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Cardiovascular System > E x a m #2 > Flashcards

E x a m #2 Flashcards

1
Q

side effects of thrombolytic therapy

A

constipation, bleeding from cuts, gyms, & wounds.

fever & hypotension.

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2
Q

cardiogenic shock

A

when there is a failure of the pump action of the heart, resulting in a decrease in cardiac output causing reduced end - organ perfusion

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3
Q

RBC range

A

F 4.2 - 5.4

M 4.7 - 6.1

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4
Q

function of hemoglobin & hematocrit

A

hemoglobin - transport oxygen to lungs

hematocrit - measures the volume of RBC compared to the total blood volume

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5
Q

indicators of shock

A

restlessness, hypotension, tachycardia, tachypnea. cool clammy skin.

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6
Q

expected findings in aortic aneurysm

A

“egg shell” appearance. pulsating mass. bruit. hypertension unless ruptured. back/flank pain.

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7
Q

priority assessment of client w/ arterial occlusion of leg

A

CMST, pain

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8
Q

nursing interventions for preventing venous stasis

A

ambulation, avoid constrictive clothing, elevate legs, wear elastic stockings after surgery

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9
Q

Tx for thrombophlebitis

A

Anticoagulants - Lovenox, Coumadin
Thrombolytic therapy - Activase
Platelet inhibitors - abciximab, eptifibatide

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10
Q

myocarditis

A

inflammation of the myocardium
S/S: tachycardia, MURMUR, friction rub, cardiomegaly, dysrhythmias
usually caused by viral infection
Tx: treat underlying cause

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11
Q

S/S of endocarditis (bacterial/infective)

A

fever & flu like symptoms, murmur, petechiae on trunk & mucous membranes. positive blood cultures, splinter hemorrhages on nail bed

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12
Q

priority assessment for the client w/ acute infective endocarditis

A

fluctuation of temp, effects of antibiotics

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13
Q

care of client in acute stage of bacterial endocarditis

A

oxygen, antibiotics, rest, analgesics

CONSERVE ENERGY

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14
Q

rheumatic fever

A

caused after infection of upper respiratory tract w/ group A beta-hemolytic streptococci (pharyngitis, impetigo)

diagnosis: ^WBC, ESR. positive c - reactive protein. ^cardiac enzymes in severe pancarditis, ASOTITER, positive throat cultures, prolonged PR interval, cardiomegaly.
Tx: antibiotics (penicillin/erythromycin) antipyretics, corticosteroids, antiHTN, digoxin, diuretics

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15
Q

location of mitral valve

A

left atrium & left ventricle

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16
Q

greatest priority in care of a client w/ varicose veins w/ edema and ulcerations

A

elevate legs, avoid sitting/standing for long periods, DO NOT CROSS LEGS, don’t massage, elastic stockings, avoid dangling

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17
Q

care of client following a vein ligation & stripping

A

supine w/ legs @ 15 degree angle. ROM exercises, elastic bandages, avoid dangling, don’t cross legs, assist with vein marking. monitor for bleeding through bandages. don’t massage. monitor CMST.

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18
Q

what stimulate the production of RBC’s?

A

erythropoietin

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19
Q

erythrocytes function

A

carry oxygen to the body and bring back carbon dioxide back into the lungs to be expelled

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20
Q

granulocytes function

A

neutrophils; fight of pathogens, eosinophils fight allergies, basophils prevent blood clots, reduce growth

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21
Q

thrombocytes function

A

stop bleeding & stop blood vessel injuries

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22
Q

lymphocytes function

A

respond to foreign invaders in the body

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23
Q

cells known for phagocytic activity

A

neutrophils, monocytes, eosinophils, basophils

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24
Q

position of the client undergoing a bone marrow biopsy from the iliac crest

A

prone

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25
Q

procedure for checking packed RBC

A

verify client, blood compatibility, and expiration time of blood product w/ another nurse. verify order.
assess labs H&H
obtain blood from bank, inspect discoloration, bubbles, or cloudiness

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26
Q

5 food sources of iron

A

red meat, poultry, seafood, beans, and dark leafy greens. dried fruit.

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27
Q

pernicious anemia

A

a decrease in RBC when the body can’t absorb enough vitB12

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28
Q

discharge teaching for client w/ aplastic anemia

A

conserve energy when standing to prevent dizziness.

wash hands and avoid other sick people, avoid bleeding activities

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29
Q

priority diagnosis for a client with sickle cell CRISIS

A
  • peripheral blood smear show presence of sickled cells

- sickle cell test evaluating sickling of RBC’s

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30
Q

expected treatment for sickle cell crisis

A

support, oral hydroxyurea to reduce number of sickle cell crisis
narcotics
IV hydration, folic acid supplements
genetic counseling and blood transfusion as necessary

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31
Q

thrombocytopenia

A

stem cell disorder of the bone marrow that is diagnosed when a client’s platelet count falls below 50,000.
Tx: remove underlying cause. blood transfusions, platelet infusions, corticosteroids, immunosuppressants, splenectomy

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32
Q

Tx for hemarthrosis (bleeding in joints causing bleeding and swelling)

A

arthrocentesis

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33
Q

priority of care for client w/ neutropenia

A

increase WBC’s, antibiotics

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34
Q

S/S of transfusion reaction. first priority intervention?

A

chills, fever, LOW BACK PAIN, tachycardia, flushing, hypotension, chest tightening, tachypnea, nausea, anxiety, hemoglobinuria (FOR ACUTE)
chills, fever, flushing, headache, anxiety (FOR FEBRILE)

*STOP TRANSFUSION, administer NS

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35
Q

S/S of folic acid deficiency

A

pallor, progressive weakness and fatigue, SOB, glossitis(tongue), cheilosis(cracks on corners of mouth), & diarrhea.

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36
Q

S/S of aplastic anemia

A

fatigue/weakness, pallor, dyspnea (decreased RBC), petechiae/ecchymosis (decreased platelets), infection (decreased WBCs)

37
Q

S/S of polycythemia

A

hypertension, headaches, dizziness, vision and hearing disruptions, ruddy red color of the face, hands, feet, and mucous membranes. severe, painful pruritus.
hepatomegaly, splenomegaly, JVD, thrombosis

38
Q

S/S od thrombocytopenia

A

petechiae/ecchymosis, prolonged bleeding/oozing from mouth/nose, epistaxis, menorrhagia, bloody stools.

39
Q

2 nursing interventions for client w/ PVD reporting cold feet

A

socks, warm environment

40
Q

thrombocytosis

A

a disorder in which your body produces too much platelets

41
Q

leukocytosis

A

high levels of WBC’s in the blood

42
Q

pernicious anemia

A

a decreased in RB when the body can’t absorb enough vitB12

43
Q

pancytopenia

A

deficiency of all 3 cellular components of the blood

44
Q

2 expected lab values for client w/ polycythemia vera

A

^RBC mass & total blood volume

excess production of myeloid stem cells

45
Q

expected lab findings for client w/ disseminated intravascular coagulation

A
  • decreased serum platelet count, serum fibrinogen level
  • prolonged prothrombin & partial thromboplastin time
  • decreased clotting factors V & VIII
  • positive d - dimer test (specific test for DIC) ***
  • peripheral blood smear shows schistocytes
46
Q

normal range for neutrophils

A

43-62% 1800-7800mmg

47
Q

thrombus vs. embolus

A

thrombus: blood clot that stays in one place, can lead to emboli
embolus: a clot that travels, can lead to pulmonary embolism

48
Q

tx for heparin induced thrombocytopenia

A

discontinuing heparin

49
Q

instructions for taking iron supplements

A

empty stomach is best, little food is ok.
milk, calcium, antacids should be taken 2 hours after iron or 1 hr before.
vitC supplements to help absorb.
avoid caffeine & high fiber foods.

50
Q

Tx for pernicious anemia

A

vitb12 suppl. for life injections

51
Q

Med to treat hemophilia A

A
  • IV Cyroprecipitate
  • clotting factors VII or IX to increase
  • fresh frozen plasma and PRBC’s
52
Q

normal range for digoxin

A

0.5 - 2ng/ml

53
Q

causes of chronic venous insufficiency

A
  • obesity, pregnancy, thrombophlebitis

- sitting/standing for long periods of time

54
Q

expected finding in client w/ history of mitral valve insufficiency

A

crackles (pulmonary congestion), SOB, rapid fluttering HB, pink frothy sputum, murmur

55
Q

expected findings in client w/ pericarditis

A

pericarditis friction rub, SOB, chest pain, pain relieved when sitting/leaning forward

56
Q

which lab test is used to confirm rheumatic endocarditis

A

positive throat culture, ESR, ADB, c - reactive protein

57
Q

expected findings in fluid volume excess

A

bounding, increased pulse rate. elevated BP. distended neck veins. elevated CVP. dysrhythmias.

58
Q

labs for hemophilia

A

CBC, coagulation studies, factor VIII

PT(11-12.5sec) PTT(30-45sec) INR (0.7-1.8)

59
Q

teaching for client undergoing bone marrow biopsy?

A

may hear crunching sound or scraping sensation as needle punctures bone
apply pressure to site for 10-15min
prone/sidelaying

60
Q

med given for a mild allergic reaction to food transfusion

A

Benadryl or another antihistamine

61
Q

3 nursing interventions for fluid overload

A

give diuretics, daily weights, monitor I&O, avoid fluids and salts

62
Q

S/S of anemia

A

fatigue, weakness, bruising, spoon shaped nails, pallor

63
Q

erythropoietin (epogen) teachings

A

report headache, don’t make up dose. avoid driving.

64
Q

antidote for heparin

A

protamine sulfate

65
Q

S/S of suspected of occlusion/rupture of graft of abdominal aorta

A

back pain, flank bruising, hypovolemic shock, absent extremity pulses, sudden pain, bruit

66
Q

3 adverse effects of daily aspirin therapy

A

stroke, gi bleed, rash

67
Q

adverse effects of epoietin alfa

A

hypertension, cold symptoms, stomach pain, joint/bone pain, fatigue, insomnia

68
Q

med for hemophilia A

A

cryoprecipitate rate

69
Q

labs monitored in pt w/ DIC

A

platelets, fibrinogen, prothrombin, partial thromboplastin time, clotting factors

70
Q

expected findings in client w/ a low platelet count?

A

autoimmune disease, bone marrow suppression, microscopic hematuria, positive fecal, prolonged bleeding time.

71
Q

S/S of DIC

A

abnormal bleeding
cyanosis, cold, mottled finger and toes
severe muscle, back, abdominal, chest pain
dyspnea, confusion, oliguria, shock

72
Q

universal donor/recipient

A

donor: O
recipient: AB

73
Q

3 risk factors for pernicious anemia

A

chronic gastritis, being strictly vegetarian, resection of stomach, lost pancreatic secretions

74
Q

nursing intervention for suspected phlebitis

A

observe q2hr, use smallest gauge needle, clean/change site. monitor redness, increased temp.

75
Q

schilling test

A

24hr urine test that measures absorption of vitb12 for pernicious anemia

76
Q

labs that may be elevated in an infective process

A

elevated WBC and ESR

77
Q

relationship between RBC and blood viscosity

A

the amount of RBC will determine how thick and sticky it will be

78
Q

IV dextron (iron) administration

A

IV give very gradually, can cause phlebitis

IM: Ztrack

79
Q

what should the nurse monitor in client receiving heparin

A

bleeding & hemorrhage. allergies. increased thrombosis.

80
Q

labs monitored when on heparin

A

aPTT, PT, blood clotting time, CBC

81
Q

risks for DVT

A

inherited a blood clot disorder, BED RIDDEN, injury, PREGNANCY, smoking, obesity, SURGERY, HF, CONTRACEPTIVES

82
Q

possible food interaction during heparin therapy

A 
vit K (helps clots), green leafy veg, animal liver
alcohol
83
Q

how does heparin work in treating thrombophlebitis?

A

to prevent enlargements of existing clots or prevent new clots

84
Q

why is Benadryl used in clients receiving a transfusion?

A

for a mild allergy reaction

85
Q

teaching for client discharged on iron supplements

A

antacids, antibiotics decreases absorption
vitc can increase absorption
may stain teeth
take on empty stomach, 1 hr before or 2 hr after meals

86
Q

Tx for hypovolemic shock

A

IV fluids, blood transfusions, plasma expanders

87
Q

patho of sick cell anemia

A

elongated RBC that for sickle shape, increases blood viscosity, accumulation in the smaller blood vessels leads to obstruction then tissue death

88
Q

patho for DIC

A

extensive thrombin enters systemic circulations and overwhelms natural anticoagulant.
wide spread clotting consume clotting factors and activates fibrinolytic process with anticoag productions causes hemorrhage

Cardiovascular System (2 decks)

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