Med surge exam 3 Flashcards
(101 cards)
1
Q
arrhythmia
A
irregular heartbeat
2
Q
bruit
A
a humming is heard that is caused by the turbulent blood flow through the vessel
3
Q
claudication
A
pain in the legs with activity
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
5
Q
hyperkalemia
A
high potassium level
healthy is 3.5 to 5
6
Q
hypomagnesemia
A
low level of magnesium
7
Q
ischemic
A
in areas of decreased arterial blood flow, the ischemic area feels cooler than the rest of the body
8
Q
murmur
A
prolonged swishing sound
9
Q
pericardial friction rub occurs from
A
inflammation of the pericardium
10
Q
poikilothermy
A
the area becomes the temperature of the environment.
because of the absence of sufficient arterial blood flow,
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)
12
Q
preload
A
pressure is stretching the ventricle of the heart from fluid that is returned to it.
13
Q
pulse deficit
A
if there are fewer radial beats than apical beats
This should be reported to the HCP
14
Q
sternotomy
A
closed with wires through the sternum.
15
Q
thrill
A
in an abnormal vessel that has a bulging or narrowed wall, a vibration is felt.
16
Q
location of the heart
A
located in the mediastinum within the thoracic cavity
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
18
Q
epithelium also covers the valve of the heart and continues into blood vessels, at which point its called
A
endothelium
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
20
Q
arteries and arterioles carry blood from the heart to
A
capillaries
21
Q
these carry blood from arterioles to venules and form extensive networks in most tissues
A
capillaries
22
Q
decreased blood pressure stimulates kidneys to secrete renin. which initiates the
A
renin-angiotensin-aldosterone mechanism
which raises blood pressure
23
Q
atherosclerosis
A
the deposition of lipids in the walls of arteries over a period of years
24
Q
if blood pressure has a different reading in both arms
A
report to the health care provider(hcp)
25
cardiac output
amount of blood pumped out each minute
26
essential hypertension (primary hypertension)
chronic high BP from an unknown cause
27
hypertension
high blood pressure
28
hypertensive emergency
risk for progression of target organ dysfunction
29
hypertensive urgency
high blood pressure without organ dysfunction progression
30
peripheral vascular resistance
is the ability of the vessels to stretch
31
primary hypertension
unknown cause
32
secondary hypertension
the cause is known
33
viscosity
thickness of the blood
34
processes that influence blood pressure
nervous system regulation, arterial baroreceptors, chemoreceptors, the renin-angiotensin-aldosterone mechanism, and balance of body fluids
35
hypercalcemia could be hazardous to a patient on
digoxin
36
if a pt needs to be on loop diuretics it is contraindicated if they are
allergic to sulfonamides
37
allograft
a human cadaveric or living donor
38
annuloplasty
the repair or reconstruction of the valve flaps or annulus
39
autograft
self donor
40
beta-hemolytic streptococci
causes rheumatic fever
41
bio-prosthesis
tissue valves
42
cardiac tamponade
life-threatening compression of the heart by fluid accumulated in the pericardial sac.
43
cardiomegaly
abnormal enlargement of the heart
44
cardiomyopathy
an abnormality and enlargement of the heart muscle that leads to ineffective pumping of the blood.
45
chorea
brief rapid, uncontrolled movements
46
commissurotomy
repairs a stenosed valve
| which is most commonly the mitral valve
47
Dressler syndrome
autoimmune response
48
emboli
results from the stasis of blood in the left atrium that may cause stroke
49
homograft
another term for allograft
| living donor
50
infective endocarditis
an infection of the endocardium
| mostly occurs in hearts with artificial or damaged valves or pacemakers
51
international normalized ratio
measures the effectiveness of warfarin therapy using a standardized testing reagent
52
myectomy
procedure to remove heart muscle
53
myocarditis
inflammation of the myocardium.
| the amount of muscle destroyed with myocarditis determines the extent of damage to the heart
54
pericardial effusion
build up of fluid in pericardial space
55
pericardial friction rub
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
what is treated with a pericardiectomy?
chronic constrictive pericarditis
57
pericardiocentesis
the pericardium is punctured with a needle and excess fluid in the pericardial sac is removed.
58
pericarditis
an acute or chronic inflammation of the pericardium
59
petechiae
tiny red or purple flat spots
60
regurgitation
if a valve does not close completely, blood backs up
61
rheumatic fever
autoimmune reaction 2 to 3 weeks after an upper respiratory infection due to a group A beta-hemolytic streptococci infection.
62
thrombophlebitis
formation of clot followed by inflammation within the vein
63
valvotomy
expansion of a balloon to open the mitral valve
64
valvuloplasty
a balloon dilates the stenosed heart valve
65
xenograft
tissue valves that com from cow(bovine) or pig (porcine)
66
the two types of valvular dysfunction
stenosis and insufficiency
67
thickening of the mitral valve flaps and shortening of the chordae tendineae, causing narrowing of the mitral valve opening.
mitral stenosis
68
post cardiac catherization care
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
which cardiac biomarker indicates an MI
troponin
| blood test
70
who is at the highest risk for death related to cardiovascular disease?
the elderly
71
the rate for the SA node
AV Node
The ventricular rate
75 to 100
40 to 60
20 to 35
72
interventions for pulse deficit
have the pt rest and have another hcp check the apical while you check the radial pulse
Contact The HCP.
73
holter monitoring
heart monitor
74
normal blood pressure reading supposed to be
120/80
75
what test do you perform if potassium level is out of range
EKG
76
under inspection
what is brown discoloration and
purple skin?
may be seen in the presence of venous flow problems.
77
interventions and rational for ineffective health management of hypertension
- 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
follow up time frames for different blood pressures
```
For those with normal B P
• 3 to 5 years
For those over the age of 39 or with
increased risk
• Annually
```
79
who is at high risk for hypertension
| nonmodifiable and modifiable
```
Nonmodifiable
family history of hypertension
age
race and ethnicity
Modifiable
weight control
diet
increase physical activity
glucose control
```
80
explain another explanation of hypertensive emergency
systolic bp higher than 180 mm Hg or diastolic BP higher than 120 occurs
81
what are the therapeutic measures for hypertension?
```
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
what medication will be prescribed for stage 1 hypertension?
Thiazide-like diuretic
Angiotensin-converting enzyme (A C E) inhibitor
Angiotensin Two receptor blocker
Calcium channel blocker
83
a non pharmacological intervention
call the physician
| do not hold unless she instructs it.
84
a non pharmacological intervention
call the hcp
85
what are the safety measures for coumadin use
monitor INR and monitor for bleeding (teach patient to report bleeding)
86
who is the highest risk for mitral valve prolapse?
ischemic heart disease
cardiomyopathy
infection damaging the mitral valve and
hereditary collagen tissue disorder
87
interventions for aortic regurgitation
Digitalis
Diuretics
Vasodilators
Valve replacement
88
antidotes for coumadin and heparin
antidote for coumadin is vitamin k
| antidote for heparin is protamine sulfate
89
interventions and rationales for a nursing diagnosis of decreased cardiac output related to post op cardiac surgery
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
causes of ineffective endocarditis
* Most commonly bacteria but possibly fungi or other organisms.
* Entry of organism into bloodstream
91
what is angina?
chest pain due to not enough blood or oxygen
92
what is dilated cardiomyopathy ?
- 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
who is at risk for DVT?
hospitalized patients who are immobile after surgery
94
What are the complications of aortic stenosis?
* Heart failure
* Arrhythmias
* Emboli
* Endocarditis
* Sudden cardiac death
95
pericarditis summary
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
data collection for thrombophlebitis
```
dimer and coagulation tests
compression ultrasonography
contrast venography
MRI
CT scan
```
97
what are some complications of a DVT?
Pulmonary embolism (Life-threatening emergency)
• Chronic venous insufficiency
• Varicose veins
• Recurrent D V T
98
what are the s/s peripheral vascular disease?
numbness, tingling, or weakness
99
what are the 6 P's of PVD
```
pain
paresthesia( decreased sensation)
pallor
pulselessness
paralysis
poikilothermia (assumes temperature of the environment)
```
100
What are the therapeutic measures for a DVT?
compression socks
blood thinners
ambulation every two hours
101
thrombophlebitis therapeutic measures
```
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
```
