NSG 223 HESI FINAL
Atrial Flutter - answer Appearance: saw tooth pattern, irregular pulse
Rate: 250-400bpm
IF over 150---> immediate cardio version
Treatment: CCB (diltiazem, verapamil), BB (propranolol),
Amiodarone (toxic to lungs--> pulmonary function test)
Cardioversion, antiarrhythmic (procainamide), heparin, warfarin
Catheter ablation--> procedure to destroy the errant electrical pathways
Atrial Fibrillation (A-Fib) - answer Appearance: No P-wave. They are irregular
Treatment: Anticoagulant therapy to prevent forming of clots
Angina Treatment/reason for pain - answer decreased oxygen supply when there is
increased myocardial demand for oxygen.
take nitroglycerin prior to exercises
FIRST step for pain = oxygen can also be used to manage anginal pain due to
increased oxygen demand
The most common cause of angina is CAD
Unstable Angina intervention - answergive nitroglycerin, and call 911 after the 1st dose
acute myocardial infarction cause & goal - answerthe main perpetrator of a MI is CAD
-goal of treatment is to improve blood flow and prevent future complications
mitral valve prolapse (MVP) DX - answer-could be asymptomatic
-Get an Echocardiogram (2d)
- type of heart valve disease that affects the valve between the left heart chambers
(floppy heart)
coronary artery disease (CAD) ACTION - answerAction
- Elevate HOB at 30 degrees
- Laying flat and 90 degrees puts stress of the heart
- Oxygen + Nitroglycerin
cardiomyopathy - answerS/S similar the CHF
- Extra heart sounds
- Cough
- Orthopnea (SOB while lying flat)
- chest pain
Treatment
- Anticoagulants
- Diuretics
, Risk
- pregnancy
-alcohol
Nursing Intervention
- Sit with legs hanging down-pulls water down
Valve Surgery Activity - answeryou can go up the stairs, but limit your activities, do not
drive until 4-6 weeks
Pericarditis pain - answer-NSAIDS are okay
-Pain worse with breathing in
-Fever, SOB
-suggest bedrest until pain is gone
-Friction Rub, Creaky
-Sitting forward can relieve the pain (orthopnic position)
-pain spread to the left shoulder and neck
pulmonary embolism (PE) - answerFirst Priority= Oxygen, keep the patient ventilated
Pharmacological Management: Heparin
Patient will have respiratory acidosis on ABG & Hypoxia
acute respiratory distress syndrome (ARDS) - answerHypoxia- even when the 100%
oxygen is given
- loss of elasticity in lung
- PEEP and Prone position
- HYPOtension
- Confusion and restlessness
- crackles
-bilateral edema
- Very labored breathing
Pneumonia - answerpink frothy sputum
Priority Labs with ARDS - answerO2
CO2
If patient is complaining of chest pain and trouble breathing, 1st action by the RN? -
answerIncrease the HOB
How to prevent recurrence of PE - answeraPTT should be maintained at approximately
1.5-2.5 higher than baseline (normal is 25-35), so therapeutic is 45-70 seconds
Respiratory Acidosis causes - answerCauses:
HYPOventilating --> High levels of CO2
ACUTE
-Shallow breathing
Atrial Flutter - answer Appearance: saw tooth pattern, irregular pulse
Rate: 250-400bpm
IF over 150---> immediate cardio version
Treatment: CCB (diltiazem, verapamil), BB (propranolol),
Amiodarone (toxic to lungs--> pulmonary function test)
Cardioversion, antiarrhythmic (procainamide), heparin, warfarin
Catheter ablation--> procedure to destroy the errant electrical pathways
Atrial Fibrillation (A-Fib) - answer Appearance: No P-wave. They are irregular
Treatment: Anticoagulant therapy to prevent forming of clots
Angina Treatment/reason for pain - answer decreased oxygen supply when there is
increased myocardial demand for oxygen.
take nitroglycerin prior to exercises
FIRST step for pain = oxygen can also be used to manage anginal pain due to
increased oxygen demand
The most common cause of angina is CAD
Unstable Angina intervention - answergive nitroglycerin, and call 911 after the 1st dose
acute myocardial infarction cause & goal - answerthe main perpetrator of a MI is CAD
-goal of treatment is to improve blood flow and prevent future complications
mitral valve prolapse (MVP) DX - answer-could be asymptomatic
-Get an Echocardiogram (2d)
- type of heart valve disease that affects the valve between the left heart chambers
(floppy heart)
coronary artery disease (CAD) ACTION - answerAction
- Elevate HOB at 30 degrees
- Laying flat and 90 degrees puts stress of the heart
- Oxygen + Nitroglycerin
cardiomyopathy - answerS/S similar the CHF
- Extra heart sounds
- Cough
- Orthopnea (SOB while lying flat)
- chest pain
Treatment
- Anticoagulants
- Diuretics
, Risk
- pregnancy
-alcohol
Nursing Intervention
- Sit with legs hanging down-pulls water down
Valve Surgery Activity - answeryou can go up the stairs, but limit your activities, do not
drive until 4-6 weeks
Pericarditis pain - answer-NSAIDS are okay
-Pain worse with breathing in
-Fever, SOB
-suggest bedrest until pain is gone
-Friction Rub, Creaky
-Sitting forward can relieve the pain (orthopnic position)
-pain spread to the left shoulder and neck
pulmonary embolism (PE) - answerFirst Priority= Oxygen, keep the patient ventilated
Pharmacological Management: Heparin
Patient will have respiratory acidosis on ABG & Hypoxia
acute respiratory distress syndrome (ARDS) - answerHypoxia- even when the 100%
oxygen is given
- loss of elasticity in lung
- PEEP and Prone position
- HYPOtension
- Confusion and restlessness
- crackles
-bilateral edema
- Very labored breathing
Pneumonia - answerpink frothy sputum
Priority Labs with ARDS - answerO2
CO2
If patient is complaining of chest pain and trouble breathing, 1st action by the RN? -
answerIncrease the HOB
How to prevent recurrence of PE - answeraPTT should be maintained at approximately
1.5-2.5 higher than baseline (normal is 25-35), so therapeutic is 45-70 seconds
Respiratory Acidosis causes - answerCauses:
HYPOventilating --> High levels of CO2
ACUTE
-Shallow breathing
