ACUTE EXAM #2 Questions & Answers 100%

ACUTE EXAM #2 Questions & Answers
100%
Quiz:> For patients with valvular disease, what is prescribed to prevent endocarditis?
{{{Answer}}} (Prophylactic antibiotics)

Quiz:> This valvular disorder leads to blood back up in the right atrium, causing
pressure to build up
{{{Answer}}} (Mitral valve stenosis)

Quiz:> The higher the _____________ of blood, the higher the ____________.
{{{Answer}}} (Volume, pressure)

Quiz:> What is the normal diameter of a valve?
{{{Answer}}} (3 fingers width in diameter)

Quiz:> What is the approximate diameter of a patient's valve with stenosis?
{{{Answer}}} (Diameter of a pencil/pen)

Quiz:> What diagnostic test will indicate narrowing of the valves?
{{{Answer}}} (ECG)

Quiz:> What does an abnormal radial pulse upon assessment indicate?
{{{Answer}}} (An arrhythmia or possible a-fib)

Quiz:> What is the normal ejection fraction of the heart?
{{{Answer}}} (60-65%)

Quiz:> What disease during young adulthood could cause mitral valve stenosis later in
life once an older adult?
{{{Answer}}} (Syphilis)

Quiz:> What complication can mitral stenosis lead to?
{{{Answer}}} (Pulmonary HTN)

Quiz:> What are teaching points for the patient with mitral stenosis that also has
regurgitation?
{{{Answer}}} (- Patient may have CHF, treat the heart failure
- Minimize risk of contracting infection: Endocarditis will be prevented by adherence to
prophylactic antibiotics
- Include periods of rest after periods of energy exertion
- Avoid strenuous activities)

,Quiz:> A disorder defined as when one of the valves stretches; More common in
women; Asymptomatic, hereditary
{{{Answer}}} (Mitral valve prolapse)

Quiz:> What valvular disorder is hereditary, asymptomatic, and more common in
women?
{{{Answer}}} (Mitral valve prolapse)

Quiz:> In mitral valve prolapse, who should get an EKG if a sibling is diagnosed?
{{{Answer}}} (First line brothers and sisters)

Quiz:> What are some teaching points to go over for a patient diagnosed with mitral
valve prolapse?
{{{Answer}}} (- Avoid stimulants
- Avoid alcohol
- Smoking cessation, avoid tobacco
- Avoid alcohol containing mouth washes
- Avoid ephedrine containing cough medicines (can cause HTN))

Quiz:> If chest pain is not relieved by ________________, is it not angina and this
needs further investigation
{{{Answer}}} (Nitroglycerin)

Quiz:> Valvular disorder defined as when blood goes back as it continues to move
forward; Backing up of blood
{{{Answer}}} (Mitral valve regurgitation)

Quiz:> What will mitral valve regurgitation eventually lead to?{
{{Answer}}} (Right sided heart failure)

Quiz:> What illness will impact the mitral valve?
{{{Answer}}} (Rheumatic fever)

Quiz:> What are s/s of worsening mitral valve regurgitation?
{{{Answer}}} (- SOB (due to pulmonary congestion
- Cough
- Fatigue
- Possible a- fib)

Quiz:> In mitral valve regurgitation, if the radial pulse is irregular upon assessment,
what is the nurse's next step?
{{{Answer}}} (Assess the apical pulse!)

Quiz:> In mitral valve regurgitation, if the radial & apical pulses have both been
assessed & both are irregular, what is the nurse's next step?

, {{{Answer}}} (Get an EKG STAT)

Quiz:> What is the aim of treatment for mitral valve regurgitation?
{{{Answer}}} (Reduce after load; want to decrease resistance of blood flow)

Quiz:> What is the medication regimen that a patient with mitral valve regurgitation will
be prescribed?
{{{Answer}}} (Possible ACE, ARB, hydrazine or BB)

Quiz:> In mitral valve regurgitation, if an ACE inhibitor is un-tolerated due to constant
dry cough, what is the next line medication that will be prescribed?
{{{Answer}}} (Hydralazine, a direct vasodilator which will reduce after load)

Quiz:> What is patient teaching that is required with hydralazine?
{{{Answer}}} (- Orthostatic hypotension (due to vasodilating effects)
- Avoid grapefruit juice
- "Dangle" feet on edge of bed before getting up
- Change positions slowly when moving from sitting to standing etc)

Quiz:> What does aortic stenosis lead to?
{{{Answer}}} (Hypertrophy and vasodilation; Similar to what happens in atherosclerosis)

Quiz:> What medication regimen will be prescribed for a patient with aortic stenosis?
{{{Answer}}} (Digoxin, BB, ACE inhibitor; looking for vasodilation)

Quiz:> Patient admitted with strep infection is worried that their heart may be affected.
What diagnostic tests will be done at this time?
{{{Answer}}} (- Blood culture (CBC) --> Looking at WBC's
- ECG --> Monitoring HR and rhythm
- TEE --> Trans-esophageal echo)

Quiz:> What is the result of an untreated streptococcal infection?
{{{Answer}}} (Infective endocarditis)

Quiz:> If a patient undergoes a valve replacement, what medications will they be on
long term?
{{{Answer}}} (Long term anticoagulant therapy as well as prophylactic antibiotics)

Quiz:> Under what two circumstances should a patient with previous valve replacement
ensure they take prophylactic antibiotics?
{{{Answer}}} (Before visits to the dentist & before surgical procedures)

Quiz:> What medication would a patient with atrial fibrillation need to be on long term?
{{{Answer}}} (Coumadin (Warfarin))

Quiz:> Why do patients with history of a-fib need to be on anticoagulant therapy?