Adult 2 Exam 2 (Xavier ABSN)
cardiac output - ✔️✔️what the nurse hopes will improve w/ treatment in patients w/
heart failure
s/s systolic failure - ✔️✔️-weakness
-fatigue
-decreased exercised tolerance
s/s diastolic failure - ✔️✔️-SOB
-tachypnea
-crackles
s/s of decreased tissue perfusion (3/5 correct) - ✔️✔️-fatigue
-weakness
-decreased exercise tolerance
(result of systolic failure)
-cyanotic
-pale
-tired
-gray
-if not perfusion as well, heart and kidneys work together, patient could be using
accessory muscle to breath to compensate.
s/s left-sided heart failure (3/5 correct) - ✔️✔️-fatigue
-activity intolerance
-dizziness/syncope
-dyspnea, shortness of breath, & cough
-orthopnea
-cyanosis
-inspiratory crackles & wheezes
-Oliguria
orthopnea position - ✔️✔️sitting erect in a chair or sitting upright in bed supported by
pillows behind the head and chest
patient cannot breath when laying down
Low-output vs High-output Failure - ✔️✔️O2 saturation and vital signs will improve,
decreased labored breathing, not struggling to get enough o2
, cardiac output high but is unable to meet increased O2 demands, reduction in vascular
resistance- decrease in arterial pressure= high output failure
ventricle is unable to effectively pump blood out of the heart leading to impaired tissue
perfusion, reduction in load output= low output failure
digoxin - ✔️✔️-increases contractility of heart
-increases stroke volume and output
-improves renal perfusion
-reduces cardiac work by decreasing preload/afterload
diuretics - ✔️✔️-inhibit sodium/water reabsorption
-reduced fluid AEB increased urination
-improvement in edema
-improved lung sounds
s/s digoxin toxicity - ✔️✔️-palpitations
-weakness
-loss of appetite
-nausea
-vomiting
-abdominal pain
-blurred/colored vision
-double vision
Which electrolyte imbalance may precipitate digoxin toxicity - ✔️✔️hypokalemia
(potassium deficiency)
notify physician immediately if develop manifestations of potassium deficiency
(weakness, lethargy, thirst, depression, muscle cramps, or vomiting)
incorporate foods high in potassium into diet (fresh orange or tomato juice, bananas,
raisins, dates, figs, prunes, apricots, spinach, cauliflower, and potatoes)
Lisinopril client education - ✔️✔️take at the same time every day to ensure stable
blood level
monitor BP and weight weekly
*report significant changes to doctor
avoid making sudden position changes
*lie down if become dizzy or light-headed, particularly after 1st dose
report any signs of easy bruising and bleeding, sore throat or fever, edema, or skin rash
*immediately report swelling of face, lips, or eyelids, & itching or breathing problems
cardiac output - ✔️✔️what the nurse hopes will improve w/ treatment in patients w/
heart failure
s/s systolic failure - ✔️✔️-weakness
-fatigue
-decreased exercised tolerance
s/s diastolic failure - ✔️✔️-SOB
-tachypnea
-crackles
s/s of decreased tissue perfusion (3/5 correct) - ✔️✔️-fatigue
-weakness
-decreased exercise tolerance
(result of systolic failure)
-cyanotic
-pale
-tired
-gray
-if not perfusion as well, heart and kidneys work together, patient could be using
accessory muscle to breath to compensate.
s/s left-sided heart failure (3/5 correct) - ✔️✔️-fatigue
-activity intolerance
-dizziness/syncope
-dyspnea, shortness of breath, & cough
-orthopnea
-cyanosis
-inspiratory crackles & wheezes
-Oliguria
orthopnea position - ✔️✔️sitting erect in a chair or sitting upright in bed supported by
pillows behind the head and chest
patient cannot breath when laying down
Low-output vs High-output Failure - ✔️✔️O2 saturation and vital signs will improve,
decreased labored breathing, not struggling to get enough o2
, cardiac output high but is unable to meet increased O2 demands, reduction in vascular
resistance- decrease in arterial pressure= high output failure
ventricle is unable to effectively pump blood out of the heart leading to impaired tissue
perfusion, reduction in load output= low output failure
digoxin - ✔️✔️-increases contractility of heart
-increases stroke volume and output
-improves renal perfusion
-reduces cardiac work by decreasing preload/afterload
diuretics - ✔️✔️-inhibit sodium/water reabsorption
-reduced fluid AEB increased urination
-improvement in edema
-improved lung sounds
s/s digoxin toxicity - ✔️✔️-palpitations
-weakness
-loss of appetite
-nausea
-vomiting
-abdominal pain
-blurred/colored vision
-double vision
Which electrolyte imbalance may precipitate digoxin toxicity - ✔️✔️hypokalemia
(potassium deficiency)
notify physician immediately if develop manifestations of potassium deficiency
(weakness, lethargy, thirst, depression, muscle cramps, or vomiting)
incorporate foods high in potassium into diet (fresh orange or tomato juice, bananas,
raisins, dates, figs, prunes, apricots, spinach, cauliflower, and potatoes)
Lisinopril client education - ✔️✔️take at the same time every day to ensure stable
blood level
monitor BP and weight weekly
*report significant changes to doctor
avoid making sudden position changes
*lie down if become dizzy or light-headed, particularly after 1st dose
report any signs of easy bruising and bleeding, sore throat or fever, edema, or skin rash
*immediately report swelling of face, lips, or eyelids, & itching or breathing problems
