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37 Cards in this Set
- Front
- Back
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What is the criteria for metabolic syndrome?
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1. Hypertension
2. hypertriglyceridemia - waist circumference of greater than 102cm in males and 88cm in females - fasting blood sugar greater than or equal to 110mg/dL -HDL less than 40mg/dL in men |
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When assessing the medication of a patient with heart disease the nurse would be most concerned when the patient reports frequent use of what medication and why?
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Decongestants because they cause vasoconstriction and contribute to hypertension and cardiac arrhythmias
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How is the degree of othopnea best measured?
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By the number of pillows hte person sleeps on at night
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What does an S3 sound represent?
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S3 sound is a marker or systolic dysfunction - they are heard early during diastolic and are associated with ventricular dysfunction
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What does S4 sounds represent?
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Diastolic dysfunction. (conduction defects are not heard as heart sounds and alterations in the mitral valve are heard as abnormal S1 sounds)
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What catagorizes someone as prehypertensive?
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individuals with a blood pressure finding on two or more visits of 130-139/80-89
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What catagorizes someone as Hypertension stage I??
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individuals with a blood pressure finding of 140-159 systolic or 90-99 diastolic
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What catagorizes someone as Hypertension stage II?
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multiple measurements of a systolic pressure greater than 160 or a diastolic that exceeds 100
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What factors have a direct influence on the regulation of blood pressure?
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-Cardiac output
-Peripheral vascular resistance -Baroreceptors -Chemoreceptors -Body fluid volume (CO X PVR= BP) |
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What are risk factors for hypertension?
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-Age (older than 55 in men and 65 in women)
-Males -African American's -obesity, smoking, excessive alcohol, sedentary lifestyle, stress |
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What should the nurse instruct the patient to do when taking nifedipine (a calcium channel blocker)?
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Not to crush, break in half, or chew the extended release form of the drug
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When taking a loop diuretic, what food is necssary to add to the patients diet?
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Potassium
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What drug is the side effect "dry cough" most associated with?
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ACE inhibitor
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What medication requires teaching blood pressure and pulse prior to medicating?
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Beta-adrenergic blocking agents. if pulse is below 60 inform healthcare provider.
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What culture has a 3 to 4 time higher risk of angioedema and cough atrributed to ace inhibitors?
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African Americans
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Individuals living in what reason have significant increases in blood pressure?
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Southeastern Region (Salt Belt)
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What type of diet is recommended for individuals in all stages of hypertension?
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a diet rich in fruits, vegtables, and whole grains, and low in sodium and saturated fats
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What is a good weight loss goal of someone trying to lose weight?
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1 to 2 lbs a week
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A priority patient outcome for an individual with long-term Stage 2 hypertension would include?
A. Avoiding use og genericbrands of anti-hypertensive meds B. Verbilizing the Warning signs and symptoms of cerebral vascular accident C. Maintaing healthy, supportive relationships D. Recording Blood Pressure measurements once a month with home monitoring |
B. Verbalizing the warning signs and symptoms of cerebral vascular accident
--High blkood pressure is called the "silent killer" - and is the leading cause of cerebral vascular accident. |
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What are the risk factors for heart failure?
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-History of:
-Hypertension -Coronary artery disease -Obesity -Diabetes -Structural and valvular disorders (aortic stenosis) |
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When caring for a patient with systolic dysfunction the nurse anticipates the patient will exhibit symptoms related to which cardiac condition?
A. Decreased cardiac output B. Aortic stenosis C. Mitral regurgitation D. Bradycardia |
A. Decreased cardiac output
(systolic dysfunction affects cardiac output, where as mitral regirgitation and aortic stenosis affects heart rate. |
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The nurse understands when a patient with heart failure experiences a decrease in cardiac output, the following neurohormonal responses will occur
A. Activation of SNS B. Avtivation of PNS C. Activation of RAS D. supression of cytokine release |
A. Activation of the sympathetic nervous system
--This will increase blood volume and rate of contractibility, the PNS would further decrease the heart rate, cytokines are released NOT supressed. |
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Which of the following symptoms should the nurse expect to see in a patient with Left sided heart failure?
A. Weight gain B. Anorexia C. Dyspnea D. Peripheral edema |
C. Dyspnea
-Dyspnea is seen secondary to pulmonary congestion, which occurs mostly in left sided heart failure. Right sided failure causes venous congestion with fluid accumulation in the interstital spaces, manifested by weight gain, anorexia, nausea, and peripheral edema |
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The nuese checks the brain naturietic peptide, (BNP) levels of a patient admitted with dyspnea and activity intolerance, becaue the levels are normal the nurse concludes:
A. a diagnosis of heart failure can be excluded B. the client has long standing heart failure C. the client is most likely expierencing cardiac ischemia D. The symptoms are related to pulmonary tissue damage |
A. a diagnosis of heart failure can be excluded
-elevated levels correlate with heart failure, increased risk of mortality, acute MI, PE and renal failure, and cardiac ischemia. Pulmonary tissue damage can not be diagnosed with BNP levels |
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The nurse should anticipate treatment for a patient with stage B heart failure to include what?
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-Ace inhibitors will reduce the afterload
-Beta-blockers (as well as a antihypertensive and diuretic will reduce the workload |
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At what stage of heart failure will the physician insert a defibrillator?
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Stage C heart failure
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What is the most important key concepts that patients with heart failure should learn to incorporate into their daily lives?
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MAWDS. Medication, Activity, weight, diet, symptoms
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What diseases have been shown to worsen the prognosis of patients with heart failure?
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Depression, anemia, renal insufficiency, hypertension, coronary heart disease, and sleep apnea
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A patient is in end stage heart failure and the family asks what they should anticipate. The nurses recognizes the need to address the following:
A. The lack of hearts available for heart transplant B. Plabs for treatment in the final stages of heart failure C. Long term home care management D, Surgical interventions to correct structural abnormalities of the heart |
B. Plans for treatment int the final stages of heart failure
-at the end stage transplants and surgical interventions are not options |
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In an ECG what does the P-wave represent?
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contraction or pepolarization of the atria
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In an ECG, What does a PR interval represent?
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the time time it takes for the impulse to travel from the SA node down the intra-atrial pathways to the ventricles
AKA-- the beginning of the atrial contaction to the beginning of the ventricular contraction. |
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In an ECG, What does the QRS complex represent?
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Depolarization - it is the vertical jolt in the ECG
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In an ECG, what does the ST segment represent?
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a line extending from the S wave that gradually curves upward to the T wave. It signifies ventricular repolarization
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In an ECG, what does the T wave represent?
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Repolarization - this is often referred to as the resting phase of the cardiac cycle
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When is the U wave present?
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the U wave is most frequently seen with low potassium levels
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What is the difference between Sinus bradycardia and normal sinus rhythm?
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the heart rate. The SA node is firing less than 60 bpm, and the QT interval tends to lenghen
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What does sinus tachycardia result in and what does the ECG look like?
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Results in increased oxygen consumption, increased workload, and decreased cardiac output
-Atrial and ventricular heart rates are over 100 bpm -PR interval and the QT interval tend to shorten slightly |
