NRSG 533 MN adult exam 3 questions with
complete solutions 2024
BP j- jANS✓✓--affected jby jcontractility, jpreload, jand jafterload j(strongest
jvariable)
-block jangiotensin jII j- jblock jvasoconstriction j
-angiotensin jII j- jpotent jvasoconstriction j
-epi j- jworks jon jheart j
-noripe- jvasoconstriction jof jvascular jsystem
primary jhypertension j- jANS✓✓-idiopathic, jmost jcommon, jno jcause
secondary jhypertension j- jANS✓✓-has ja jspecific jcause jthat jcan jbe jidentified
jcorrected
when jyou jthink jHTN jthink j- jANS✓✓-ischemia
HTN jischemia jeffects j- jANS✓✓--heart, jbrain, jkidney, jeyes, jlungs
# jfor jHTN j- jANS✓✓--proxy jof jtelling jus jhow jtight jthe jpressure jin jvessel j- jblood
jmoving jthrough jartery
higher jBP jmeans j- jANS✓✓-less jblood jflow jthrough jarteries
high jBP jis jnot jsymptomatic juntil j- jANS✓✓-you jhit jthe jorgan jfailure jstage
normal jBP j- jANS✓✓-Systolic j<120
and j
Diastolic j<80
elevated jBP j- jANS✓✓-S: j120-129 j
and j
D: j< j80
stage j1 jhypertension j- jANS✓✓-S: j130-139 j
or j
D: j80-89
,stage j2 jhypertension j- jANS✓✓-S: jgreater jthan jor jequal jto j140 j
or j
D: jgreater jthan jor jequal jto j90
HTN jemergency j- jANS✓✓->180/120 jwith jend jorgan jdamage
Treat jwith jIV jnitroprusside
reduce jby j25% jin jfirst jhour
HTN jurgency j- jANS✓✓--no jtarget jorgan jdamage j
-treat jwith jPO jmeds j- jclonidine j
-returns jto jtheir jnormal j
-reduce jby j25%
-dont jwant jto jdrop jBP jto jfast, jbc jit jcan jeffect jbrain, jpump jloosen, jpressure jnot
jenough jprofusion
how jto jcalculate jMAP j- jANS✓✓-MAP= j1/2SBP j+ j2/3DBP
calculating jreducing jMAP j- jANS✓✓-MAP= j180, jreduce jby j25% j
=180 jx j.25
=45
new jMAP j= j135
HF jsymptoms jdont jmanifest j- jANS✓✓-in jheart jbut jheart jis jmain jproblem
jbecause jits jnot jputting jout jenough jblood jto jmaintain jrest jof jbody jneeds
why jliver jis jnot jeffected jby jHF j- jANS✓✓-bc jof jhepatic jcirculation j- jblood jflow
jfrom jother jplaces
kidneys jand jHF j- jANS✓✓--kidneys jcan jcompensate jfor ja jshort jperiod jof jtime j
-kidneys jeffect jwater jretention jdue jto jlack jof jprofusion j-vasoconstriction j-
jincrease jblood jvolume jin jbody
left jsided jHF jsymptoms j- jANS✓✓--SOB j
-dyspnea j
-wheezing j
-moist jcough j
-confusion j
-crackles jin jlungs
right jsided jHF jsymptoms j- jANS✓✓--peripheral jedema, jpitting j
-JVD j(pulsating) j
-liver jtenderness j- jhepatomegaly j
-anorexia j- jloss jof jappetite j
-weight jgain j(2/3 jlbs jper jday jor j5 jlbs jper jweek j)
major jcauses jof jright jsided jheart jfailure j- jANS✓✓--smoking j
, -COPD j
-enphazemia
systolic jHF j(contractility jproblem) j- jANS✓✓--HFref j(reduced) j
-left jsided j
-ejection jfraction j< j40 j%
causes jof jHFref j- jANS✓✓--ischemic jCAD j(70%) j
-dilated jcardiomyopathy j(30% jfamilial) j
-myocarditis j- jviral j
-valvular jheart jdisease j- jaortic jstenosis j
-tachycardia j- jmetabolic, jthyroid j
-atrial jfibrillation j
-Adriamycin jfor jcancer jtreatment
diastolic jheart jfailure j(filling jproblem) j- jANS✓✓--HFpef j(perserved) j
-left jsided j
-EF jWNL jor j> j50% jor jhigher
causes jof jHFpef j- jANS✓✓--aging j
-thickening jof jheart jmuscle j- jHTN j
-diabetes j
-obesity j
-alcohol/substance jabuse j
-viral j
-cardiomyopathy
diagnosis jof jHF j- jANS✓✓--CXR j(cardiomegaly, jpulmonary jcongestion),
-BNP j(brain jnatriuretic jpeptide) j
-echocardiogram
stage jA jHF jtreatment jfocuses jon j- jANS✓✓--blocking jconversion jof jangiotensin
jI jto jangiotensin jII j( jACE jInhibitors) j
-block jangiotensin jII j(ARBS)
ACE jinhibitor jprototypes j- jANS✓✓--lisinopril j
-vasotec j
-altace j
-prinivil
ACE jinhibitor j- jANS✓✓--improves jsymptoms, jexercise jcapacity, jLVEF jand
jelectrolytes j
-recommended jfor jall jpatients junless jcontraindicated
ACEI jside jeffects j- jANS✓✓--cough j
-hypotension j
complete solutions 2024
BP j- jANS✓✓--affected jby jcontractility, jpreload, jand jafterload j(strongest
jvariable)
-block jangiotensin jII j- jblock jvasoconstriction j
-angiotensin jII j- jpotent jvasoconstriction j
-epi j- jworks jon jheart j
-noripe- jvasoconstriction jof jvascular jsystem
primary jhypertension j- jANS✓✓-idiopathic, jmost jcommon, jno jcause
secondary jhypertension j- jANS✓✓-has ja jspecific jcause jthat jcan jbe jidentified
jcorrected
when jyou jthink jHTN jthink j- jANS✓✓-ischemia
HTN jischemia jeffects j- jANS✓✓--heart, jbrain, jkidney, jeyes, jlungs
# jfor jHTN j- jANS✓✓--proxy jof jtelling jus jhow jtight jthe jpressure jin jvessel j- jblood
jmoving jthrough jartery
higher jBP jmeans j- jANS✓✓-less jblood jflow jthrough jarteries
high jBP jis jnot jsymptomatic juntil j- jANS✓✓-you jhit jthe jorgan jfailure jstage
normal jBP j- jANS✓✓-Systolic j<120
and j
Diastolic j<80
elevated jBP j- jANS✓✓-S: j120-129 j
and j
D: j< j80
stage j1 jhypertension j- jANS✓✓-S: j130-139 j
or j
D: j80-89
,stage j2 jhypertension j- jANS✓✓-S: jgreater jthan jor jequal jto j140 j
or j
D: jgreater jthan jor jequal jto j90
HTN jemergency j- jANS✓✓->180/120 jwith jend jorgan jdamage
Treat jwith jIV jnitroprusside
reduce jby j25% jin jfirst jhour
HTN jurgency j- jANS✓✓--no jtarget jorgan jdamage j
-treat jwith jPO jmeds j- jclonidine j
-returns jto jtheir jnormal j
-reduce jby j25%
-dont jwant jto jdrop jBP jto jfast, jbc jit jcan jeffect jbrain, jpump jloosen, jpressure jnot
jenough jprofusion
how jto jcalculate jMAP j- jANS✓✓-MAP= j1/2SBP j+ j2/3DBP
calculating jreducing jMAP j- jANS✓✓-MAP= j180, jreduce jby j25% j
=180 jx j.25
=45
new jMAP j= j135
HF jsymptoms jdont jmanifest j- jANS✓✓-in jheart jbut jheart jis jmain jproblem
jbecause jits jnot jputting jout jenough jblood jto jmaintain jrest jof jbody jneeds
why jliver jis jnot jeffected jby jHF j- jANS✓✓-bc jof jhepatic jcirculation j- jblood jflow
jfrom jother jplaces
kidneys jand jHF j- jANS✓✓--kidneys jcan jcompensate jfor ja jshort jperiod jof jtime j
-kidneys jeffect jwater jretention jdue jto jlack jof jprofusion j-vasoconstriction j-
jincrease jblood jvolume jin jbody
left jsided jHF jsymptoms j- jANS✓✓--SOB j
-dyspnea j
-wheezing j
-moist jcough j
-confusion j
-crackles jin jlungs
right jsided jHF jsymptoms j- jANS✓✓--peripheral jedema, jpitting j
-JVD j(pulsating) j
-liver jtenderness j- jhepatomegaly j
-anorexia j- jloss jof jappetite j
-weight jgain j(2/3 jlbs jper jday jor j5 jlbs jper jweek j)
major jcauses jof jright jsided jheart jfailure j- jANS✓✓--smoking j
, -COPD j
-enphazemia
systolic jHF j(contractility jproblem) j- jANS✓✓--HFref j(reduced) j
-left jsided j
-ejection jfraction j< j40 j%
causes jof jHFref j- jANS✓✓--ischemic jCAD j(70%) j
-dilated jcardiomyopathy j(30% jfamilial) j
-myocarditis j- jviral j
-valvular jheart jdisease j- jaortic jstenosis j
-tachycardia j- jmetabolic, jthyroid j
-atrial jfibrillation j
-Adriamycin jfor jcancer jtreatment
diastolic jheart jfailure j(filling jproblem) j- jANS✓✓--HFpef j(perserved) j
-left jsided j
-EF jWNL jor j> j50% jor jhigher
causes jof jHFpef j- jANS✓✓--aging j
-thickening jof jheart jmuscle j- jHTN j
-diabetes j
-obesity j
-alcohol/substance jabuse j
-viral j
-cardiomyopathy
diagnosis jof jHF j- jANS✓✓--CXR j(cardiomegaly, jpulmonary jcongestion),
-BNP j(brain jnatriuretic jpeptide) j
-echocardiogram
stage jA jHF jtreatment jfocuses jon j- jANS✓✓--blocking jconversion jof jangiotensin
jI jto jangiotensin jII j( jACE jInhibitors) j
-block jangiotensin jII j(ARBS)
ACE jinhibitor jprototypes j- jANS✓✓--lisinopril j
-vasotec j
-altace j
-prinivil
ACE jinhibitor j- jANS✓✓--improves jsymptoms, jexercise jcapacity, jLVEF jand
jelectrolytes j
-recommended jfor jall jpatients junless jcontraindicated
ACEI jside jeffects j- jANS✓✓--cough j
-hypotension j
