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Cardio Test Review
Adult Health I; Cardio Test 11-12-07
| Question | Answer |
|---|---|
| Why is it important for someone with peripheral arterial disease to exercise? | it will increase collateral circulation |
| What is the 1st assessment finding indicating occlusion of an aorto-femoral bypass graft? | no pulses below the graft |
| What is the most desired treatment outcome for a client with congestive heart failure? | respiratory status improves, edema reduction, breath sounds clearing |
| What assessment findings indicate left-sided heart failure? | crackles and pink, frothy sputum |
| What is one of the first signs of a DVT? | pain in calf |
| What physical finding does a client with chronic venous disease exhibit? | edema and venous stasis ulcers |
| What is the emergency procedure for V-fib? | Defibrillation; synchronize button OFF; increase charge to 200; this will stop and restart the heart |
| What is the name of the scheduled procedure performed for A-fib? | Cardio version - conscious sedation; synchronize button ON; decrease charge to 50; this will restore normal rhythm |
| What is the BEST indicator that diuretics are working? | Daily weights |
| When Digoxin and diuretics are adminstered to the patient with CHF, what lab test would you check and why? | K+ - because some diuretics cause hypokalemia and hypokalemia can potentiate digitalis toxicity |
| What BP indicates hypertension and when should it be treated? | 140/90; check 3x; drug therapy initiated much earlier |
| What measures should be taken to facilitate patency of a graft following surgical repair of an aneurysm? | maintain systolic BP between 90-130; if it goes above 130, too much pressure and graft will tear; maintain extremities in neutral position |
| How can you verify that the graft is patent through your assessment? | check pulses below the graft |
| What signs indicate a ruptured aneurysm? | Abdominal pain, flank pain, pulsating mass, hypotension, shock |
| Following an abdominal aneurysm repair, the patient complains of severe flank pain and decreased urinary output. Why? | Renal artery embolism |
| How do you ensure that the graft site does not leak or rupture? | Keep the BP under control (systolic below 130) |
| What is the most common initial response for those experiencing chest pains due to a myocardial infarction? | DENIAL; there is a typical 3 hour delay between the onset of pain and going to the hospital |
| Following cardiac catheterization, what would be the signs of retroperitoneal bleeding? | bruising, pressure on the kidneys, back pain |
| Post op - CABG; What should you know about chest tube drainage amounts? | 1 hour post op - 300 cc is normal; 8 hours post-op - 300 cc is ABnormal; when the patient sits up for the 1st time - 300 cc is normal |
| What is the significance of continued chest pain with tPA therapy? | Continued chest pain indicates that tPA therapy is not working; do not give tPA therapy if there has been a recent trauma (tPA is a thrombolytic drug used to dissolve a clot) |
| PCTA does what? | It is a BALLOON that pushes plaque away |
| A STENT does what? | It holds the artery open |
| What is the most significant cardiac marker for MI | Troponin; it is a myocardial muscle protein releases into the bloodstream ONLY if there is cardiac necrosis or MI; any increase in troponin levels indicates cardiac necrosis or MI |
| When is it best to perform a MIDCAB? | When only one or two anterior coronary arteries are involved (such as the left anterior descending artery - LAD) |
| Safety precautions with a TEMPORARY pacemaker include wearing __________ | gloves |
| Your patient is coughing up pink, frothy sputum; what does this indicate? | pulmonary edema |
| The pain associated with angina is typically brought on by _________ and relieved by ________ | brought on by exertion and relieved by resting |
| When a patient is experiencing chest pain (angina pectoris), what is the standard treatment? | give Nitro sublingually and check BP |
| What is preload? | refers to the amount of myocardial fiber stretch at the end of diastole just before contraction; it is determined by the amount of blood returning to the heart from both the venous system and the pulmonary system |
| What is afterload? | the pressure or resistance that the ventricles must overcome to eject blood through the semilunar valves and into the peripheral blood vessels |
| What is the treatment for symptomatic bradycardia following an MI? | Atropine 1st, then pacemaker; avoidance of parasympathetic stimulation such as prolonged suctioning or stimulation of the gag reflex |
| What is the most common cause of sudden cardiac death? | ventricular fibrillation (v-fib, VF) usually preceded by ventricular tachycardia (v-tach,VT) |
| What is the most common arrhythmia following MI? | PVC's (premature ventricular contractions) |
| a radial arterial line is placed to measure what? | BP |
| What is arteriosclerosis? | fatty plaque in arterial wall; arteries become narrowed and blood flow decreases |
| What is atherosclerosis? | atheromatous plaques containing cholesterol and lipids on the innermost layer of the walls of large and medium-sized arteries; causes a thickening or hardening of the arterial wall |
| 1 in 4 Americans (about 50 million) suffer from what? | hypertension |
| List some of the symptoms of hypertension. | None at first, then headache, dizziness, visual disturbances and confusion |
| Which classes of drugs are used to treat essential HTN? | diuretics, ACE inhibitors, beta-blockers, calcium channel blockers and vasodialators (apresoline) |
| What does LEAD stand for? | lower extremity arterial disease |
| The drugs Trental, ASA and Plavix are used for the management of what? | peripheral arterial disease (PAD) |
| List some of the Post-Op nursing care responsibilities following a bypass graft | risk for occlusion 1st 24 hours; check pulses every 15 minutes for 1st hour - then every hour with color and temp; mark location of pulses; assess for pain; keep leg straight |
| What is done if there is a graft occlusion? | Immediate surgery; tPA therapy (tissue plasminogen activator); ReoPro (inhibits platelet aggregation) |
| What are the modifiable risk factors for coronary disease? | weight, activity, diabetes, hypertension, smoking, cholesterol |
| What are the non-modifiable risk factors for coronary disease? | age, sex, race, family history |
| The acronym MONA can be used to remember key terms for the management of an MI. What does MONA stand for? | Morphine, Oxygen, Nitroglycerine, Aspirin |
| List some of the contraindications for tPA therapy | active internal bleeding; CVA within previous 2 months; recent spinal or cerebral surgery; cranial neoplasm; prolonged CPR; recent eye surgery |
| What are the key indicators that cardiovascular perfusion has returned? | chest pain abruptly subsides; sudden onset of PVC's; resolution of ST changes; marker of myocardial damage peak @ 12 hours |
| Why is aspirin given following MI? | antiplatelet aggregation |
| Why are beta-blockers given following MI? | to reduce muscle damage |
| Why are ACE inhibitors given following MI? | to reduce CHF |
| Why are calcium channel blockers given following MI? | to enhance myocardial perfusion |
| The surgical intervention performed if one or more coronary arteries are diseased is called a _____________ | CABG (coronary artery bypass graft) |
| The surgical intervention performed if only one or two anterior coronary arteries is diseased is called a ___________ | MIDCAB (minimally invasive direct coronary artery bypass) |
| When you listen over carotid arteries or sometimes over the aorta and you hear a swooshing or blowing sound you are hearing _________ | bruits (brew-ees); a characteristic feature of atherosclerosis |
| Cyanosis of the great toe and dependent rubor of the foot is characteristic of ______________ _______________ | aterial insufficiency |
| What is the procedure called when the plaque is kind of smashed against the arterial walls by inflating a balloon over and over again? | PTA (percutaneous transluminal angioplasty) |
| How often do you check pedal and posterial tibial pulses immediately following an aortal-femoral bypass graft? | Every 15 minutes for the first hour; then hourly along with temp and color |
| Remember the SIX P's when trying to determine if a patient has an arterial occlusion. What are the 6 P's? | Pallor, Pain, Pulselessness, Paresthesia, Paralysis, Poikilothermia |
| long-standing, uncontrolled HTN can cause these; it is just like overinflating a bicycle innertube many times; causes it to become weak and burst | aortic aneurysms |
| a ruptured abdominal aortic aneurysm (AAA) results in internal bleeding so severe that only ____% of victims survive | 20% |
| Most aortic aneurysms are the result of ________________ | atherosclerosis |
| Complications of a DVT would include a _________ ___________ and would necessitate the nurse monitoring closely for signs of ______________ | pulmonary embolism; monitor closely for signs of SOB and chest pain (dyspnea) |
| Sudden cardiac death is caused by __________ ______________ | Ventricular fibrillation |
| Dysrhythmias occur most commonly following a myocardial infarction due to ___________ | irritability of the damaged heart muscle |
| What is the most effective way to reduce one's risk of restenosis of blocked coronary arteries? | lowering LDL |
| Extensive muscle damage following myocardial damage can cause cardiogenic shock which is manifested by heart ___________ | failure |
| Left flank pain and decreased urine output following aneurysm repair of the aorta indicates ______________ | renal artery embolism |
| The pain of angina is preceded by what? | exertion, emotions, elimination, extreme changes in temperature |
| Priority patient care following DVT includes... | bedrest, do NOT massage the legs, be aware of complications of pulmonary embolism |
| left-sided heart failure lungs sound like ________ | crackles |
| Diuretics do what to preload? | decrease preload |
| What helps increase venous return? | walking |
| What happens to the ST segment following a stent and angioplasty? | ST should return to baseline |
| What is used to treat frequent PVC's following MI? | Lidocaine |
| What action is required if you obtain a BP reading of 160/100 at a routine screening (after you recheck it two more times that day)? | Refer the client to their MD for immediate attention |
| a high HDL to LDL ratio indicates what? | low risk for CV disease |
| Uncontrolled atrial fibrillation increases the risk for what? | stroke |
Created by:
KCdoula200
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