NR 324 Exam 2 Study Guide
Cardio and Hematology Chapters 30, 31, 32, 33, 34, 35, 36 & 67
Alternate Type Questions: Multiple Choices - Select all that Apply -
Medication Calculation
Total Number of Questions: Exam 2: 60 questions; 4 points each
Topics
Dysrhythmias
• Cardiopulmonary Resuscitation (See Appendix A highlights)
• Normal Sinus Rhythm – starts at SA node w/ rate of 60-100 bpm & has normal conduction
• Sinus Bradycardia – same conduction pathway as sinus rhythm; SA node fires at less than 60
bpm
o ECG interpretation – HR <60 bpm; P wave precedes each QRS complex & has normal
shape & duration; PR interval is normal; QRS complex is normal shape & duration
o Clinical Manifestations – pale, cool skin; hypotension; weakness; angina; dizziness
orsyncope; confusion or disorientation; SOB. Normal in athletes & during sleep.
Causes are from carotid sinus massage, Valsalva maneuver, hypothermia, increased
intraocular pressure , vagal stimulation & certain drugs (beta-adrenergic blockers,
calcium channel blocker)
o Treatment – give atropine (anticholinergic): AtroPen; if ineffective transcutaneous
pacing or dopamine (Intropin) or epinephrine (Adrenalin) infusion considered;
permanent pace maker may be need; if brady due to drugs then hold drugs,
discontinue or change the dosage
• Sinus Tachycardia – same conduction pathway as sinus rhythm; SA node fires 101-200 bpm;
caused by vagal inhibition or sympathetic stimulation.
o ECG interpretation – HR >100 bpm; regular just like sinus brady
o Clinical Manifestations – depends on HR tolerance; dizziness; dyspnea; hypotension
(because of decreased cardiac output); increased myocardial oxygen consumptions;
angina or an increase in infarction size w/ CAD or acute MI. caused by exercise, fever,
pain, hypotension, hypovolemia, anemia, hypoxia, hypoglycemia, myocardial ischemia,
heart failure, hyperthyroidism, anxiety & fear. Effects of drugs like epinephrine,
norepinephrine, atropine, caffeine, theophylline & hydralazine.
o Treatment – if its from pain then pain management; clinically stable do vagal
maneuvers; drugs to decrease HR & decrease myocardial oxygen consumption (IV
beta-adrenergic blockers, adenosine, calcium channel blockers); in clinically stable
use synchronized cardioversion.
• Atrial Fibrillation/ Flutter
o ECG interpretation
o Clinical Manifestations
o Treatment including medications
o Complications
o Patients’ education
• Ventricular tachycardia
, o ECG interpretation
o Clinical Manifestations
o Treatment
o Complications
• Ventricular Fibrillation
o ECG interpretation
o Clinical Manifestations
o Treatment
o Complications
• Cardiac tamponade
o Clinical Manifestations
o Treatment
o Complications
• PATIENT & CAREGIVER TEACHING GUIDE: Implantable Cardioverter-Defibrillator
• Heart Failure
o Risk Factors
o Clinical Manifestations
o Treatment (therapeutic effect of digoxin and diuretics side effects and nursing
considerations such as K+ and Na+ management)
o Digitalis toxicity
o Complications
• Hypertension – bp higher than 140/90 mm Hg; prehypertension 120-139/80-89 mm Hg
o Risk Factors – increased SNS activity; over producing sodium-retaining hormones &
vasoconstricting substances; increased sodium intake; overweight, diabetes mellitus,
tobacco; excessive alcohol; w/ age systolic bp increases; elevated serum lipids
(cholesterol & triglycerides); for male after age 55; for women after age 64; family
history; higher in African Americans; sedentary lifestyle; low socioeconomic status;
increased stress.
o Clinical Manifestations – called “silent killer” because often asymptomatic; fatigue;
dizziness; palpitations; angina; dyspnea. w/ hypertensive crisis they may have severe
headaches, dyspnea, anxiety, & nosebleeds
o Treatment - lose weight; stop smoking; less drinking alcohol; antihypertension drugs;
change diet; lose weight; low sodium diet; exercise; adequate potassium, calcium &
vitamin D from food;
o Complications – are target organ diseases: heart (hypertensive heart disease); brain
(cerebrovascular disease), peripheral vessels (PVD); kidneys (nephrosclerosis); eyes
(retinal damage)
• Myocardial infarction
o Risk Factors
o Clinical Manifestations
o Nursing diagnoses
o Diagnostic studies
o Treatment (therapeutic effect of aspirin,morphine,nitroglycerin, coumadin, heparin
[partial thromboplastine time])
o Complications
• Angina
o Types
Cardio and Hematology Chapters 30, 31, 32, 33, 34, 35, 36 & 67
Alternate Type Questions: Multiple Choices - Select all that Apply -
Medication Calculation
Total Number of Questions: Exam 2: 60 questions; 4 points each
Topics
Dysrhythmias
• Cardiopulmonary Resuscitation (See Appendix A highlights)
• Normal Sinus Rhythm – starts at SA node w/ rate of 60-100 bpm & has normal conduction
• Sinus Bradycardia – same conduction pathway as sinus rhythm; SA node fires at less than 60
bpm
o ECG interpretation – HR <60 bpm; P wave precedes each QRS complex & has normal
shape & duration; PR interval is normal; QRS complex is normal shape & duration
o Clinical Manifestations – pale, cool skin; hypotension; weakness; angina; dizziness
orsyncope; confusion or disorientation; SOB. Normal in athletes & during sleep.
Causes are from carotid sinus massage, Valsalva maneuver, hypothermia, increased
intraocular pressure , vagal stimulation & certain drugs (beta-adrenergic blockers,
calcium channel blocker)
o Treatment – give atropine (anticholinergic): AtroPen; if ineffective transcutaneous
pacing or dopamine (Intropin) or epinephrine (Adrenalin) infusion considered;
permanent pace maker may be need; if brady due to drugs then hold drugs,
discontinue or change the dosage
• Sinus Tachycardia – same conduction pathway as sinus rhythm; SA node fires 101-200 bpm;
caused by vagal inhibition or sympathetic stimulation.
o ECG interpretation – HR >100 bpm; regular just like sinus brady
o Clinical Manifestations – depends on HR tolerance; dizziness; dyspnea; hypotension
(because of decreased cardiac output); increased myocardial oxygen consumptions;
angina or an increase in infarction size w/ CAD or acute MI. caused by exercise, fever,
pain, hypotension, hypovolemia, anemia, hypoxia, hypoglycemia, myocardial ischemia,
heart failure, hyperthyroidism, anxiety & fear. Effects of drugs like epinephrine,
norepinephrine, atropine, caffeine, theophylline & hydralazine.
o Treatment – if its from pain then pain management; clinically stable do vagal
maneuvers; drugs to decrease HR & decrease myocardial oxygen consumption (IV
beta-adrenergic blockers, adenosine, calcium channel blockers); in clinically stable
use synchronized cardioversion.
• Atrial Fibrillation/ Flutter
o ECG interpretation
o Clinical Manifestations
o Treatment including medications
o Complications
o Patients’ education
• Ventricular tachycardia
, o ECG interpretation
o Clinical Manifestations
o Treatment
o Complications
• Ventricular Fibrillation
o ECG interpretation
o Clinical Manifestations
o Treatment
o Complications
• Cardiac tamponade
o Clinical Manifestations
o Treatment
o Complications
• PATIENT & CAREGIVER TEACHING GUIDE: Implantable Cardioverter-Defibrillator
• Heart Failure
o Risk Factors
o Clinical Manifestations
o Treatment (therapeutic effect of digoxin and diuretics side effects and nursing
considerations such as K+ and Na+ management)
o Digitalis toxicity
o Complications
• Hypertension – bp higher than 140/90 mm Hg; prehypertension 120-139/80-89 mm Hg
o Risk Factors – increased SNS activity; over producing sodium-retaining hormones &
vasoconstricting substances; increased sodium intake; overweight, diabetes mellitus,
tobacco; excessive alcohol; w/ age systolic bp increases; elevated serum lipids
(cholesterol & triglycerides); for male after age 55; for women after age 64; family
history; higher in African Americans; sedentary lifestyle; low socioeconomic status;
increased stress.
o Clinical Manifestations – called “silent killer” because often asymptomatic; fatigue;
dizziness; palpitations; angina; dyspnea. w/ hypertensive crisis they may have severe
headaches, dyspnea, anxiety, & nosebleeds
o Treatment - lose weight; stop smoking; less drinking alcohol; antihypertension drugs;
change diet; lose weight; low sodium diet; exercise; adequate potassium, calcium &
vitamin D from food;
o Complications – are target organ diseases: heart (hypertensive heart disease); brain
(cerebrovascular disease), peripheral vessels (PVD); kidneys (nephrosclerosis); eyes
(retinal damage)
• Myocardial infarction
o Risk Factors
o Clinical Manifestations
o Nursing diagnoses
o Diagnostic studies
o Treatment (therapeutic effect of aspirin,morphine,nitroglycerin, coumadin, heparin
[partial thromboplastine time])
o Complications
• Angina
o Types
