Med Surg Exam 1 latest update 2022 Study Guide
Heart Failure
• Symptoms of left-sided heart failure:
o Confusion, orthopnea, fatigue, cyanosis, dyspnea, wheezing, sleep
apnea, pulmonary
edema, pallor, and clammy skin.
• Symptoms of right-sided heart failure:
o Fatigue increased peripheral venous pressure, ascites with abdominal
distention,
enlarged liver & spleen, distended jugular veins, weight gain,
dependent edema, edema in sacrum, legs, and sacrum.
• Drugs used to treat heart failure:
o Loop diuretic: Remove excess fluid
▪ Furosemide (Lasix), bumetanide (Bumex)
o Angiotensin-converting enzyme (ACE) inhibitors: Prevent
vasoconstriction
▪ Enalapril (Vasotec), captopril (Capoten), lisinopril (Zestril)
o Beta-adrenergic blockers: Reduce blood pressure, slow heart
rate
▪ Atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard)
o Calcium channel blockers: Produce vasodilation and reduced
heart rate
▪ Amlodipine (Norvasc), diltiazem (Cardizem), nifedipine
(Procardia)
o Vasodilators (Nitrates): Dilate blood vessels; relieves myocardial
ischemia
▪ Nitroglycerin
• Diet:
o Limit foods high in saturated fat, trans fat, and cholesterol.
o Limit meat intake to no more 6 oz. Per day.
o Eat fish at least twice a week.
o Eat 5 to 7 servings of fruit and veggies per day.
o Eat less than 1500 mg of salt (sodium chloride) per day
• Concerning symptoms:
o Weight gain of 2 pounds in 24 hours, or 5 pounds in one week.
Implanted Cardioverter-Defibrillator (ICD)
• It monitors the heartbeat and provide an electrical shock similar to that
delivered in cardiac defibrillation or cardioversion when life-
threatening rhythm is detected.
• Avoid long exposure to strong magnetic fields such as microwave
towers, transformers and electrical transmitters, electrical generators,
Med Surg Exam 1 latest update 2022 Study Guide
, Med Surg Exam 1 latest update 2022 Study Guide
handheld security devices at airports, and arc welding equipment.
Automatic Implanted Cardioverter-Defibrillator (AICD)
• what does it do?
• What should patients avoid?
Temporary transvenous pacer vs. Temporary pacemaker
• Pacing can be a temporary measure if the problem is an
emergent, transient condition, such as drug toxicity.
• A temporary transvenous pacemaker is placed if a transient rhythm such as
heart block develops after an MI or drug toxicity.
Permanent pacemaker
• Avoid lifting the arm away from the body on pacemaker side until
provider says okay for progression.
• Keep incision dry for at least 4 days after the surgery.
• Check for redness, swelling, drainage, or fever and report findings.
• Refrain from activities that might cause a direct blow to the pacemaker.
• Use cellular or cordless phones on the ear opposite the pacemaker.
• Stay away from high-output electrical generators or large magnets.
• Monitor pulse daily.
• Carry a pacemaker information card.
• Wear a medical alert bracelet or necklace at all times.
• Microwave ovens are safe to use, and airport security screening
should not cause a problem with the function of the pacemaker.
Travel is not restricted.
Digitalis
• Occasionally used to increase the force of heart contraction and slow
rate, thereby increasing cardiac output.
• Treats cardiac dysrhythmias by decreasing heart rate.
Med Surg Exam 1 latest update 2022 Study Guide
Heart Failure
• Symptoms of left-sided heart failure:
o Confusion, orthopnea, fatigue, cyanosis, dyspnea, wheezing, sleep
apnea, pulmonary
edema, pallor, and clammy skin.
• Symptoms of right-sided heart failure:
o Fatigue increased peripheral venous pressure, ascites with abdominal
distention,
enlarged liver & spleen, distended jugular veins, weight gain,
dependent edema, edema in sacrum, legs, and sacrum.
• Drugs used to treat heart failure:
o Loop diuretic: Remove excess fluid
▪ Furosemide (Lasix), bumetanide (Bumex)
o Angiotensin-converting enzyme (ACE) inhibitors: Prevent
vasoconstriction
▪ Enalapril (Vasotec), captopril (Capoten), lisinopril (Zestril)
o Beta-adrenergic blockers: Reduce blood pressure, slow heart
rate
▪ Atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard)
o Calcium channel blockers: Produce vasodilation and reduced
heart rate
▪ Amlodipine (Norvasc), diltiazem (Cardizem), nifedipine
(Procardia)
o Vasodilators (Nitrates): Dilate blood vessels; relieves myocardial
ischemia
▪ Nitroglycerin
• Diet:
o Limit foods high in saturated fat, trans fat, and cholesterol.
o Limit meat intake to no more 6 oz. Per day.
o Eat fish at least twice a week.
o Eat 5 to 7 servings of fruit and veggies per day.
o Eat less than 1500 mg of salt (sodium chloride) per day
• Concerning symptoms:
o Weight gain of 2 pounds in 24 hours, or 5 pounds in one week.
Implanted Cardioverter-Defibrillator (ICD)
• It monitors the heartbeat and provide an electrical shock similar to that
delivered in cardiac defibrillation or cardioversion when life-
threatening rhythm is detected.
• Avoid long exposure to strong magnetic fields such as microwave
towers, transformers and electrical transmitters, electrical generators,
Med Surg Exam 1 latest update 2022 Study Guide
, Med Surg Exam 1 latest update 2022 Study Guide
handheld security devices at airports, and arc welding equipment.
Automatic Implanted Cardioverter-Defibrillator (AICD)
• what does it do?
• What should patients avoid?
Temporary transvenous pacer vs. Temporary pacemaker
• Pacing can be a temporary measure if the problem is an
emergent, transient condition, such as drug toxicity.
• A temporary transvenous pacemaker is placed if a transient rhythm such as
heart block develops after an MI or drug toxicity.
Permanent pacemaker
• Avoid lifting the arm away from the body on pacemaker side until
provider says okay for progression.
• Keep incision dry for at least 4 days after the surgery.
• Check for redness, swelling, drainage, or fever and report findings.
• Refrain from activities that might cause a direct blow to the pacemaker.
• Use cellular or cordless phones on the ear opposite the pacemaker.
• Stay away from high-output electrical generators or large magnets.
• Monitor pulse daily.
• Carry a pacemaker information card.
• Wear a medical alert bracelet or necklace at all times.
• Microwave ovens are safe to use, and airport security screening
should not cause a problem with the function of the pacemaker.
Travel is not restricted.
Digitalis
• Occasionally used to increase the force of heart contraction and slow
rate, thereby increasing cardiac output.
• Treats cardiac dysrhythmias by decreasing heart rate.
Med Surg Exam 1 latest update 2022 Study Guide
