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AdultCare1-Cook > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

What are unilateral leg pain, calf tenderness, and swelling manifestations of?

A

deep vein thrombosis

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2
Q

How can the risk for coronary artery disease be reduced?

A

-decreasing LDL level (weight loss program)
- regular exercise (increases HDL)
- increase omega-3 fatty acid intake

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3
Q

What does troponin test indicate?

A

troponin appears in the bloodstream when there is damage to the heart (myocardial infarction)

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4
Q

Which diagnostic tests could the nurse suspect in the confirmation of DVT diagnosis?

A

venous duplex ultrasound and d-dimer

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5
Q

What post-surgical complication is a client at risk for following a hip arthroplasty?

A

deep-vein thrombosis (this may also occur from gynecological and urological procedures)

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6
Q

Which portion of the ECG strip would represent the time it takes for ventricular depolarization and repolarization combined (ventricular cycle)?

A

QT interval

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7
Q

What tests should the nurse prepare to obtain for a client that reports chest pressure and SOB?

A

troponin (MI)

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8
Q

Why should massaging be avoided in those at risk for VTE (venous thromboembolism)?

A

blood clot could detach and become an embolus

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9
Q

If a patient has a confirmed case of sepsis and is hypotensive, how much fluid should the nurse administer IV?

A

30 mL/kg

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10
Q

Is medicating the client for pain part of the 1hr bundle in sepsis treatment?

A

No, but drawing lactate, admin ABX, IV fluids, blood cultures, and vasopressors if needed all are

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11
Q

What lab is indicative of sepsis?

A

increased lactate

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12
Q

What are the hallmarks of sepsis?

A

increased serum lactate and increased bands
- inc. procalcitonin (in response to inflammatory cytokines)
- abnormal WBC

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13
Q

What is a priority for the nurse to ensure when administering ABX in a patient who has sepsis?

A

drawing blood cultures

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14
Q

If a patient has a urinary output of 15 mL/hr what may be indicated?

A

organ dysfunction
(renal dysfunction r/t poor perfusion in septic clients)

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15
Q

When is an example of a time that the nurse should notify the provider in regards to assessing surgical incision/site?

A

redness at surgical site, as this may indicate infection

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16
Q

what are examples of modifiable risk factors for cardiovascular disease?

A

personal lifestyle, smoking, physical inactivity, obesity, and psychological variables (stress, anger, etc)

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17
Q

What are some factors that may contribute to the likelihood of cardiovascular disease that cannot be changed?

A

pts age, gender, ethnic origin, family hx of CVD

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18
Q

What does the P- wave on an EKG represent?

A

atrial depolarization (contraction)

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19
Q

What represents the combination of ventricular depolarization (contraction) and atrial repolarization (relaxation)?

A

QRS complex

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20
Q

What does the T- wave represent on an EKG?

A

ventricular repolarization

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21
Q

What is considered a normal cholesterol level?

A

less than 200 mg/dL

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22
Q

What are the four steps of the electrical conduction in the heart?

A
  1. SA node
  2. AV node
  3. bundle of HIS
  4. purkinje fibers
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23
Q

What is the preferred diagnostic test for DVT?

A

venous duplex ultrasound

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24
Q

The nurse should monitor for which lab while a patient is receiving IV heparin?

A

aPTT

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25
When and how often should aPTT be monitored while patient is receiving IV heparin?
6 hr after initiation, 6 hr after ANY dose changes, and at least daily
26
Which medication should PT/INR be evaluated while administering?
warfarin
27
What is the antidote for warfarin?
Vitamin K
27
What may early ambulation prevent in post-surgical patients?
DVTs
27
What is the benefit of novel (direct) oral anticoagulants? ex. dabigatran, rivaroxaban, apixaban, and edoxaban
fixed dosing without the need for frequent lab monitoring
27
In case of a heparin overdose, the nurse should have what available?
protamine sulfate (antidote)
28
How does the onset of pain usually occur for DVTs?
sudden
29
Name an example of a gram + bacteria.
staphylococcus
30
What is considered a therapeutic INR while taking warfarin?
< 2
31
What body temp indicates SIRS?
> 100.5 or < 96.8 F
32
What respiratory rate indicates positive SIRS?
> 20 BPM or < 32 mmHg PaCO2
32
What HR parameter is given for SIRS criteria?
90 bpm
33
What is considered shock in a patient with sepsis?
hypotension regardless of administration of vasopressors
34
Which wave represents atrial depolarization (contraction)?
P-wave
35
What type of medications cause the heart to beat more slowly and with less force?
beta-blockers
36
What are some symptoms that a patient may have with a PE (pulmonary embolism)?
-dyspnea, tachypnea and chest pain -acute confusion, restlessness -crackles - decrease SpO2
37
What may be used as drug therapy for DVT prevention?
heparin, warfarin, enoxaparin
38
What is the therapeutic INR for a patient with a DVT?
1.5-2
39
What should the nurse do if the output of a chest tube is > 70mL/ hr?
contact the provider
40
What is important for positioning the chest tube drainage system?
keep the system below the level of the chest
41
What are 2 supplies that should always be at the bedside in case of an emergency with a chest tube?
sterile water and occlusive dressing
42
Why should sterile water be kept at the bedside of a patient with a chest tube?
if the tube disconnects, place tip into 2 in of water to create a seal, preventing air from entering the patient
43
How would Vaseline gauze be used for a chest tube emergency?
tubing disconnects from patient
44
When would NPPV (like CPAP and BiPAP) be contraindicated/used with great caution?
patients with nausea, thick secretions, or emesis. If the throw up it'll likely be blown back into their airway (aspiration)
45
What consumption instructions should be given prior to a PFT (pulmonary function test)?
no smoking 6-8 hr before and no bronchodilators 4-6 hr before
46
How long should a patient be NPO prior to a scheduled bronchoscopy?
4-8 hr before
47
What is the normal time for the PR interval?
0.12-0.2 secs
48
What is the normal time for the QRS compex?
0.6- 0.10 sec (<0.10 secs)
49
what is normal for the normal time for the QT interval?
<0.44 sec
50
What drug may given to a patient with sinus bradycardia?
atropine
51
What are the 3 components of Virchow's triad that increase the risk for a patient developing a VTE?
hypercoagulable state stasis of blood endothelial blood
52
What are some factors that may cause stasis of blood
immobility, atrial fibrillation, venous insufficiency, venous obstruction, heart failure
53
What may be some causes of endothelial injuries?
surgery (hip, knee, and prostate) trauma atherosclerosis smoking catheter
54
What is Homan's sign?
pain with dorsiflex that may indicate DVT (this often has false positives)
55
What may be indicated by elevated lactate levels in a septic client?
poor perfusion and/or oxygenation to tissues
56
What interventions should the nurse implement to prevent atelectasis?
turn, cough, deep breathe incentive spirometry use
57
How often should an incentive spirometer be utilized?
10 times per hour
58
What is a serious complication that patients receiving benzocaine for a bronchoscopy should be monitored for?
methemoglobinemia
59
If methemoglobinemia is recognized, what should the nurse do?
call rapid response and prepare to admin methylene blue
60
What may a patient with methemoglobinemia present with?
chocolate-colored blood and hypoxia that does not respond to O2 therapy
61
What difference may the nurse note while percussing the chest wall of a client with a pleural effusion?
dullness with percussion
62
How may the trachea appear with a tension pneumothorax?
deviation to unaffected side
63
What can the nurse offer to a client experiencing a sore throat following a bronchoscopy?
gargle salt water and lozenges

AdultCare1-Cook (8 decks)

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