Cardiac

Question 1

Chronic stable angina occurs with…

Answer 1

Exertion, stress, or emotional upset

Question 2

Can chronic stable angina be relieved? If so, how?

Answer 2

Rest or NG

Question 3

Unstable angina occurs…

Answer 3

At rest or minimal exertion

Question 4

Can unstable angina be relieved? If so, how?

Answer 4

May not be relieved w/ NG

Question 5

Variant angina

Answer 5

Can occur at rest or during sleep

Question 6

Variant angina interventions

Answer 6

SL NG or light exercise

Question 7

S+S of right HF

Answer 7

Distended neck veins
Hepatomegaly
Ascites
Peripheral edema
Weight gain

Question 8

S+S of left HF

Answer 8

Dyspnea, orthopnea, PND
Cough w/ pink, frothy sputum
Crackles, rales
Weakness and fatigue
Cold, clammy skin
Weight gain

Question 9

Nursing interventions for acute HF

Answer 9

High Fowler position
Oxygen
Loop diuretics
Strict I+O

Question 10

Meds for HF

Answer 10

Diuretics: reduce preload
BB: to reduce cardiac workload
ACE inhibitors: to reduce afterload (BP)
Digoxin: to increase cardiac contractility

Question 11

Patho of MI

Answer 11

Sudden rupture of unstable plaque -> thrombus in coronary artery -> ischemia and cardiac cell death

Question 12

S+S of MI

Answer 12

Chest pain
Anxiety
Feeling of impending doom
EKG changes: ST depression, ST elevation

Question 13

Difference between ST depression and ST elevation

Answer 13

ST depression: partial thrombotic obstruction
ST elevation: total

Question 14

Tx of MI

Answer 14

Aspirin
SL NG
Morphine
Oxygen
BB prescribed AFTER MI
Anticoagulants
Statin
PCI
t-PA

Question 15

PCI

Answer 15

First-line tx
Involves: thrombus retrieval, angioplasty, coronary artery stent placement
Perform w/in 90 min

Question 16

CABG

Answer 16

Rerouting myocardial blood flow around blocked coronary arteries

Question 17

Nursing interventions of MI

Answer 17

Semi-Fowler position
Bed rest
Assess distal peripheral pulses and skin temp

Question 18

Pericarditis causes

Answer 18

Autoimmune dz
Viral or idiopathic
Renal failure
Following MI

Question 19

Patho of pericarditis

Answer 19

Fluid accumulation -> pericardial effusion -> cardiac tamponade

Question 20

S+S of pericarditis

Answer 20

Pleuritic chest pain
Pericardial friction rub
Systemic symptoms

Question 21

Interventions for pericarditis

Answer 21

Encourage to lean forward
Monitor for melena

Question 22

Meds for pericarditis

Answer 22

Colchicine (anti-inflammatory)
NSAIDs

Question 23

Signs of cardiac tamponade

Answer 23

Muffled heart sounds
Hypotension

Question 24

Patho of CAD

Answer 24

Narrowing of coronary arteries due to buildup of hardened fat deposits (plaques)
Impaired blood supply to heart -> tissue ischemia and necrosis (MI)

Question 25

Dx of CAD

Answer 25

EKG Stress cardiac testing Cardiac catheterization Lipid levels

Question 26

Meds for CAD

Answer 26

Antiplatelets Nitrates Cholesterol-lowering meds BB ACE inhibitors CCB

Question 27

Thrombolytic agents CI

Answer 27

Active bleeding Recent trauma Hx of hemorrhagic stroke Recent surgery Uncontrolled HTN (BP > 180/110)

Question 28

CABG teaching

Answer 28

Report any redness, swelling, warmth, or drainage from incisions Wash incisions daily w/ soap and water in shower and gently pat them dry Wear elastic compression hose on legs and elevate while sitting

Question 29

For interventions following CABG

Answer 29

Cover w/ warming blanket, increasing room temp, using warmed IV fluids Monitor BP via arterial line Notify HCP > 100 mL/hr

Question 30

Assess for pulsus paradoxus

Answer 30

Measure difference b/w Korotkoff sounds auscultated during expiration and throughout respiratory cycle Place a blood pressure cuff on the patients arm and very very slowly deflate the cuff while listening for brachial pulsations

Question 31

ICD insertion teaching

Answer 31

Refrain from lifting affected arm above shoulder until approved by HCP to prevent dislodgement of lead wire on endocardium

Question 32

Cardiac cath includes what?

Answer 32

IV iodinated contrast

Question 33

Cardiac cauterization teaching

Answer 33

Increase fluid intake: promote clearance of IV contrast Keep leg straight for 4 hrs Anticoagulants prescription

Question 34

Complications of IV iodinated contrast (cardiac cath)

Answer 34

Allergic rxn Lactic acidosis Contrast-induced neuropathy

Question 35

Endocarditis S+S

Answer 35

Stroke Septic pulmonary emboli Kidney infarction and hematuria Splinter hemorrhage Petechiae Splenic infx Pallor and ischemia = report

Question 36

tPA CI

Answer 36

After 3.5-4.5 hr from onset of S+S Recent major hx Hemorrhagic stroke Head trauma (recent) Severe HTN (>185/110) Coagulation disorders

Question 37

Pt reports HA when taking NG...

Answer 37

Administer acetaminophen

Question 38

S3 indicates

Answer 38

HF