constriction
▪️Crushing

Question 627

Acute Coronary Syndrome

😷 What complication of PCI does the nurse monitoring for and is a medical emergency?

Answer 627

Recurrent Angina

Question 628

Acute Coronary Syndrome

♿️ What develops when ischemia is prolonged and not immediately reversible?

Answer 628

Acute Coronary Syndrome

Question 629

Acute Coronary Syndrome

😷 What are the initial interventions for a patient having a MI?

Answer 629

▪️12-Lead ECG
▪️Semi Fowlers Position
▪️Keep O2 @ 93%
▪️IV Access
▪️Nitroglycerin (SL) or spray
▪️Chewable Aspirin (ASA)
▪️Morphine IV if no relief with NTG

Question 630

Acute Coronary Syndrome
😷 When a Pulmonary Catheter is inserted, a balloon is wedged into a branch of the pulmonary artery so that pressures in what area of the heart can be measured indirectly?

Answer 630

Left Ventricle

Question 631

Acute Coronary Syndrome
😰 What type of angina is described as chest pain that is a new onset, occurs at rest, or has a worsening pattern that is requiring more nitroglycerin to relieve symptoms?

Answer 631

Unstable Angina

Question 632

Acute Coronary Syndrome

😷 What classic signs of reperfusion do you want to assess for in patients on Thrombolytic Therapy?

Answer 632

▪️ST segment return to baseline
▪️Chest pain is resolved
▪️Rapid rise and fall of Troponin because damage to heart has been stopped.

Question 633

Acute Coronary Syndrome

😷 Cardiogenic Shock has a high mortality rate and requires what type of management?

Answer 633

Aggressive Management in an ICU Setting

Question 634

Acute Coronary Syndrome
📚 When the patient is discharged after a MI, what do you want to teach them to do if they’re going to increase their activity level?

Answer 634

Take their Pulse and BP

Question 635

Acute Coronary Syndrome

😰 What is the hallmark of a MI?

Answer 635

Severe, immobilizing chest pain not relieved by rest, position changes, or nitrate administration.

Question 636

Acute Coronary Syndrome

😰 What patients may not have with a MI?

Answer 636

Diabetes (Cardiac Neuropathy)

Question 637

Acute Coronary Syndrome

💉 How often are serum cardiac markers repeated to see if they are going down?

Answer 637

Q6-8 hours

Question 638

Acute Coronary Syndrome

😷 Why is the catheter insertion site monitored after a PCI?

Answer 638

Monitored for bleeding because they received anticoagulants during the procedure and if bleeding occurs, it is arterial bleeding and the patient could die quickly.

Question 639

Acute Coronary Syndrome

😷 Patients on Thrombolytics should be monitored closely for what?

Answer 639

Bleeding - Neuro Checks & VS for internal bleeding

Question 640

Acute Coronary Syndrome

📚 What steps do you want to teach the patient to take if they experience chest pain or SOA during exercise?

Answer 640

▪️Stop
▪️Sit Down
▪️Take Nitroglycerin
▪️Call HCP because its a new event

Question 641

Acute Coronary Syndrome
😷 So the heart doesn’t get compressed, patients often have tubes coming out of the mediastinum during a CABG to remove what?

Answer 641

Blood because there may be bleeding around the heart during surgery

Question 642

Acute Coronary Syndrome
♿️ Pericarditis may result in what what complication that causes decreased SV and compromises the cardiac output due to fluid build up under the pericardium that compresses the heart muscle?

Answer 642

Cardiac Tamponade

Question 643

Acute Coronary Syndrome

📚 What medication can the nurse teach the patient with a MI to take prophylactically before sexual activity?

Answer 643

Nitrates

Question 644

Acute Coronary Syndrome

😷 Why should a patient recovering from a MI be on bed rest / limited activity for 12-24 hours?

Answer 644

Don’t want the heart to work harder than it has to. If oxygen demand is increased, less oxygen will get to the areas that need it and cells will die.

Question 645

Acute Coronary Syndrome

😷 What action does the nurse take if there is any type of bleeding at the catheter insertion site after a PCI?

Answer 645

Apply firm pressure nonstop for 20 minutes

Question 646

Acute Coronary Syndrome
📚 How long after MI has scar tissue replaced necrotic tissue and the injured area is considered healed but less compliant?

Answer 646

6 weeks

Question 647

Acute Coronary Syndrome

😷 Why are patients with ACS on continuous heart monitoring?

Answer 647

They are at risk for life threatening dysrhythmias

Question 648

Acute Coronary Syndrome

What is the overall expected outcomes for patients with ACS?

Answer 648

▪️Stable VS
▪️Relief of Pain
▪️Decreased Anxiety
▪️Realistic Program of Activities
▪️Effective Management of Therapeutic Regimen

Question 649

Acute Coronary Syndrome

😷 What common complication of a CABG is the reason that a chest tube is inserted postoperatively?

Answer 649

Atelectasis (Collapse of the lung)

Question 650

Acute Coronary Syndrome
💊 During a bypass graft, what most commonly used artery is left attached to its original (Subclavian Artery) and sutured just past the blockage at the opposite end to provide blood flow to the distal tissue?

then dissected f

Answer 650

Internal Mammary Artery (IMA)

Question 651

Acute Coronary Syndrome

When plaque builds up in the coronary arteries and ruptures, what is formed?

Answer 651

thrombus

Question 652

Acute Coronary Syndrome

😰 What characteristic clinical manifestation of Pericarditis is relieved by sitting in a forward position?

Answer 652

Chest Pain

Question 653

Acute Coronary Syndrome
💉 What is the Gold Standard serum cardiac marker that is most specific to heart cells and is sensitive to myocardial injury?

Answer 653

Troponin T & Troponin I

Question 654

Acute Coronary Syndrome
📚 If a patient is taking Nitroglycerin, what medication do you want to instruct them not to take because it is contraindicated with Nitrates and will drop the BP significantly?

Answer 654

Erectile Dysfunction Drugs

Question 655

Acute Coronary Syndrome
😷 How long after a MI may the patients activity level be increased even though the new scar tissue is still weak and vulnerable to stress?

Answer 655

10-14 Days

Question 656

Structure & Functions of Cardiovascular System

Systole reading of a BP is the results of what contraction?

Answer 656

Ventricles

Question 657

Structure & Functions of Cardiovascular System
When capillaries vasoconstrict due to decreased CO, blood traveling from the heart to arteries system shunts directly over to the venous system using what channel?

Answer 657

Thoroughfare Channel

Question 658

Structure & Functions of Cardiovascular System

What Mean Arterial Pressure (MAP) is essential to maintain organ perfusion in most cases?

Answer 658

MAP of 60 or greater

Question 659

Structure & Functions of Cardiovascular System

What is measured at the end of diastole when the heart is at its fullest and the ventricles are relaxed?

Answer 659

Preload

Question 660

Structure & Functions of Cardiovascular System

If the BP cuff is too small, what results will occur?

Answer 660

Artificially too high

Question 661

Structure & Functions of Cardiovascular System

How do Chemoreceptors respond to high CO2?

Answer 661

Raises RR and BP to get rid of CO2

Question 662

Structure & Functions of Cardiovascular System
What occurs due to blood cooling in the lower extremities and incompetent venous valves that make blood return to R. side of the heart more difficult?

Answer 662

Edema

Question 663

Structure & Functions of Cardiovascular System

What ventricle is 2-3 thicker and works against gravity to get blood back to opposite side of the heart?

Answer 663

Left Ventricle

Question 664

Structure & Functions of Cardiovascular System

What is the pulse pressure for BP 134/78

Answer 664

PP= 56

Question 665

Structure & Functions of Cardiovascular System

What measures how good the body is getting circulation and how well its being oxygenated?

Answer 665

Cardiac Output

Question 666

Structure & Functions of Cardiovascular System

What will happen to vital organs if the MAP is <60 and vital organs are under-perfused?

Answer 666

Will become ischemic

Question 667

Structure & Functions of Cardiovascular System

Rapid exchange of what generates electrical activity of the heart.

Answer 667

Electrolytes

Question 668

Structure & Functions of Cardiovascular System

😰 What is the earliest indicator of poor cardiac output?

Answer 668

Mental Confusion

Question 669

Structure & Functions of Cardiovascular System

When capillaries vasoconstrict due to decreased cardiac output, what does not occur at the tissue level?

Answer 669

oxygenation or removal of CO2

Question 670

Structure & Functions of Cardiovascular System

What Autonomic Nervous System regulator slows HR and decreases heart strength?

Answer 670

Parasympathetic

Question 671

Structure & Functions of Cardiovascular System

In what way does cardiac index differ from cardiac output?

Answer 671

Cardiac Index is normalized to body size

Question 672

Structure & Functions of Cardiovascular System

What happens to heart valves as a result of increased collagen and decreased elastin due to age related changes?

Answer 672

Thick and Stiff

Question 673

Structure & Functions of Cardiovascular System

What receptors make blood vessels constrict and dilate?

Answer 673

Alpha Receptors

Question 674

Structure & Functions of Cardiovascular System
💥Used blood from the heart muscle goes into the venous system and drains back into what area of the heart where other de-oxygenated blood is collected?

Answer 674

Right Atrium

Question 675

Structure & Functions of Cardiovascular System

What is known as relaxation of the myocardium and allows for filling of the ventricles?

Answer 675

Diastole

Question 676

Structure & Functions of Cardiovascular System
In older adults, what Sympathetic Nervous System receptor in the heart is not able to stimulate the heart in the same way as it did when they were younger?

Answer 676

Beta Receptor

Question 677

Structure & Functions of Cardiovascular System

What two valves are semilunar valves and close simultaneously?

Answer 677

Aortic & Pulmonic

Question 678

Structure & Functions of Cardiovascular System

Veins bring blood in which direction in relation to the heart?

Answer 678

Brings blood back to the heart

Question 679

Structure & Functions of Cardiovascular System

Cardiovascular changes are not sudden but happen over a lifetime as a result of what?

Answer 679

Aging
Disease
Environmental Factors
Lifetime Behaviors

Question 680

Structure & Functions of Cardiovascular System

😰 What clinical manifestations are present when the capillaries aren’t getting blood flow?

Answer 680

Cold

Clammy

Question 681

Structure & Functions of Cardiovascular System

Vasoconstriction occurs with what Autonomic Nervous System regulator?

Answer 681

Sympathetic

Question 682

Structure & Functions of Cardiovascular System

What do Chemoreceptors respond to?

Answer 682

CO2 levels

Question 683

Structure & Functions of Cardiovascular System

What formula is used to determine the Pulse Pressure?

Answer 683

SBP-DBP = PP

Question 684

Structure & Functions of Cardiovascular System

What is the normal range for Cardiac Output?

Answer 684

4-8 L/min

Question 685

Structure & Functions of Cardiovascular System

As a response to the sympathetic nervous system, what happens to capillaries when there is decreased cardiac output?

Answer 685

Vasoconstriction and shut down

Question 686

Structure & Functions of Cardiovascular System

What is known as the pacemaker of the heart?

Answer 686

SA Node

Question 687

Structure & Functions of Cardiovascular System

What is the major difference between veins and arteries?

Answer 687

Veins have valves to push the blood back up

Question 688

Structure & Functions of Cardiovascular System

What is postprandial?

Answer 688

After Meals

Question 689

Structure & Functions of Cardiovascular System
What regulator of the CV system responds to vessel pressures (Slows HR with high BP and Increases BP & HR when BP is low)?

Answer 689

Baroreceptors

Question 690

Structure & Functions of Cardiovascular System

Blockage of what artery is often called the “widow maker”?

Answer 690

Left Coronary Artery

Question 691

Structure & Functions of Cardiovascular System

What is the CO x SVR (systemic vascular resistance / afterload)?

Answer 691

BP

Question 692

Structure & Functions of Cardiovascular System

What autonomic nervous system regulator increases HR and contractility?

Answer 692

Sympathetic

Question 693

Structure & Functions of Cardiovascular System

What is the measure of blood pumped by each ventricle in 1 minute?

Answer 693

Cardiac Output

Question 694

Structure & Functions of Cardiovascular System

Arteries bring blood in which direction in relation to the heart?

Answer 694

Brings blood away from the heart

Question 695

Structure & Functions of Cardiovascular System

A clot in what blood flow system will cause a Pulmonary Embolism?

Answer 695

Venus System

Question 696

Structure & Functions of Cardiovascular System

What turns into acid in the blood making the body want to naturally become acidotic?

Answer 696

CO2

Question 697

Structure & Functions of Cardiovascular System

What is known as the peripheral resistance against which the left ventricle must pump?

Answer 697

Afterload

Question 698

Structure & Functions of Cardiovascular System

What is known as the amount of blood ejected with each heart beat?

Answer 698

Stroke Volume

Question 699

Structure & Functions of Cardiovascular System

Pulse Pressure increases in older adults due to what BP changes?

Answer 699

↑ SBP & a↓or unchanged DBP

Question 700

Structure & Functions of Cardiovascular System

If you can hear a radial pulse, you know that the Systolic Blood Pressure is at least what?

Answer 700

60

Question 701

Structure & Functions of Cardiovascular System

What type of catheter can measure Stroke Volume?

Answer 701

Pulmonary Artery Catheter

Question 702

Structure & Functions of Cardiovascular System

💊 What drug therapy can be given to increase afterload?

Answer 702

Vasodilators

Question 703

Structure & Functions of Cardiovascular System

What happens to the cardiac output and stroke volume if there is increased resistance with afterload?

Answer 703

CO and SV are reduced

Question 704

Structure & Functions of Cardiovascular System

How many mL of blood is ejected from the L. Ventricle with each beat?

Answer 704

70-100 mL

Question 705

Structure & Functions of Cardiovascular System

What controls blood flow and makes sure it flows in one direction?

Answer 705

Valves

Question 706

Structure & Functions of Cardiovascular System

What cranial nerve is the primary nerve of the Parasympathetic Nervous System?

Answer 706

Vagus Nerve

Question 707

Evolve- Ch 37

📈 What diagnostic study helps detect the presence of vegetation on the heart valves in a patient with endocarditis?

Answer 707

Transesophageal Echocardiogram

Question 708

Evolve- Ch 36

💊 What is the most effective technique for the treatment of atrial flutter?

Answer 708

Radiofrequency Catheter Ablation

Question 709

Evolve- Ch 38

😰 How is chest pain associated with acute dissection of the ascending aorta described?

Answer 709

Ripping in nature

Question 710

Evolve- Ch 36
📚 What instructions should be given to patients upon discharge who have underwent a cardioverter-defibillator implant (ICD)?

Answer 710

▪️Keep dry & report S&S of infection
▪️Avoid large magnets and strong electromagnetic fields
▪️Inform the cardiologist if the implant fires
▪️Don’t lift the arm on the side of the ICD until approved

Question 711

Evolve- Ch 3

😰 Pulmonary congestion and edema are manifestations of what type of heart failure?

Answer 711

Left-Sided Heart Failure

Question 712

Evolve- Ch 35

😷 What is the treatment of choice to end ventricular fibrillation and pulseless ventricular tachycardia?

Answer 712

Defibrillation

Question 713

Evolve- Ch 34

🍓 Heavy meals should be avoided to prevent angina because it would divert more blood to what area?

Answer 713

Gastrointestinal System

Question 714

Evolve- Ch 38

💊 What medication is contraindicated in patients diagnosed with Buerger’s Disease?

Answer 714

Nicotine Transdermal

Question 715

Evolve- Ch 38
😰 The patient reports leg pain that occurs when they are elevated and disappears when the legs are dangled. What is the patient most likely experiencing?

Answer 715

Arterial Insufficiency

Question 716

Evolve- Ch 35

😷 What is the priority intervention when caring for a patient with manifestations of Left-Sided Heart Failure?

Answer 716

Auscultate Lung Sounds

Question 717

Evolve- Ch 35
😰 The acronym “FACES” (Fatigue, Asphyxia, Chest Congestion, Edema, SOB) are used to teach patients about symptoms of what complication?

Answer 717

Heart Failure

Question 718

Evolve- Ch 38
💊 What should the nurse do to avoid leaving medication in the needle track in the tissue when administering enoxaparin (Lovenox)?

Answer 718

Leave the air bubble in the prefilled syringe

Question 719

Evolve- Ch 38

😰 What symptom is indicative of lipodermatosclerosis?

Answer 719

Leathery, brown-colored skin

Question 720

Evolve- Ch 37

😰 While admitting a patient with Pericarditis, the nurse will assess for what manifestations of this disorder?

Answer 720

Pulsus Paradoxus because >10 mm Hg is a sign of cardiac tamponade that should be assessed at least Q4 hrs in a patient with Pericarditis.

Question 721

Evolve- Ch 36

📈 ST segment depression and T wave inversion indicates what?

Answer 721

Myocardial Ischemia

Question 722

Evolve- Ch 37

💊 What medication should the nurse expect to implement to provide pain relief in a patient with pericarditis?

Answer 722

NSAID’s

Question 723

Evolve- Ch 38
📚 To decrease vasospasm and promote normal blood circulation in patients with Raynaud’s Phenomenon, what should the nurse teach the patient?

Answer 723

Immerse hands in warm water

Question 724

Evolve- Ch 37

💊 What are the side effects of Digoxin?

Answer 724

May result in dysrhythmias & it may cause toxicity

Question 725

Evolve- Ch 36

💊 A patient in asystole is likely to receive which drug treatment?

Answer 725

Epinephrine and Atropine

Question 726

Evolve- Ch 38

😷 What is the priority nursing action to maintain graft patency for patients that have had an aortic aneurysm repair?

Answer 726

IV fluids to maintain adequate BP.

Question 727

Evolve- Ch 38

💉 The therapeutic range for INR is 2.0 - 3.0. The larger the INR number, the greater the amount of what?

Answer 727

Anticoagulation

Question 728

Evolve- Ch 35

😰 Edema, Ascites, and Anasarca are assessment findings that are expected with what type of heart failure?

Answer 728

Right Sided Heart Failure

Question 729

Evolve- Ch 34

📚 If symptoms improve, patients should be taught to repeat nitroglycerin every 5 mins for a maximum of how many doses?

Answer 729

Q5 mins for maximum of 3 doses

Question 730

Evolve- Ch 37

😰 What heart sounds should the nurse expect to hear in a patient with chronic mitral valve regurgitation?

Answer 730

Third heart sound (S3) gallop & Holosystolic Murmur

Question 731

Evolve- Ch 38

😰 What clinical manifestation does the nurse expect the patient with Buerger’s Disease to report?

Answer 731

Leg pain with exercise and relief with rest

Question 732

Evolve- Ch 36
💊 Adenosine should be given within what amount of time via an IV site as close as possible to the heart and followed immediately by 20 mL of normal saline bolus flush?

Answer 732

Should be given within 1-2 seconds

Question 733

Evolve- Ch 35
😰 Because fluid moves from the pulmonary capillary bed into the pulmonary interstitium and alveoli, crackles and wheezes are manifestations of what type of heart failure?

Answer 733

Left Sided Heart Failure

Question 734

Evolve- Ch 36

📈 A rate of 200 beats/min and a P wave that isn’t visible is characteristic of what dysrhythmia?

Answer 734

Ventricular Tachycardia

Question 735

Evolve- Ch 37

♿️ What complication could result from infective endocarditis (IE)?

Answer 735

Pulmonary Embolization

Question 736

Evolve- Ch 35

😰 The nurse notes that paroxysmal nocturnal dyspnea is a condition indicative of what more serious problem?

Answer 736

CHF

Question 737

Evolve- Ch 36

💊 What action does flecainide have on the heart?

Answer 737

Decreases conduction

Question 738

Evolve- Ch 38

😰 What finding would the nurse expect in a patient with superficial vein thrombosis?

Answer 738

Appearance of the vein as a palpable cord

Question 739

Evolve- Ch 34

😷 When planning emergent care for a patient with a suspected MI, what should the nurse anticipate administering?

Answer 739

Oxygen, Nitroglycerin, Aspirin, and Morphine

Question 740

Evolve- Ch 37

😰 What is the therapeutic role of digoxin in treating myocarditis?

Answer 740

To improve myocardial contractility

Question 741

Evolve- Ch 38
📈 When the patient is being examined for venous thromboembolism (VTE) in the calf, what diagnostic test should the nurse expect to teach the patient about first?

Answer 741

Duplex Ultrasound

Question 742

Evolve- Ch 38

😰 What assessment finding is considered a classic symptom of lower extremity PAD?

Answer 742

Intermittent Claudication

Question 743

Evolve- Ch 38
😰 What manifestation involving the lower extremities should the nurse expect when doing a physical assessment on a patient with chronic venous insufficiency?

Answer 743

Brown color

Question 744

Evolve- Ch 35
😰 Extreme SOB, persistent cough with pink frothy sputum, and auscultation of aS3 gallop are recognized as symptoms caused by what?

Answer 744

Acute Pulmonary Edema

Question 745

Evolve- Ch 38
😰 The majority of patients with an acute ascending aortic dissection report an abrupt onset of excruciating chest or back pain that radiates to what areas?

Answer 745

Neck & Shoulders

Question 746

Evolve- Ch 36

📈 What is identified with ST-segment elevation?

Answer 746

Myocardial Injury

Question 747

Evolve- Ch 34

💊 What is the treatment of choice for third-degree heart block?

Answer 747

Pavemaker

Question 748

Evolve- Ch 36
😰 What is caused by muscle activity, electrical interference, or insecure leads and electrodes that could be caused by excessive chest wall hair?

Answer 748

Artifact

Question 749

Evolve- Ch 37
😰 A nurse is assessing a patient with infective endocarditis (IE). On observation, the nurse find that the patient has red, painful, pea-like lesions on the fingertips. Which term best describes the assessment findings?

Answer 749

Osler’s Nodes

Question 750

Evolve- Ch 38

😰 What symptom is indicative of lipodermatosclerosis?

Answer 750

Leathery, brown colored skin

Question 751

Evolve- Ch 36

📈 What is identified with ST-segment elevation and widened and deep Q wave?

Answer 751

Myocardial Infarction

Question 752

Evolve- Ch 37

😰 What findings are expected in patients with dilated cardiomyopathy?

Answer 752

Changes in Doppler echocardiography & ECG with conduction disturbance

Question 753

Evolve- Ch 34
📚 What should the patient be taught to do if symptoms are unchanged or worse 5 mins after taking one tablet of nitroglycerin?

Answer 753

Seek medical attention

Question 754

Mechanical Ventilation

What is the initial Tidal Volume ventilator settings?

Answer 754

6-10 ml/kg

Question 755

Mechanical Ventilation

What is the initial PEEP ventilator setting?

Answer 755

0-5 cmH2O

Question 756

Mechanical Ventilation

Alveolar pressures should be maintained at less than what?

Answer 756

30 cmH2O

Question 757

Mechanical Ventilation

What PaO2 indicates oxygenation failure?

Answer 757

<60 mmHg

Question 758

Mechanical Ventilation

Respirations >30 is an important sign of what complication in adults?

Answer 758

Respiratory Distress

Question 759

Mechanical Ventilation

What PaCO2 & pH results indicate ventilatory failure?

Answer 759

> 50 mmHg

<7.30

Question 760

Blood & Blood Product Transfusion

What blood type is a universal recipient?

Answer 760

AB

Question 761

Blood & Blood Product Transfusion

Infusion of blood during the first 15 mins should not exceed how many mL/min?

Answer 761

No greater than 2mL/min

Question 762

Blood & Blood Product Transfusion
After obtaining blood product from the blood bank, who must check the ID, Blood Type & Rh, Donor #, Patient ID on the blood bag, and the expiration date?

Answer 762

2 RN’s

Question 763

Blood & Blood Product Transfusion

How long can blood be out of blood bank window after blood is handed off?

Answer 763

4 hours

Question 764

Blood & Blood Product Transfusion 
😰 Which manifestations are common with transfusion reactions? (Select all that Apply)😩
1) Hypertension
2) Fever
3) Low Back Pain
4) Flushing
5) Hypertension
6) Tachycardia

Answer 764

1,2,3,4,& 6

Common Manifestations: Chills/Fever, Low Back Pain/Muscle Pain, Flushing, Itching, Vomiting, Anxiety, Tachycardia, Dyspnea, Tachypnea, Hypotension

Question 765

Blood & Blood Product Transfusion
📚 When explaining autologous transfusion, instruct the patient that the last donation should take place at least how long before surgery to allow for equilibrium of blood volume?

Answer 765

48-72 hours

Question 766

Blood & Blood Product Transfusion
PRBC should not be infused quickly unless in an emergency but other blood components such as fresh frozen plasma and platelets can infuse over how many mins?

Answer 766

15-30 mins

Question 767

Blood & Blood Product Transfusion

During a blood transfusion, the HCP should be notified if the patient has what temperature?

Answer 767

> 101

Question 768

Blood & Blood Product Transfusion

Blood must be returned to blood bank if it isn’t used within how long after arriving at the nursing unit?

Answer 768

30 mins

Question 769

Blood & Blood Product Transfusion

What blood type is the universal donor?

Answer 769

O Neg

Question 770

Blood & Blood Product Transfusion

If an acute transfusion reaction occurs, what is the priority intervention after the transfusion has been stopped?

Answer 770

Maintain patient IV with new tubing and new bag of NS

Question 771

Blood & Blood Product Transfusion
📚 When teaching the patient about autologous transfusions preoperatively, instruct the patient that they can donate up to 450 mL of blood every few days beginning up to how many weeks prior to the surgery?

Answer 771

5 weeks

Question 772

Blood & Blood Product Transfusion

Renal damage is directly proportional to what?

Answer 772

The amount of blood infused

Question 773

Blood & Blood Product Transfusion

💊 What pre-medications are commonly used before blood transfusions?

Answer 773

Benadryl & Tylenol

Question 774

Blood & Blood Product Transfusion

💥 Why are LR or Dextrose Solution not used to prime “Y” tubing for blood transfusions?

Answer 774

They increase clot formation

Question 775

Blood & Blood Product Transfusion

After obtaining blood product from blood bank, what information has to be checked by 2 RN’s?

Answer 775

▪️Make positive ID of donor & recipient
▪️Determine Blood Type/Rh, Donor #, & Patient ID on blood bag
▪️Check expiration date on blood

Question 776

Blood & Blood Product Transfusion

How long must you remain with a patient after starting a blood transfusion?

Answer 776

15 mins or 50 mL

Question 777

Blood & Blood Product Transfusion

Who must be notified if you move a blood bank bracelet?

Answer 777

You cant move a blood bank bracelet. Blood bank person is the only one that can move blood bank braceltes.

Question 778

Blood & Blood Product Transfusion

When does the patients transfusion slip become part of their medical record?

Answer 778

When the transfusion is complete. Remains on blood product until transfusion is complete.

Question 779

Blood & Blood Product Transfusion

When are blood type & screen bracelet and blood allowed to be separated?

Answer 779

When they are both labeled

Question 780

Blood & Blood Product Transfusion

💥 One arm of the “Y tubing is for blood and the other arm is primed with what solution?

Answer 780

Saline Solution