HURST ACTUAL FINALS QUESTIONS AND ANSWERS
SET A+
✔✔what are some S/S of opiod withdrawal? - ✔✔- agitated and anxious mod, nausea,
vomiting, muscle aches, pupil dilation
✔✔what is the treatment for opiod withdrawal? - ✔✔- methadone
✔✔methadone - ✔✔- long acting opioid that can be substituted for the opiod of
addiction
- can be titrated downward during rehab to ease withdrawal symptoms
- users do not crave methadone
- now have time to do purposeful things such as work, school, and therapy
- must be monitored in a methadone clinic long term, because the dose is adjusted
frequently
✔✔what are some nursing considerations for alzheimers disease? - ✔✔- always identify
yourself and call client by name
- speak slowly so the client can process the information
- use short, simple sent.
- talkin about meaningful things
- keep clocks, calendars, and personal items within reach and vision
✔✔what are the two major veins that bring blood to the right side of the heart ? - ✔✔-
superior and inferior vena cava
✔✔the superior and inferior vena cava that bring blood to the right side of the heart is
that oxygenated or deoxygenated? - ✔✔- deoxyengated
✔✔what kind of oxygen does the pulmonary artery blood carry? - ✔✔- deoxygenated
blood
✔✔what kind of oxygen does the pulmonary veins carry? - ✔✔- oxygenated blood
,✔✔what is preload? - ✔✔- amt of blood RETURNING to the right side of the heart and
the muscle STRETCH that the volume causes
✔✔what is afterload? - ✔✔- the PRESSURE in the aorta and PERIPHERAL ARTERIES
that the left ventricle has to pump against to get the blood out
✔✔what is the pressure called during afterload? - ✔✔- resistance
✔✔with hypertension there is even more of what? - ✔✔- resistance for the left ventricle
to pump against. that why hypertension can eventually lead to HF and pulmonary
edema
✔✔what is stroke volume? - ✔✔- amt of blood pumped OUT of the ventricles with each
beat
✔✔cardiac output - ✔✔heart rate x stroke volume
- tissue perfusion is dependent on an adequate cardiac output
✔✔cardiac output changes according to the bodys what? - ✔✔- needs
✔✔what are some factors affect cardiac output ? - ✔✔- heart rate and certain
arrythmias
- blood volume
1. less volume= DECREASE CO
2. more volume= MORE CO
- DECREASED contractility ( MI, medication, cardiac muscle disease)
✔✔what are some medications that effect preload? - ✔✔- diuretics ( furosemide)
- nitrates ( nitroglycerin)
✔✔what are some medications that effect afterload? - ✔✔- ACE inhibitors ( enalapril)
- Hydralazine
✔✔what are some effects that effect improve contractility ? - ✔✔- inotropes ( dopamine,
dobutamine)
✔✔what are some effects that effect rate control? - ✔✔- beta blockers ( propranolo,
metoprolol)
- calcium channel blockers ( amlopidine)
- digoxin
✔✔what are some effects that effect rhythm control ? - ✔✔- antiarrythmics (
amiodarone)
,✔✔if your CO is decreased, will you perfuse properly? - ✔✔no
✔✔what are three arrythias that are always a big deal? - ✔✔- v-fib
- pulseless vtac
- asystole
✔✔what is the most common type of cardiovascular diseases? - ✔✔- coronary artery
disease
✔✔coronary artery disease is a broad term that includes what - ✔✔-chronic stable
angina
- acute coronary syndrome
✔✔chronic stable angina - ✔✔chest pain that occurs intermittently over a long period
with the same pattern of onset, duration, and intensity of symptoms
✔✔intermittent decreased blood flow to the myocardium leads to ischemia or necrosis?
- ✔✔- ischemia
- can lead to temp. pain/pressure in chest
✔✔what brings angina pain on? - ✔✔- low O2 usually due to exertion
✔✔what relieves angina pain? - ✔✔- rest/and or nitroglycerin SL
✔✔nitroglyerin ( nitrostat) sublingual causes what? - ✔✔- venous and arterial DILATION
- dilation causes DECREASE preload and afterload
✔✔what does nitrogylcerin cause to dilate? - ✔✔- coronary arteries which will increase
blood flow to the actual heart muscle ( myocardium)
✔✔how often should one take nitrogylcerin? - ✔✔- take 1 every 5 minutes
- max three doses!!
- DO NOT SWALLOW
- keep in dark, glass bottle;dry, cool
- client will get a HA
✔✔how often do you renew nitroglycerin - ✔✔3-5 months
- spray? - 2 years
✔✔After Nitroglycerin, what do you expect the BP to do? - ✔✔drop
✔✔for testing strategy rule: NEVER LEAVE WHAT KIND OF CLIENT? - ✔✔-
UNSTABLE!!!!!!!!!
, ✔✔algorithm for NTG; take one NTG SL after 5 minutes if chest pain/discomfort is
unimproved or worsened what should the nurse do? - ✔✔- activate emergency
response
✔✔what drug is used for the prevention of angina? - ✔✔- beta blockers
- ex: propranolol ( inderal)
- metoprolol ( lopressor)
- calcium channel blockers
- ex: amlodopine ( norvasc)
✔✔what do beta blockers do to BP, P, and myocardial contractility? - ✔✔- decrease
✔✔what does beta blockers do to the workload of the heart? - ✔✔decrease
✔✔beta blockers do what? - ✔✔- block the beta cells .... these are the receptor sites for
catecholamines- the epi and norepi
✔✔we just decreased the contractility .... so what happened to our CO? - ✔✔-
decreased
- we have decreased the workload of our heart
✔✔when we decrease the work of the heart, the need for oxygen is DECREASED, and
that DECREASES angina. but, could we decrease the clients cardiac output ( HR, BP)
too much with these drugs? - ✔✔- yes
✔✔what does calcium channel blockers do to BP? - ✔✔- decrease
✔✔caclium channel blockers cause what? - ✔✔- vasodilation of the arterial system
- they dilate coronary arteries
✔✔what are the two benefits of calcium channel blockers ? - ✔✔- decrease afterload
- increase oxygen to the heart muscle
✔✔what dosage range is good for aspirin ( acetylasalicystic acid) for angina pain? -
✔✔- 81-325 mg ( determined by PCP)
✔✔what is some client teaching for someone with chronic stable angina? - ✔✔- rest
freq
- avoid overeating
- avoid excess caffeine
SET A+
✔✔what are some S/S of opiod withdrawal? - ✔✔- agitated and anxious mod, nausea,
vomiting, muscle aches, pupil dilation
✔✔what is the treatment for opiod withdrawal? - ✔✔- methadone
✔✔methadone - ✔✔- long acting opioid that can be substituted for the opiod of
addiction
- can be titrated downward during rehab to ease withdrawal symptoms
- users do not crave methadone
- now have time to do purposeful things such as work, school, and therapy
- must be monitored in a methadone clinic long term, because the dose is adjusted
frequently
✔✔what are some nursing considerations for alzheimers disease? - ✔✔- always identify
yourself and call client by name
- speak slowly so the client can process the information
- use short, simple sent.
- talkin about meaningful things
- keep clocks, calendars, and personal items within reach and vision
✔✔what are the two major veins that bring blood to the right side of the heart ? - ✔✔-
superior and inferior vena cava
✔✔the superior and inferior vena cava that bring blood to the right side of the heart is
that oxygenated or deoxygenated? - ✔✔- deoxyengated
✔✔what kind of oxygen does the pulmonary artery blood carry? - ✔✔- deoxygenated
blood
✔✔what kind of oxygen does the pulmonary veins carry? - ✔✔- oxygenated blood
,✔✔what is preload? - ✔✔- amt of blood RETURNING to the right side of the heart and
the muscle STRETCH that the volume causes
✔✔what is afterload? - ✔✔- the PRESSURE in the aorta and PERIPHERAL ARTERIES
that the left ventricle has to pump against to get the blood out
✔✔what is the pressure called during afterload? - ✔✔- resistance
✔✔with hypertension there is even more of what? - ✔✔- resistance for the left ventricle
to pump against. that why hypertension can eventually lead to HF and pulmonary
edema
✔✔what is stroke volume? - ✔✔- amt of blood pumped OUT of the ventricles with each
beat
✔✔cardiac output - ✔✔heart rate x stroke volume
- tissue perfusion is dependent on an adequate cardiac output
✔✔cardiac output changes according to the bodys what? - ✔✔- needs
✔✔what are some factors affect cardiac output ? - ✔✔- heart rate and certain
arrythmias
- blood volume
1. less volume= DECREASE CO
2. more volume= MORE CO
- DECREASED contractility ( MI, medication, cardiac muscle disease)
✔✔what are some medications that effect preload? - ✔✔- diuretics ( furosemide)
- nitrates ( nitroglycerin)
✔✔what are some medications that effect afterload? - ✔✔- ACE inhibitors ( enalapril)
- Hydralazine
✔✔what are some effects that effect improve contractility ? - ✔✔- inotropes ( dopamine,
dobutamine)
✔✔what are some effects that effect rate control? - ✔✔- beta blockers ( propranolo,
metoprolol)
- calcium channel blockers ( amlopidine)
- digoxin
✔✔what are some effects that effect rhythm control ? - ✔✔- antiarrythmics (
amiodarone)
,✔✔if your CO is decreased, will you perfuse properly? - ✔✔no
✔✔what are three arrythias that are always a big deal? - ✔✔- v-fib
- pulseless vtac
- asystole
✔✔what is the most common type of cardiovascular diseases? - ✔✔- coronary artery
disease
✔✔coronary artery disease is a broad term that includes what - ✔✔-chronic stable
angina
- acute coronary syndrome
✔✔chronic stable angina - ✔✔chest pain that occurs intermittently over a long period
with the same pattern of onset, duration, and intensity of symptoms
✔✔intermittent decreased blood flow to the myocardium leads to ischemia or necrosis?
- ✔✔- ischemia
- can lead to temp. pain/pressure in chest
✔✔what brings angina pain on? - ✔✔- low O2 usually due to exertion
✔✔what relieves angina pain? - ✔✔- rest/and or nitroglycerin SL
✔✔nitroglyerin ( nitrostat) sublingual causes what? - ✔✔- venous and arterial DILATION
- dilation causes DECREASE preload and afterload
✔✔what does nitrogylcerin cause to dilate? - ✔✔- coronary arteries which will increase
blood flow to the actual heart muscle ( myocardium)
✔✔how often should one take nitrogylcerin? - ✔✔- take 1 every 5 minutes
- max three doses!!
- DO NOT SWALLOW
- keep in dark, glass bottle;dry, cool
- client will get a HA
✔✔how often do you renew nitroglycerin - ✔✔3-5 months
- spray? - 2 years
✔✔After Nitroglycerin, what do you expect the BP to do? - ✔✔drop
✔✔for testing strategy rule: NEVER LEAVE WHAT KIND OF CLIENT? - ✔✔-
UNSTABLE!!!!!!!!!
, ✔✔algorithm for NTG; take one NTG SL after 5 minutes if chest pain/discomfort is
unimproved or worsened what should the nurse do? - ✔✔- activate emergency
response
✔✔what drug is used for the prevention of angina? - ✔✔- beta blockers
- ex: propranolol ( inderal)
- metoprolol ( lopressor)
- calcium channel blockers
- ex: amlodopine ( norvasc)
✔✔what do beta blockers do to BP, P, and myocardial contractility? - ✔✔- decrease
✔✔what does beta blockers do to the workload of the heart? - ✔✔decrease
✔✔beta blockers do what? - ✔✔- block the beta cells .... these are the receptor sites for
catecholamines- the epi and norepi
✔✔we just decreased the contractility .... so what happened to our CO? - ✔✔-
decreased
- we have decreased the workload of our heart
✔✔when we decrease the work of the heart, the need for oxygen is DECREASED, and
that DECREASES angina. but, could we decrease the clients cardiac output ( HR, BP)
too much with these drugs? - ✔✔- yes
✔✔what does calcium channel blockers do to BP? - ✔✔- decrease
✔✔caclium channel blockers cause what? - ✔✔- vasodilation of the arterial system
- they dilate coronary arteries
✔✔what are the two benefits of calcium channel blockers ? - ✔✔- decrease afterload
- increase oxygen to the heart muscle
✔✔what dosage range is good for aspirin ( acetylasalicystic acid) for angina pain? -
✔✔- 81-325 mg ( determined by PCP)
✔✔what is some client teaching for someone with chronic stable angina? - ✔✔- rest
freq
- avoid overeating
- avoid excess caffeine
