NSG 210 perfusion gas exchange UPDATED
ACTUAL Questions and CORRECT
Answers
left vs right heart failure - CORRECT ANSWER - *left*: failure of left ventricle to pump out
blood and meet demands of tissues OR failure to pump out all blood leading to back up into the lungs
*right*: failure of right ventricle to pump to left side = accumulation of fluid/blood in periphery
4 stages of heart failure - CORRECT ANSWER - Class 1: at risk
Class 2/3: current/prior symptoms
Class 4: end stage
BNP panic value - CORRECT ANSWER - >400
significant for heart failure
Normal H & H - CORRECT ANSWER - Hct men >40%, women >36%
Hgb men 14.0 or greater, women 12.0 or greater
S/S of left sided heart failure - CORRECT ANSWER - L=Lungs
-Pulmonary congestion
-dyspnea
-cough
-blood-tinged frothy sputum
-paroxysmal nocturnal dyspnea
-arm heaviness
-fatigue/weakness
-chest pain and palpitations
-S3
,S/S of right sided heart failure - CORRECT ANSWER - -Jugular vein distention
-Anorexia
-N/V
-Abdominal distention
-Ascites
-Hepatomegaly
-Dependent edema, peripheral edema
-Weight gain
Priority assessments for HF - CORRECT ANSWER - Respiratory, cardiac, urinary
Management of HF - CORRECT ANSWER - Control volume and decrease afterload (diuretics,
blood pressure meds)
ACE inhibitors
Cardiac glycosides/Beta blockers- control rate and rhythm
Pulmonary edema - CORRECT ANSWER - s/s: early=change in LOC, late=SOB, frothy sputum
Interventions: sit up, oxygen, get help, diuretics, maintain airway
Education for HF - CORRECT ANSWER - Manage fatigue, diet (low sodium, limit fluids), daily
weight, meds
Causes of HF - CORRECT ANSWER - MI, CAD, AFIB, infection, ischemia, HTN, hypervolemia,
thyroid disease, anemia, diabetes
Positive inotropic drugs - CORRECT ANSWER - increase force of contraction
Positive chronotropic drugs - CORRECT ANSWER - Increase heart rate
, Positive dromotropic drugs - CORRECT ANSWER - accelerate cardiac conduction
Common adverse effect of ACE inhibitors - CORRECT ANSWER - dry cough, hyperkalemia
If a patient experiences a dry cough on lisinopril, what are they likely to change the drug to? - CORRECT
ANSWER - an ARB
Intended effects of beta blockers - CORRECT ANSWER - reduced heart rate, delayed AV node
conduction, reduced myocardial contractility, decreased myocardial automaticity
Ivabradine - CORRECT ANSWER - Used in stable symptomatic HF with EF of <35%
Avoid grapefruit
Milrinone - CORRECT ANSWER - phosphodiesterase inhibitor, short term
Adverse effects: dysrhythmias, thrombocytopenia, liver damage
Cardiac glycosides - CORRECT ANSWER - Digoxin
Increases myocardial contractility, negative chronotropic and dromotropic
Normal level for digoxin - CORRECT ANSWER - 0.5-2
What increases digoxin toxicity - CORRECT ANSWER - hypokalemia
Digoxin toxicity s/s - CORRECT ANSWER - GI effects - anorexia, nausea, vomiting, abdominal
pain; CNS effects - fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around
objects
What assessment must be done before administering digoxin? - CORRECT ANSWER - Apical
pulse for 1 minute, electrolyte monitoring
ACTUAL Questions and CORRECT
Answers
left vs right heart failure - CORRECT ANSWER - *left*: failure of left ventricle to pump out
blood and meet demands of tissues OR failure to pump out all blood leading to back up into the lungs
*right*: failure of right ventricle to pump to left side = accumulation of fluid/blood in periphery
4 stages of heart failure - CORRECT ANSWER - Class 1: at risk
Class 2/3: current/prior symptoms
Class 4: end stage
BNP panic value - CORRECT ANSWER - >400
significant for heart failure
Normal H & H - CORRECT ANSWER - Hct men >40%, women >36%
Hgb men 14.0 or greater, women 12.0 or greater
S/S of left sided heart failure - CORRECT ANSWER - L=Lungs
-Pulmonary congestion
-dyspnea
-cough
-blood-tinged frothy sputum
-paroxysmal nocturnal dyspnea
-arm heaviness
-fatigue/weakness
-chest pain and palpitations
-S3
,S/S of right sided heart failure - CORRECT ANSWER - -Jugular vein distention
-Anorexia
-N/V
-Abdominal distention
-Ascites
-Hepatomegaly
-Dependent edema, peripheral edema
-Weight gain
Priority assessments for HF - CORRECT ANSWER - Respiratory, cardiac, urinary
Management of HF - CORRECT ANSWER - Control volume and decrease afterload (diuretics,
blood pressure meds)
ACE inhibitors
Cardiac glycosides/Beta blockers- control rate and rhythm
Pulmonary edema - CORRECT ANSWER - s/s: early=change in LOC, late=SOB, frothy sputum
Interventions: sit up, oxygen, get help, diuretics, maintain airway
Education for HF - CORRECT ANSWER - Manage fatigue, diet (low sodium, limit fluids), daily
weight, meds
Causes of HF - CORRECT ANSWER - MI, CAD, AFIB, infection, ischemia, HTN, hypervolemia,
thyroid disease, anemia, diabetes
Positive inotropic drugs - CORRECT ANSWER - increase force of contraction
Positive chronotropic drugs - CORRECT ANSWER - Increase heart rate
, Positive dromotropic drugs - CORRECT ANSWER - accelerate cardiac conduction
Common adverse effect of ACE inhibitors - CORRECT ANSWER - dry cough, hyperkalemia
If a patient experiences a dry cough on lisinopril, what are they likely to change the drug to? - CORRECT
ANSWER - an ARB
Intended effects of beta blockers - CORRECT ANSWER - reduced heart rate, delayed AV node
conduction, reduced myocardial contractility, decreased myocardial automaticity
Ivabradine - CORRECT ANSWER - Used in stable symptomatic HF with EF of <35%
Avoid grapefruit
Milrinone - CORRECT ANSWER - phosphodiesterase inhibitor, short term
Adverse effects: dysrhythmias, thrombocytopenia, liver damage
Cardiac glycosides - CORRECT ANSWER - Digoxin
Increases myocardial contractility, negative chronotropic and dromotropic
Normal level for digoxin - CORRECT ANSWER - 0.5-2
What increases digoxin toxicity - CORRECT ANSWER - hypokalemia
Digoxin toxicity s/s - CORRECT ANSWER - GI effects - anorexia, nausea, vomiting, abdominal
pain; CNS effects - fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around
objects
What assessment must be done before administering digoxin? - CORRECT ANSWER - Apical
pulse for 1 minute, electrolyte monitoring
