NUR 210
EXAM 4 STUDY GUIDE
Principles Of Pharmacology
Galen College of Nursing
, Final Exam 4 Cardiac Assessment:
Unit 9
Heart sounds:
APE To Man
Apical: right side- 2nd intercostal
Pulmonary: Left side 2nd intercostal Labs and DX:
Erb’s Point: Left side 3rd intercostal • BNP: higher the #, higher indicative of
heart failure
Tricuspid Valve: left side 4 intercostal
• CK, CKMB, myoglobin, Troponin
Mitral Valve: left side 5th intercostal (specific to the cardiac muscle)
NONREVERSABLE
Apical pulse: left side 5th intercostal midclavicular
Myocardial Infarction: blockage or disruption of blood Treatment:
flow to the coronary tissue • Morphine
s/s: • Oxygen
• Crushing/ chest tightness • Nitrogen
• Unrelieved with nitro • Aspirin
• Increased HR • 2 preferred IV accesses
• Extreme weakness • Synthetic TPA (fibrinolytic therapy) breakdown of clot
• Pain radiation to the back, jaw, neck, shoulder, arm I have to
Nursing Interventions: Pharmacological Interventions:
• Administer analgesic • Betablockers: LOLs
• Cluster care to provide rest - Assess BP/HR prior to administration
• Clear liquid diet • Ace-inhibitors: PRILS
• Stool softeners to prevent straining - Hold onto potassium- monitor levels; assess for palpitations,
• ROM exercise diarrhea, vomiting, muscle cramps
Cardiac Catheterization considerations: - If BP drops <90, notify the provider, and place the patient
• To confirm suspected HF, CAD, MI, or valvular supine with legs elevated- causes a cough
dysfunction • Digoxin: increased contractility
• To perform the best therapeutic option such as - Assess apical HR for 1 full min prior to administration-
angioplasty, stents, bypass graft decreased HR is an expected response
• Obtain consent for dye, assess urine output, baseline - Teach pt to report nausea, vomiting, diarrhea, paresthesia,
VS, and mark pedal pulses, assess BUN levels- stop confusion, and visual disturbance= can indicate dig toxicity
metformin 48 hours pre-surgery - Monitor HR and rhythm: increased HR is expected
• Post TX: - Avoid Hypokalemic patients: higher risk of dig toxicity
- Best rest • Calcium channel blocker: Diltiazem
- Distal pulses - Asses bp and HR
- Assess for bleeding at the site - Reposition slowly,
- Increase fluid to flush out dye - Used for AF or atrial flutter
- May need a medication adjustment
• Muscarinic blocker: atropine- increases heart rate and BP - blocks
the PNS
Left-sided heart failure: back flow to the lungs Right-sided heart failure: the back flow of the systemic
s/s: extremities
• Crackles and wheezing of the lungs s/s:
• Weakness/ lethargic • Peripheral edema
• SOB/ dyspnea/Apnea • Jugular vein distention
• Pallor/ delayed cap refill • Ascites due to fluid backup in the hepatic system
• Tachycardia • Weight gain
• Cough • Fatigue
Interventions: TX:
• Position in semi-fowlers position • Digoxin
• Cluster care • Loops diuretics
This study source was downloaded by 100000902171055 from CourseHero.com on 11-20-2025 17:24:05 GMT -06:00
https://www.coursehero.com/file/235473612/FInal-Exam-4-reviewpdf/
EXAM 4 STUDY GUIDE
Principles Of Pharmacology
Galen College of Nursing
, Final Exam 4 Cardiac Assessment:
Unit 9
Heart sounds:
APE To Man
Apical: right side- 2nd intercostal
Pulmonary: Left side 2nd intercostal Labs and DX:
Erb’s Point: Left side 3rd intercostal • BNP: higher the #, higher indicative of
heart failure
Tricuspid Valve: left side 4 intercostal
• CK, CKMB, myoglobin, Troponin
Mitral Valve: left side 5th intercostal (specific to the cardiac muscle)
NONREVERSABLE
Apical pulse: left side 5th intercostal midclavicular
Myocardial Infarction: blockage or disruption of blood Treatment:
flow to the coronary tissue • Morphine
s/s: • Oxygen
• Crushing/ chest tightness • Nitrogen
• Unrelieved with nitro • Aspirin
• Increased HR • 2 preferred IV accesses
• Extreme weakness • Synthetic TPA (fibrinolytic therapy) breakdown of clot
• Pain radiation to the back, jaw, neck, shoulder, arm I have to
Nursing Interventions: Pharmacological Interventions:
• Administer analgesic • Betablockers: LOLs
• Cluster care to provide rest - Assess BP/HR prior to administration
• Clear liquid diet • Ace-inhibitors: PRILS
• Stool softeners to prevent straining - Hold onto potassium- monitor levels; assess for palpitations,
• ROM exercise diarrhea, vomiting, muscle cramps
Cardiac Catheterization considerations: - If BP drops <90, notify the provider, and place the patient
• To confirm suspected HF, CAD, MI, or valvular supine with legs elevated- causes a cough
dysfunction • Digoxin: increased contractility
• To perform the best therapeutic option such as - Assess apical HR for 1 full min prior to administration-
angioplasty, stents, bypass graft decreased HR is an expected response
• Obtain consent for dye, assess urine output, baseline - Teach pt to report nausea, vomiting, diarrhea, paresthesia,
VS, and mark pedal pulses, assess BUN levels- stop confusion, and visual disturbance= can indicate dig toxicity
metformin 48 hours pre-surgery - Monitor HR and rhythm: increased HR is expected
• Post TX: - Avoid Hypokalemic patients: higher risk of dig toxicity
- Best rest • Calcium channel blocker: Diltiazem
- Distal pulses - Asses bp and HR
- Assess for bleeding at the site - Reposition slowly,
- Increase fluid to flush out dye - Used for AF or atrial flutter
- May need a medication adjustment
• Muscarinic blocker: atropine- increases heart rate and BP - blocks
the PNS
Left-sided heart failure: back flow to the lungs Right-sided heart failure: the back flow of the systemic
s/s: extremities
• Crackles and wheezing of the lungs s/s:
• Weakness/ lethargic • Peripheral edema
• SOB/ dyspnea/Apnea • Jugular vein distention
• Pallor/ delayed cap refill • Ascites due to fluid backup in the hepatic system
• Tachycardia • Weight gain
• Cough • Fatigue
Interventions: TX:
• Position in semi-fowlers position • Digoxin
• Cluster care • Loops diuretics
This study source was downloaded by 100000902171055 from CourseHero.com on 11-20-2025 17:24:05 GMT -06:00
https://www.coursehero.com/file/235473612/FInal-Exam-4-reviewpdf/
