CNUR 203 LATEST 2026 STUDY GUIDE QUESTIONS AND
SOLUTIONS GRADED A+
✔✔R HF - ✔✔(body)
dt R ventricle hypertrophy and failure
- backup of blood in R atrium and venous circulation
- venous congestion
- JVD and peripheral edema
- can result from L HF = cor pulmonale
✔✔R HR clinical manifestations - ✔✔(swelling)
- dyspnea/orthopnea
- rales
- weakness
- nocturnal paroxysmal dyspnea (pillows)
- ^ HR
- cough
- weight gain
- activity intolerance
✔✔CHF dx - ✔✔CBC, lytes, renal
Natriuretic peptide presence
ECG
✔✔CHF assessment findings - ✔✔weak pulse, tachycardia, low Spo2, cyanosis, pallor
cold/moist skin
N&V
low urine output
aus: S3 gallop, crackles, wheeze
✔✔CHF meds - ✔✔diuretics
ACE inhibitors
angiotensin II receptor blockers
b-adrenergic antagonists
inotropic drugs
O2
✔✔CHF tx - ✔✔-correct Na and H2o retention (V overload)
- lower workload and ^ contractility
- control factors
- meds
- DASH diet
- high fowlers
,✔✔CHF nursing - ✔✔assess
- chest pain, resp, CVS and PVS, weight, I&O
- precordium, neck veins, neuro
- edema
- BS
✔✔emergency HF signs - ✔✔dyspnea, SOB
tachycardia, chest pain
confusion
fainting
✔✔HF teaching - ✔✔health promotion and diet
exercise and rest
progression
limit Na
✔✔Acute HF - ✔✔acute LV failure dt myocardial ischemia (no blood to cardiac muscles)
leads to chronic HF
✔✔acute HF clinical manifestations - ✔✔pulmonary edema
^ RR
low SpO2
tachypnea
resp acidosis
✔✔acute HF tx - ✔✔reduce fluid overload
reduce venous return = lower preload
lower anxiety and reassure
limit CO
^ gas exchange and O2
Meds to ^ CVS
✔✔mitral valve stenosis - ✔✔refers to irregular conditions of the mitral valve. LA-->LV
^LA V and pressure
- hypertrophy of pulmonary vessels
causes
- rheumatic fever
- valve obstruction
✔✔mitral valve stenosis clinical manifestations - ✔✔dyspnea, chest pain
palpitations
fatigue
hoarse voice
,emboli risk
✔✔mitral valve stenosis assessment findings - ✔✔Loud S1
rumbling murmur at apex
✔✔Stenosis - ✔✔valve narrowing
= restriction or forwards blood flow = retrograde
pressure gradient across open valve
✔✔regurgitation - ✔✔valve leaks
incompetent closure of leaflets = retrograde blood
✔✔aortic valve stenosis - ✔✔narrowing of the aortic valve (calcify) = obstruction LV-->
aorta
LV hypertrophy
^ workload = low CO = HF
cause
- rheumatic fever
- CHF
✔✔valvular heart disease - ✔✔stenosis or regurgitation or mitral or aortic valve
✔✔aortic valve stenosis clinical manifestations - ✔✔- angina
- syncope
- exertional dyspnea
- this triad reflects left ventricular failure
- murmur and S4
✔✔Mitral valve regurgitation - ✔✔incompetent closure of mitral valve = backflow
^ work of LA and LV to maintain CO
^ V in LA
atrial and ventricular hypertrophy
Cause
- rheumatic fever
- MI
- trauma
✔✔Mitral valve regurgitation clinical manifestations - ✔✔Chronic: asymptomatic, LV
failure, S3
Acute: low CO, thready pulse, murmur
✔✔aortic valve regurgitation - ✔✔disease of leaflet and aortic root
, retrograde flow from aorta --> LV
V overload
LV hypertrophy = compensation
back up in LA, pulmonary bed, RV
Pulmonary HTN
R HF
✔✔aortic valve regurgitation clinical manifestations - ✔✔SOB, fatigue, lightheaded,
chest pain
murmur
✔✔valvular heart disease dx by - ✔✔physical
Hx
ECG
x-ray
cardiac catheterization
✔✔Valvular Heart disease tx - ✔✔percutaneous transluminal balloon valvuloplasty
transcatheter aortic valve implantation
limit complications
perc valve replacement
open air valve
✔✔valvular heart disease nursing - ✔✔assess
- chest pain
- resp, CVS, PVS
- lifestyle
- palapte: carotid, precordium, pulses, and skin
do
- high fowlers
- prevent HF
✔✔DM T1 - ✔✔common in young. genetic or viral exposure
autoimmune: destruction of pancreatic b-cells
NO endogenous insulin
= no insulin --> cells, ^BGM, glucose not used --> urine
No glycogenolysis or gluconeogenesis
= hyperglycemia and cell starvation = fat broken down = ketone production = DKA
✔✔DM T1 clinical manifestations - ✔✔months--> years (rapid onset)
occur when pancreas produces no insulin
- 3P's (polyuria, polydipsia, polyphagia)
- weight loss
- fatigue
- infections
SOLUTIONS GRADED A+
✔✔R HF - ✔✔(body)
dt R ventricle hypertrophy and failure
- backup of blood in R atrium and venous circulation
- venous congestion
- JVD and peripheral edema
- can result from L HF = cor pulmonale
✔✔R HR clinical manifestations - ✔✔(swelling)
- dyspnea/orthopnea
- rales
- weakness
- nocturnal paroxysmal dyspnea (pillows)
- ^ HR
- cough
- weight gain
- activity intolerance
✔✔CHF dx - ✔✔CBC, lytes, renal
Natriuretic peptide presence
ECG
✔✔CHF assessment findings - ✔✔weak pulse, tachycardia, low Spo2, cyanosis, pallor
cold/moist skin
N&V
low urine output
aus: S3 gallop, crackles, wheeze
✔✔CHF meds - ✔✔diuretics
ACE inhibitors
angiotensin II receptor blockers
b-adrenergic antagonists
inotropic drugs
O2
✔✔CHF tx - ✔✔-correct Na and H2o retention (V overload)
- lower workload and ^ contractility
- control factors
- meds
- DASH diet
- high fowlers
,✔✔CHF nursing - ✔✔assess
- chest pain, resp, CVS and PVS, weight, I&O
- precordium, neck veins, neuro
- edema
- BS
✔✔emergency HF signs - ✔✔dyspnea, SOB
tachycardia, chest pain
confusion
fainting
✔✔HF teaching - ✔✔health promotion and diet
exercise and rest
progression
limit Na
✔✔Acute HF - ✔✔acute LV failure dt myocardial ischemia (no blood to cardiac muscles)
leads to chronic HF
✔✔acute HF clinical manifestations - ✔✔pulmonary edema
^ RR
low SpO2
tachypnea
resp acidosis
✔✔acute HF tx - ✔✔reduce fluid overload
reduce venous return = lower preload
lower anxiety and reassure
limit CO
^ gas exchange and O2
Meds to ^ CVS
✔✔mitral valve stenosis - ✔✔refers to irregular conditions of the mitral valve. LA-->LV
^LA V and pressure
- hypertrophy of pulmonary vessels
causes
- rheumatic fever
- valve obstruction
✔✔mitral valve stenosis clinical manifestations - ✔✔dyspnea, chest pain
palpitations
fatigue
hoarse voice
,emboli risk
✔✔mitral valve stenosis assessment findings - ✔✔Loud S1
rumbling murmur at apex
✔✔Stenosis - ✔✔valve narrowing
= restriction or forwards blood flow = retrograde
pressure gradient across open valve
✔✔regurgitation - ✔✔valve leaks
incompetent closure of leaflets = retrograde blood
✔✔aortic valve stenosis - ✔✔narrowing of the aortic valve (calcify) = obstruction LV-->
aorta
LV hypertrophy
^ workload = low CO = HF
cause
- rheumatic fever
- CHF
✔✔valvular heart disease - ✔✔stenosis or regurgitation or mitral or aortic valve
✔✔aortic valve stenosis clinical manifestations - ✔✔- angina
- syncope
- exertional dyspnea
- this triad reflects left ventricular failure
- murmur and S4
✔✔Mitral valve regurgitation - ✔✔incompetent closure of mitral valve = backflow
^ work of LA and LV to maintain CO
^ V in LA
atrial and ventricular hypertrophy
Cause
- rheumatic fever
- MI
- trauma
✔✔Mitral valve regurgitation clinical manifestations - ✔✔Chronic: asymptomatic, LV
failure, S3
Acute: low CO, thready pulse, murmur
✔✔aortic valve regurgitation - ✔✔disease of leaflet and aortic root
, retrograde flow from aorta --> LV
V overload
LV hypertrophy = compensation
back up in LA, pulmonary bed, RV
Pulmonary HTN
R HF
✔✔aortic valve regurgitation clinical manifestations - ✔✔SOB, fatigue, lightheaded,
chest pain
murmur
✔✔valvular heart disease dx by - ✔✔physical
Hx
ECG
x-ray
cardiac catheterization
✔✔Valvular Heart disease tx - ✔✔percutaneous transluminal balloon valvuloplasty
transcatheter aortic valve implantation
limit complications
perc valve replacement
open air valve
✔✔valvular heart disease nursing - ✔✔assess
- chest pain
- resp, CVS, PVS
- lifestyle
- palapte: carotid, precordium, pulses, and skin
do
- high fowlers
- prevent HF
✔✔DM T1 - ✔✔common in young. genetic or viral exposure
autoimmune: destruction of pancreatic b-cells
NO endogenous insulin
= no insulin --> cells, ^BGM, glucose not used --> urine
No glycogenolysis or gluconeogenesis
= hyperglycemia and cell starvation = fat broken down = ketone production = DKA
✔✔DM T1 clinical manifestations - ✔✔months--> years (rapid onset)
occur when pancreas produces no insulin
- 3P's (polyuria, polydipsia, polyphagia)
- weight loss
- fatigue
- infections
