NRSG 3420 FINAL EXAM REVIEW EXAM QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Priority nursing diagnoses for cardiac and respiratory patients
- hemodynamic instability
- impaired gas exchange
- fluid/electrolyte imbalance
- ineffective airway clearance
Cardiac index
cardiac output per body surface area
normal 2.5-4.0L/min/m2
Central venous pressure (CVP)
- Pressure in the SVC, measures right sided heart function
- Normal = 2-8mmHg
- >6 = excessive volume/right sided HF
- <2 = hypovolemia, dehydration
Pulmonary artery wedge pressure (PAWP)
evaluation of LV filling pressure
normal = 6-12mmHg
Mean arterial pressure (MAP)
,- average pressure in arteries during 1 cardiac cycle
- normal is >65mmHg, ideal 70-100
- calculation: (SBP + 2DBP)/3
Beta blockers
- BLOCK beats
- dampen sympathetic nervous system response, improves LV remodeling, decreases
reoccurrence of ventricular arrhythmias
- do not use in pts with asthma/other pulmonary diseases. bradycardia, heart block
- slows HR, reduces BP, reduced contractility
Calcium channel blockers
- lowers HR and reduce strength of contraction to reduce workload
- increases O2 supply by dilating arteries and reduces O2 demand by decreasing LV
workload
- ex. amlodipine, diltiazem
HMG-CoA Reductase Inhibitors
- "statins"
- inhibits enzyme involved in lipid synthesis --> decreased LDL, triglycerides, total
cholesterol and increased HDL
ACE inhibitors
- inhibits conversion of angiotensin I to II --> lowers peripheral resistance and decreases
BP/afterload
- reduces preload, afterload, and ventricular remodeling
, - indicated for tx of HF, not recommended for initial dx of ADHF
- ex. prils: captopril, lisinopril, enalapril
Angiotensin II Receptor Blockers (ARBs)
- blocks effects of angiotensin II to reduce peripheral resistance --> decreases BP and
afterload
- sartans: losartan, valsartan
Digoxin
- positive inotrope= improved cardiac contractility--> increased CO
- decreases HR, withhold if HR <60
treatment algorithm for CP/MI
MONA - morphine, oxygen, nitroglycerin, aspirin
Inotropic
- force of heart contraction
- positive: digoxin, dobutamine --> improve contractility, increased SV, CO, and O2
demand
- negative: beta blockers, CCBs --> weaken/decrease force of heart contraction
chronotropic
- rate of heart contraction
- positive: epi, atropine
- negative: beta blockers
dromotropic
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Priority nursing diagnoses for cardiac and respiratory patients
- hemodynamic instability
- impaired gas exchange
- fluid/electrolyte imbalance
- ineffective airway clearance
Cardiac index
cardiac output per body surface area
normal 2.5-4.0L/min/m2
Central venous pressure (CVP)
- Pressure in the SVC, measures right sided heart function
- Normal = 2-8mmHg
- >6 = excessive volume/right sided HF
- <2 = hypovolemia, dehydration
Pulmonary artery wedge pressure (PAWP)
evaluation of LV filling pressure
normal = 6-12mmHg
Mean arterial pressure (MAP)
,- average pressure in arteries during 1 cardiac cycle
- normal is >65mmHg, ideal 70-100
- calculation: (SBP + 2DBP)/3
Beta blockers
- BLOCK beats
- dampen sympathetic nervous system response, improves LV remodeling, decreases
reoccurrence of ventricular arrhythmias
- do not use in pts with asthma/other pulmonary diseases. bradycardia, heart block
- slows HR, reduces BP, reduced contractility
Calcium channel blockers
- lowers HR and reduce strength of contraction to reduce workload
- increases O2 supply by dilating arteries and reduces O2 demand by decreasing LV
workload
- ex. amlodipine, diltiazem
HMG-CoA Reductase Inhibitors
- "statins"
- inhibits enzyme involved in lipid synthesis --> decreased LDL, triglycerides, total
cholesterol and increased HDL
ACE inhibitors
- inhibits conversion of angiotensin I to II --> lowers peripheral resistance and decreases
BP/afterload
- reduces preload, afterload, and ventricular remodeling
, - indicated for tx of HF, not recommended for initial dx of ADHF
- ex. prils: captopril, lisinopril, enalapril
Angiotensin II Receptor Blockers (ARBs)
- blocks effects of angiotensin II to reduce peripheral resistance --> decreases BP and
afterload
- sartans: losartan, valsartan
Digoxin
- positive inotrope= improved cardiac contractility--> increased CO
- decreases HR, withhold if HR <60
treatment algorithm for CP/MI
MONA - morphine, oxygen, nitroglycerin, aspirin
Inotropic
- force of heart contraction
- positive: digoxin, dobutamine --> improve contractility, increased SV, CO, and O2
demand
- negative: beta blockers, CCBs --> weaken/decrease force of heart contraction
chronotropic
- rate of heart contraction
- positive: epi, atropine
- negative: beta blockers
dromotropic
