Cardio

Question 1

Infective Endocarditis: Patho

Answer 1

Vegetations growing on valves break off and embolism to various organs -> life threatening complications

Question 2

Infective Endocarditis: Life threatening complications

Answer 2

Stroke, Spinal cord ischemia, Ischemia to extremities, Intestinal infarction, Splenic infarction

Question 3

Ischemia to extremities meaning:

Answer 3

Pain, pallor, and cold foot or arm

Question 4

Which is reported immediately?

Answer 4

Pain and Pallor in one foot

Question 5

Chronic venous insufficiency: Patho

Answer 5

Valves in veins of lower extremities consistently fail to keep venous blood moving

Question 6

What does CVI cause?

Answer 6

Chronic increased venous pressure; pushing fluid out of vascular space to surrounding tissues, tissue enzymes then break RBC down

Question 7

Clinical finding for Chronic venous insufficiency

Answer 7

Brownish, hardened skin on lower extremities

Question 8

Chronic venous insufficiency clinical manifestations

Answer 8

Brownish skin discoloration: chronic edema and inflammation; Tissue then harden appearing leathery, this skin prone to breakdown and ulcerations inside of the ankle

Question 9

Emphasis of Discharge teaching for DVT

Answer 9

Minimize risk factors and promote blood flow and venous return and prevent reoccurrence

Question 10

Teaching points for DVT education

Answer 10

Drink plenty of fluids: avoid caffeine and alcohol
Elevate legs when sitting and dorsiflex
Begin exercise program
Change position frequently
Stop Smoking
Avoid wearing restrictive clothes

Question 11

Irregular waveforms of varying shapes/amplitudes

Answer 11

VFIB

Question 12

EO: Potentially lethal dysrhythmia, irregular waveforms of varying shapes/amplitudes

Answer 12

VF

Question 13

Dysrhythmia: Ventricle quivering with no effective contraction or cardiac output

Answer 13

VF

Question 14

What does VF result in?

Answer 14

Unresponsive pulse less, apneic state

Question 15

Treatment for VF

Answer 15

Rapid:
CPR
Defib
Drug Therapy

Question 16

What drug therapies are used for VF?

Answer 16

Epinephrine
Vasopressin
Amiodarone

Question 17

Discharge instructions for CABG

Answer 17

Hygiene
Medications
Activity Level
Sexual activity
Symptoms to report

Question 18

CABG: Hygiene teaching

Answer 18

Shower instead of bath
No soaking or applying lotions to incisions

Question 19

CABG: Activity level

Answer 19

No lifting objects >5lb
No driving for 4-6 weeks

Question 20

CABG: Sexual activity

Answer 20

Resume able to walk 1 block or climb 2 flights of stairs w/o symptoms

Question 21

CABG: Symptoms to report

Answer 21

Chest pain or SOB during rest
Signs of infection

Question 22

Modify cardiac risk factors for CABG

Answer 22

No smoking, lose weight, maintain healthy diet, and increasing activity levels through exercises

Question 23

Heart failure: Full Patho

Answer 23

Cardiac output reduced: unable to pump blood right
Leads to: Reduce perfusion to vital organs
Reduced perfusion leads to: Decreased renal blood flow
Decreased renal leads to: Renin-angiotensin system to compensate by increasing blood volume via increased water resorption
Final result of compensation: Fluid volume excess and dilutional hyponatremia

Question 24

Heart Failure: Dilutional hyponatremia

Answer 24

Treated with:
Fluid restrict
Loop diuretics
ACE inhibitors

Question 25

Heart Failure: Furosemide

Answer 25

Resolve hyponatremia by: Promote free water excretion Allow hemoconcentration and increased sodium

Question 26

Pt with heart failure 8-hour urine output of 200 mL. What action should be first?

Answer 26

Auscultation of pts breath sounds

Question 27

What does Urine output of <30 mL/hr indicate?

Answer 27

Low vascular volume: Dehydration or blood loss Decreased Renal Perfusion: Low cardiac output Intrinsic kidney injury Urinary obstruction: Prostate or foley

Question 28

Why would auscultation be necessary for client’s with heart failure, low urine output?

Answer 28

Decreased cardiac function and buildup of fluid: Leads to need to assess lung sounds for crackles

Question 29

S/S Failing pacemaker

Answer 29

Failure to capture with: Bradycardia Hypotension

Question 30

Failure to capture in pacemaker

Answer 30

Pacer spikes without associated QRS

Question 31

PRIORITY for Failed Pacemaker

Answer 31

Initiate transcutaneous pacing

Question 32

Acute blood loss: Interventions

Answer 32

Improve perfusion to brain and vital organs

Question 33

Acute blood loss: Priority

Answer 33

Lowering the head of the bed prior to other interventions

Question 34

PAD: Description

Answer 34

Chronic atherosclerotic disease Caused by buildup of plaque in arteries

Question 35

What does PAD commonly affect?

Answer 35

Lower extremities: Leading to tissue necrosis

Question 36

PAD: Management

Answer 36

Lower extremities below heart when sitting/lying (improves arterial blood flow) Engage moderate exercise Daily skin care Stop smoking Avoid tight clothes Take meds as prescribed

Question 37

Focuses of management

Answer 37

Improving blood flow and circulation to extremities via lifestyle changes and medications

Question 38

Halter Monitor: Pt education

Answer 38

Diary of activities and symptoms Do not bathe or shower Engage in normal activities

Question 39

Clinical manifestations of DVT:

Answer 39

Calf pain Lower leg warmth, and redness Unilateral leg edema

Question 40

DVT occurs:

Answer 40

Commonly from decreased activity or mobility

Question 41

DVT S/S

Answer 41

Unilateral edema Calf Pain or TTP Warmth Erythema Low-grade fever

Question 42

Clients with … are at risk for life-threatening dysrhythmias (Heart block, V-tach, V-fib)

Answer 42

Myocardial Infarction

Question 43

Myocardial Ischemia damages what? Causing what?

Answer 43

Cardiac muscle cells causing electrical irritability (PVC)

Question 44

What increase the risk for dysrhythmias?

Answer 44

Electrolyte imbalances/ Hypokalemia

Question 45

How does hypokalemia relate to Dysrhythmias?

Answer 45

Hyperpolarizes cardiac conduction pathways increasing risk for dysrhythmias

Question 46

Medications administered for pts w/ NSR w/ PVC and lab values of Potassium 3.3 mEq/L

Answer 46

Potassium chloride IVPB once

Question 47

A-fib discharge pt stable w/ meds (Digoxin). What education is needed before discharging?

Answer 47

Visit doctor to check drug levels Report to HCP if nausea and vomiting Tell HCP if HR below 60 BPM NO need for increasing potassium intake

Question 48

Troponin:

Answer 48

High specific cardiac marker for detection of MI

Question 49

Difference from Troponin and CK MB

Answer 49

Troponin:Greater sensitivity and specificity for myocardial injury

Question 50

Troponin serum levels increase…

Answer 50

4-6 hours after onset of MI

Question 51

Troponin value indicative of cardiac muscle damage

Answer 51

0.7 ng/mL Immediate focus

Question 52

Highest priority for intervention with patients having chest pain

Answer 52

Elevated Troponin value: indicative of myocardial injury

Question 53

Pt education for Mitral valve prolapse

Answer 53

Stay hydrated Avoid caffeine and EOTH Exercise regularly Reduce stress Take beta blockers (for palp and chest Px)

Question 54

S/S of Mitral Valve Prolapse

Answer 54

Experiencing occasional palpitations, lightheadedness, and dizziness