NURS 114 - Final Exam questions with multiple choices questions with correct answers

No P wave; irregular rhythm, irregular pattern; very fast rate (350-600 atrial beats/minute) - correct answers characteristics of A fib decrease inflammation methotrexate and hydroxychloroquine - correct answers main fn of DMARDs and 2 types low CO; arf thrombus & stroke bc heart is quivering not actually pumping - correct answers risks/sxs associated with A fib Amiodarone - regulates rhythm (Ami won't turn One unless we regulate her rhythm) Digoxin (do not give if HR 60) - regulates rhythm (A fIb - dIg) Anti-coag (warfarin, heparin) - dt thrombus risk CCB (-pines, diltiazem, verapamil) - relaxes the heart muscle B-blockers(-lols) - decrease HR - correct answers drugs for A fib anorexia, NV, fatigue, HA, visual changes, depression monitor K while giving Dig - correct answers whats Dig toxicity potassium - correct answers What level should you monitor while taking Dig Too much potassium can cause digoxin not to be effective/therapeutic - correct answers how does too much potassium effect Dig Too little potassium can cause digoxin to be TOO effective causing toxicity - correct answers how does too little potassium effect Dig Cardioversion, ablation - correct answers Sx for a fib Sawtooth-shaped flutter waves - correct answers how can you describe A flutter No P waves; regular pattern, irregular rhythm; very fast atrial rate - correct answers what is A flutter characterized by Low CO; arf thrombus & stroke - correct answers sxs/ risks when you have a flutter Amiodarone - to maintain nL rhythm i want ami to stay 1 forever Anti-coag (warfarin, heparin) - dt thrombus risk CCB (-pines, diltiazem) - relaxes the heart muscle B-blockers(-lols) - decrease HR - correct answers drugs for a flutter Cardioversion, ablation - correct answers sx for a flutter regular rhythm, high rate (150-220 bpm) basically tachycardia, just rate above 150 - correct answers how would you describe SVT Low CO; low BP; CP & dyspnea - correct answers sxs of having SVT #1: IV adenosine - reduce HR (give rapidly, follow with flush) (drink gator*ADE* to cool down and *decrease HR* .......or.... I want to slow down on my sinning) Digoxin - decreases HR (monitor potassium) Anti-coag (warfarin, heparin) - dt thrombus risk CCB (-pines, diltiazem) - relaxes the heart muscle B-blockers(-lols) - decrease HR - correct answers drugs for SVT P wave present, regular rhythm, slow rate ( 60 bpm) - correct answers how can you describe bradycardia ASK if this is normal for them.. if it is and they are asymptomatic tx isnt needed - correct answers what should you do FIRST with a brady pt? Fatigue, dizzy, CP, syncope, confusion, SOB, low BP, pale/cool skin - correct answers sxs of bradycardia IF SYMPTOMATIC... IV aTrOPine (causes HR to get to the *TOP*) - correct answers drugs for bradycardia P wave present, regular rhythm, fast rate (101-149 bpm) - correct answers describe tachycardia stressors, exercise, fever, pain, low BP, low volume, low O2, MI, HF, fear - correct answers what can cause tachycardia Dizzy, SOB, low BP, CP → like when you're running outside and it's hot - correct answers sxs of tachycardia TREAT THE CAUSE ex. if they have fever - antipyretic if theyre in pain- analgesic - correct answers what the first thing you should do for a tachycardic pt IV adenosine - reduce HR (give rapidly, follow with flush) (drink gator*ADE* to cool down and *decrease HR*) CCB (-pines, diltiazem) - relaxes the heart muscle B-blockers(-lols) - decrease HR - correct answers drugs for tachycardia P wave present, regular rhythm, regular rate (60-100 bpm) - correct answers whats normal sinus look like treat what the pt presents w not the monitor - correct answers rule of thumb for dysrythmias #1: ABCs (AIRWAY AIRWAY AIRWAY) O2 via cannula or non-rebreather 12-lead EKG IV access Get labs - correct answers Immediate nursing interventions for symptomatic dysrhythmias Allow access for repeated access to the vascular system (cont. infusion; TPN; vesicants) - correct answers what would a CVAD be given for XRAY - correct answers how must you verify CVAD prior to use NO bp or needle sticks in that arm - correct answers nursing considerations for CVAD lower rate of infection bc PICC starts farther away from heart so bugs have farther to travel - correct answers whats better ab a PICC than a CVC Distal tip lies within superior vena cava (NOT THE VENTRICLE!) - correct answers where does a PICC end implanted into skin - correct answers whats a port look like Use Huber needles at 90 degree angle; sterile technique when accessing; palpate using 2 fingers - correct answers how can you access a port yep - correct answers can you give meds/ draw blood from port NO VESSICANTS - correct answers contrindication for midlines? 2-4 wks - correct answers how long can you have a midline 1/2 way to superior vena cava - correct answers where does a midline end Could be caused by kink, tip against vessel wall, thrombus, occlusion - correct answers what can an occlusion be caused by Try changing pt position (raise arm and cough); Assess for kinks/clamps; Flush with 10 mL NS; DO NOT FORCE IT; Notify HCP - correct answers how can you try to fix an occlusion Could be caused by broken cath, thrombus, or air - correct answers what could cause an embolism CP, acute resp distress, high HR, low BP - correct answers sxs of embolism O2 Clamp cath; Pt pos on LEFT side with head down; Notify HCP - correct answers first thing you do for an embolism in the catheter Could be caused by perforation during insertion of a CVAD - correct answers what could cause a pneumo absent/decreased breath sounds, SOB, CP - correct answers sxs of pneumo O2 semi fowlers chest tube - correct answers what do you do for pneumo contamination during insertion/use - correct answers what causes a CLABSI Fever, elevated WBC - correct answers sxs of clabsi Blood cultures (do not waste first 10 mL); remove cath - correct answers dx for CLABSI ABX - correct answers dx for CLABSI Redness, tenderness, edema, warmth, purulent drainage at site *different than a CLABSI bc this is infection of tissue not of BLOOD* - correct answers sxs pf central line associated LOCAL infection Culture of exudate; warm compress; remove cath - correct answers dx and tx for central line ass. LOCAL infection 24h p insertion and then q7 days or sooner if needed - correct answers how often is dressing change for CVAD STERILE technique Hand hygiene, clean gloves, mask; turn pt head away; removed edges TOWARDS insertion site; discard; hand hygiene, STERILE gloves; cleanse with chlorhexidine 30s, back and forth; dry; sterile dressing - correct answers how is dressing change of a CVAD done To maintain line patency and prevent occlusion STOP if you feel resistance