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Med Surge and Maternity > Med surge exam 3 > Flashcards

Med surge exam 3 Flashcards

1
Q

arrhythmia

A

irregular heartbeat

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2
Q

bruit

A

a humming is heard that is caused by the turbulent blood flow through the vessel

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3
Q

claudication

A

pain in the legs with activity

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4
Q

clubbing

A

this occurs from oxygen deficiency over time

it is often caused by congenital heart defects or long term use of tobacco

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5
Q

hyperkalemia

A

high potassium level

healthy is 3.5 to 5

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6
Q

hypomagnesemia

A

low level of magnesium

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7
Q

ischemic

A

in areas of decreased arterial blood flow, the ischemic area feels cooler than the rest of the body

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8
Q

murmur

A

prolonged swishing sound

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9
Q

pericardial friction rub occurs from

A

inflammation of the pericardium

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10
Q

poikilothermy

A

the area becomes the temperature of the environment.

because of the absence of sufficient arterial blood flow,

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11
Q

point of maximum impulse

A

the thorax can be palpated at this point.
If palpable a thrust is felt when the ventricle contracts
(an enlarged heart may shift the PMI to the left of the midclavicular line)

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12
Q

preload

A

pressure is stretching the ventricle of the heart from fluid that is returned to it.

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13
Q

pulse deficit

A

if there are fewer radial beats than apical beats

This should be reported to the HCP

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14
Q

sternotomy

A

closed with wires through the sternum.

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15
Q

thrill

A

in an abnormal vessel that has a bulging or narrowed wall, a vibration is felt.

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16
Q

location of the heart

A

located in the mediastinum within the thoracic cavity

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17
Q

the structure of the heart.

A

the walls of the four chambers of the heart are made of cardiac muscle (myocardium) and are lined with endocardium

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18
Q

epithelium also covers the valve of the heart and continues into blood vessels, at which point its called

A

endothelium

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19
Q

during exercise, venous return increases and stretches the ventricular myocardium, which in response contracts more forcefully. this is called

A

starlings law

this results in increase stroke volume

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20
Q

arteries and arterioles carry blood from the heart to

A

capillaries

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21
Q

these carry blood from arterioles to venules and form extensive networks in most tissues

A

capillaries

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22
Q

decreased blood pressure stimulates kidneys to secrete renin. which initiates the

A

renin-angiotensin-aldosterone mechanism

which raises blood pressure

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23
Q

atherosclerosis

A

the deposition of lipids in the walls of arteries over a period of years

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24
Q

if blood pressure has a different reading in both arms

A

report to the health care provider(hcp)

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25
Q

cardiac output

A

amount of blood pumped out each minute

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26
Q

essential hypertension (primary hypertension)

A

chronic high BP from an unknown cause

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27
Q

hypertension

A

high blood pressure

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28
Q

hypertensive emergency

A

risk for progression of target organ dysfunction

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29
Q

hypertensive urgency

A

high blood pressure without organ dysfunction progression

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30
Q

peripheral vascular resistance

A

is the ability of the vessels to stretch

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31
Q

primary hypertension

A

unknown cause

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32
Q

secondary hypertension

A

the cause is known

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33
Q

viscosity

A

thickness of the blood

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34
Q

processes that influence blood pressure

A

nervous system regulation, arterial baroreceptors, chemoreceptors, the renin-angiotensin-aldosterone mechanism, and balance of body fluids

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35
Q

hypercalcemia could be hazardous to a patient on

A

digoxin

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36
Q

if a pt needs to be on loop diuretics it is contraindicated if they are

A

allergic to sulfonamides

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37
Q

allograft

A

a human cadaveric or living donor

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38
Q

annuloplasty

A

the repair or reconstruction of the valve flaps or annulus

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39
Q

autograft

A

self donor

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40
Q

beta-hemolytic streptococci

A

causes rheumatic fever

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41
Q

bio-prosthesis

A

tissue valves

42
Q

cardiac tamponade

A

life-threatening compression of the heart by fluid accumulated in the pericardial sac.

43
Q

cardiomegaly

A

abnormal enlargement of the heart

44
Q

cardiomyopathy

A

an abnormality and enlargement of the heart muscle that leads to ineffective pumping of the blood.

45
Q

chorea

A

brief rapid, uncontrolled movements

46
Q

commissurotomy

A

repairs a stenosed valve

which is most commonly the mitral valve

47
Q

Dressler syndrome

A

autoimmune response

48
Q

emboli

A

results from the stasis of blood in the left atrium that may cause stroke

49
Q

homograft

A

another term for allograft

living donor

50
Q

infective endocarditis

A

an infection of the endocardium

mostly occurs in hearts with artificial or damaged valves or pacemakers

51
Q

international normalized ratio

A

measures the effectiveness of warfarin therapy using a standardized testing reagent

52
Q

myectomy

A

procedure to remove heart muscle

53
Q

myocarditis

A

inflammation of the myocardium.

the amount of muscle destroyed with myocarditis determines the extent of damage to the heart

54
Q

pericardial effusion

A

build up of fluid in pericardial space

55
Q

pericardial friction rub

A

grating, scratching, high pitched sound that is the result of friction from the inflamed pericardial and epicardial layers rubbing together as the heart fills and contracts.

56
Q

what is treated with a pericardiectomy?

A

chronic constrictive pericarditis

57
Q

pericardiocentesis

A

the pericardium is punctured with a needle and excess fluid in the pericardial sac is removed.

58
Q

pericarditis

A

an acute or chronic inflammation of the pericardium

59
Q

petechiae

A

tiny red or purple flat spots

60
Q

regurgitation

A

if a valve does not close completely, blood backs up

61
Q

rheumatic fever

A

autoimmune reaction 2 to 3 weeks after an upper respiratory infection due to a group A beta-hemolytic streptococci infection.

62
Q

thrombophlebitis

A

formation of clot followed by inflammation within the vein

63
Q

valvotomy

A

expansion of a balloon to open the mitral valve

64
Q

valvuloplasty

A

a balloon dilates the stenosed heart valve

65
Q

xenograft

A

tissue valves that com from cow(bovine) or pig (porcine)

66
Q

the two types of valvular dysfunction

A

stenosis and insufficiency

67
Q

thickening of the mitral valve flaps and shortening of the chordae tendineae, causing narrowing of the mitral valve opening.

A

mitral stenosis

68
Q

post cardiac catherization care

A

Firm pressure to the insertion site for several minutes to prevent hemorrhage or hematoma formation.
A pressure dressing/sandbag may be applied to the site when bleeding stops.
Vital signs

69
Q

which cardiac biomarker indicates an MI

A

troponin

blood test

70
Q

who is at the highest risk for death related to cardiovascular disease?

A

the elderly

71
Q

the rate for the SA node
AV Node
The ventricular rate

A

75 to 100
40 to 60
20 to 35

72
Q

interventions for pulse deficit

A

have the pt rest and have another hcp check the apical while you check the radial pulse
Contact The HCP.

73
Q

holter monitoring

A

heart monitor

74
Q

normal blood pressure reading supposed to be

A

120/80

75
Q

what test do you perform if potassium level is out of range

A

EKG

76
Q

under inspection
what is brown discoloration and
purple skin?

A

may be seen in the presence of venous flow problems.

77
Q

interventions and rational for ineffective health management of hypertension

A
  • Identify patient’s modifiable risk factors and lifestyle modifications needs.
  • Develop plan to overcome identified barriers to patient adhering to therapy.
  • Make referrals as needed
  • Teach patient to take medications as prescribed and not to skip dosages.
  • Teach pt. to change positions slowly to prevent falls.
78
Q

follow up time frames for different blood pressures

A 
For those with normal B P
• 3 to 5 years
For those over the age of 39 or with 
increased risk
• Annually
79
Q

who is at high risk for hypertension

nonmodifiable and modifiable

A 
Nonmodifiable 
family history of hypertension
age
race and ethnicity
Modifiable
weight control
diet 
increase physical activity
glucose control
80
Q

explain another explanation of hypertensive emergency

A

systolic bp higher than 180 mm Hg or diastolic BP higher than 120 occurs

81
Q

what are the therapeutic measures for hypertension?

A 
Lifestyle changes.
L- limit salt, caffeine, and alcohol.
I-Include daily potassium and calcium 
F- Fight fat and cholesterol 
E-Exercise regularly 
S-Stay on your BP regime
T-Try to quit smoking
Y-Your medication is to be taken daily 
L-Lose weight
E- End-stage complications will be avoided.
consideration of antihypertensive 
medications.
82
Q

what medication will be prescribed for stage 1 hypertension?

A

Thiazide-like diuretic
Angiotensin-converting enzyme (A C E) inhibitor
Angiotensin Two receptor blocker
Calcium channel blocker

83
Q

a non pharmacological intervention

A

call the physician

do not hold unless she instructs it.

84
Q

a non pharmacological intervention

A

call the hcp

85
Q

what are the safety measures for coumadin use

A

monitor INR and monitor for bleeding (teach patient to report bleeding)

86
Q

who is the highest risk for mitral valve prolapse?

A

ischemic heart disease
cardiomyopathy
infection damaging the mitral valve and
hereditary collagen tissue disorder

87
Q

interventions for aortic regurgitation

A

Digitalis
Diuretics
Vasodilators
Valve replacement

88
Q

antidotes for coumadin and heparin

A

antidote for coumadin is vitamin k

antidote for heparin is protamine sulfate

89
Q

interventions and rationales for a nursing diagnosis of decreased cardiac output related to post op cardiac surgery

A

For patients with increased preload, limit fluids and sodium as ordered.
Closely monitor fluid intake, including IV lines. Maintain fluid restriction if ordered.
Place on a cardiac monitor; monitor for dysrhythmias, especially atrial fibrillation.

90
Q

causes of ineffective endocarditis

A
  • Most commonly bacteria but possibly fungi or other organisms.
  • Entry of organism into bloodstream
91
Q

what is angina?

A

chest pain due to not enough blood or oxygen

92
Q

what is dilated cardiomyopathy ?

A
  • Size of the heart chambers increase
  • The wall of the heart become thin
  • Cardiac output is reduced
  • Blood moves more slowly from the left ventricle
  • This often results in blood clot formation
93
Q

who is at risk for DVT?

A

hospitalized patients who are immobile after surgery

94
Q

What are the complications of aortic stenosis?

A
  • Heart failure
  • Arrhythmias
  • Emboli
  • Endocarditis
  • Sudden cardiac death
95
Q

pericarditis summary

A

s/s chest pain, cough, edema, low-grade fever, and pericardial friction rub

therapeutic measures
treat underlying causes
Anti-inflammatory medication, corticosteroids, pericardiocentesis, and percardiectomy

96
Q

data collection for thrombophlebitis

A 
dimer and coagulation tests
compression ultrasonography
contrast venography 
MRI
CT scan
97
Q

what are some complications of a DVT?

A

Pulmonary embolism (Life-threatening emergency)
• Chronic venous insufficiency
• Varicose veins
• Recurrent D V T

98
Q

what are the s/s peripheral vascular disease?

A

numbness, tingling, or weakness

99
Q

what are the 6 P’s of PVD

A 
pain
paresthesia( decreased sensation)
pallor
pulselessness
paralysis
poikilothermia (assumes temperature of the environment)
100
Q

What are the therapeutic measures for a DVT?

A

compression socks
blood thinners
ambulation every two hours

101
Q

thrombophlebitis therapeutic measures

A 
Superficial veins
‒ Warm, moist heat
‒ Analgesics
‒ N S A I D’s 
‒ Elastic compression stockings
D V T (if uncomplicated)
‒ Low-molecular weight heparin/heparin
‒ Warfarin (coumadin)
‒ Monitor appropriate lab values
‒ Bedrest (elevate extremity above heart level)
‒ Warm, moist heat
‒ Compression stocking therapy
‒ Thrombolytic therapy
thrombectomy

Med Surge and Maternity (14 decks)

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