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NURS 440 M4-M6: Accurate Answers To All Questions

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NURS 440 M4-M6: Accurate Answers To All Questions

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NURS 440 M4-M6: Accurate Answers To All
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Valve disorders Alters blood flow


Functional valve disorder Insufficiency or Regurgitation


Structural valve disorder Stenosis


Pressure Gradient Increase in Pressure Gradient (pressure on each side
of valve)


Causes of valve disorders Age-related, Congenital, Infections, Rheumatic Heart
Disease, Vegetation, Atherosclerosis, HTN, RA, MI,
HF, Radiation, Chemotherapy, risks - smoking,
obesity, inactivity, family history


Signs and symptoms of CHF Decreased CO (r/t stenosis >↓ flow; r/t incompetent
valve> bi-directional flow)


Activity Intolerance Fatigue; SOB


Fluid Volume Excess S3, crackles, cough, edema, weight gain


Management of CHF Rest, Gradual increase activity, Fluid Balance (I &O),
Diuretics, Vasodilators, Inotropes, Breath & Heart
sounds, C/DB


Patient education for valve disorders Oral hygiene, Prophylactic antibiotics for dental
procedures (AHA), Severe valve disorders, Total Joint
patients

,Activity restrictions Avoid Isometric & Endurance activities; no abrupt ↑
BP (Aortic)


Surgical treatment options Valvuloplasty, Balloon Open Area of Stenosis, Valve
Replacement


Types of valve replacement Human/Pig - less duration; Mechanical - Coumadin
life-long


TAVR Transcatheter Aortic Valve Replacement, Minimally
invasive


What is shock? A widespread lack of tissue perfusion resulting in
cellular, metabolic, and hemodynamic disorders.


What can occur if shock is not Multi-system organ dysfunction syndrome (MODS).
reversed?


What are the three types of shock? Hypovolemic, Cardiogenic, and Distributive
(Vasogenic).


What characterizes hypovolemic Decreased intracellular fluid volume due to absolute
shock? or relative blood loss.


What is cardiogenic shock? Pump failure leading to decreased perfusion and
cardiac output (CO).


What is anaphylactic shock? A severe antibody-antigen reaction causing
histamine release, vasodilation, and decreased blood
pressure.


What is neurogenic shock? Loss of sympathetic tone leading to vasodilation,
decreased cardiac output, and decreased blood
pressure.


What triggers septic shock? An invading microorganism leading to systemic
inflammatory response syndrome (SIRS).

,What are the consequences of septic Increased capillary permeability, microvascular
shock? thrombosis, decreased tissue perfusion, and massive
peripheral vasodilation.


What is lactate and its significance in A byproduct of metabolism that builds up when cells
shock? are deprived of oxygen, indicating tissue hypoxia.


What are the normal lactate levels? 0.5-1 mmol/L; levels above 2 mmol/L are seen in ICU
patients.


What are the symptoms of lactic Extreme fatigue, muscle cramps, weakness,
acidosis? abdominal pain, increased respiratory rate, and
irregular heartbeat.


What are the three stages of shock? Compensatory, Progressive, and Refractory.


What happens during the The body activates neural, hormonal, and
compensatory stage of shock? biochemical responses to maintain cardiac output
and blood pressure.


What occurs in the progressive stage Compensatory mechanisms begin to fail, leading to
of shock? symptomatic hypotension and cellular damage.


What is the refractory stage of shock? Shock becomes unresponsive to therapy and is
irreversible.


What is MODS? Failure of two or more separate organ systems due
to widespread systemic inflammation from the initial
insult.


What is the medical management for Maintain airway, support oxygen transport, correct
shock? acidosis, improve tissue perfusion, and provide
nutrition support.

, What is the first choice medication for Levophed (norepinephrine).
improving blood pressure in shock?


What nursing management strategies Identify clients at risk, recognize subtle signs of
are important for shock? shock, and monitor response to treatment.


What are common nursing diagnoses Altered tissue perfusion, ineffective breathing,
for patients in shock? anxiety, imbalanced nutrition, risk for infection, and
risk for injury.


What is the importance of monitoring Elevated lactate levels can predict sepsis outcomes
lactate levels in shock? and indicate tissue hypoperfusion.


What should be done within one hour Administer antibiotics.
for septic shock patients?


What is the significance of maintaining It ensures adequate tissue perfusion and oxygen
MAP above 65 in shock management? delivery.


What is hypovolemic shock? Absolute or relative loss of circulating blood volume.


What is cardiogenic shock? Pump failure marked by reduction in cardiac output
with inadequate perfusion to vital organs.


What is anaphylactic shock? Severe allergic reaction causing widespread
vasodilation and capillary permeability.


What causes neurogenic/distributive Vasodilation due to loss of sympathetic tone, often
shock? from spinal cord injury or spinal anesthesia.


What is septic shock? Stimulation of inflammatory/immune response from
infection causing capillary permeability and
increased metabolic state.


What are typical symptoms of shock? Pale, cool skin; diminished heart sounds;
dysrhythmias; crackles; decreased cardiac output.

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