PN2 Final Review A2 Winter 2020 - Rasmussen College | NUR 2571 Final Review A2 Winter 2020 - A Grade

PN2 2571 Final Review A2 Winter 2020 - Rasmussen College Final Outline Cardiac Left sided heart failure Causes: blood isn’t moving forward into the aorta and out to the body. If it doesn’t move forward it will go back into the LUNGS s/s: pulmonary congestion (crackles), dyspnea, cough, blood tinged frothy sputum, restlessness, tachycardia (S3), orthopnea nocturnal dyspnea tx: ACE inhibitors, ARBS, diuretics, beta blockers diet: low sodium, no salt substitutes, no processed or canned foods pt. teaching: stop smoking Right sided heart failure Causes: blood isn’t moving forward into the lungs and if it doesn’t move forward it will go backwards into the VASCULAR SYSTEM s/s: distended neck veins (JVD), edema, enlarged organs, weight gain (shoes get tighter), ascites, nocturia, increased aortic pressure tx: ACE inhibitors, ARDS, diuretics, beta blockers pt. teaching: stop smoking Infective Endocarditis Precautions: give antibiotics before dental work Standard precautions Diagnosing: blood test for bacteria, CBC for anemia, and an echocardiogram Pericarditis s/s: characterized by pain in the precordial area (over the heart and lower thorax) which is aggravated by breathing and twisting movements non pharmalogical pain interventions: give a pillow to splint their breathing where to hear a rub: pericardium (over the heart and lower thorax) left sternal border meds for: antibiotics and anti-inflammatory drugs HTN s/s: HEADACHE, angina, dyspnea, palpitations, dizzy, fatigue what is essential HTN: primary hypertension and the cause is unknown Pulse Pressure How to figure it out: subtracting diastolic blood pressure from systolic blood pressure Systolic – diastolic Vascular Aneurysms S/s: hypotension, tachycardia, pallor, cool and clammy skin, and abdominal/back pain what not to do: do not palpate the abdomen – risk for rupture causes: hypertension and smoking risk factors: smoking, high blood pressure DVT Pt. goals: oxygen saturation at 98% non pharmalogical pain interventions: elevation, elastic supports, warm soaks, - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - Pneumococcal pneumonia – s/s: fever, chills, chest pain when breathing, SOB, cough, blood stained or rusty sputum (phlegm), drowsiness (excessive sleepiness), confusion COPD s/s: persistent dyspnea on exertion and reduced airflow, wheezing, chronic cough, barrel chest Nsg interventions: fowlers or orthopneic position, small frequent meals, don’t exceed 3L/min of oxygen, increase fluid intake, avoid irritants, avoid extreme hot/cold Gerd s/s: what to assess: Peptic Ulcers Medications for, know the classes and actions of the meds - Ranitidine: H2 antagonist that reduces acid in the stomach - Famotidine: H2 antagonist that blocks the action of histamine and reduces production of acid- promotes healing of ulcers and pain - Sucralfate: forms a barrier over wound so acid can’t get on - Omeprazole: proton pump inhibitor that decreases acid secretion s/s: burning pain on the mid epigastric area/back & heartburn diet: Avoid extreme temperatures, spicy foods, and acidic foods pt. teaching: decrease stress and bad eating habits (fast food), stop smoking complications of: -Gastric ulcer: laboring person, malnourished, pain is half an hour to an hour AFTER MEALS, FOOD DOES NOT HELP – but vomiting does -Duodenal ulcer: executives, well-nourished, night time pain is common 2-3 hours after eating. BLOOD IN STOOL. Cold drinks and eating helps. Inflammation Rheumatoid Arthritis S/s: morning stiffness, pain at rest and with movement, joint pain/swelling, lack of function, warmth, erythema, boutonniere deformity Treatment: NSAIDS, corticosteroids (exacerbations), DMARDS, antibiotics (infection) what to avoid: alcohol