quiz after after midterm

Question 1

major assessment for MI

Answer 1

specific cardiac
incisions
chest tubes
neuro for CABG and a fib

Question 2

veins usually used for CABG

Answer 2

mammary and saphenous vein

Question 3

HF BNP

Answer 3

high (hormone from atria)

Question 4

chest tube post CABG should drain how much per hour

Answer 4

<100mL/hr

Question 5

HF: DVBS

Answer 5

daily vacation bible school
Dyspnea
Venous distention
Bounding pulses
Sensorium decreased

Question 6

two types of HF

Answer 6

left sided (backs up into lungs)
right sided (backs up into body)

Question 7

left sided HF

Answer 7

pulmonary edema
dyspnea
orthopnea
hemoptysis – coughing up blood

Question 8

right sided HF

Answer 8

JVD
hepatomegaly
ascites
peripheral edema

Question 9

L and R HF

Answer 9

Oliguria
confusion and cheyne stokes
slow cap refill

Question 10

what is A-fib

Answer 10

atrial quiver rather than contracting normally

Question 11

first prob in a-fib

Answer 11

35% loss of cardiac output

Question 12

second prob in a-fib (how does a-fib cause a CVA)

Answer 12

blood pools, clots form in left atria auricle, then left ventricle, kicked out of aorta and up to carotid into brain causing CVA

Question 13

watchman devise

Answer 13

blocks off auricles

Question 14

a-fib requires what assessments

Answer 14

neuro and cardiac

Question 15

heart murmur characterized by….

Answer 15

• swooshing or buzzing
• turbulent flow
• regurgitating valve
• listen at erbs point
• at mitral valve because under most pressure

Question 16

what is stenosed valve

Answer 16

doesn’t open all the way / narrowed

Question 17

valve replacements are often …

Answer 17

aortic and mitral

Question 18

mechanical valves

Answer 18

• cause clicking sound
• pts w this HAVE to be on anticoags

Question 19

tissue valve replacement

Answer 19

• pig or bovine
• no anti coag req.
• lasts 15 years

Question 20

S3 ventricular gallop

Answer 20

ken-tuck-y
caused by sudden tensing of ventricular wall as blood enters from atria

Question 21

S4 atrial gallop

Answer 21

ten-nes-see (S4-S1-S2)
atrial walls contracting
indicates HTN, CAD, or MI
listen with pt on left side

Question 22

If amplitude of arteries is strong…

Answer 22

can have visible distention and pulsation

Question 23

if arteries are bounding what does it indicate

Answer 23

fluid overload

Question 24

when to do allen test

Answer 24

before sticking the radial artery

Question 25

what is allen test for

Answer 25

arterial blood gas (ABG) and cardiac cath - checking to see if blood flow to hand via ulnar artery is okay

Question 26

how is Allen test performed

Answer 26

- raise hand - make fist - press arteries until looks pale

Question 27

check what pulses especially

Answer 27

most distal

Question 28

amplitude

Answer 28

pulse quality

Question 29

pulsus alternans

Answer 29

a physical sign of an irregular pulse that alternates between strong and weak beats - sign of HF

Question 30

signs of decreased arterial flow

Answer 30

- cool to the touch - sluggish cap refill

Question 31

signs of venous problems

Answer 31

redness, warmth, pain (think DVT)

Question 32

check what at pulse sites

Answer 32

- sign of arterial blood flow such as temperature and cap refill - most distal pulses - amplitude - venous problems such as edema

Question 33

what does a bruit feel like

Answer 33

buzz or swoosh - like a murmur but over an artery

Question 34

cause of a bruit

Answer 34

stenosis, atherosclerosis

Question 35

bruits over arteries indicate what blood flow

Answer 35

low blood flow

Question 36

main concern with bruits

Answer 36

can lead to the brain and cause CVA

Question 37

when is a bruit normal to feel

Answer 37

over AV fistula

Question 38

abnormalities in veins

Answer 38

- edema - varicose veins - spider veins - medial malleolus - DVT

Question 39

edema is a sign of what

Answer 39

venous backup, injury, or fluid overload (could be d/t HF)

Question 40

brawny edema

Answer 40

form, hard, discolored (fibrosed), unable to be displace fluid, brownish appearance

Question 41

brawny edema indicates...

Answer 41

edema that has been there for a while

Question 42

are varicose veins superficial or deep

Answer 42

superficial (very visible)

Question 43

varicose veins can cause...

Answer 43

chronic venous stasis

Question 44

chronic venous stasis S&S

Answer 44

hemosiderin staining brawny edema stasis dermatitis: dry, flaky, itchy skin venous stasis ulcers

Question 45

medial malleolus

Answer 45

most common place for an ulcer to form

Question 46

thrombophlebitis

Answer 46

- when a vein becomes inflamed and a blood clot forms in the vein blocking off blood flow - sign of DVT

Question 47

#1 sign of DVT

Answer 47

unilateral edema

Question 48

biggest concern of a DVT

Answer 48

- pulmonary embolism - can cause sudden death - prevents blood from being oxygenated

Question 49

arterial abnormalities

Answer 49

PAD, raynaud phenomenon, ABI (for PAD)

Question 50

peripheral arterial diesease

Answer 50

- PAD: decreased O2 out of the body, gradual atherosclerosis, DM is #1 cause, sudden occlusion

Question 51

S&S of sudden occlusion

Answer 51

- weak or absent pulses - intermittent claudication - thin, shiny, hairless skin - coolness of skin and pale or molting - dependent rubor - severe= necrosis or gangrene

Question 52

raynaud phenomenon

Answer 52

- vasospasm of small arteries of fingers - seen in cold temps - increased with autoimmune collagenous disease (lupus and RA)

Question 53

ankle brachial index

Answer 53

- ABI - screening for PAD in legs - pt lies supine for 5 mins - BP cuff on right and left arms and right ankle - use doppler to measure SBP on right and left arms, right DP and right PT - repeat with left DP and PT - calculate ABI for right leg then left leg - higher ankle pressure on that side is divided by the higher arm pressure

Question 54

normal ABI

Answer 54

1.00-1.29

Question 55

borderline ABI

Answer 55

0.91-0.99

Question 56

mid to moderate ABI

Answer 56

0.41-0.90

Question 57

severe ABI

Answer 57

less than 0.40