NUR 114 Exam #4 Questions and Answers

NUR 114 Exam #4 Questions and Answers


Question 1.
what is heart failure?

Correct Answer: a clinical syndrome characterized by symptoms of fluid
overload and poor tissue perfusion that both result in *decreased cardiac
output*


Question 2.
HF is a chronic, _____________ condition that is managed with?

Correct Answer: progressive. It is managed with lifestyle changes and
medications to prevent episodes of acute decompensated heart failure


Question 3.
which race has a higher incidence of HF, african americans or caucasians?

Correct Answer: african americans


Question 4.
Frank-Starling Law

Correct Answer: the greater the stretch, the stronger is the heart's contraction.
*associated with HF*


Question 5.
how many classifications of HF are there?

Correct Answer: four; A-D, with D being the final and worst. D indicates
end-stage HF


Question 6.
what marker tells us "how much fluid is on board"

Correct Answer: BNP - should be less than 100.


Question 7.
what is the normal ejection fraction percentage in a healthy heart?

Correct Answer: 55%-65%


Question 8.
what are the s/s of right sided heart failure?

Correct Answer: 1. JVD 2. Dependant Edema 3. Hepatomegaly 4. Ascites 5.
Weight gain 6. Polyuria (nocturia)

,Question 9.
Edema usually affects the feet and ankles and worsens when?

Correct Answer: the patient stands or sits for long periods of time *telling
patient to elevate the legs can help decrease edema*


Question 10.
what are the s/s of left sided HF?

Correct Answer: 1. dyspnea /DOE 2. cough (dry, nonproductive initially) 3.
pulmonary crackles 4. decreased O2 sat 5. S3 (ventricular gallop) 6. orthopnea
7. oliguria 8. frothy sputum *L*eft = *L*ung issues


Question 11.
what are some potential complications of HF?

Correct Answer: - poor perfusion - dysrhythmias - thromboembolism - pericardial
effusion /cardiac tamponade - pulmonary edema


Question 12.
what tests might be done to diagnose HF?

Correct Answer: - BNP is a key diagnostic factor. Levels greater than 100
indicate high cardiac filling. electrolytes, urinalysis, BUN, serum creatinine, ECG,
echocardiogram, ABG's, CXR, and a variety of other tests may be used


Question 13.
the goals of medical management of HF may include?

Correct Answer: relieving patient symptoms, improving functional status, and
quality of life, and to extend survival


Question 14.
what are some lifestyle recommendations for a patient with HF?

Correct Answer: - restriction of dietary sodium - avoidance of smoking (including
passive) - avoid excessive fluids and alcohol - weight reduction if indicated -
regular exercise


Question 15.
Name the medications that may be used for treatment of HF?

Correct Answer: - Ace inhibitors - ARBS - Beta blockers - Diuretics - Digitalis -
Hydralazine and Dinitrate


Question 16.
nursing considerations for ACE Inhibitors

Correct Answer: - They decrease secretion of aldosterone, decreasing retention

, of sodium and water - they may be the first medication prescribed for patients
in *mild* failure - started at a low dose that is gradually increased - may be d/c if
potassium levels remain greater than 5.5 or if the serum creatinine rises - may
cause hypotension, hyperkalemia, cough, or angioedema - if angioedema
occurs, d/c the medication immediately - *prevents progression and relieves
symptoms*


Question 17.
nursing considerations for beta-blockers

Correct Answer: - the therapeutic effects of these drugs may not be seen for
weeks or months - side effects are most common in the initial few weeks of
treatment - they are started at a low dose and titrated up every few weeks with
close monitoring - contraindicated for patients with history of COPD or asthma -
may cause bradycardia, hypotension, dizziness, fatigue - *relieves symptoms*


Question 18.
Nursing considerations for Lasix (loop diuretic) and HCTZ (thiazide diuretic)

Correct Answer: - monitor serum potassium closely - both a loop and a thiazide
diuretic may be used in patients with severe HF who are unresponsive to a
single diuretic -loop diuretics are administered IV for exacerbations of HF when
rapid diuresis is needed - will *decrease s/s* - monitor kidney function


Question 19.
what is spironolactone's drug category?

Correct Answer: aldosterone antagonist


Question 20.
Hydralazine and Isosorbide

Correct Answer: medications used to treat HF. Will dilate the blood vessels.
Observe for symptomatic hypotension


Question 21.
Nursing considerations for digitalis

Correct Answer: - It is a positive inotropic drug - decreased the s/s of HF -
improves cardiac contractility - can result in bradycardia or digitalis toxicity -
patients with renal dysfunction and older patients should receive smaller doses
of digoxin - can cause hypokalemia - hold with an apical pulse of less than 60


Question 22.
what are the s/s of dig toxicity?

Correct Answer: anorexia, nausea, visual disturbances (yellow halos), confusion,
bradycardia