What is HDL?
Answer:
good cholesterol, want it >60
QUESTION
What is LDL?
Answer:
bad cholesterol, want it <150
QUESTION
What are triglycerides?
Answer:
“sugary cholesterol”
QUESTION
Atherosclerosis and Arteriosclerosis can cause what conditions?
Answer:
peripheral arterial disease (PAD) – shiny hairless legs
peripheral vascular disease (PVD)
QUESTION
S\/S: Peripheral Vascular Disease (PVD)<\/em>
Answer:
\u25aa cool hands and feet
\u25aa bad pedal pulses
\u25aa leg pain<\/p>\n\n\n\n
\u25aa decreased capillary refill respiratory alkalosis pH: 7.35-7.45 acidic-basic metabolic acidosis pH: 7.35-7.45 acidic-basic respiratory acidosis pH: 7.35-7.45 acidic-basic metabolic alkalosis pH: 7.35-7.45 acidic-basic \u25aa change in condition make take priority over ABCs (ex: post op bleeding is priority over an O2 Sat% of 90%) CPR, press the code button bag resuscitation, press the code button \u25aa unconscious, pulseless \u25aa How will they present? \u25aa make them bear down (valsalva maneuver) \u25aa What are you going to do?<\/p>\n\n\n\n Supraventricular Tachycardia (SVT) \u25aa they may end up with a blood clot because the blood is pooling in the atria control RVR for patient: \u25aa chest pain Oxygen – 1st \u25aa CPK angioplasty CABG (Coronary Artery Bypass Graft) pericarditis heart can’t expand and contract properly (cardiac tamponade) pleural friction rub pericardial effusion Pericardialcentesis aneurysm Abdominal Aortic Aneurysm (AAA) \u25aa epigastric pain immediately go to the OR for surgery monior BP periodically and check the size of it elevated BP 3 times in a six month period – documented by MD \u25aa lifestyle modifications (diet, exercise) \u25aa obesity primary – because of the pressure in the arteries only, usually hereditary \u25aa ACE inhibitors atherosclerosis \u25aa Cholesterol arteriosclerosis good cholesterol, want it >60 bad cholesterol, want it <150 “sugary cholesterol” peripheral arterial disease (PAD) – shiny hairless legs \u25aa cool hands and feet lower extremity doppler \u25aa anticoagulants \u25aa no crossing legs -aortic mitral valve due to increasing age valve regurgitation valve stenosis rheumatic fever decreased cardiac output which leads to heart failure \u25aa mitral regurgitation: High pitched holosystolic murmur – begins at S1 and continue to S2<\/p>\n\n\n\n \u25aa aortic regurgitation: Blowing, decrescendo diastolic murmur \u25aa high pitched holosystolic murmur endocarditis antibiotics dental work Transient Ischemic Attack (TIA) – why? because of microclots that get loose and travel left-sided heart failure aka CHF \u25aa SOB \u25aa loop diuretics \u25aa GI effects (anorexia, N\/V) \u25aa raise the head of the bed \u25aa echocardiogram heart transplant – post op our biggest concern is REJECTION iron deficiency anemia first: tell them to eat more in their diet! red meat \u25aa fatigue leukemia infection; in the hospital we put them on neutropenic precautions which means reverse isolation (no live flowers, wash hands) \u25aa bone pain, joint pain \u25aa chemotherapy hemophilia prolonged aPTT \u25aa this condition is life-long sickle cell anemia pain, they are having infarctions all over their body \u25aa opioids, morphine Heparin-induced thrombocytopenia (HIT)<\/p>\n\n\n\n 50% reduction in platelet count within 7-10 days of exposure of heparin<\/p>\n<\/blockquote>\n\n\n\n -Severe form results in global thromboembolism due to immune reaction with platelet factor 4<\/p>\n\n\n\n PLTs decrease by 50% in a 2 day period platelet factor 4 (PF4) blood test Idiopathic Thrombocytopenic Purpura (ITP) Bruising, purpura PLT transfusions anything invasive like needlesticks, catheters, rectal tubes Vitamin K \u25aa avoid large amounts of dark leafy green vegetables PT\/INR \u25aa 2 nurses verifying the orders \u25aa stop the infusion Yes! You’ll just get some allergy meds first like benadryl Yes! Even though they are at risk for overload we will give them some furosemide (Lasix) first. Weigh the risk with benefit \u25aa pneumonia – we can prevent this by telling them to cough, deep breathing, splinting pain, incentive spirometer<\/p>\n\n\n\n \u25aa paralytic ileus – r\/t pain medication and anesthesia constipation BPH (benign prostatic hyperplasia) \u25aa prostatectomy Continuous Bladder Irrigation (CBI) – we want to see the output as light pink; we don’t want to see clots; color decreases over time lymphoma lymphadenopathy (enlarged lymph nodes) Reed Steinberg cells – seen in Hodgkin’s Lymphoma Lovenox (enoxaparin) hemophilia ischemia Keep BP controlled to keep pressure off artery.
\u25aa mottled skin
QUESTION
How do you diagnose Peripheral Vascular Disease (PVD)?
Answer:
lower extremity doppler
QUESTION
Treatment: Peripheral Vascular Disease (PVD)<\/em>
Answer:
\u25aa anticoagulants
\u25aa cath lab to have stent placement
\u25aa angioplasty
QUESTION
Patient Education: Peripheral Vascular Disease (PVD)<\/em>
Answer:
\u25aa no crossing legs
\u25aa no pressure on legs, keep them in a dependent or dangling position
\u25aa no constrictive clothing
QUESTION
Types of valves
Answer:
-aortic
-mitral
-tricuspid
-pulmonic
Powered by https:\/\/learnexams.com\/search\/study?query=<\/a><\/p>\n\n\n\n![\"\"](\"https:\/\/learnexams.com\/blog\/wp-content\/uploads\/2023\/12\/final-exam-nur2502-nur-2502-new-2023-2024-update-multidimensional-care-iii-mdc-3-exam-questions-and-verified-answers-100-correct-grade-a-rasmussen-725x1024.png\")
<\/a><\/figure>\n\n\n\n
high pH, low CO2<\/p>\n\n\n\n
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic<\/p>\n\n\n\n
low pH, low HCO3<\/p>\n\n\n\n
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic<\/p>\n\n\n\n
low pH, high CO2<\/p>\n\n\n\n
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic<\/p>\n\n\n\n
high pH, high HCO3<\/p>\n\n\n\n
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic<\/p>\n\n\n\n
\u25aa pick the patient that is going to die first
Priority questions\u2026something to consider<\/p>\n\n\n\n
You walk into your patient’s room and they don’t have a pulse, what are you going to do?<\/p>\n\n\n\n
You walk into your patient’s room and they are not breathing but have a pulse, what are you going to do?<\/p>\n\n\n\n
\u25aa shock them with the AED!
If you walk into a room with a patient that is in ventricular fibrillation (v fib)<\/p>\n\n\n\n
\u25aa What must we do to get them out of that state?<\/p>\n\n\n\n
\u25aa make them cough (vagal maneuver)
If you walk into a room and a patient is alert and oriented, speaking to you, has a pulse, but their cardiac monitor shows they are in ventricular tachycardia<\/p>\n\n\n\n
Which cardiac rhythm requires the patient to take adenosine?<\/p>\n\n\n\n
What is our priority concern for a patient in atrial fibrillation (a-fib)?<\/p>\n\n\n\n
\u25aa give anticoagulants
\u25aa beta blockers, digoxin, diltiazem
\u25aa if meds don’t work\u2026cardioversion (synchronized shock to re-start the rhythm)
\u25aa if cardioversion doesn’t work\u2026ablation
Nursing Interventions: A-fib RVR<\/p>\n\n\n\n
\u25aa SOB
\u25aa diaphoresis
\u25aa N\/V
\u25aa hypertension
\u25aa tachycardia
\u25aa jaw pain, anxiety, indigestion (women)
\u25aa elevated troponin levels
\u25aa EKG changes – ST elevation
If you have a patient who comes into the ED and they are having an MI, what are the signs\/symptoms? lab values to confirm this?<\/p>\n\n\n\n
Nitro – given sublingual, 3 doses q 5 min (home), drip (hospital), drops BP (vasodilator)
Aspirin – antiplatelet, stops clotting, 325 mg, chew it
Morphine – calms the patient down, helps pain
Treatment: Myocardial Infarction<\/p>\n\n\n\n
\u25aa troponin
\u25aa CK-MB
\u25aa BNP
Name the cardiac enzymes<\/p>\n\n\n\n
stent the artery
angiogram
remove clots
cardiac catheterization
Procedures: Myocardial Infarction (MI)<\/p>\n\n\n\n
Procedure: Patient has an MI and extreme plaque build up<\/p>\n\n\n\n
inflammation of the membrane surrounding the heart<\/p>\n\n\n\n
When you have pericarditis what are you at risk for?<\/p>\n\n\n\n
What sounds will you hear in a patient with pericarditis?<\/p>\n\n\n\n
accumulation of fluid in the pericardial cavity<\/p>\n\n\n\n
Surgical treatment: Pericardial Effusion<\/p>\n\n\n\n
a localized weak spot or balloon-like enlargement of the wall of an artery<\/p>\n\n\n\n
Which is the most common aneurysm?<\/p>\n\n\n\n
\u25aa pulsating in the abdomen – do not push on it!
S\/S: Abdominal Aortic Aneurysm (AAA)<\/p>\n\n\n\n
\u25aa pain between the scapulas (straight across the back)
S\/S: Thoracic Aortic Aneurysm<\/p>\n\n\n\n
no anticoagulants!!!
Non-emergent thoracic aortic aneurysm interventions<\/p>\n\n\n\n
How do we diagnose hypertension?<\/p>\n\n\n\n
\u25aa record values at home
Patient Education: Hypertension<\/p>\n\n\n\n
\u25aa drugs
\u25aa alcohol
\u25aa age
\u25aa race (hispanic, african american)
\u25aa high cholesterol
\u25aa family Hx
\u25aa elevated LDL, decreased HDL
Risk Factors: Hypertension<\/p>\n\n\n\n
secondary – r\/t kidney problems or other issues
What’s the difference between primary and secondary hypertension?<\/p>\n\n\n\n
\u25aa Beta Blockers
\u25aa ARBs
\u25aa Calcium Channel lockers
Pharmacological Treatment: Hypertension<\/p>\n\n\n\n
plaque builds up on the inner walls of the arteries<\/p>\n\n\n\n
\u25aa Smoking
\u25aa Uncontrolled diabetes
\u25aa Uncontrolled HTN
\u25aa Obesity
\u25aa Diet
\u25aa Lack of exercise
Causes of plaque build up<\/p>\n\n\n\n
hardening of the arteries, happens with age, normal<\/p>\n\n\n\n
What is HDL?<\/p>\n\n\n\n
What is LDL?<\/p>\n\n\n\n
What are triglycerides?<\/p>\n\n\n\n
peripheral vascular disease (PVD)
Atherosclerosis and Arteriosclerosis can cause what conditions?<\/p>\n\n\n\n
\u25aa bad pedal pulses
\u25aa leg pain
\u25aa decreased capillary refill
\u25aa mottled skin
S\/S: Peripheral Vascular Disease (PVD)<\/p>\n\n\n\n
How do you diagnose Peripheral Vascular Disease (PVD)?<\/p>\n\n\n\n
\u25aa cath lab to have stent placement
\u25aa angioplasty
Treatment: Peripheral Vascular Disease (PVD)<\/p>\n\n\n\n
\u25aa no pressure on legs, keep them in a dependent or dangling position
\u25aa no constrictive clothing
Patient Education: Peripheral Vascular Disease (PVD)<\/p>\n\n\n\n
-mitral
-tricuspid
-pulmonic
Types of valves<\/p>\n\n\n\n
aortic valve
Which valves most commonly have issues?<\/p>\n\n\n\n
backward flow of blood through a heart valve<\/p>\n\n\n\n
when valves become narrower than normal, impeding the flow of blood.<\/p>\n\n\n\n
What are some reasons, besides age, patients might end up with mitral stenosis?<\/p>\n\n\n\n
When we have any damage to our valves, whether it be regurgitation or stenosis, what are we at risk for?<\/p>\n\n\n\n
Murmur sounds associated with mitral regurgitation vs aortic regurgitation<\/p>\n\n\n\n
\u25aa JVD
\u25aa SOB
\u25aa fatigue
\u25aa tachycardia
S\/S: Mitral Regurgitation<\/p>\n\n\n\n
inflammation of the inner lining of the heart<\/p>\n\n\n\n
How do we FIRST treat endocarditis?<\/p>\n\n\n\n
IV drugs
strep
Causes of Endocarditis<\/p>\n\n\n\n
Complication of Endocarditis<\/p>\n\n\n\n
Heart failure where it backs up to the lungs<\/p>\n\n\n\n
\u25aa decreased O2 Sat
\u25aa fluid around lungs
\u25aa fluid in lungs
\u25aa crackles
\u25aa potential confusion
\u25aa fatigue
\u25aa weakness
\u25aa impending doom
S\/S: Left-Sided Heart Failure<\/p>\n\n\n\n
\u25aa potassium sparing diuretics
\u25aa digoxin
\u25aa ACE inhibitors
\u25aa ARBs
\u25aa calcium channel blockers
Treatment: Left-Sided Heart Failure<\/p>\n\n\n\n
\u25aa CNS depressant effects (fatigue, weakness, dizziness)
\u25aa Headache
\u25aaDecreased HR and BP
\u25aaHeart arrhythmia (paradoxical effect)
Adverse effects of Digoxin<\/p>\n\n\n\n
\u25aa monitor I&O
\u25aa daily weight<\/em>
\u25aa low sodium diet
\u25aa avoid NSAIDs
\u25aa fluid restriction
\u25aa instruct patient to seek help when weight gain > 2 lbs
Nursing Interventions\/Patient Education: Heart Failure<\/p>\n\n\n\n
\u25aa BNP lab value
How do we diagnose heart failure?<\/p>\n\n\n\n
Treatment: End Stage Heart Failure<\/p>\n\n\n\n
anemia caused by inadequate iron intake, decreased RBC production<\/p>\n\n\n\n
then can try supplements
then might need iron infusion or blood transfusion
Treatment: Iron Deficiency Anemia<\/p>\n\n\n\n
\u25aa dyspnea
\u25aa pale
\u25aa weak
\u25aa SOB
All anemias, what will your patient present with?<\/p>\n\n\n\n
cancer of white blood cells, too many immature WBCs<\/p>\n\n\n\n
Leukemia patients are at risk for what?<\/p>\n\n\n\n
\u25aa fatigue
\u25aa bleeding gums
\u25aa bruising
\u25aa weight loss, decreased appetite
S\/S: Leukemia<\/p>\n\n\n\n
\u25aa stem cell transplant
\u25aa bone marrow transplant
Treatment: Leukemia<\/p>\n\n\n\n
A hereditary disease where blood does not coagulate to stop bleeding; S\/S: bleeding, bruising, joint pain<\/p>\n\n\n\n
How do you diagnose hemophilia?<\/p>\n\n\n\n
\u25aa electric razors
\u25aa soft tooth brushes
\u25aa don’t play sports
\u25aa bleeding precautions
Patient Education: Hemophilia<\/p>\n\n\n\n
a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape<\/p>\n\n\n\n
Main symptom of Sickle Cell Anemia<\/p>\n\n\n\n
\u25aa IV fluids
\u25aa transfusions
\u25aa oxygen
\u25aa no restrictive clothing
\u25aa warmth
Treatment: Sickle Cell Anemia<\/p>\n\n\n\n\n
How do you diagnose HIT?<\/p>\n\n\n\n
Diagnostic Test for Heparin-Induced Thrombocytopenia<\/p>\n\n\n\n
disorder in which a deficiency of platelets results in abnormal blood clotting, marked by tiny purple bruises (purpura) that form under the skin<\/p>\n\n\n\n
Most common s\/s of ITP<\/p>\n\n\n\n
Treatment: Idiopathic Thrombocytopenic Purpura<\/p>\n\n\n\n
therefore we want a central line or PICC so we aren’t constantly sticking needles in them
If your patient has thrombocytopenia, what are we going to try to avoid doing with this patient?<\/p>\n\n\n\n
What’s the antidote to warfarin (Coumadin)?<\/p>\n\n\n\n
\u25aa avoid gingko biloba
Patient Education: Warfarin<\/p>\n\n\n\n
How do we monitor warfarin?<\/p>\n\n\n\n
\u25aa stay with the patient the first 15 min
\u25aa monitor vital signs 15 min after
\u25aa 4 hours start-finish
When we are giving patients blood transfusions, what is the protocol?<\/p>\n\n\n\n
\u25aa start normal saline(NS), flush
\u25aa send bag and tubing to the lab for testing
What do you do if you notice a blood transfusion reaction? Fever, chills, headache\u2026<\/p>\n\n\n\n
Can you still get blood products if you had an allergic reaction?<\/p>\n\n\n\n
A patient has CHF and needs a blood transfusion, will we give them the blood?<\/p>\n\n\n\n
What are we most worried about post-op for anyone who has had surgery?<\/p>\n\n\n\n
Age-associated prostate gland enlargement that can cause urination difficulty.<\/p>\n\n\n\n
\u25aa TURP
\u25aa continuous bladder irrigation (CBI)
Treatment: BPH<\/p>\n\n\n\n
When a patient gets out of surgery for BPH what are we monitoring for?<\/p>\n\n\n\n
cancer of the lymph nodes<\/p>\n\n\n\n
Most common symptom of lymphoma<\/p>\n\n\n\n
Difference between Hodgkin’s and NonHodgkins lymphoma<\/p>\n\n\n\n
What meds do we typically give in the hospital to prevent DVTs?<\/p>\n\n\n\n
hemorrhagic stroke
recent surgical procedure
ulcers, any bleeding issues\u2026
Contraindications to blood thinners<\/p>\n\n\n\n
angina is pain caused from<\/p>\n\n\n\n
If we have a patient with an aortic aneurysm, what do we need to do to prevent aneurysm from growing?<\/p>\n\n\n\n