NURS 480 Exam Study Questions with Elaborate Answers | Latest Edition

NURS 480 Exam Study Questions with Elaborate Answers | Latest Edition 1. Reading an ECG Strip - ANSWER - Each small box is 0.04 seconds - Each large box is 0.20 seconds - 30 large boxes = 6 seconds 2. Premature Atrial Contraction - ANSWER - early electrical impulse initiated by neural tissue in the atria - Causes: stimulants, strong emotion, smoking tobacco, caffeine - Intervention: check electrolytes, lifestyle changes 3. Sinus Bradycardia - ANSWER - HR 60 bpm - Rhythm: regular - Risk Factors: hypoxia, medications (beta-blockers), lyme disease, hypothyroid, hypothermia - Symptoms: asymptomatic, syncope, low BP, SOB, dizziness, confusion - Treatment: Atropine 4. Heart Failure Types - ANSWER -Left sided: systolic (estimated by ejection fraction) and diastolic (less defined and more difficult to measure; impaired relaxation filling); decreased cardiac output (tachycardia, confusion) and pulmonary congestion (crackles, tachypnea) -Right sided: most common cause is Left sided but can also be pulmonary disease or primary pulmonary artery HTN; systemic congestion (JVD, edema, affected BP) -High output heart failure 5. Functional classifications of Heart Failure - ANSWER -Class I: mild; no limitation of physical activity -Class II: mild; slight limitation, comfortable at rest but ordinary physical activity results in fatigue, palpitations, or SOB -Class III: moderate; marked limitation of activity; comfortable at rest but less than ordinary activity causes fatigue, palpitations or SOB -Class IV: severe; unable to carry out activities without discomfort; fatigue, palpitations, SOB present at rest 6. Interventions and Labs for Heart Failure - ANSWER -Labs: ECG, chest x ray, Echo, CBC, BMP, cardiac enzymes, ABG, BNP, exercise testing -Interventions: diuretics (potassium sparing), beta blockers, Pacer, CPAP, ACE inhibitor, BP/HR monitor, elevate edema, daily weights, change diet (low fat, fluid, cholesterol, salt) 7. Heart Valve Disease: Aortic Stenosis - ANSWER -Fibrosis/ calcification of valve -Narrowing valve- increased L ventricle pressure/dilation - L ventricle hypertrophy -May eventually lead to L sided Heart failure then R sided 8. Heart Valve Disease: Mitral Regurgitation - ANSWER -Fibrosis/ calcification of valve -Incomplete closure of valve -backflow of blood into L atrium- L atrium/ventricle hypertrophy -May eventually lead to R sided heart failure from increased preload/afterload on L side of heart 9. Heart Valve Disease: Atrial Regurgitation - ANSWER -Fibrosis/ calcification of valve -Incomplete closure of valve- backflow of blood into L atrium decreasing blood flow with ejection -L ventricle hypertrophy -Initially may be asymptomatic due to compensation of L ventricle -May eventually lead to L sided heart failure 10. Heart Valve Disease: Mitral Prolapse - ANSWER -Valvular leaf enlargement- prolapses into L atrium during systole -Initially asymptomatic -May eventually cause atypical chest pain, dizziness, atrial or ventricular tachycardia 11. Heart Valve Interventions - ANSWER -Educate; emphasize compliance; when to see medical care -Anti-coagulation for prosthetic valve replacement an A-fib 12. Endocarditis vs Pericarditis - ANSWER -Endocarditis: fever, petechiae, Osler's nodes, positive blood culture, Janeways nodes -Pericarditis: fever, pericardial friction rub, positive blood culture 13. Hypertensive Crisis - ANSWER -a severe increase in blood pressure which could result in stroke (180/110) -Drugs: beta blockers, Vasodilators such as nitroprusside and nitroglycerin