Test 1

Question 1

Atrial flutter

Answer 1

can be caused by drugs, coronary artery disease, abnormal heart valves, or a change in electrical impulses through the heart

Blood clots are a concern

treated with antiarrhythmics, beta blockers, and anticoagulants

If medications dont work cardioversion can be done in order to restore the rhythm or catheter ablation which uses radiation to scar the area where the electrical impulses are coming from

Question 2

Risk factors for Heart Failure

Answer 2

Previous heart attacks
Coronary artery disease
Hypertension
Arrhythmias
Heart valve disease 
Cardiomyopathy 
Congenital heart defects 
Alcohol and drug abuse
Hemochromatosis
Cardiomyopathy
Myocarditis
Pericarditis
Endocarditis

Question 3

What is pericardial effusion?

Answer 3

Pericardial effusion is the buildup of fluid in the pericardium

Question 4

What are the two types of valvular heart disease?

Answer 4

Stenosis

Regurgitant

Question 5

What is valvular heart disease of the stenosis kind?

Answer 5

Narrowing of valve opening
Impedes forward blood flow
Reduces cardiac output

Question 6

What is valvular heart disease of the regurgitant kind?

Answer 6

Incomplete closure of the heart valve
Allows backwards blood flow
Causes chamber enlargement
Reduced cardiac output

Question 7

What are the general effects of valvular heart disease?

Answer 7

Volumes and pressures in chambers increase 
Chambers enlarge
Myocardial hypotrophies
Murmurs develop due to turbulent flow 
L&R heart failure

Question 8

How do you manage valvular heart disease

Answer 8

Limit physical activity
Sodium restriction
Diuretics
Digoxin
Nitrates
Ace inhibitors
Valve replacement
Prophylactic antibiotics

Question 9

What medication is PT/INR used to monitor?

What are the normal ranges and therapeutic ranges of PT/INR?

Answer 9

PT/INR is used to monitor the effects of warfarin/coumadin therapy
Normal ranges for PT is 10-12 seconds
Normal ranges for INR is 1.1 seconds
Therapeutic ranges for INR will be 2-3 seconds

Question 10

What medication is monitored with aPTT/PTT?

What are the normal ranges for aPTT/PTT?

Answer 10

aPTT/PTT is used to monitor the effects of heparin therapy
Normal ranges for aPTT is 30-40 seconds
Normal ranges for PTT is 60-70 seconds

Question 11

What is a normal CVP?

Answer 11

Normal CVP is 2 to 6 mm HG

Question 12

What are some s/s of sepsis?

Answer 12

Leukocytosis >12000 WBC
Leukopenia <4000 WBC
Acute oliguria 
INR >1.5 or PTT >60
Paralytic ileus 
Arterial hypoxemia 
Shivering 
Pain 
Paleness 
SOB

Question 13

What are some causes of multiple organ dysfunction?

Answer 13

Trauma
Perfusion
Infection

Question 14

How would a patient with multiple organ dysfunction be treated?

Answer 14

Focus care on effected organs and maintaining functionality
Intubate client
Give O2 until lactate levels return to normal

Question 15

What is DIC?

Answer 15

Disseminated intravascular coagulation is where excessive clotting is formed in the blood vessels

Question 16

What can occur to cause DIC?

Answer 16

Infections
Trauma
Obstetrical
Snake bites
Overstimulation of the normal coagulation process
Thrombosis and fibrinolysis are magnified to life-threatening proportions

Question 17

How is DIC treated?

Answer 17

Immediate treatment of underlying cause (i.e. infection, snakebites)
Heparin (use cautiously as it can cause bleeding in patients with cranial injuries)
Antifibrinolytic agents

Question 18

What are some signs of MODS?

Answer 18

S/s of multiple organ dysfunction syndrome are:
Brain swelling and ischemia
Cardiovascular instability
Vena caval flattening
Increased peak pressure/ difficult ventilation and oxygenation
Anuria/ acute renal failure
Increased gut ischemia, impending necrosis
Further worsening of acidosis