Exam 2 - Summary Set Flashcards
1
Q
____ is a loss of lung elastic tissue, leading to hyperinflation and air trapping
A
emphysema
2
Q
___ is inflammation of the bronchi and bronchioles
A
chronic bronchitis
3
Q
mucus plugs, inflammation, hypoxemia, and respiratory acidosis are associated with ____
A
chronic bronchitis
4
Q
____ is the #1 risk factor for COPD
A
smoking
5
Q
name at least 4 s/s of COPD
A
(1) dyspnea
(2) thin, dusky extremities
(3) barrel chest
(4) pursed lip breathing
(5) rapid, shallow respirations
(6) chronic cough and sputum production
(7) fatigue
6
Q
barrel chest and pursed lip breathing is associated with
A
emphysema
7
Q
name s/s of early hypoxia
A
(1) tachycardia
(2) tachypnea
(3) elevated BP
(4) pale skin
(5) O2 <90
(6) confusion
8
Q
name s/s of late hypoxia
A
(1) stupor
(2) cyanosis
(3) bradycardia
(4) bradypnea
(5) hypotension
(6) dysrhythmias
9
Q
name s/s of chronic hypoxia
A
(1) nail clubbing
(2) cyanosis
(3) delayed cap refill
(4) barrel chest
(5) pursed lip breathing
10
Q
describe 4 components of a COPD exacerbation
A
(1) RR 40-50
(2) SpO2 80-85%
(3) Accessory muscle use
(4) Abnormal lung sounds (wheezing, crackles)
11
Q
___-sided heart failure is a complication of COPD
A
right
12
Q
how do you diagnose COPD? (5)
A
(1) History
(2) Peak flow expiratory flow
(3) ABGs
(4) Chest x-ray
(5) Sputum & WBC
13
Q
____ is the #1 priority for COPD
A
impaired gas exchange
14
Q
the 5 priorities r/t COPD are
A
(1) gas exchange
(2) anxiety
(3) weight loss
(4) fatigue
(5) preventing infection
15
Q
name at least 3 nursing interventions for impaired gas exchange
A
(1) raise HOB
(2) give O2 to get SaO2 88-92%
(3) Hydration to thin secretions
(4) medication
(5) smoking cessation
(6) suctioning
16
Q
name 3 nursing interventions for anxiety r/t COPD
A
(1) breathing exercises
(2) relaxation techniques
(3) anti-anxiety meds
17
Q
pts with COPD should eat _____ type of meals to avoid weight loss
A
protein / calorie-dense meals; frequent and small
18
Q
use ____ 30 minutes before meals
A
bronchodilator
19
Q
what are the 5 main medications for COPD?
A
(1) short-acting b2 agonists
(2) long-acting b2 agonists
(3) inhaled corticosteroids
(4) inhaled anticholingergics
(5) mucolytics
20
Q
____ is an example of a SABA
A
albuterol
21
Q
____ is an example of a LABA
A
salmeterol
22
Q
____ is an example of an inhaled anticholinergic
A
tiotropium
23
Q
____ is an example of an inhaled corticosteroid
A
fluticasone
24
Q
____ is the rescue inhaler
A
albuterol / SABA
25
which medication do you take first (before other meds)?
SABA / albuterol
26
what is the purpose of Tiotropium?
bronchodilator
27
___ is a side effect of inhaled anticholinergics / tiotropium
dry mouth
28
what is the purpose of Fluticasone?
reduce airway inflammation
29
teach pts to ____ when taking inhaled corticosteroids to decrease risk of thrush
rinse their mouth
30
____ is an example of a mucolytic
acetylcysteine
31
what is the action of mucolytics?
thin secretions
32
the main side effect of mucolytics is _____
hepatotoxicity
33
which medication can smell like rotten eggs?
acetylcysteine / mucolytics
34
explain the steps of MDI use:
(1) exhale completely
(2) inhale slowly and release one puff over 3-5 seconds
(3) hold breath for 10 seconds
(4) exhale
(5) wait 5 minutes before next dose
(6) rinse mouth after
35
in a COPD action plan, when do you call 911?
when the pt is in the red zone
36
___ is a lung infection that causes airway inflammation and fluid buildup
pneumonia
37
is the biggest risk factor for pneumonia
underlying lung condition
38
name at least 3 s/s of pneumonia
(1) fever, chills, malaise
(2) cough (sputum or not)
(3) dyspnea
(4) pleuritic chest pain
(5) increased RR
(6) wheezing, rhonchi, crackles
(7) low O2
39
WBC will be ___ in pneumonia
elevated
40
what are the 4 nursing priorities for pneumonia?
(1) gas exchange
(2) airway obstruction
(3) possible sepsis
(4) anxiety
41
encourage _____ L/day of ____ to thin secretions
2-3; fluids
42
what are the 2 main medications for pneumonia?
(1) cephalosporin (ceftriaxone)
(2) fluoroquinolone (levofloxacin)
43
___ is one of the safest antibiotics
ceftriaxone
44
name the 4 main side effects of levofloxacin
(1) N/V
(2) swelling of tendon
(3) C. diff
(4) yeast infections
45
the 3 things you should teach pts when taking levofloxacin are...
(1) take with food
(2) avoid sun exposure
(3) complete the course
46
multiple rapid impulses from the atria that are disorganized is ____
atrial fibrillation
47
chaotic rhythm, no atrial contraction, loss of atrial kick, and irregular ventricular response can all be used to describe
A Fib
48
the two biggest risk factors for A Fib are
HTN and CV disease
49
name at least 3 other risk factors for A Fib (besides HTN and CV disease)
(1) obesity
(2) DM
(3) advanced age
(4) smoking
(5) excessive alcohol use
(6) OSA
(7) hyperthyroidism
50
if CO is impacted by AFib, ___ is affected
perfusion
51
what are the key characteristics of A Fib on an ECG?
(1) heart rate can vary (normal 60-100 or rapid 100-200)
(2) irregular R to R rhythm
(3) no clear P wave
52
the 3 main nursing priorities for A Fib are
(1) risk for embolus formation
(2) risk for heart failure
(3) potential knowledge deficit
53
embolus formation can lead to ___, ___, and ___
stroke, DVT, and PE
54
the two main drug classes for A Fib are
antidysrhythmics and anticoagulants
55
___, ___, and ___ are antidysrhythmics
diltiazem, metoprolol, and digoxin
56
diltiazem class
Ca channel blocker
57
diltiazem action
slow conduction
58
diltiazem monitoring & ed
(1) monitor HR and BP
(2) slow position changes
(3) monitor s/s HF
59
metoprolol class
beta blocker
60
metoprolol action
slow ventricular response
61
metoprolol monitoring & ed
(1) monitor HR and BP
(2) slow position changes
(3) can cause bronchospasm
62
if HR<60 bpm hold _____ and call the provider
diltiazem, metoprolol, and digoxin
63
____ drugs are a high fall risk
antidysrhythmics
64
___ and ___ are the two anticoagulants used for A Fib
Coumadin / Warfarin, Apixaban / Rivaroxaban
65
Coumadin class
anticoagulant
66
Coumadin action
thin blood and prevent clot
67
Coumadin monitoring & ed
(1) INR testing required
(2) avoid / limit vit K
(3) herbals can interfere (ginseng, ginger)
(4) monitor for bleeding
68
Apixaban / Rivaroxaban class
DOAC
69
Apixaban / Rivaroxaban action
thin blood and prevent clots
70
Apixaban / Rivaroxaban monitoring & ed
(1) No INR testing
(2) Monitor for bleeding
71
name 5 ways to prevent bleeding when on anticoagulants
(1) electric razors
(2) no aspirin
(3) small gauge needles
(4) limit needles sticks
(5) protect from injury (falls, trauma, etc.)
72
3 lifestyle recommendations the nurse can provide for pts with A Fib include:
(1) 210 minutes of moderate to vigorous exercise
(2) smoking cessation
(3) weight reduction
(4) alcohol reduction to <3 drinks/week
(5) control HTN
73
____ is an increase in HR
sinus tachycardia
74
name at least 3 causes of sinus tachycardia
(1) anemia
(2) normal response to physical activity, stress, or pain
(3) hypoxia
(4) hyperthyroidism
(5) drugs
(6) compensation for decreased CO and BP
75
name at least 3 s/s of sinus tachycardia
(1) fatigue
(2) weakness
(3) SOB
(4) orthopnea
(5) decreased O2 sat
(6) decreased BP
76
the 2 nursing priorities with sinus tachycardia are
(1) avoid drugs that increase HR
(2) help with stress management
77
partial or total arterial occlusion
peripheral arterial disease (PAD)
78
___ can lead to decreased perfusion of the extremities / lower extremities
PAD
79
___ usually occurs on the toes and has well-defined edges
PAD
80
what is the main cause of PAD?
systemic atherosclerosis
81
name at least 3 s/s of PAD
(1) intermitent claudication
(2) weak or absent pedal pulses
(3) prolonged cap refill
(4) skin is hairless, shiny, dry, cool to touch
(5) pallor on elevation
(6) rubor in dependent position
82
the #1 priority for treatment of PAD is to ___
improve perfusion
83
why should people with PAD avoid smoking, caffeine, and nicotine?
b/c they are vasoconstrictors and can worsen poor perfusion
84
____ agents are used to treat PAD
antiplatelet
85
the 2 main meds used in PAD are ___ and ___
aspirin, clopidogrel
86
elevating the legs in _____ injuries will cause more pain
arterial
87
one key different between PAD and Venous insufficiency is that ____ has present pedal pulses and ____ does not
venous insufficiency; PAD
88
prolonged venous hypertension stretches the veins and damages the valves
venous insufficiency
89
venous insufficiency often occurs in the ____
malleolus medialis
90
venous insufficiency general cause is ____
anything that impacts venous return
91
what are 4 things that impact venous return?
(1) DVT
(2) decreased skeletal muscle pump
(3) increased ABD pressure
(4) sedentary lifestyle
92
name at least 3 s/s of venous insufficiency
(1) pitting edema
(2) eczema / dermatitis
(3) ulcers
(4) hyperpigmentation
(5) pedal pulses present and palpable
(6) ABI WNL
93
what are 3 things we can do to decrease edema (non-pharm)?
(1) avoid prolonged sitting
(2) compression stockings (Teds, Jobst)
(3) SCDs
94
which compression stocking requires a prescription?
Jobst
95
compression of 8-18 mmHg and can be worn in bed is which type of compression sock?
Teds
96
___ has a compression of 15-20 mmHg
Jobst
97
what is the most important thing about compression stockings?
Making sure they are the right size so they don't fall down
98
name 3 ways to protect the skin and avoid infection
(1) use mild soap
(2) limit sun exposure
(3) avoid skin irritants
(4) wear shoes
99
patients with _____ should not wear constrictive clothing or cross their legs
venous insufficiency
100
____ are dressings with zinc oxide that are covered in a wrap that hardens
Unna boot
101
what is the difference between PR segment and PR interval?
PR segment starts AFTER the P wave; PR interval INCLUDES the P wave
102
on an ECG strip, each small square represents ___ seconds
0.04
103
on an ECG strip, each large square represents ____ seconds
0.20 seconds
104
____ represents atrial depolarization
P wave
105
P waves should measure ___ seconds
<0.12; no more than 3 small squares
106
____ demonstrates the delay of the AV node
PR segment
107
___ can help determine if there is a heart block
PR interval
108
if PR interval is ____, it can indicate a potential heart block
too long
109
PR interval should be ____ in duration
0.12-0.20 seconds; 3-5 small squares
110
___ represents ventricular depolarization
QRS complex
111
QRS interval should be ____ in duration
<0.12 seconds (no more than 3 small squares)
112
____ is where the QRS complex meets the ST segment
J point
113
____ represents the completion of ventricular depolarization and the beginning of ventricular repolarization
ST segment
114
what shape should the ST segment be?
flat / isoelectric
115
____ represents the beginning of ventricular repolarization
T wave
116
what shape should the T wave be?
round and upright (in most leads)
117
after the T wave we see ___
the flat line
118
which wave may be caused by hypokalemia and is not seen in all patients?
U wave
119
____ represents the time it takes for for electrical signals to cause ventricles to contract and then rest
QT interval
120
QT interval duration should be ___
0.35-0.44 seconds
121
who has shorter QT intervals - males or females?
males
122
a prolonged QT interval can indicate what?
increased risk of ventricular dysrhythmias, like Torsades de Pointes
123
what are the 3 Rs of ECG analysis?
(1) Regularity
(2) Rate
(3) Resemblance
124
Regularity in ECG readings means
making sure the waves / segments are the same distance from one another
125
Rate in ECG readings means
the number in a certain duration (like a 6-second strip)
126
Resemblance in ECG readings means
do the waves / segments resemble one another? are the measurements similar / normal?
127
which type of glaucoma is a medical emergency?
angle-closure glaucoma (ACG)
128
____ is the most common form of glaucoma
open-angle glaucoma (OAG)
129
what measures elevated intraocular pressure (IOP)?
tonometry
130
___ determines if glaucoma is open or closed-angle
gonioscopy
131
the 2 nursing priorities for glaucoma are:
(1) impaired visual sensory perception
(2) health teaching d/t treatment regimen
132
name at least 4 tips when communicating with someone with hearing loss
(1) Make sure room is well-lit
(2) Offer hearing devices
(3) Get the pt’s attention before you speak
(4) Position yourself directly in front of the patient
(5) Don’t stand or sit in front of a bright light or window
(6) Move closer to the better-hearing ear
(7) Do not shout
(8) Speak clearly and slowly
(9) Lowering voice can be helpful
(10) Keep hands and objects away from mouth
133
every ECG rhythm strip is ____ seconds long
6
134
which arrhythmia is highlighted as life-threatening?
ventricular fibrillation (V Fib)
135
_____ is full cardiac arrest
ventricular asystole
136
_____ is not a shockable rhythm
asystole
137
Brief, temporary moment of imbalance of O2 supply and demand can cause
stable angina
138
stable angina is usually resolved by
rest, nitroglycerin, and stopping the activity that triggered it
139
____ lasts <15 minutes
stable angina
140
name 4 key characteristics of unstable angina
(1) lasts >15 minutes
(2) not relieved by nitro
(3) may have ST segment changes
(4) no changes in troponin levels
141
normal troponin T levels are
<0.01 ng/mL
142
normal troponin I levels are
<0.03 ng/mL
143
name 3 non-modifiable risk factors for ACS
(1) increased age
(2) male sex
(3) family history
144
the biggest risk factor for ACS and MI is
atherosclerosis
145
silent ischemia is ____
ischemia without pain
146
silent ischemia is more common in ____
females
147
vasospasm, dissection, and narrowing of arteries are all causes of
NSTEMI
148
describe the ECG changes associated with NSTEMI
(1) ST depression
(2) T inversion
149
initial troponin levels will be normal and eventually elevate in ____
NSTEMI
150
rupture of atherosclerotic plaque is the main cause of ____
STEMI
151
what are the ECG changes associated with STEMI?
ST segment elevation on 2 contiguous leads
152
elevated troponin levels indicate which type of ACS?
STEMI
153
which type of ACS occurs without cause, usually in the morning?
MI
154
name at least 4 associated s/s of NSTEMI/STEMI
(1) N/V
(2) diaphoresis
(3) dyspnea
(4) anxiety, fear, impending doom
(5) dysrhythmias
(6) fatigue
(7) dizziness
(8) disorientation
(9) feeling SOB
155
name at least 3 distinct s/s of NSTEMI/STEMI for females
(1) indigestion
(2) pain b/t shoulders
(3) aching jaw
(4) flu-like symptoms
156
____ may experience indigestion, SOB, and confusion during an MI
older adults
157
name the initial steps a nurse should take if they learn the pt has chest pain / symptoms of ACS (6)
(1) delay rest of history
(2) assess pain but fast
(3) obtain vitals
(4) ensure IV access
(5) notify provider / call Rapid
(6) pain relief
158
only use O2 with ____ during possible MI
hypoxemia
159
What is the optimal positioning during a possible MI?
semi-fowler's
160
the two meds for pain relief of MI initially are
(1) IV morphine
(2) Nitroglycerin sublingual
161
___ needs to be managed within 4-6 hours of symptoms
NSTEMI
162
___ needs to be managed within 90 minutes of symptoms
STEMI
163
which type of MI requires PCI?
STEMI
164
percutaneous coronary intervention (PCI) should be performed within ___ of onset of symptoms
90 minutes
165
if a patient can't receive PCI, what is the next therapy choice?
fibrinolytics
166
on arrival to the ED with possible MI, what is given to pts?
aspirin, chewable 325 mg
167
___ is given 1-2 hours after MI and stable BP and HR
beta blocker
168
what is given within 24 hours of MI?
ACEIs or ARBs
169
what med do you give for MI pts with abnormal lipid panel?
Statin therapy
170
when should a MI pt stop walking therapy?
if they experience dyspnea, angina, or exceed their target pulse
171
when should MI pts resume sexual activity?
(1) after exercise tolerance test is completed
(2) when they can climb 2 flights of stairs without symptoms
172
avoid taking ____ with aspirin
NSAIDs
173
teach patients to monitor ___ and ____ on beta blockers
BP and HR
174
take ___ in the evening to be most effective
statins
175
what are 4 things to teach pts about Nitro?
(1) sun-resistant container
(2) carry at all times
(3) replace every 3-5 months
(4) if no relief after 5 mins, call 911
176
after a pt experiences an MI, when should they call the provider? (4)
(1) HR <50
(2) Dyspnea
(3) Weight gain 3 lbs/week or 1-2 lbs/day
(4) Activity intolerance
177
when should MI pts call 911?
(1) no relief with 1 dose of Nitro
(2) severe chest pain + associated symptoms
178
what is the medication management during a COPD exacerbation?
(1) nebulizer (albuterol / ipratropium)
(2) IV / oral corticosteroids
(3) monitor BG
(4) antibiotics if infection
179
what are the two diagnostic tests for PE?
D-dimer and CTPA
180
what D-dimer result indicates a positive test for PE?
>250 ng/mL
181
what lab test can help differentiate if a cause is respiratory or cardiac?
BNP
182
asymmetric chest expansion and decreased or absent breath sounds are s/s of ____
pneumothorax
183
T/F: The three-way dressing for a chest tube will have one side open for air to exit during exhalation
true
184
atropine is used to treat ____
bradycardia
185
long-term A Fib leads to decreased CO and poor perfusion. This is associated with which s/s?
fatigue, dizziness, hypotension, chest discomfort
186
what do you give for MI pain?
IV morphine
Nitroglycerin
187
What other drugs do you give for the treatment of MI (in general)?
(1) aspirin chewable 325 mg
(2) platelet inhibitor (clopidogrel)
(3) Beta blocker
(4) ACEI or ARB
(5) statin therapy
188
give beta blocker ____ after MI and when pt is stabilized
1-2 hours
189
when do you give ACEI or ARB for MI?
within 24 hours of MI and when pt is stable
190
who should receive statin therapy for MI?
those with abnormal lipid panel
191
treat a STEMI within ___ of onset of symptoms
90 minutes
192
which type of MI receives PCI?
STEMI
193
if a patient can't receive a PCI in time, what should they receive instead?
fibrinolytics within 30 minutes
194
treat NSTEMI within ____ of symptoms
4-6 hours
195
when do you give alteplase for PE?
patient deterioration and shock
196
excessive bubbling of a chest tube can indicate ___
a leak
197
what are the main causes of A Fib? (5)
(1) HTN
(2) CV disease
(3) ACS
(4) CAD
(5) HF
198
which antidysrhythmic is good for A Fib and HF?
digoxin
199
amlodipine will do what to heart rate?
decrease
200
when is the EF concerning in heart failure?
If EF <50%
201
which drug causes a dry cough?
ACEIs
202
what tool can be used to diagnose heart failure?
echocardiography
203
how do you treat pulmonary edema?
(1) high Fowler's
(2) give O2
(3) IV push Furosemide over 1-2 minutes
(4) reassess respiratory
204
the three nursing interventions for a hypertensive crisis are:
(1) semi-fowler's
(2) give O2
(3) call a rapid
205
avoid grapefruit juice with what med?
Ca channel blockers
206
the main risk factor for MI is
atherosclerosis
207
within 10 minutes of chest pain, what should happen?
a 12-lead ECG should be hooked up
208
name at least 4 pieces of discharge teaching for a MI
(1) risk factor modification
(2) diet
(3) exercise
(4) sexual activity
(5) medications
209
hypertensive crisis is defined as...
Systolic >180 and/or Diastolic >120
210
s/s of hypertensive crisis include
(1) severe headache
(2) blurred vision
(3) dyspnea
(4) anxiety
(5) uremia
211
____ glaucoma is slow vision loss over time
open-angle
212
what are the goals of medication for glaucoma?
(1) decrease pressure
(2) maintain vision
213
Holding pressure after eye drops to ensure the drop doesn’t go to the whole body via the lacrimal duct is called?
punctal occlusion
214
Name at least 3 guidelines for talking to patients with vision loss in the hospital
(1) announce yourself
(2) don't move stuff around without telling them
(3) make sure they have their glasses
(4) speak in a normal voice
(5) don't stand with window / light behind you
215
name at least 4 things for hearing aid care
(1) keep aid dry
(2) wash mold with warm water and gentle soap
(3) keep charged
(4) turn off when not in use
(5) avoid use of hairspray, cosmetics, etc.
(6) use soft brush to clean debris
216
name 4 risk factors for OSA
(1) obesity
(2) male sex
(3) genetics
(4) older age
217
name at least 3 s/s of OSA
(1) daytime sleepiness
(2) waking up gasping
(3) overweight
(4) irritability
(5) memory problems
218
ability to perceive stimulation through sensory organs
sensation
219
process of receiving, organizing, and interpreting sensation
perception
220
ability to receive inputs and translate into meaningful information
sensory perception
221
CN II controls ___
visual acuity and visual field
222
CN III is the ____ nerve
oculomotor
223
CN IV
trochlear
224
____ controls downward and inward eye movement
trochlear
225
____ controls the sensation of the eye
CN V / trigeminal
226
CN V
trigeminal
227
CN VI
abducens
228
___ controls lateral eye movement
abducens / CN VI
229
what are the 3 CN involved in taste?
CN VII, IX, and X
230
stage 1 of sleep is ____ sleep
light
231
during ___ (stage of sleep), eye movement stops and brain waves slow
stage 2
232
during stage 2 sleep, RR, HR, and temp will ____
decrease
233
___ takes 90-110 minutes to achieve (sleep type)
REM
234
deep sleep and little muscle activity is associated with which stage of sleep?
3 & 4
235
Describe characteristics of REM sleep
(1) increased RR and HR
(2) brain is active
(3) muscle paralysis
(4) active dreaming
236
tissue degeneration, muscle / bone development, immune enhancement, and hormone regulation occur during ___
deep sleep
237
recurring or chronic insufficient sleep time, poor quality of sleep despite adequate time, or problems falling or staying asleep
sleep disorders
238
3 primary sleep disorders are
(1) insomnia
(2) OSA
(3) RLS
239
name at least 3 physiological consequences of inadequate sleep
(1) HTN
(2) heart disease
(3) HF
(4) stroke
(5) obesity
240
what is the most important intervention for impaired sleep?
sleep hygiene
241
what are the 2 risks of sleep aids?
(1) make people drowsy
(2) increase risk of falls
242
a nurse is teaching a pt with a new rx for ferrous sulfate. which of the following should be included in the teaching?
a. stools will be dark
b. take with a glass of milk if GI distress
c. foods high in vitamin C will promote absorption
d. take for 14 days
C
243
when might we place a pacemaker?
if someone with sinus bradycardia can't regain normal HR
244
we give ___ for sinus bradycardia (medication)
atropine
245
we give ___ for v tach with a pulse (medication)
amiodarone
246
always pulseless, apneic, absent heart sounds -- what is this describing?
V fib
247
___ is the arrhythmia that typically precedes V fib
V Tach
248
complete absence of any ventricular rhythm
ventricular asystole
249
____ is not a shockable rhythm
ventricular asystole
250
idarucizumab is the antidote for ____
dabigatran
251
____ can cause bronchospasm (medication)
metoprolol
252
____ is a useful drug for both A fib and HF
Digoxin
253
what is Virchow's Triad?
(1) decreased blood flow
(2) endothelial / vessel injury
(3) hypercoaguable state
254
Virchow's Triad is a risk for ___ and ___.
DVT and PE
255
beta blockers, carbonic anhydrase inhibitors, and alpha agonists all treat ___
glaucoma
256
never give which two drugs together?
ACEI and ARB
257
a normal sinus rhythm is
60-100 bpm
258
normal rate in the Bundle of His is
40-60 bpm
259
normal rate of the Purkinje fibers is
20-40 bpm
260
what are the 4 steps of analyzing an ECG?
(1) assess rhythm
(2) assess rate
(3) identify waveforms
(4) interpret rhythm
261
R-R interval represents the ___ rhythm
ventricular
262
p-p interval represents the ___ rhythm
atrial
263
all strips are __ seconds
6
264
when assessing the rate of an ECG, count what?
the QRS intervals (because they are larger typically)
265
if you have 8 QRS intervals in a 6-second strip, what is the heart rate?
80 (8 * 10)
266
compare the ST segment to ___ to assess for elevation / depression
isoelectric line
267
always assess if a patient is taking ED meds before giving ___
nitroglycerin
268
hold additional doses of nitroglycerin if _____
BP < 100 mmHg
269
sildenafil is an example of what type of med?
ED medication
270
pain occurs due to decreased oxygen supply to your leg muscles. what does this describe?
PAD
271
which intervention is most appropriate for venous insufficiency?
a. keep legs in a dependent position when sitting
b. encourage frequent walking with legs elevated when resting
c. apply warm compresses to both legs
d. limit fluid intake to reduce swelling
encourage frequent walking with legs elevated when resting
272
the valsalva maneuver can cause
bradycardia
273
name 3 causes of bradycardia
(1) being healthy / athletic
(2) valsalva maneuver
(3) drugs
(4) vomiting / suctioning
274
the 4 hypos can cause tachycardia. what are they?
hypovolemia
hypotension
hypoxia
hypoglycemia
275
widened QRS
regular rhythm
fast rate (140-180)
no P wave
what is this describing?
V Tach
276
chaotic
no discernible PQRST
rapid rate
V Fib
277
side effects of albuterol are ___ and ___
tachycardia and tremor
278
name the 5 nursing priorities for chest tube care:
(1) Measure drainage q1h for the first 24 hours
(2) Get baseline drainage amount at the beginning of the shift
(3) <30 mL/24 hours
(4) Monitor for infection
(5) Keep the chest tubes / drainage bags below heart level
279
Before and after the chest tube drainage, what are the nursing actions? (3)
(1) give morphine before and after
(2) do a repeat CXR to see if the placement is correct
(3) do not manipulate the dressing
280
If the chest tube becomes dislodged, what is the immediate nursing intervention?
Apply pressure with sterile gauze
281
for HTN, limit salt intake to ___
<1.5g/day
282
what are the safety precautions for thiazide diuretics?
(1) monitor for hypokalemia
(2) monitor BP
(3) encourage potassium-rich foods
(4) take in the morning
283
weight gain, edema, and ascites are key characteristics of ___
right-sided heart failure
284
an extra S3 gallop sound can be a sign of ___
heart failure
285
what are the 4 secondary causes of hypertension?
(1) Kidney disease
(2) Cushing's
(2) Immunosuppressant
(4) Corticosteroids
286
what is the main cause of secondary hypertension?
kidney disease
287
What is the significance of monitoring drainage amount from a chest tube?
To assess respiratory status and lung re-expansion
288
___ can impact glucose control
thiazide diuretics
289
fatigue, weakness, bradycardia, and loss of P wave are a sign of ____
digoxin toxicity
290
do not take ____ with antacids
digoxin
291
do not stop ____ abruptly
beta blockers
292
fluid intake for heart failure is ____ L/day
2-3
293
name at least 3 risk factors for V tach
(1) heart disease
(2) history of MI
(3) hypokalemia
(4) hypomagnesemia
(5) HF
(6) cocaine use
294
cardioversion is used for ____
V tach
295
hypokalemia and hypomagnesemia can both lead to ___ and ___
V tach and V fib
296
name at least 3 risk factors for V Fib
(1) CAD
(2) MI
(3) hypokalemia
(4) hypomagnesemia
(5) hemorrhage
(6) rapid supraventricular tachycardia
(7) shock
(8) surgery
297
the three causes of ventricular asystole are
myocardial hypoxia, severe hyperkalemia, and acidosis
298
ventilate at what rate for CPR?
10-12 breaths per minute or
30 compressions to 2 breaths
299
the purpose of _____ is to measure clot breakdown, indicating a thromboembolic event
D-dimer test
300
the nurse should provide ____ lighting when talking to patients with vision loss
indirect
301
which 2 drugs can cause hyperkalemia?
ACEI and ARB
302
which 2 drugs can cause hypokalemia?
HCTZ, Furosemide
303
how long should you wait between eye drops for glaucoma?
5-10 minutes
304
name at least 3 reasons for reduced blood flow
(1) AFib
(2) Long distance travel
(3) bedrest / immobility
(4) venous obstruction
(5) venous insufficiency
305
name at least 3 reasons for blood vessel injury
(1) trauma
(2) surgery
(3) HTN
306
name at least 3 reasons for increased coagulability
(1) sepsis
(2) smoking
(3) coagulation disorders
(4) malignancy / cancer
307
facial flushing can be a sign of ____
hypertension
308
name at least 3 s/s of anemia
(1) fatigue
(2) cold intolerance
(3) spoon-shaped nails
(4) irritability
(5) N/T of extremities
(6) pallor
