Kim's study question answers

What is angina?
Chest pain, exertion- exercise, emotion, eating

Pt w/ essential hypertension, what is the cause and/or symptoms?
Unknown, asymptomatic

What is a serious complication of HTN?
Cardiomyopathy, kidney failure – watch creatinine level 0.5-1.5mg/dl

**What is digoxin? Causes?
Negative chronotrop, positive inotrop

What part of the ECG makes the ventricles work?
QRS interval

What part of the ECG makes the atria work?
P wave

How does cardizem help you?
Blocks ca channels in the heart and blood vessels. It will lower BP through arteriol dilation.
* Used for Angina, HTN, and dysrhthmias

Pt. has activity intolerance r/t reduced cardiac reserve and enforced bedrest. Before you let them get up what are you going to do?
check blood work for Sed rate (erythrocyte sedimentation rate) and make sure normal.T
heir pulse should be less than 150

Sed is useful for?
Monitoring the course of inflammatory activity in rheumatic diseases

When doing pt. teaching first you want to:
assess their level of understanding

Pt. has had a splenectomy (spleen removed), what will be impaired?
Their immune system, and they will need a pneumonia and flu vaccine.

The most common adverse effect to chemo?
Nausea & vomiting

To combat the most adverse effect to chemo?
give antiemetics

ABCDE in assessing skin cancer, what do they stand for?
Assemetry, border, color, diameter, elevation

A pt. has ACS, what did they come in with?
chest pain, acute coronary syndrome, any chest pain is referred to as this

Beta-blockers- how can you tell if they are being effective?
By reducing the heart rate
Decrease the effects of norepineferine
Inhibit the sympathetic nervous system
End in ol / lol

Ace-Inhibitors
Block angiotension from being converted to renin; thus decreasing afterload, used for cardiomyopathy

If you have PVC, what electrolytes are off?
Potassium, decreased cardiac output & using more O2 due to decreased filling pressures

Why do TENS unit work?
Delivery of electric current thru electrodes connected by lead wires to a small battery operated simulator

Which would predispose your pt. to correctal cancer?
Having polyp formation

Pt. has GI bleed, what kind of diet should they have?
NPO

Pt. is having a peritoneal lavage what is contraindicated?
Having a full bladder, they need to empty their bladder

Your 70 yr. old pt. wants to get up and use bathroom. He has pain, is anemic, and weak. How are you going help him?
Get a bedpan for him to use

Real estate agent smokes a pack a day and drinks several cocktails in the evening, what is the most powerful contributor to their Coronary Artery Disease?
smoking

When assessing a HTN pt. what do they most commonly experience?
NOTHING, they are many times asymptomatic

Dietary control of HTN in addition to a sodium restriction is?
Grains 8 serve
Vegie 4.5 serve
Fruit 5 serve
Low fat / fat free foods 3 serve
Meat, poultry, fish 2 serve
Nuts, seeds, dry beans 4-5 serve/week
Fats & oils 2-3 serve
Sweets 5 serve/week
* IF IT TASTES GOOD SPIT IT OUT!! DASH DIET!

What are target organs secondary to HTN?
kidneys, KIDNEY FAILURE! Water retention - need to look at BUN and creatinine

Petechia are related to?
Aspirin products

What do you measure when client is taking heparin?
PTT or aPTT (same type of test)

What do you measure when pt. taking coumadin?
INR, PT, PTT

What do you tell a pt. eating green leafy veggies with anticoagulants?
eat same amount everyday

Vegan pt. has anemia what are some things they can eat to increase their iron?
Legumes, whole grains, wheat products – this have higher iron content

Pernicious anemia pt. that is a vegan will need?
B12 shots for the rest of their life

**Calculate MAP


A shift in the location of the PMI indicates?
enlarged heart, left sided heart failure

When talking with a pt. regarding pt. efforts to control cardiac disease you speak of?
preventative measure


Troponin why monitor?
heart failure. Additional tests include ck, ckmb, myglobin

What would you advise the client that would have the maximum amount of impact on that pts. Health of HTN?
Having a sedentary lifestyle.
Alcohol use is the 2nd best answer

What are challenges faced by 65 year old?
Some wrong answers are: managing home, developing licensure activities, and selecting a vocation

Acute Coronary Syndrome tx:
MONA, not in that order
Oxygen, Aspirin, Nitrates, Morphine

PMI location
5th intercostal, 2” left of the midline

Clubbed fingers indicates?
Inadequate oxygen to digits, prolonged O2 deficiency

CHF is
#1 admitting dx. For pts. 65 & older, readmission is mainly due to noncompliance

** Cardiomyopathy


Myocardial infarction
Death to an area of the heart, TISSUE IS TIME!!!

Distended neck veins / jugular vein distention indicates
Elevated right arterial pressure

Myocardial Infarction blood studies include
CK-creatine kinase, LDH-lactic dehydrogenase, AST-serum asparte aminotransferase (formerly SGOT)

Preload
The volume of blood in the ventricles @ end of diastole

Afterload
The peripheral resistance against which the ventricle must pump

Medication the a pt. will take to combat breast cancer
Tamoxifin
Hep A
Interferon ( page 1110), antiviral

CHF: serious complications; risk factors, causes, symptoms
Risk factors: Hypertension, CAD, MI, obesity, diabetes, hyperlipidemia

INR lab test is used for
Coumadin

Included in pain assessment tool
Pattern of pain, area of pain, intensity of pain, nature of pain

Transdermal pain relief
For a pt. that can’t tolerate PO meds
Absorbtion is slow for some of the meds

A 42 yr. old male that drinks & smokes is prone to?
Coronary Artery Disease, teach no smoking!

Male testicular exams should start at
Should start at the start of puberty

P wave
Atrial depolarization / 0.06-0.12 sec / precedes QRS-T waves

QRS wave
Ventricular depolarization / 0.04-0.12 sec / follows each p wave

T wave
Ventricular repolarization / 0.16 sec / follows each QRS wave

PR interval
Timing 0.12-0.20 / should not vary from one complex to another

QT interval

Timing varies w/ pulse rate0.31-0.38 sec @ HR of 72 beats/min – should not vary from one complex to another. Should not be more than half the preceding RR interval

RR interval
Timing varies w/ pulse rate / should be equidistant w/ slight variations on respirations

No P wave
Atrial fibrillation

Ventricles work
QRS wave

Atrials work
P wave

Your pt. has pancreatitis, why are they NPO?
To decrease pancreatic secretions

Stable angina is
Predictable

Unstable angina is
Unpredictable – occurs @ rest

What are some early signs of pulmonary edema?
Coughing, crackes, F ailure- left ventricular, O rthopnea, W heezing, L ung congestion, E mergency, R estless, S kin- cyanotic

A weight concern for a pt. w/ heart failure is?
gain of 5# in 3 days

Pt taking clonadine & thiazide
must stop meds, can’t take together

Taking beta-carotene, what theory is this
Free-radical theory

Man that is non compliant w/ heart meds #1 reason
They cause impotence

Aging & constipation
Increase activity & strengthen abd.

PVC causes
Caffeine, stimulants

Edema in legs causes
Nocturia, nocturnal dyspnea, keep pt. semi-fowlers position to sleep

Complication of a fibrinolytic
The clot-busters, check for scaps or bleeding, we don’t want this, they will become a bleeder!

Hospice
Referred by doctor, pt must accept care, 6 months to live

Lab values for prostate cancer PSA
Prostate specific antigen < 4 mcg/L
If higher than value above it’s cancer

**Increase in stress for families w/ dementia family member causes are
Lack of support


**Time limit after exposure to Hep A & B




**What to do w/ GI bleed



What to do with stomatitis
Bland diet, rinse mouth frequently normal saline lidocaine wash

Responsibility for tube feeding
Check placement, flushing, change tubing every 24 hr or manufacture guidelines = pump tubing, keep head elevated during & 30 min. after feeding

**Know basics of CPR


**Malnutrition related to CHF
ensure


How to feed pt w/ bowel resection
Advanced as tolerated diet clear-full etc.

Ischemia drug given
Cardizem, calcium channel blocker