NUR 133 - Exam 2; Craig Hint-Hint Flashcards
(88 cards)
1
Q
Which layer of the heart is most susceptible to ischemia?
A
Endocardium.
2
Q
Which medication is typically used to treat atrial fibrillation alongside CHF?
A
Digoxin.
3
Q
What is the effect of Digoxin?
A
- Slows HR
- Strengthens contractility
4
Q
Which component of the heart’s conduction system is the pacemaker?
A
SA Node.
5
Q
What are the intrinsic rates of conduction for all the components?
A
- SA Node (pacemaker) - 60-100 bpm
- AV Node (backup) - 40-60 bpm
- Bundles of HIS - 20-40 bpm
- Perkinje fibers - 20 bpm
6
Q
What is the general function of beta-blockers?
A
- Slow HR
- Vasodilate
7
Q
When are beta-blockers contraindicated?
A
- Respiratory disease due to bronchoconstriction
- Asthma, COPD, etc.
8
Q
What does right-sided heart failure lead to?
A
- Peripheral edema
- JVD
- Hepatomeglia (enlargement of liver)
- Portal hypertension
9
Q
What does left-sided heart failure lead to?
A
- Pulmonary edema
- Crackles, rales, pink-frothy sputum
10
Q
How is stroke volume measured?
A
By the amount of blood moved per single contraction.
11
Q
What is the average stroke volume?
A
70mL.
12
Q
How is cardiac output measured?
A
Amount of blood moved over 1 minute.
13
Q
What is the average cardiac output?
A
4-6 litres.
14
Q
What value of diastolic BP is considered pre-hypertensive?
A
80’s.
15
Q
What is afterload?
A
The pressure that the heart must work against to eject blood during systole (ventricular contraction).
16
Q
Where is renin released from?
A
Kidneys.
17
Q
What does renin do?
A
- Converts angiotensin I to angiotensin II
- Vasoconstriction (increases BP)
18
Q
What does aldosterone do?
A
Holds on to sodium (increases BP).
19
Q
What does anti-diuretic hormone (ADH) do?
A
Holds on to water (increases BP).
20
Q
Which receptors initiate the release of renin, aldosterone, and ADH?
A
Baroreceptors (detect a pressure drop).
21
Q
How do palpitations occur?
A
Increase in HR (sympathetic).
22
Q
How does syncope occur?
A
Decrease in HR.
23
Q
Why does syncope occur?
A
The SA node does not receive enough acetylcholine for contraction.
24
Q
What are all the proper values for the lipid panel?
A
- Total cholesterol = <200
- HDL = >40
- LDL = <100
- Triglycerides = <150
25
What are all the proper values for blood chemistry?
- Sodium = 135-145
- Potassium = 3.5-5
- Magnesium = 1.3-2.1
26
What are all the proper values for hematology panels?
- RBC = 4.5-6
- WBC = 5,000-10,000
- Hct = (m)42-52%, (f)37-47%
- Hgb = 12-18
- Platelets = 150,000-400,000
27
How many leads to you use to identify the origin of ischemia?
12-lead EKG.
28
When is the best time to administer diuretics?
In the morning.
29
What is claudication indicative of?
Peripheral Arterial Disease (PAD).
30
How will a patient with PVD present with venous issues?
- Red
- Warm
- Edema
31
How will a patient with PAD present with arterial issues?
- Cool
- No blood
- No pulse
32
What should a patient on diuretics do every morning?
- Weigh themselves every morning
| - Monitor electrolytes (K+, Na+, etc.)
33
What is Artherosclerosis?
Build up of plaque, more commonly affects medium-large arteries.
34
What is Arteriosclerosis?
Narrowing of the arteries/vessels.
35
What position do you place a patient with an air embolism?
Left-lateral trendelenburg position.
36
What can uncontrolled cardiovascular disease or hypertension lead to?
- Retinopathy
- Thicker arteries
- Renal failure
- Stroke
37
What are the mercury values for prehypertension?
120-139/80-89 mmHg.
38
What are the mercury values for Stage 1 hypertension?
140-159/90-99 mmHg.
39
What are the mercury values for Stage 2 hypertension?
>160/>100 mmHg.
40
What are the symptoms of hypertension?
- Retinal damage
- Renal damage
- Myocardial infarction
- Cardiac infarction
- Stroke
41
What is the the number one cause of hemorrhagic stroke?
Hypertension.
42
What do loop diuretics do?
Inhibit sodium reabsorption.
43
Typical nursing suggestions for patients with hypertension.
- Walk 30 minutes a day
| - Limit alcohol consumption to 2 drinks/day
44
What are the mercury values for Hypertensive crisis?
180/120 mmHg.
45
What are the nursing procedures for caring for patients with hypertensive crisis?
- Treat w/ nitroprusside
- Reduce BP by 20-25% in first hour
- Administer IV slowly
- Monitor BP every 5-15 minutes
46
What is the general function for ACE-Inhibitors?
Block the conversion of angiotensin I into angiotensin II.
47
What are the side-effects of ACEI's?
- Angioedema
- Dry cough
- Hyperkalemia
- Rash
- Neutropenia
- Heart failure
- Altered taste
- Renal impairment
48
What is the premise behind the DASH diet?
- Having a healthy diet
| - Reducing sodium intake
49
What are the 5 conditions where you must have 3 in order to have metabolic syndrome?
- Abdominal obesity
- Hypertension
- Increase triglycerides
- Increase blood glucose
- Decrease in HDL's
50
What do you administer first and second when a patient has a heart attack?
- Aspirin first
| - Nitroglyceride
51
What is the purpose of administering a statin?
- To prevent further complication from claudication/PAD
| - Increase HDL's
52
What do you monitor when you're on statins?
- Muscle pain
- Abdominal pain
- Jaundice
53
What do you not ingest when you're on statins?
Grapefruit juice.
54
What are the side effects of statins?
- Myopathy
- Rhabdomyolysis (break down of protein in muscles, which lead to kidney failure)
- Liver toxicity
55
What are the ranges for Hemoglobin A1C?
- 5.7-6.4 is predisposed/pre-diabetic
- >6.4 is diabetic
- If they have diabetes, anything <6 is compliant with their diet
56
What are the pre-disposed factors for Type I Diabetes?
- Genetic
- Usually diagnosed at a young age
- Fasting hyperglycemia (no insulin)
57
What are the pre-disposed factors for Type II Diabetes?
- Onset over 30 y/o
- R/T obesity, poor diet, sedentary lifestyle
- Insulin resistant/impaired
58
What are the 3 P's for Hyperglycemia?
- Polyuria
- Polydipsia
- Polyphagia
59
What are the other manifestations for hyperglycemia?
- Weakness/Fatigue
- Wounds slow to heal
- Tingling in extremities
- Dry skin
- Stomach pain
60
What are typical blood sugar levels for an individual with hypoglycemia?
50-60.
61
What are some manifestations for hypoglycemia?
- Cool, pale, diaphoretic
- Anxiety/Irritability
- Tachycardia
- shakiness
- Blurred vision
- Unconsciousness
62
How many carbohydrates should a diabetic consume before exercising?
15 grams.
63
What do you typically administer to treat hypoglycemia?
- Sugar & water
| - Dextrose IV/Glucagon IM
64
Which glucose medication won't work with alcoholics?
Glucagon IM.
65
What is the primary treatment for yhperglycemia?
Fluids.
66
Patients with DKA (diabetic ketoacidosis) will present with what?
- Type I
- Blood glucose: 300-1,000 (hyperglycemia)
- Fruity breath
- Dehydration
67
What is the typical treatment for DKA?
- Fluids first (normal saline)
- Electrolyte replacement (K+)
- Regular insulin (slowly)
68
What is the important patient education for a Type II Diabetic?
- How to give insulin
| - Side effects
69
What are the general insulin mixing rules?
- Draw up short-acting (clear)
- Then draw up long-acting (cloudy)
- Clear over cloudy
70
Short-acting insulin facts.
- Onset: 30-60min
- Peak: 1-5 hours
- Duration: 6-10 hours
71
Intermediate-acting insulin facts.
- Onset: 1-2 hours
- Peak: 6-14 hours
- Duration: 16-24 hours
72
Long-acting insulin facts.
- Onset: 70 min
- Peak: None
- Duration: 24 hours
- Long-acting cannot be mixed
73
Injectable hypoglycemics treat which type of diabetes?
Both type I and type II.
74
Oral hypoglycemics treat which type of diabetes?
Only type II.
75
How long do you have to feed patients when you've administered insulin?
30 minutes.
76
What are cataracts?
Cloudiness forming over the clear lens in the eye.
77
What causes cataracts?
- Exposure to UV
- Toxicity from corticosteroids/beta-blockers
- Diabetes
- Thyroid disorders
- Smoking
78
What is the treatment for cataracts?
- Sunglasses
- Increase available room light
- Snellen chart
- Adaptive devices
- Anticholinergics (atropine)
79
What is glaucoma?
Functional disturbance of the optic nerve.
80
What is glaucoma caused by?
- Infection
- Tumors
- Diabetes
- HT
- Myopia
- Retinal damage
81
What is the treatment for glaucoma?
- Medication
- Eye drops every 12 hours
- 5-10 minutes between drops
- Apply pressure with punctual occlusion
82
What is meniere's disease?
- Episodic vertigo
- Tinnitus
- Hearing loss
- Vomiting
- Imbalance
- Nystagmus
83
What is the treatment for meniere's disease?
- Fall risk precautions
- Home safety
- Assistive devices
- Monitor ototoxic blood levels
- Antivertigo/Antiemetics
84
What is macular degeneration?
Age-related loss of vision.
85
What are the treatments for macular degeneration?
- Laser therapy
- Ocular injections (-zumabs)
- Assistive devices
86
What is myopia?
- Near-sighted
| - Blurred distance vision
87
What is hyperopia?
Having farsightedness.
88
What manifestations should you watch for with patients who have undergone LASIK?
- Halos
| - Glare
