3800 exam 2
● Valsartan→ potassium levels and kidney function, lowers BP and afterload
● Mitral stenosis→ what does it sound like? Low pitched rumbling diastolic,
best heard at apex
○ Can lead to a dysrhythmia→ a fib, if uncontrolled→
cardioversion, asymptomatic→ monitor patient
○ Rheumatic heart disease
● Mitral regurgitation→ BLOWING at apex, goes with prolapse, manifests as
sudden HF
● Valve issues side effects→ DOE
● Water hammer sign→ aortic regurgitation
● KNOW VALVES!!!!!!!!!!!!!!!!!!!!! What goes with regurgitation for mitral valve
○ Mitral stenosis→ low pitch
○ Mitral regurg→ whooshing
○ Mitral prolapse→ click, extra heart sound
○ Aortic stenosis→ prominent s4, crescendo-decrescendo murmur,
GENERALLY RADIATES TO THE BACK, rheumatic endocarditis
○ Aortic regurg→ high pitch murmur during ventricular diastole, water
hammer sign
● ARBS
● Valve side effects
● Geriatric normal aging things→ lower BP, murmurs, s4
● If biomarkers are normal, watch patients!!!
● What is happening to the heart in heart failure→ ineffective ability to pump
blood, can’t keep up with body's demands, increased cardiac workload
● V FIB→ squiggles- Cpr then shock
● Symptomatic bradycardia→ give atropine, causes: straining, vagal
stimulation, hypoxemia, valsalva
● Crackles in lungs with HF patients→ what else can you hear? Wheezing,
rails, moist sounds
● Don’t tell doc if they have a little fatigue or appetite
● Signs of left sided heart failure→ fatigue, paroxysmal dyspnea, sleeping
propped up, cough, coughing pink frothy sputum, do not want weight gain
of more than 1 pound a day
● Cardiac tamponade signs→ muffled heart sounds, hypertension, tachycardia
○ EMERGENCY, EKG TO CONFIRM
● Pericarditis, can relieve pain by sitting up and leaning forward
● 23.2, page 734, nitrates short term vasodilators
● Pulse deficit w/ uncontrolled A FIB apical and radial pulses, increase ischemia
● Calcium channel blockers for people who can't use beta blocker
● If someone comes in with chest pain→ first get vital signs
● Antidote for heparin→ protamine
● Teachings for chronic venous insufficiency→ don’t keep legs in
dependent position, compression stockings, put your legs up
● Teaching for active DVT→ DO NOT WALK
● DASH diet→ low sodium low fat low cholesterol
, ● ABGs for respiratory→ increased CO2, decreased O2
● Tripod position→ sign of respiratory compromise
● TB meds→ 6-9 months, teachings for TB, avoid foods with tyramine and
histamine, red wine, tuna
○ Hygiene measures
○ Reported to health department
● Interventions for acute exacerbation of COPD→ bronchodilators, sit them
up, monitor oxygen levels
● Corticosteroids→ hyperglycemia
● Pleurisy→ teaching points, can use hands pillows or arms for splinting,
turn ONTO affected side, stretching of the pleura
● No neck Ed/obesity hypoventilation syndrome→ fat people in low fowlers
● Sputum culture steps→ clear nose and throat, rinse out mouth, few deep
breaths, cough and expectorate fluid from lungs, do it first thing in the
morning
○ IF CAN’T COUGH, NEBULIZER
● Can obstructive sleep apnea being managed with surgery and lifestyle
changes→ yes
● Barrel chest→ COPD, 2:2 AP diameter
● Emphysema→ looking at oxygen on ABG, so if there is decrease, that is really
bad
● Cheynes stokes and biots, know the differences
● Pleural effusion thoracentesis nursing interventions→ positioning of
patient, offers support, record fluid amount and send to lab
● Meds long term antibiotics→ high infection risk for multidrug
resistant organism infections and pneumonia
● Enteral nutrition→ aspiration pneumonia with bolus’
● Infective endo→ school children after strep infection
● Endocartis→ drug users or
● Pericarditis→ scratchy friction rub, first sign chest pain, pain relieved
with sitting up leaning forward
EXTRA SHIT
Loiw pitched rumbling best heard at apex→mitral
stenosis Aortic→ murmur, mitral→ no
AFIB→ manual cuff
● Valsartan→ potassium levels and kidney function, lowers BP and afterload
● Mitral stenosis→ what does it sound like? Low pitched rumbling diastolic,
best heard at apex
○ Can lead to a dysrhythmia→ a fib, if uncontrolled→
cardioversion, asymptomatic→ monitor patient
○ Rheumatic heart disease
● Mitral regurgitation→ BLOWING at apex, goes with prolapse, manifests as
sudden HF
● Valve issues side effects→ DOE
● Water hammer sign→ aortic regurgitation
● KNOW VALVES!!!!!!!!!!!!!!!!!!!!! What goes with regurgitation for mitral valve
○ Mitral stenosis→ low pitch
○ Mitral regurg→ whooshing
○ Mitral prolapse→ click, extra heart sound
○ Aortic stenosis→ prominent s4, crescendo-decrescendo murmur,
GENERALLY RADIATES TO THE BACK, rheumatic endocarditis
○ Aortic regurg→ high pitch murmur during ventricular diastole, water
hammer sign
● ARBS
● Valve side effects
● Geriatric normal aging things→ lower BP, murmurs, s4
● If biomarkers are normal, watch patients!!!
● What is happening to the heart in heart failure→ ineffective ability to pump
blood, can’t keep up with body's demands, increased cardiac workload
● V FIB→ squiggles- Cpr then shock
● Symptomatic bradycardia→ give atropine, causes: straining, vagal
stimulation, hypoxemia, valsalva
● Crackles in lungs with HF patients→ what else can you hear? Wheezing,
rails, moist sounds
● Don’t tell doc if they have a little fatigue or appetite
● Signs of left sided heart failure→ fatigue, paroxysmal dyspnea, sleeping
propped up, cough, coughing pink frothy sputum, do not want weight gain
of more than 1 pound a day
● Cardiac tamponade signs→ muffled heart sounds, hypertension, tachycardia
○ EMERGENCY, EKG TO CONFIRM
● Pericarditis, can relieve pain by sitting up and leaning forward
● 23.2, page 734, nitrates short term vasodilators
● Pulse deficit w/ uncontrolled A FIB apical and radial pulses, increase ischemia
● Calcium channel blockers for people who can't use beta blocker
● If someone comes in with chest pain→ first get vital signs
● Antidote for heparin→ protamine
● Teachings for chronic venous insufficiency→ don’t keep legs in
dependent position, compression stockings, put your legs up
● Teaching for active DVT→ DO NOT WALK
● DASH diet→ low sodium low fat low cholesterol
, ● ABGs for respiratory→ increased CO2, decreased O2
● Tripod position→ sign of respiratory compromise
● TB meds→ 6-9 months, teachings for TB, avoid foods with tyramine and
histamine, red wine, tuna
○ Hygiene measures
○ Reported to health department
● Interventions for acute exacerbation of COPD→ bronchodilators, sit them
up, monitor oxygen levels
● Corticosteroids→ hyperglycemia
● Pleurisy→ teaching points, can use hands pillows or arms for splinting,
turn ONTO affected side, stretching of the pleura
● No neck Ed/obesity hypoventilation syndrome→ fat people in low fowlers
● Sputum culture steps→ clear nose and throat, rinse out mouth, few deep
breaths, cough and expectorate fluid from lungs, do it first thing in the
morning
○ IF CAN’T COUGH, NEBULIZER
● Can obstructive sleep apnea being managed with surgery and lifestyle
changes→ yes
● Barrel chest→ COPD, 2:2 AP diameter
● Emphysema→ looking at oxygen on ABG, so if there is decrease, that is really
bad
● Cheynes stokes and biots, know the differences
● Pleural effusion thoracentesis nursing interventions→ positioning of
patient, offers support, record fluid amount and send to lab
● Meds long term antibiotics→ high infection risk for multidrug
resistant organism infections and pneumonia
● Enteral nutrition→ aspiration pneumonia with bolus’
● Infective endo→ school children after strep infection
● Endocartis→ drug users or
● Pericarditis→ scratchy friction rub, first sign chest pain, pain relieved
with sitting up leaning forward
EXTRA SHIT
Loiw pitched rumbling best heard at apex→mitral
stenosis Aortic→ murmur, mitral→ no
AFIB→ manual cuff
