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CARDIAC KQ
Cardiac Bullets
| FACT | FACT |
|---|---|
| the nurse should assess for dependent edema in the lower extremities such as the ankles in the ambulatory patient or the sacrum in the w/c bound patient | in acute venous insufficiency collateral blood flow doesnt have an oportunity to develop |
| The normal pH of arterial blood is 7.35 - 7.45 | pulse deficit is the difference between the apical pulse and the peripheral pulse (such as the radial pulse) |
| During heparin therapy, the pateint shoudl receive tylenol not aspirin for headaches | in chronic venous insufficiency collateral blood flow develops to the affected area |
| a milliequivelent (mEq) is the nunit of measurement used to describe the chemical activity of electrolytes - mEq is the number of milligrams per 100 milliliters of a solution | pulse pressure is the difference between the systolic and diastolic pressures. For example if blood pressure is 120/80 the pulse pressure is 40 mm/hg |
| the nurse should weigh the patient at the same time every day using the same scale and with the patient wearing the same type of clothing | before engaging in strenuous activity a patient with angina pectoris should take a nitroglycerin tablet |
| a pteint with orthopnea must sit or stand to breathe deeply or comfortably | a positiv eHomans sign is a sign of DVT |
| before administering protamine sulfate as an antidote for heparin overdose the nurse should verify that the patient doesn't have an allergy to fish | patients with heart failure should avoid canned or processed foods, which are high in sodium |
| during lasix therapy the patient is at risk for potassium loss which can lead to hypokalemia | in a dark skinned pateint the nurse should assess for petechiae on teh oral mucosa rather than on the skin |
| a patient with heart failue should avoid canned or processed foods which are high in sodium | in a dark skinned pt the nurse should assess for petechiae on the oral mucosa rather than on the skin |
| biological death with the irreversible destruction and death of brain tissue | a tilt table allows gradual movment from horizontal to a vertical position |
| using a tilt table allows the pt body to compensate for position changes | stable angina pectoris is characterized by substernal pain thats caused by myocardial ischemia and lasts 2-3 min |
| angina that lasts for more than 20 minutes and isnt relieved by ntg indicates a developing myocardial infarction | the results of ntg test are positive if ntg adminstration relieves angina |
| for a patient with angina pectoris the goal of treatment is to reduce the hearts workload | ntg causes genralized vasodilation which promotes blood flow to the heart muscle |
| the nurse should teach a patient who has angina and is receiving sublingual ntg to place a tablet under the tongue at the first sign of chest pain | the patient may repoeat the ntg dosage every 5 to 15 minutes for maximum of 3 tablets |
| if hcest pain peresists for longer than 15 minutes the pt should be instructed to go to the nearest health care facility | to administer subcutaneous heparin the nurse should insert the needle into the skin at a 45 degree angle |
| for the post op patient who is at risk for deep veing thrombosis, heparin or Lovenox is usually given | oral anticoagulants such as warfarin to prevent thrombus formation |
| anitcoagulants cant dissolve a throumbus that has already formed | anticoagulant therapy is contraindicated in patients who has severe diabetes liver or kidney disease or ulcers |
| to assess a pt for thrombophlebitis the nurse should compare the measurements of the affected and unaffected limbs every day | ntg tablets are considered expired 5 to 6 months after the bottle is opened |
| signs of a pacemaker failure include dizziness, fainting palpitations hiccups and chest pain | before getting the pt out of bed for the first time after surgery, the nurse should have the pt dangle his legs over the edge of the bed |
| a pacemaker surgical or orthopedic clips or shrapnel will interfere with the results of a magnetic resonance imaging scan | the optimal schedule for adminstering an around the clock antibiotic is 6 am 12 pm 6pm and 12am |
| a pt who has unstable angina experiences pain at rest | atelectasiss typically occurs 24 to 48 hours after surgery |
| in dark skinned persons skin color changes can best be seen in areas of less pigmentation such as lips, mucous membranes ear lobes palms and soles | therapeutic range for digoxin is 0.5 to 2 mg/ml |
| a pt who is taking anticoagulants as an outpatient should be instructed to call the physician if he has black tarry feces | the nurse should monitor the partial thromboplastin time of the patient who is recieving heparin |
| to determine whether a patient has a pulse deficit one nurse should measure the apical pulse while a second nurse measures the radial pulse at the same time using the same watch | before contrast medium is injected the nurse should tell the pt to expect a transient burning sensation and a metallic taste in his mouth |
| the most reliable way to identify a pt is to check his id bracelet | the nurse should being d/c planning when the pt is admitted |
| dangling the pt legs before getting him out of bed helps prevnent pooling of blood and orthostatic hypotension | green leafy veggies are good sources of Magnesium |
| sodium is the major cation in extracellular fluid | hemoglobin is an oxygen carrying pigment in red blood cells |
| abnormal breath sounds are called adventitious | the most common cause of pulmonary edema is left sided heart failure |
| the most common cause of pulmonary edema is left sided heart failure | diuretic use is the leading cause of potassium deficit |
| potassium is the major cation in intracellular fluid | the SA node is the heart's pacemaker |
| the T wave represents repolarization of the ventricles | after a diagnostic study in which the femoral site is used, the patient must lie flat for 8 hours |
| when caring for a patient who has undergone a cardiac catheterization the nurse must report a rapid or irregular pulse immediately | yellowing of vision is a symptom of digoxin toxicity |
| digoxin causes a slower stronger heartbeat and allows the heart to rest between beats | a bounding pulse indicates excess fluid volume |
| muscle weakness and cardiac arrhythmia are common in patients with hypokalemia or hyperkalemia | a bruit or rushing sound heard with a stethoscope over the thydroid gland indicates a hypermetabolic state |
| to conserve energy in a patient who is in a weakened state the nurse may need to alternate care procdedures with rest periods | a decreased vitamin K level causes a prolonged PT |
| the pt with serum K level of less than 3mEq/L needs potassium replacement therapy | about 85% of arterial emboli originate from thrombi in the heart chambers |
| when caring for pt with an embolus in an arm or leg the nurse should keep the affected part at or below the horizontal plane | during the early stage of shock , the pt blood pressure may be nromal but the resp. and HR increase |
| cool moist pale skin as is seen during shock results from diversion of blood from the skin to major organs | to assess cap refill the nurse applies pressure over the nailbed until blanching occurs quickly releases the pressure and notes how quickly the blanching fades |
| the nurse should suspect thrombophlebitis in the patient with homan's sign | petechiae are tiny round red purplish spots that may appear on the skin and mucous membranes |
| the antidote for heparin overdose is protamine sulfate | the antidote for warfarin overdose is vitamin K |
| all pts older than age 65 should be assessed for aneurysm because of the normal vascular changes that accompany aging | Raynaud's disease is characterized by recurrent inflammation of the intermediate small veins of the extremities |
| As raynaud's disease progressses the pt may have ulcers and superficial gangrene of the hands | ascites is excess fluid in the peritoneal cavity |
| a thready pulse is fine and scarcely perceptible | when taking a pt radial pulse the nurse should assess its rate rhythm quality and force |
| to obtain an accurate flood pressure raeding the nurse should pump the bulb until the mercury column or aneroid dial reaches 20-30mm Hg before the point at which the pulse disappears or above the pts baseline systolic pressure | the nurse shouldnt massage a leg with a blood clot because this could dislodge the clot |
| mydriatic drugs dilate the pupils | miotic drugs constrict the pupils |
| when placing a ntg patch on a pt the nurse should avoid touching the medicated disc and should wash her hands after application however gloves aren't required | the nurse should count an irregular pulse for 1 full minute |
| a pt who has MV stenosis typically has signs and symptoms associated with improper emptying of the left atrium and subsequent pulmonary congestion | MV stenosis usually arises as a complication of rheumatic fever |
| atelectasis is an abnormal condition thats characterized by the collapse of the lung tissue and incomplete expansion of lobules or a lung segment | to perform a CPR the nurse should place the vicitim on a flat and solid surface |
| for the pt with heart failure decreasing the workload of the heart is one of the nurses most important goals | antiembolism stockings provide gradual compression of the superficial blood vessels helping to prevent thrombus formation |
| a pt who no longer requires bed rest after a femoral politeal bypass graft should be permitted to walk and stand | the nurse should give aluminum hydroxide separately and at least 1 hour before or after the administration of enteric coated medications |
| acid base balance is the body's hydrogen ion concentration | buffers are substances in teh blood that prevent body fluid from becoming overly acidic or alkaline |
| metabolic acidosis results from excessive loss of bicarbonate or excessive production or retention of acid | nausea vominting restlessness and twitching are signs of disequilibrium syndrome caused by rapid fluid shift |
| early signs and symptoms of ketoacidosis include polyuria polyphagia faigue malaise drowsiness headache and abdominal pain | prothrombin is a clotting factor thats produced by the liver |
| the pt is usually the best source of health history information | the cardiovascular and respiratory systems are regulated by the ANS |
| to guard against a charge of malpractice the nurse should provide care in a reasonable and prudent manner | crackles indicate lung congestion caused by fluid or pus |
| wheezing is an abnormal high pitched breath soudn that indicates obstruction or closure of the bronchi | when caring for a pt with heart failure the nurse should elevate the head of the bed |
| after chest surgery the nurse should encourage the pt to raise the arm on the affected side above the head frequently | in a pt who is receiving digoxin a below normal serum K level increases the risk of digoxin toxicity |
| a silent MI causes no symptoms | adverse effects of verapamil include dizziness headache constipation hypotension and AV condction disturbances |
| foods high in vitamin D include fortified milk fish liver liver oil and egg yolk | bread and cereal are good sources of thiamine iron niacin and riboflavin |
| central cyanosis is the most significant sign of hypoxia | when taking BP the nurse should support the pts arm rather than letting the pt use his own strenght to hold the arm up |
| nonmodifiable risk factors for coronary artery disease include heredity, sex, race, and age | foods that are high in sodium can cause fluid retention |
| when prioritizing nursing diagnosis the nurse houdl give life-threatening problems top priority | spinal shock is loss of all spinal reflexes and sensations below the level of injury after spinal cord transection |
| in R sided cardiac cath, a radiopaque catheter passes through the antecubital or femoral vein and into the pts right atrium right ventricle and pulmonary vasculature | in a stroke, blood vessels in the brain are blocked by an embolus or a hemmorrahge. As a result blood supply is decrased to brain tissues that are nromally perfused by damaged vessels |
| the nurse shouldn't administer atropoine to a pt who has glaucoma | smooth muslces are controlled by the ANS |
| Inderal blocks sympathetic nerve stimulation that increases the cardiac workload during exercise or stress | ECG changes usually appear during the first 24 hours after a myocardial infarction but in some cases they are delayed 5 to 6 days |
| cottage cheese fish canned beans chuck steak chocolate pudding Italian salad dressing dill pickles and beef broth are extremely high in sodium | prunes watermelons dired lima beans soybeans bananas oranges nectarines and cantelopes are high in potassium |
| pulmonary congestion may lead to accumulation of fluid throughout the body | the nurse should use the bell of the stethoscope to listen for venous hums and murmurs |
| the normal serum Ca level is 4.5 to 5.5 mEq/L | the normal serum sodium level is 135 - 145 MEq/L |
| the normal serum potassium level is 3.5 - 5.0 mEq/L | lactated ringers solution is an isotonic solution |
| a serum sodium level of less than 135 mEq/L indicates hyponatremia | one unti of blood is 500ml |
| heparin is the drug of choice to treat thrombembolitic disease | the surgeon can use a Fogarty emoblectomy catheter to extract an embolus from a large artery |
| blockage of a large artery by an embolus is a life threatening emergency that requires immediate surgery | acute iliofemoral veous thrombosis causes limb enlargement It can be detected by measuring the affected part and comparing it with the opposite extremity |
| the ares that sustain the greatest damage from arteriosclerosis are the brain heart GI tract kidneys and extremities | Warfarin is an anticoagulant |
| foods that are high in iron include organ meats such as liver, nuts, legumes, dired fruits, eggs, whole grains, fortified cereals, and green leafy veggies | the best sources of vitamin B6 are liver kidney muslce meats soybeans corn and whole grain cereals |
| signs of arterial obstruction cuased by an embolism inlcude absent pulse anesthesia paralysis and pale cool skin | the heart has 4 valves tricuspid, mitral, pulmonic and aortic |
| heparin incactivates thromboplastin and thrombin | the cause of essential hypertension is unknown |
| administration of inderal reduces portal pressure and decreases the risk of bleeding from esophageal varices | the most common vascular complication of diabetes mellitus is atherosclerosis |
| the PMI is located at the fifth intercostal space near the apex of the heart | the first heart sound represents closure of the mitral and tricuspid valves |
| the second heart sound represents clousre of the aortic and pulmonic valves | the coronary artery supplies blood to the myocardium |
| the nurse should instruct a pt who is following a low salt diet to avoid canned veggies | a pt who is taking Lasix should eat bananas and citrus fruits becasue they are a good source of K |
| dyspnea is a common sign of left ventricle failure | if the pt BP rises 30 mm Hg above the baseline value the nurse should notify the physician |
| after cardiac surgery the pt should follow a diet that provides 2gm of sodium and 300 mg of cholestrol daily | the kidneys play a major role in maintaining the bodys fluid balance |
| orange juice and green leafy veggies are good sources of folic acid | sodium regulates extracellular osmolality |
| in the early stage of shock, teh heart and brain maintain blood circulation | a trauma pt who has received multiple blood transfusions is at risk for hypocalcemia and hypothermia |
| Lidocaine is the drug of choice to treat PVCs | the ventricles usually sustain the greateast damage during MI |
| during MI pain occurs when anorexia causes myocardial ischemia | the pt with diabetic ketoacidosis is at risk for shock |
| the pt with DM is susceptible to atherosclerosis | tetany may result from hypocalcemia |
| alcohol interferes with the absorption of vitamin B 12 in the GI tract | K is the most abundant cation in intracellular fluid |
| hypovolemia occurs when 15-25% of the bodys total blood volume is lost | CPR shouldnt be interrupted unless the rescuer is alone and must stop to get help |
| in balloon angioplasty a small balloon tipped catheter is inflated inside an artery to exert pressure against a plaque and flatten it | a clear liquid diet consists of clear fluids and foods that become liquid at body temperature |
| a full liquid diet consist of simple easily digested foods this diet provides fluids and calories but may be inadequate in folic acid iron Vitamin B 6 and fiber | a pureed diet supplies all of the patients nutritional needs |
| a soft diet includes semisolid foods and is often supplemented with between meal snacks | a mechanical soft diet is used for the pt who has difficulty chewing or tolerating a reg diet |
| the pt who requires no dietary modifications can recieve a regular diet | a bland diet doesnt include foods that cause gastric irritation or excess acid secretions unless they provide a neutralizing effect |
| respiratory acidosis may occur in conditions such as drug overdose, guillain Barre syndrome, myasthenia gravis, and COPD | respiratory alkalosis may occur in such conditions as high fever, servere hypoxia, asthma, and pulmonary embolism |
| metabolic acidosis may result from renal failure, diarrhea, diabetic ketosis, or lactic ketosis | metabolic alkalosis may result from nasal and gastric suctioning, excessive diuretic use, or steroid therapy |
| during cardiac catheterization the pt may experience a thudding sensation in the chest as a result of maniupulation of the catheter | signs of acute rheumatic fecer include chorea, fever, carditis, migratory polyarthritis, skin rash and subcutaneous nodules |
| A pt how has a history rheumatic fever should take prophylactic antibiotic s before undergoing dental or invasive procedures | after an MI most pts are permitted to resume sexual activity when they can climb 2 flights of stair without fatigue or dyspnea |
| hypercapnia is an excess of CO 2 in the blood | hemorrhage is the most common post op problem |
| Kussmauls respirations are the body's attemtp to blow off excess CO2 | green leafy veggies are high in fiber |
| drinking too much plain water can lead to electrolyte imbalances | brain damage occurs 4 to 6 minutes after cardiopulmonary function ceases |
| metabolic acidosis results from excessive loss of Bicarb or excessive production or retention of acid | arterial blood is bright red flows rapidly and spurts with each heartbeat |
| venous blood is dark red and tends to ooze from a wound | atropine blocks the effects of acetylcholine |
| the nurse should suspect respiratory alkalosis in a patient whose partial pressure of CO 2 is less than 35 mm Hg | angiotensin converting enzyme inhibitors decrease blood pressure by interfering with the renin angiotensin mechanism |
| the nromal value for arterial blood oxygen saturation is 94 - 100% | if a pt is receiving propranolol the nurse should tell the pt not to discontinue the medication suddenly |
| the radial artery is most commonly used for obtaing ABGs | almost all external bleeding can be stopped with direct pressure |
| verapamil is a calcium channel blocker | when administering heparin subcutaneously the nurse should not aspirate |
| the normal serum creatinine level is 0 - 200 / 24 hours | a low fat low sodium diet includes chicken and fresh salad |
| pts with varicose veins may have achiness heaviness and pain in the affected leg | claudication is pain on ambulation the most likely cuase is inadequate arterial blood flow |
| the best method to relieve the pain associated with varicose veins is to elevate the affected lef periodically throughout the day | stasis ulcers first appear as darkly pigmented scaly areas and progress to skin breakdown and craters that are difficult to heal |
| for the pt who has had vein stripping and vein ligation surgery the MD usually orders walking hourly in the immediate post op period | caffeine can impair blood flow because it constricts arteries and arterioles it should be avoided by patients who have a history of venous stasis |
| signs of adequate circulation in a leg include warm toes and feet and CR < 3 sec | anaphylactic reaction causes dyspnea hypotension and loss of consciousness |
| a treatment for anaphylaxis is epinephrine | a sign of diabetic ketoacidosis is ketones which ar by products of fat metabolism fat metabolism occurs when the body cant use glucose as energy source and breaks down fat as a substitute |
| the best method to prevent blood clots after surgery is ambulation | the pt who is taking mannitol should have a catheter because the osmtoic effect of the drug causes increased urination |
| adverse effects associated with mannitol therapy include dehydration, electrolyte imbalance and diarrhea | decreasing blood pressure increased pulse and increased respirations are signs of impending shock in the postoperative patient |
| the organ that usually sustains damage from hypertension is the eye | administration of diuretics in the morning minimizes disruption of sleep for urination |
| cholesterol is animal fat that attaches to the intimal layer or the arteries It enlarges to form plaque that occludes the passageway of the vessels causingn atherosclerosis | a stress ECG should be stopped if the patient has chest pain, dangerous cardiac rhythm changes or a significant incrase in blood pressure |
| adverse effects of ntg tablets include headache, flushing and dizziness | concentrated urine is one of the first signs of dehydration |
| tomatoe juice is high in vitamin C | night blindness is associated with vitamin A deficiency |
| before putting antiembolism stockings on the patient the nurse should have the patient lie down with the feet elevated for 20 to 30 minutes | the daily dose of digoxin is 0.125 to 0.5 mg daily |
| a sign that heart failure is resolving is increasing urine output | a sign or pericarditis is friction rub |
| a pt who recieves an organ transplant must take an mmunosupressant for life | frothy blood tinged sputum is a sign of pulmonary edema |
| normal central venous pressure is 2 ot 8 mm Hg or 5 to 10 cm H2O | a decrease in central venous pressure indicates a decrease in circulating fluid as is seen in renal failure |
| If a central venous pressure is associated with an incrase in circulating fluid volume as seen in renal failure | to ensure an accurate baseline CVP reading the zero point of the transducer must be at the level of the right atrium |
| CKMB is an isoenzyme of CK that's specific to the heart increases 4 ot 6 hours after a MI peaks at 12 to 18 hours and returns to nromal in 3 to 4 days | a pt who survives an M I and has no other cardiopathology usually requires 6 ot 12 weeks for a full recovery |
| risk factors associated with embolism are increased blood viscocity decreased circulation, prolonged bed rest and increased blood coagulability | dependent edema is an early sign of right sided heart failure |
| If contrast medium is used during MRI the pt may experience diuresis when the medium is flushed from his body | (blank) |
Created by:
Kelly Quijano
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