NRSG 3420 Final Exam Review With Correct Solutions

NRSG 3420 Final Exam Review With
Correct Solutions.




Priority nursing diagnoses for cardiac and respiratory patients - CORRECT ANSWER✔✔- hemodynamic
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instability
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- impaired gas exchange
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- fluid/electrolyte imbalance
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- ineffective airway clearance
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Cardiac index - CORRECT ANSWER✔✔cardiac output per body surface area
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normal 2.5-4.0L/min/m2
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Central venous pressure (CVP) - CORRECT ANSWER✔✔- Pressure in the SVC, measures right sided heart
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function
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- Normal = 2-8mmHg
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- >6 = excessive volume/right sided HF
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- <2 = hypovolemia, dehydration
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,Pulmonary artery wedge pressure (PAWP) - CORRECT ANSWER✔✔evaluation of LV filling pressure
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normal = 6-12mmHg j j




Mean arterial pressure (MAP) - CORRECT ANSWER✔✔- average pressure in arteries during 1 cardiac cycle
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- normal is >65mmHg, ideal 70-100
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- calculation: (SBP + 2DBP)/3
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Beta blockers - CORRECT ANSWER✔✔- BLOCK beats
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- dampen sympathetic nervous system response, improves LV remodeling, decreases reoccurrence of
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ventricular arrhythmias
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- do not use in pts with asthma/other pulmonary diseases. bradycardia, heart block
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- slows HR, reduces BP, reduced contractility
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Calcium channel blockers - CORRECT ANSWER✔✔- lowers HR and reduce strength of contraction to reduce
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workload
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- increases O2 supply by dilating arteries and reduces O2 demand by decreasing LV workload
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- ex. amlodipine, diltiazem
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HMG-CoA Reductase Inhibitors - CORRECT ANSWER✔✔- "statins"
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- inhibits enzyme involved in lipid synthesis --> decreased LDL, triglycerides, total cholesterol and increased
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HDL
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ACE inhibitors - CORRECT ANSWER✔✔- inhibits conversion of angiotensin I to II --> lowers peripheral
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resistance and decreases BP/afterload
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- reduces preload, afterload, and ventricular remodeling
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- indicated for tx of HF, not recommended for initial dx of ADHF
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- ex. prils: captopril, lisinopril, enalapril
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, Angiotensin II Receptor Blockers (ARBs) - CORRECT ANSWER✔✔- blocks effects of angiotensin II to reduce
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peripheral resistance --> decreases BP and afterload
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- sartans: losartan, valsartan
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Digoxin - CORRECT ANSWER✔✔- positive inotrope= improved cardiac contractility--> increased CO
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- decreases HR, withhold if HR <60
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treatment algorithm for CP/MI - CORRECT ANSWER✔✔MONA - morphine, oxygen, nitroglycerin, aspirin
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Inotropic - CORRECT ANSWER✔✔- force of heart contraction
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- positive: digoxin, dobutamine --> improve contractility, increased SV, CO, and O2 demand
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- negative: beta blockers, CCBs --> weaken/decrease force of heart contraction
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chronotropic - CORRECT ANSWER✔✔- rate of heart contraction
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- positive: epi, atropine
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- negative: beta blockers
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dromotropic - CORRECT ANSWER✔✔- electrical conduction
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- positive: atropine --> increased conduction velocity
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- negative: digoxin, verapamil
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When to hold cardiac meds (vitals) - CORRECT ANSWER✔✔HR <60 or BP <110/70
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Interventions for chest pain - CORRECT ANSWER✔✔STAT: MONA, rest, thrombolytic agents, percutaneous
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coronary intervention
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