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Comprehensive Medical-Surgical Nursing Final Exam Review: Key Concepts, Conditions, and Clinical Interventions

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Comprehensive Medical-Surgical Nursing Final Exam Review: Key Concepts, Conditions, and Clinical InterventionsComprehensive Medical-Surgical Nursing Final Exam Review: Key Concepts, Conditions, and Clinical InterventionsComprehensive Medical-Surgical Nursing Final Exam Review: Key Concepts, Conditions, and Clinical InterventionsComprehensive Medical-Surgical Nursing Final Exam Review: Key Concepts, Conditions, and Clinical Interventions Comprehensive Medical-Surgical Nursing Final Exam Review: Key Concepts, Conditions, and Clinical Interventions 1. medications for hypertension: -HCTZ -furosemide -spironolactone -metoprolol -labetalol -clonodine -captopril -losartan -dilitiazem -hydralazine 2. knowledge furosemide: -used to treat hypertension -contraindicated with sulfa allergy 3. knowledge for spironolactone: -used for hypertension -potassium sparing (always check potassium levels before giving) 4. knowledge for metoprolol: -used for hypertension -check heart rate and BP (bradycardia/orthostatic hypertension) -monitor for bronchospasm!! 5. knowledge for labetalol: -used for hypertension -monitor for JVD, lung sounds, edema 6. knowledge for clonodine: -used for hypertension -gum or hard candy for dry mouth 7. knowledge for captopril: -used for hypertension -ACE inhibitor -monitor for angioedema!! -report new onset cough 8. knowledge for diltiazem: -used for hypertension -may increase blood levels of digoxin 9. infection of the endocardium that occurs primarily in hearts with artifical or damaged valves and in those who inject drugs: infective endocarditis 10. patho of infective endocarditis: invading organism forms a vegetative lesion in heart, may break off and become an emboli 11. risk factors for infective endocarditis: -IV catheter -gingival gum disease -IV drug use -artifical heart valve/heart disease 12. prevention for infective endocarditis: -2x a year dental cleaning -daily brushing and flossing -antibiotic prophylaxis before dental procedures 13. S/sx of infective endocarditis: **petechiae -weight loss -dyspnea/cough -fever/chills 14. treatment for infective endocarditis: -antibiotics up to 6 weeks (penicillin and vancomycin) 15. genetic abnormality and enlargement of the heart muscle that results in ineffective blood pumping: cardiomyopathy 16. types of cardiomyopathy: dilated and restrictive 17. type of cardiomyopathy: -heart chamber size increased/thin heart walls -most frequent type of cardiomyopathy -frequent cause of HF: dilated cardiomyopathy 18. type of cardiomyopathy: -impaired ventricle stretch -limited ventricle filling -stiff cardiac muscle -systolic emptying of the ventricle: restrictive cardiomyopathy 19. treatment for cardiomyopathy: -treat underlying cause -anticoagulants -antihypertensives **avoid digoxin and vasodilators **avoid strenuous exercise and sports 20. knowledge for warfarin (coumadin): -monitor PT and INR 21. what is the antidote for warfarin: vitamin K 22. knowledge for heparin: monitor PTT 23. antidote for heparin: protamine sulfate 24. most serious form of thrombophlebitis that occurs most often in the immobile (recent surgery/hospitalized): DVT 25. what is virchow's triad?: 3 factors in the formation of a thrombus/DVT -stasis of blood flow (sitting for long periods/immobile) -damage to vein wall lining (venipuncture/IV meds) -increased blood coagulation (birth control, smoking, estrogen therapy) 26. how to prevent DVT: -avoid dehydration -leg exercises for the immobile -ambulate ASAP -avoid smoking 27. treatments/prophylaxis: -compression stockings/SCDs -heparin, warfarin, enoxoparin (lovenox), reteplase -warm, moist heat -elevate above heart 28. S/sx of DVT: -calf pain -swelling -warmth -venous distention 29. how to diagnose DVT: ultrasound 30. biggest complication of DVT: pulmonary embolism (PE) 31. obstruction of blood flow through the coronary arteries to the heart muscle cells, due to atherosclerosis results in angina, MI, sudden death: coronary artery disease (CAD) 32. what cholesterol level increases risk for CAD?: above 200 33. medications to lower lipid levels: simvastatin (monitor liver and take at night) gemfibrozil (take 30 min before meals, may increase effectos of anticoagulants and hypoglycemia) 34. type of angina that : -occurs w moderate exercise -lasts a few min -relieved w resting or nitro: stable angina 35. type of angina that: -cyclical -happens same time each day -often occurs at night: vasospastic angina 36. type of angina that: -spasms in tiny heart arteries -severe and long lasting pain: microvascular 37. death of heart muscle partial or complete blockage of a coronary artery: myocardial infarction (MI) 38. classic signs of MI: ** chest pain (crushing, may radiate) -short of breath -dizzy -nauseous -sweating 39. atypical signs of MI: -no chest pain -feeling of impending doom 40. common signs of MI in women: -stomach pain -pain between shoulder blades -indigestion/gas pai


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