Otc Lpn Adult Health Chapter 8 Care Of The Patient With Cardiovascular Disorder

Front 1

aneurysm

Back 1

An enlarged, dilated portion of an artery that is more than 1.5 times the artery's circumference. Must involve all 3 layers, or tunics. Monitor BP.

Front 2

angina pectoris

Back 2

severe, thoracic pain and choking feeling caused by anoxia of the mycocardium

Front 3

arteriosclerosis

Back 3

thickening, loss of elasticity, and calcification of arterial walls, resulting in decreased blood supply

Front 4

atherosclerosis

Back 4

yellowish plaques of cholesterol, lipids & cellular debris in inner layers of walls of arteries.

Front 5

B-type natriuretic peptide (BNP)

Back 5

neurohormone secreted by heart in response to ventricular expansion. BNP >100pg/mL=HF

Front 6

cardioversion

Back 6

procedure to restore fast or irregular heartbeat by delivery of electric shock

Front 7

coronary artery disease (CAD)

Back 7

Term to describe a varierty of conditions that obstruct blood flow in the coronary arteries

Front 8

defibirillation

Back 8

Termination of ventricular fibrillation by delivering direct countershock to patient's precordium.

Front 9

dysrhythmia

Back 9

any cardiac rhythm that deviates from normal sinus rhythm

Front 10

embolus

Back 10

thrombus, air, gas, tissue or foreign object that circulates in the bloodstream until it becomes lodged in a vessel

Front 11

endarterectomy

Back 11

surgical removal of the intimal lining of an artery

Front 12

heart failure (HF)

Back 12

circulatory congestion as a result of the heart's inability to act as an effective pump

Front 13

hypoxemia

Back 13

abnormal deficiency of oxygen in the arterial blood; often noted in HF

Front 14

intermittent claudication

Back 14

weakness of legs with cramplike pains in calves caused by poor circulation of arterial blood to leg muscles

Front 15

ischemia

Back 15

decreased blood supply to an organ or body part; pain and organ dysfunction

Front 16

myocardial infarction (MI)

Back 16

occlusion of a major coronary artery or one of its branches with subsequent necrosis of myocardium caused by atherosclerosis or an embolus

Front 17

occlusion

Back 17

an obstruction or closing off in a canal, vessel or passage of the body

Front 18

orthopnea

Back 18

patient must sit or stand to breathe deeply or comfortably

Front 19

peripheral

Back 19

pertaining to the outside, surface or surrounding area

Front 20

pleural effusion

Back 20

an abnormal accumulation of fluid in the thoracic cavity between the visceral and parietal pleurae

Front 21

polycythemia

Back 21

abnormal increase in number of RBC

Front 22

pulmonary edema

Back 22

accumulation of extravascular fluid in lung tissues and alveoli, most often caused by HF

Front 23

bradycardia

Back 23

slow rhythm; < 60 bpm

Front 24

tachycardia

Back 24

rapid, regular rhythm originating in SA node; 100-150 bpm or more

Front 25

supraventricular tachycardia

Back 25

sudden onset of rapid heartbeat, starts in atria; 150-250 bpm

Front 26

atrial fibrillation

Back 26

disorganized electrical activity in atria causing quivering rather than contracting; 350-600 bpm

Front 27

premature ventricular tachycardia (PVCs)

Back 27

abnormal heartbeats that come from left or right ventricle

Front 28

ventricular tachycardia (VT)

Back 28

saw blade; when three or more PVCs occur; regualr or slightly irregular rhythm; greater than 100 bpm, usually 140-240 bpm; lidocaine is used only if myocardial ischemia or MI is suspected cause

Front 29

ventricular fibrillation

Back 29

emergency; ventricular musculature of heart is quivering; CPR and defibrillation is needed

Front 30

atrioventricular block (AV)

Back 30

occurs when a defect in the AV junction slows or impairs conduction of impulses of SA node to ventricles; 3 types of blocks, 1st, 2nd, & 3rd

Front 31

fluroscopy

Back 31

action-picture radiograph; allows observation of movement; invaluable in pacemaker or intracardial catheter placement

Front 32

CABG

Back 32

coronary artery bypass graft

Front 33

LMWH

Back 33

low-molecular-weight heparin

Front 34

infective endocarditis

Back 34

infection or inflammation of the inner membranous lining of the heart, esp. the heart valves

Front 35

IV med for MI dysrhythmias

Back 35

lidocaine

Front 36

Pt. w/right sided heart failure would be comfortable in what position?

Back 36

dorsal recumbent

Front 37

Pt w/chronic arterial insufficiency needs further instruction if he says ________

Back 37

"I will drink hot coffee several times a day to increase the circulation and warmth in my feet"

Front 38

NYHA Class IV

Back 38

severe

Front 39

Nursing intervention for NYHA Class IV pt. wanting to ambulate & use restroom

Back 39

Offer urinal or bedpan

Front 40

Nursing intervention for NYHA Class IV and +4 edema

Back 40

elevate lower extremities

Front 41

To decrease s/sx of Buerger's Disease

Back 41

quit smoking

Front 42

complete bed rest

Back 42

Pt must remain as quiet as possible, w/any task requiring physical effort done for him

Front 43

An old term defined as the condition in which the patient suffers peripheral or pulmonary congestion is called:

Back 43

congestive heart failure (CHF)

Front 44

Nursing intervention for patient w/infective endocarditis who has activity intolerance and generalized weakness.

Back 44

decreased activity

Front 45

Holter monitor

Back 45

portable EKG device

Front 46

After flu-like illness, pt complains of chills & small petechiae in his mouth and legs. A heart murmur is detectable. These are characteristic signs of:

Back 46

Infective Endocarditis

Front 47

A patient is admitted w/diagnosis of possible aortic aneurysm. Most important to monitor:

Back 47

blood pressure

Front 48

What is defined as a distended dilated segment of an artery?

Back 48

Aneurysm

Front 49

Dependent edema of the extremities, enlargement of the liver, oliguria, jugular vein distension, and abdominal distension are s/s of:

Back 49

Right-sided heart failure

Front 50

A pt w/newly diagnosed HTN tells nurse he uses alot of salt on his foods & has not been able to lose 30 lbs that he has gained in last 10 years. He doesn't understand why he is HTN since he's not an anxious person. Which nursing diagnosis does the nurse identify for this patient?

Back 50

Ineffective health maintenance related to lack of knowledge of disease process and management

Front 51

A patient, 72, was admitted to the medical unit w/diagnosis of angina pectoris. Characteristic s/s of angina pactoris include:

Back 51

Substernal pain that radiates down the left arm

Front 52

56 y/o patient was admitted to the emergency room with an MI. Cardiac enzymes were drawn. In a patient with an MI, which lab values would be abnormal?

Back 52

Elevated levels of serum glutamic oxaloacetic transaminase (SGOT) (AST), Creatine phosphokinase (CPK-MB), and Lactic dehydrogenase (LDH), Troponin 1

Front 53

Restlessness, diaphorisis, severe dyspnea, tachypnea, hemotysis, audible wheezing, and crackles are s/s of:

Back 53

Pulmonary Edema

Front 54

Nurse identifies problem of potential complication--pulmonary edema--for a patient in acute CHF. For which early symptom of this problem does the nurse asses?

Back 54

Pink, frothy sputum

Front 55

left-sided heart failure

Back 55

Orthopnea with bubbling crackles throughout the lungs

Front 56

third degree heart block

Back 56

A defect in AV junctions slows and impairs conduction of impulses from the SA node to the ventricles.

Front 57

In evaluating pain for the management of MI, the most important aspect using objective data is:

Back 57

vital signs during painful periods

Front 58

A type of medication useful for preventing venous thrombus is:

Back 58

low-molecular-weight heparin (LMWH)

Front 59

A thrombectomy is done to:

Back 59

prevent the flow of emboli to the lungs

Front 60

Nursing intervention that reduces myocardial oxygen demand:

Back 60

Elevating the head of the bed 30 to 45 degrees

Front 61

Another name for Buerger's disease

Back 61

thromboangiitis obliterans

Front 62

In older adults, rapid infusion of fluids can lead to:

Back 62

heart failure

Front 63

Edema and pulmonary congestion are treated with:

Back 63

diuretics, restriction of sodium diet and fluid intake

Front 64

Which would be included in teaching for patients with Raynaud's disease?

Back 64

Use mittens in cold weather, Practice stress-reducing techniques, Complete smoking cessation, Use caution when cleaning the refrigerator or freezer

Front 65

Which information should be taught to patients starting on anticoagulant therapy?

Back 65

Take medication at the same time each day, Report to physician cuts that don't stop bleeding with direct pressure.

Front 66

The functions of the cardiovascular system are to:

Back 66

deliver O2 and nutrients to cells; remove CO2 and waste products from the cells

Front 67

Three kinds of blood vessels are organized for carrying blood to and from the heart

Back 67

veins, arteries, capillaries

Front 68

When assessing a patient MI, objective data includes:

Back 68

HTN, vomiting, diaphoresis, cardiac rhythm changes

Front 69

Signs of digoxin (Lanoxin) toxicity

Back 69

nausea, bradycardia, headache, VISUAL DISTURBANCE

Front 70

Serium cardiac markers are________ that indicate cardiac muscle damage after a MI.

Back 70

proteins

Front 71

B-type natriuretic peptide (BNP) is a ___________, which is secreted by the heart in response to an expanded left ______________.

Back 71

neurohormone; ventricle

Front 72

An _____________is an enlarged, dilated portion of an artery and may be the result of arteriosclerosis, trauma, or a congenital defect.

Back 72

Aneurysm

Front 73

When a patient suddenly experiences respiratory difficulty in the cafeteria, the nurse begins assessment for foreign body airway obstruction. The most appropriate question to the victim is:

Back 73

"Are you choking?"

Front 74

The patient arrived at the emergency department in pain and bleeding profusely with the following vital signs: BP 80/54, P 102, RR 22. The nurse recognizes these symptoms as indicative of:

Back 74

Circulatory Shock

Front 75

After CPR has been initiated on an adult patient, the nurse assesses the effectiveness of CPR by confirming:

Back 75

a palpable carotid pulse during each compression

Front 76

Mrs. Jones is pulseless and has a rhythm with visible P waves, narrow QRS complexes associated with P waves, and a rate of 130 beats/min on the cardiac monitor. Which of the following would best describe the rhythm?

Back 76

Pulseless electrical activity

Front 77

Ventricular depolarization is shown on the rhythm strip as a

Back 77

RS complex

Front 78

The normal PR interval is _____ second

Back 78

0.12 to 0.20

Front 79

The normal QRS duration is ________second

Back 79

0.06 to 0.10

Front 80

If a ventricular rhythm is regular, then each

Back 80

R wave is equidistant from the next R

Front 81

A rhythm originating in the sinoatrial (SA) node with a rate of 112 is called

Back 81

sinus tachycardia

Front 82

May cause bradycardia

Back 82

Medications with negative chronotropic activity

Front 83

The sawtooth waveform of atrial flutter is formed by an irritable focus in the

Back 83

atrial tissue

Front 84

The quivering of the atria in atrial fibrillation results in:

Back 84

a loss of atrial kick

Front 85

A prolonged PR interval is called

Back 85

first-degree heart block

Front 86

assessed to monitor for injury to the cardiac muscle

Back 86

ST segment

Front 87

A complication of prolonged tachycardia is

Back 87

decreased cardiac output

Front 88

patient that might require a pacemaker

Back 88

A 45-year-old acute MI patient with a HR of 45 and a BP of 80/50

Front 89

Vagal stimulation (e.g., carotid massage) usually results in:

Back 89

decreased heart rate

Front 90

methods for temporary pacing include

Back 90

epicardial pacemaker, transcutaneous pacemaker, transvenous pacemaker

Front 91

ACE inhibitors

Back 91

-pril; lisinopril

Front 92

beta blockers

Back 92

-olol, metoprolol

Front 93

diuretics

Back 93

HCTZ, Aldactone, Lasix

Front 94

thiazide diuretic

Back 94

hydrochlorothiazide (HCTZ)

Front 95

potassium-sparing diuretics

Back 95

spironolactone (Alsactone)

Front 96

loop diuretic

Back 96

fursosemide (Lasix)

Front 97

antidysrhythmics

Back 97

calcium channel blockers, sodium channel blockers & potassium channel blockers

Front 98

antidysrhythmic/calcium channel blockers

Back 98

slow heart rate; Amlodipine (Norvasc), diltiazem (Cardizem)

Front 99

antidysrhythmic/sodium channel blocker

Back 99

flecainide (Tambocor)

Front 100

antidysrhythmic/potassiium channel blocker

Back 100

amiodarone (Cordarone)

Front 101

cardio glycoside

Back 101

makes heart beat stronger and more efficiently; digoxin (Lanoxin)

Front 102

nitrate

Back 102

nitroglycerin

Front 103

angiotensin receptor blockers (ARBs)

Back 103

-sartan; candesartan, eprosartan, irbesartan

Front 104

anticoagulants

Back 104

Coumadin, heparin, Lovenox

Front 105

antiplatelet

Back 105

no sticky; aspirin; Plavix

Front 106

thrombolytics

Back 106

busts ups clots; tissue plasminogen activators (tPA), Retavase

Front 107

antifibrinolytics

Back 107

help form clots; aminocaproic acid (Amicar), vitamin K

Front 108

digitalis

Back 108

foxglove

Front 109

dilantin

Back 109

anti-seizure medication used to treat digoxin toxicty/dysrhythmias

Front 110

vasopressors

Back 110

epinephrine, norepinphrine, dopamine

Front 111

inotropic agents

Back 111

dobutamine (Dobutrex)

Front 112

vasodilators

Back 112

isorbide dinitrate (Dilatrate-SR, Iso-Bid, Isorbid) and hydralazine (Apresoline), latter is very potent

Front 113

HMG-CoA reductase inhibitors

Back 113

-statin; atorvastatin (Lipitor)

Front 114

bile acid sequestrants

Back 114

cholestyramine (Questran)

Front 115

fibic acid derivatives

Back 115

-fib-; clofibrate (Atromid-S), fenofibrate

Front 116

atropine

Back 116

increase heart rate

Front 117

right-sided heart failure

Back 117

edema

Front 118

left-sided heart failure

Back 118

fluid in lungs

Front 119

s/sx of HF

Back 119

anxiety, restlessness, cyanotic, clammy skin, tachycardia, lower leg edema, tachypnea, persistent cough and a forward leaning position

Front 120

shock

Back 120

collapse of cardiovascular system and CNS symptoms usually are first signs followed by cardiogenic origin, hypovolemic origin and septic origin

Front 121

Five P's of arterial occlusion

Back 121

pain, pulselessness, pallor, paresthesia & paralysis

Front 122

peripheral arterial disease of the lower extremities (PAD)

Back 122

narrowing or occlusion of the intima & the media of the blood vessel walls

Front 123

Raynaud's disease

Back 123

intermittent arterial spasms, esp. of fingers, toes, ears and nose & caused by exposure to cold or by emotional stimuli

Front 124

clean out blood vessels

Back 124

high-density lipids (HDL)

Front 125

deposit fat in blood

Back 125

low-density lipids (LDL)

Front 126

small lipoproteins that become wedged inside blood vessel walls and are difficult to clear; worst typs of fats

Back 126

very low-density lipids (VLDL)

Front 127

determines how long it takes blood to clot; used mostly in pts. taking Coumadin

Back 127

INR

Front 128

usually done to evaluate heparin therapy effectiveness

Back 128

aPTT

Front 129

evaluates the ability of blood to clot; often done before surgery

Back 129

PT

Front 130

troponin I

Back 130

myocardial muscle protein released into circulation after a myocardial injury

Front 131

arterial blood gases

Back 131

measure oxygenation (PaO2, PaCO2) and acid-base balance (pH)

Front 132

creatine kinase (CK)

Back 132

cardiac enzyme relased into blood after MI

Front 133

creatine phosphokinase (CK-MB)

Back 133

isoenzyme released into blood after MI, surgery, muscle trauma and muscular diseases

Front 134

C-reactive protein (CRP)

Back 134

liver produces this during acute inflammation; a predictor of cardiac events