Med Surg Quiz #6

Front 1

Coronary Artery Disease (CAD)

Back 1

Nurse will assess for EKG changes, angina pectoris

Front 2

Arteriosclerosis

Back 2

Nurse will assess for s/s of MI including pain, EKG changes, diaphoresis, and pallor

Front 3

Atherosclerosis

Back 3

Nurse will assess for pain, EKG changes, diaphoresis, pallor

Patient is at risk for MI; should consider lifestyle changes such as reducing high fat foods, smoking cessation

Front 4

Ischemia

Back 4

Nurse will assess for pain, EKG changes, diaphoresis, and pallor

Treat pt w/ suspected MI w/ MONA-Morphine, oxygen, nitroglycerin, aspirin

Front 5

Thrombus

Back 5

The nurse will promptly administer anticoagulant prophylactics in pts at risk for thrombus formation

Front 6

Hyperlipidemia

Back 6

Nurse should educate patient about risk reduction (regular lipid screen, diet, exercise, use of lipid-lowering drugs)

Front 7

Metabolic Syndrome

Back 7

Nurse should encourage risk factor reduction through weight reduction, increased physical activity, interventions to lower BP (meds/low Na), lower serum glucose (good control), and lower serum lipids (meds/dietary)

Front 8

Angina Pectoris

Back 8

Nurse will administer nitroglycerin as ordered to pt experiencing angina pectoris to increase perfusion and O2 supply

Front 9

Stable Angina

Back 9

Nurse will teach patient to avoid triggering factors and to self-administer nitroglycerin when experiencing angina at home

Front 10

Variant/Prinzmetal, or vasospastic angina

Back 10

Nurse will teach patient to avoid triggering factors and to self-administer nitroglycerin when experiencing angina at home

Front 11

Cardiac catheterization

Back 11

Assess pt for contraindications to catheterization: severe CHF, severe electrolyte imbalances, bleeding diathesis, serum creatinine >1.5

Front 12

Percutaneous Coronary Intervention (PCI)

Back 12

Keep NPO status prior to procedure

Front 13

Stents

Back 13

Nurse should assess CV, vital signs, and ECG to avoid complications

Nurse should assess distal pulses frequently as part of post-op focused assessment

Front 14

AV Fistula

Back 14

Protect site by ensuring all staff understands NO BP or lab drawn on that arm

Nurse should ensure that their is a sign informing other health care team members that no BP or lab drawn on that arm

Front 15

Acute coronary syndrome (ACS)

Back 15

Nurse should administer appropriate meds (as ordered) - MONA

Front 16

Unstable Angina

Back 16

Nurse should maintain pt on continuous tely monitor and carefully assess for s/s of ACS

Front 17

Myocardial infarction (MI)

Back 17

Administer appropriate drugs (MONA)

Front 18

NSTEMI

Back 18

Monitor ECG & encourage pt to inform nurse of any new s/s

Administer appropriate drugs (MONA)

Front 19

STEMI

Back 19

If on thrombolytic therapy, monitor for signs of reperfusion such as chest pain & ST segment elevation

Encourage pt to inform nurse of any new s/s

Front 20

Troponin

Back 20

High levels can indicate MI; nurse should notify MD of suspected MI

Front 21

Creatine Kinase (CK)

Back 21

Nurse should recognize and monitor CK-MB for cardiac ischemia & infarction

Front 22

Myoglobin

Back 22

Nurse should monitor for heart muscle damage

Front 23

MONA

Back 23

Nurse should administer and titrate drugs per order for patients with suspected MI

Front 24

Remodeling

Back 24

Nurse should monitor signs for adequate myocardial oxygen supply.

Administer and titrate meds to balance O2 supply and demand

Front 25

Coronary artery bypassing grafting (CABG)

Back 25

Nurse should provide post-op care to promote recovery & prevent complications (early mobilization, asses neuro status, OOB to chair, etc)

Front 26

Annuloplasty

Back 26

Nurse should elevate HOB, encourage turning, C&DB post-op, and change dressing using aseptic technique

Front 27

Aortic Valve Regurgitation

Back 27

Nurse should assess palpitation and diastolic murmur that is heard best at 2nd right intercostal space and radiating to the left sternal border

Front 28

Aortic Valve Stenosis

Back 28

Nurse will assess for dyspnea, angina, exertional syncope, increased pulmonary artery pressure, and harsh crescendo-decrescent systolic murmur developing due to the valve orifice becoming one-third of its normal size

Front 29

arrhythmogenic right ventricular cardiomyopathy (ARVC)

Back 29

Nurse should assess for palpitations, lightheadedness, and fatigue

Front 30

Beck's triad

Back 30

Classic assessment findings for patients with cardiac tamponade, consisting of decreased blood pressure, muffled heart sounds, and jugular venous distension

Front 31

Cardiac Tamponade

Back 31

Nurse should monitor for anxiety, CP (sharp, stabbing, radiating to shoulder, back or abdomen), cyanosis, palpations, tachypnea, weak or absent pulses

Front 32

Cardiomyopathies (CMPS)

Back 32

Caused by alcohol intake, hypertension, CAD, or may be idiopathic

Front 33

Dilated Cardiomyopathy (DCM)

Back 33

Nurse should continuously monitor for changes in mental status, fluid status, peripheral persuion, and heart rate and rhythm.

Front 34

Echocardiography

Back 34

The noninvasive assessment of the structures and function of the heart and great vessels utilizing high-frequency (ultrasound) sound waves

Front 35

Effusion

Back 35

abnormal accumulation of fluid

Front 36

hypertrophic cardiomyopathy (HCM)

Back 36

NI:Administer beta-adrenergic blocking agents and calcium antagonists as prescribed

Front 37

infective endocarditis (IE)

Back 37

NI:Assess for new or changing murmurs, embolic events, and skin manifestations

Front 38

mitral valve prolapse (MVP)

Back 38

Assess for sharp stabbing chest pain during rest or periods of stress, panic attacks,chronically cold hands and feet.

Front 39

mitral valve regurgitation

Back 39

NI: If acute, assess for sudden onset of dyspnea, blowing high-pitched, systolic murmur and thready peripheral pulses.

NI: If chronic, assess for gradual onset of dyspnea, peripheral edema, S3 and pansystolic murmur at the apex radiating to the left axilla.

Front 40

mitral valve stenosis

Back 40

Assess for dyspnea, orthopnea, afib, and loud first heart sound (S1)

Front 41

myocarditis

Back 41

Educate pt to avoid excessive fatigue and stop all activities immediately when light-headedness, dyspnea, or faintness occurs

Front 42

pericardial effusion

Back 42

An excess buildup of pericardial fluid that is a threat to normal cardiac function. The fluid buildup is the result of an accumulation of infectious exudates or toxins and/or blood.

Front 43

pericardial friction rub

Back 43

Auscultate for grating, scraping, or crunching sound over pericardial sac.

Front 44

pericarditis

Back 44

NI:Assess for pericardial friction rub or pericardial effusion

Front 45

pulmonic valve regurgitation

Back 45

Assess for high-pitched diastolic blowing murmur along left sternal border, dyspnea,and afib.

Front 46

pulmonic valve stenosis

Back 46

Assess for systolic crescendo-decrescendo murmur heard in 2nd left intercostal space and tall peaked T waves from atrial hypertrophy.

Front 47

restrictive cardiomyopathy (RCM)

Back 47

Assess for S3 systolic murmur, syncope, exercise intolerance, signs of pulmonary and systemic congestions

Front 48

rheumatic fever

Back 48

NI:Assess for fever, headache, swollen tender joints with small bony protuberances, SOB, elevated WBC.

Front 49

rheumatic heart disease

Back 49

Educate patient to decrease myocardial oxygen demand/cardiac workload

Front 50

tricuspid valve regurgitation

Back 50

Assess for high-pitched blowing systolic murmur heard over xiphoid process, prominent waves in the neck veins, and tall P waves in normal sinus rhythm.

Front 51

tricuspid valve stenosis

Back 51

Low-pitched rumbling diastolic murmur heard over 4th intercostal space of left sternal border, prominent waves in the neck veins, and tall P waves in normal sinus rhythm.

Front 52

valvuloplasty

Back 52

Educate patient that this procedure is surgically repairing a valve leaflet under general anesthesia and cardiopulmonary bypass.

Front 53

Ascites:

Back 53

Nursing:nurse will know ascites is a clinical manifestation of heart failure and will assess for other signs such as, hypotension, rales, tachypnea, confusion,pitting edema etc

Front 54

Cardiomegaly

Back 54

Nursing:this is found in stage B of heart failure- these patients are usually asymptomatic; treatment if a cardiomegaly along with other signs of stage B heart failure are found is admin ACE inhibitors, ARBs and beta blockers to prevent further damage to the myocardium

Front 55

Diastolic dysfunction

Back 55

Nursing:nurse will know that this type of heart failure most often effects older women and patients with HTN, diabetes, obesity and A Fib; treatment focuses on controlling HTN, ischemia and ventricular rate when A Fib is present and minimizing congestion

Front 56

Left-sided heart failure

Back 56

S/S:fatigue, activity intolerance, SOB, cough, pulmonary congestion, crackles,orthopnea, poor concentration

Front 57

Left Ventricular Ejection Fraction (LVEF):

Back 57

Nursing:nurse will know that a dysfunctional LVEF correlates with systolic dysfunction and will be aware that the heart will be unable to pump blood to sustain metabolic demands and if damage is extensive Left, Right or biventricular HF can occur- watch for symptoms of HF and determine

Front 58

Right-sided heart failure

Back 58

S/S: ascites, edema, elevated neck veins, lower extremity swelling Nursing:determine if the signs/symptoms are associated with heart failure. Rule out other disorders such as neurological

Front 59

Systolic Dysfunction

Back 59

left ventricular systolic dysfunction (LVSD) results in volume overload and decreased contractility. The heart is unable to pump enough blood to sustain the body’s metabolic demands and can result in heart failure. Most commonly caused by CAD & HTN.