Med-Surg Exam 2 jersey college
the purpose of a cardiac stress test? - to determine the hearts ability to respond to increase
oxygen demand
this protein triggers sodium excretion and a decrease in volume? - Brain Natriuretic Peptide (BNP)
these protein levels increase as ventricular pressure increase in order to rid the body of excess fluid? -
Brain Natriuretic Peptide (BNP)
BNP level greater than _____ suggests what? - BNP levels greater than 100 suggest heart failure
what is the classic finding of angina? - it is relieved with rest or nitroglycerine
Pt. education for nitroglycerin? - 1. keep in a dark bottle
2.renew every 6 months
3.place under tongue, never swallowed
4. can take every 5 minutes x 3 doses
5. call 911 after the first dose if pain is not relieved
decrease in cardiac output, expect the pulse to be? - weak, thready pulse
signs of hypokalemia? - muscle weakness
fatigue
muscle cramps
constipation
inverted T waves and a U wave on ekg
,metabolic syndrome increases the risk of? - heart disease
spironolactone is a potassium sparing diuretic that could? - potentiate fluid and electrolyte
imbalances ( if given with potassium supplements, hyperkalemia can occur)
how do bet-blockers work? end in -olol - decreases heart rate and blood pressure. mask the signs
of hypoglycemia or worsen asthma because of bronchoconstriction
why should you avoid discontinuing anti-hypertensives medications abruptly? - increase risk for
rebound hypertension
ACE inhibitors and Angiotensin 2 receptor blockers (ARBs) increase the risk of? - hyperkalemia
ACE inhibitors, how do they work? ends in -pril - stop angiotensin 1 from converting to
angiotensin 2 (powerful vasoconstrictor) thereby lowering total peripheral vascular resistance and blood
pressure
How to take a proper blood pressure reading? - instruct pt. to not eat or drink for 30 mins
support arm at heart level
make sure both feet are flat on the floor
the target organs affected by long standing hypertension? - retinopathy
neuropathy
nephropathy
decrease in output could cause what? - decrease in tissue perfusion which results in organ failure
Following a pulmonary artery pressure reading you should deflate the balloon. Why? - to restore
the blood flow through the pulmonary artery
,Straining with bowel movements is not good because? - it triggers the valsalva maneuver which
increases intrathoracic pressure decreasing the venous blood flow to the heart and results in decrease
cardiac output.
change patients position slowly to prebent? - orthostatic hypotension
Low central venous pressure levels could suggests? - could suggest dehydration or overdiuresis
increase central venous pressure could suggest? - heart failure
increase central venous pressure provides a measurement of what? - measurement of the volume
of blood that returned to the right side of the heart (2-6 mm Hg)
angina could be triggered by ? - eating a heavy meal
Exp: blood shunted to the GI area which decreases blood availability to the myocardium
locations of chest pain? - typically felt behind the sternum and may radiate to:neck, jaw,
shoulders, and along the inner aspect of the left arm.
Hemodynamic monitoring is performed where? - in ICU and allows for direct cardiac monitoring
homocysteine - damage the endothelial lining of the arteries
increase risk for thrombus formation and lead to stroke, CAD, and peripheral artery disease
the radiology procedure ECHOCARDIOGRAM shows what about the heart? - direction of blood
flow
heart shape and size
ventricular function
ejection fraction
, complication that may occur following cardiac catherization? - fatal dysrhythmias
Adventitious sound heard of the lower airway narrowing? - wheezing
fluid accumulation in the lower basis of the lungs, you will hear what sound? - crackles
what suggest increase pressure and filling volumes in the ventricles? - JVD
Peripheral edema
hepatomegaly
scrotal edema
shortness of breath
crackles
S3 in older adults are significant and may suggest? - heart failure
Valve disorders contribute to? - turbulent blood flow and heart murmurs
what is an MI? - blockages or constriction of the coronary arteries
unresolved ischemia leads to? - necrosis of myocardial cells and the release of enzymes (CK-MB
creatine) and proteins (Troponin, Troponin 1, kinase, and myoglobin) into the blood stream
blood flow through the right atrium is done through? - the inferior and superior vena cava
this initiates the impulse that causes atrial contraction? - Sinostrial (SA) node
the SA node is observed by what wave on the the EKG? - the P wave
the purpose of a cardiac stress test? - to determine the hearts ability to respond to increase
oxygen demand
this protein triggers sodium excretion and a decrease in volume? - Brain Natriuretic Peptide (BNP)
these protein levels increase as ventricular pressure increase in order to rid the body of excess fluid? -
Brain Natriuretic Peptide (BNP)
BNP level greater than _____ suggests what? - BNP levels greater than 100 suggest heart failure
what is the classic finding of angina? - it is relieved with rest or nitroglycerine
Pt. education for nitroglycerin? - 1. keep in a dark bottle
2.renew every 6 months
3.place under tongue, never swallowed
4. can take every 5 minutes x 3 doses
5. call 911 after the first dose if pain is not relieved
decrease in cardiac output, expect the pulse to be? - weak, thready pulse
signs of hypokalemia? - muscle weakness
fatigue
muscle cramps
constipation
inverted T waves and a U wave on ekg
,metabolic syndrome increases the risk of? - heart disease
spironolactone is a potassium sparing diuretic that could? - potentiate fluid and electrolyte
imbalances ( if given with potassium supplements, hyperkalemia can occur)
how do bet-blockers work? end in -olol - decreases heart rate and blood pressure. mask the signs
of hypoglycemia or worsen asthma because of bronchoconstriction
why should you avoid discontinuing anti-hypertensives medications abruptly? - increase risk for
rebound hypertension
ACE inhibitors and Angiotensin 2 receptor blockers (ARBs) increase the risk of? - hyperkalemia
ACE inhibitors, how do they work? ends in -pril - stop angiotensin 1 from converting to
angiotensin 2 (powerful vasoconstrictor) thereby lowering total peripheral vascular resistance and blood
pressure
How to take a proper blood pressure reading? - instruct pt. to not eat or drink for 30 mins
support arm at heart level
make sure both feet are flat on the floor
the target organs affected by long standing hypertension? - retinopathy
neuropathy
nephropathy
decrease in output could cause what? - decrease in tissue perfusion which results in organ failure
Following a pulmonary artery pressure reading you should deflate the balloon. Why? - to restore
the blood flow through the pulmonary artery
,Straining with bowel movements is not good because? - it triggers the valsalva maneuver which
increases intrathoracic pressure decreasing the venous blood flow to the heart and results in decrease
cardiac output.
change patients position slowly to prebent? - orthostatic hypotension
Low central venous pressure levels could suggests? - could suggest dehydration or overdiuresis
increase central venous pressure could suggest? - heart failure
increase central venous pressure provides a measurement of what? - measurement of the volume
of blood that returned to the right side of the heart (2-6 mm Hg)
angina could be triggered by ? - eating a heavy meal
Exp: blood shunted to the GI area which decreases blood availability to the myocardium
locations of chest pain? - typically felt behind the sternum and may radiate to:neck, jaw,
shoulders, and along the inner aspect of the left arm.
Hemodynamic monitoring is performed where? - in ICU and allows for direct cardiac monitoring
homocysteine - damage the endothelial lining of the arteries
increase risk for thrombus formation and lead to stroke, CAD, and peripheral artery disease
the radiology procedure ECHOCARDIOGRAM shows what about the heart? - direction of blood
flow
heart shape and size
ventricular function
ejection fraction
, complication that may occur following cardiac catherization? - fatal dysrhythmias
Adventitious sound heard of the lower airway narrowing? - wheezing
fluid accumulation in the lower basis of the lungs, you will hear what sound? - crackles
what suggest increase pressure and filling volumes in the ventricles? - JVD
Peripheral edema
hepatomegaly
scrotal edema
shortness of breath
crackles
S3 in older adults are significant and may suggest? - heart failure
Valve disorders contribute to? - turbulent blood flow and heart murmurs
what is an MI? - blockages or constriction of the coronary arteries
unresolved ischemia leads to? - necrosis of myocardial cells and the release of enzymes (CK-MB
creatine) and proteins (Troponin, Troponin 1, kinase, and myoglobin) into the blood stream
blood flow through the right atrium is done through? - the inferior and superior vena cava
this initiates the impulse that causes atrial contraction? - Sinostrial (SA) node
the SA node is observed by what wave on the the EKG? - the P wave
