med surg 2 final exam (test bank)
With Correct Answers!!
list out the conduction sytem of the heart - <<<ANSWER>>>1. inferior/superior vena
cava
2. R atrium
3. tricuspid valve
4. right ventricle
5. pulmonary valve
6. pulmonary artery
7. lungs
8. pulmonary veins
9. left atrium
10. mitral valve
11. left ventricle
12. aortic valve
13. aorta
what are the signs and symptoms of afib? - <<<ANSWER>>>palpitations or chest
discomfort
polyuria
fatigue
dyspnea
lightheadedness
what is the treatment for afib? - <<<ANSWER>>>Drugs to control ventricular rate
and/or convert to sinus rhythym (amiodarone and ibutilide are the most
common)Electrical cardioversionAnticoagulationRadiofrequency ablationMaze
procedure with cryoablation
what is a normal INR? - <<<ANSWER>>>Normal INR = 1.0, normal INR on blood
thinners = 2-3. Otherwise >3 = supratherapeutic (too much coumadin), <2
=subtherapeutic (not enough coumadin)
,what is angina? - <<<ANSWER>>>chest pain caused by reduced blood flow to the
heart
The pain of typical angina subsides with _____ or _____. - <<<ANSWER>>>rest or
NTG
Unstable angina is characterized by... - <<<ANSWER>>>increased frequency and
severity and is not relieved by rest and NTG. Requires medical intervention!
what are nursing interventions for angina? - <<<ANSWER>>>-patient is to stop all
activity and sit or rest in bed
-get VS, look for respiratory distress, and assess pain
assess ECG
-give meds as ordered, usually NTG up to 3 doses
-give 2L oxygen by nasal cannula
define STEMI - <<<ANSWER>>>ECG evidence of acute MI, characteristic changes in 2
continuous leads on a 12 lead ECG
-there is significant damage to myocardium
define NSTEMI - <<<ANSWER>>>elevated cardiac biomarkers (e.g troponin) but no
ECG evidence of acute MI
-may be less damage to the myocardium
MI interventions - <<<ANSWER>>>MONAVOMIT
-morphine
-oxygen
-nitrates
-aspirin
-vitals
-oxygen
-monitor
-IV access
-time to decide
what lab studies are we going to look at for MI - <<<ANSWER>>>TROPONIN
cardiac enzymes
creatine kinase (released when there is muscle damage)
myoglobin
normal troponin - <<<ANSWER>>>Tropinin I- <0.5
Tropinin T <0.1
manifestations of MI - <<<ANSWER>>>Sudden severe chest pain; may radiate
Nausea, vomiting
, Diaphoresis
Dyspnea
*Women may be different: they may just be fatigued or have stomach pain
patient teaching for ICD - <<<ANSWER>>>Implantable cardiac defirillator teaching:
-follow up appointments
-incision care-arm restrictions (don't lift anything above the head or anything heavy)
-sexual activity (wait a week and see how you feel)
-driving (don't drive for 2 weeks)
-avoid direct blows (ex. turn back to the shower water)
-avoid large magnets, MRI-air travel (must be wanded)
-avoid antitheft devices
-what to do if ICD fires
-medic alert ID
-ICD id card
-caregivers should learn CPR
what are the signs of TB - <<<ANSWER>>>BLOODY SPUTUM
-cough
-chest pain
-weight loss
-fever
-night sweats
-dark urine
Besides TB, when will you also see bloody sputum - <<<ANSWER>>>left sided heart
failure
How do we administer eye drops? - <<<ANSWER>>>When administering eye drops,
have the patient tilt their head back slightly and use your hand to pull down the lower
eyelid. Then, hold the dropper close to the eyes and squeeze the prescribed number of
drops in the conjunctival sac. Then close the patient's eye for a minute to make sure the
medication does not leave the eye
Explain the Rinne hearing test - <<<ANSWER>>>With the Rinne test, a tuning fork is
used and is placed first 2 inches from the ear canal opening and then on the mastoid
bone. During the position change, the patient should be able to recognize that the ear
canal position is louder
Explain the Weber Test - <<<ANSWER>>>With the Weber test, a tuning fork is used
and placed on the forehead of the patient to see if the patient hears the sound equally in
both ears.
With Correct Answers!!
list out the conduction sytem of the heart - <<<ANSWER>>>1. inferior/superior vena
cava
2. R atrium
3. tricuspid valve
4. right ventricle
5. pulmonary valve
6. pulmonary artery
7. lungs
8. pulmonary veins
9. left atrium
10. mitral valve
11. left ventricle
12. aortic valve
13. aorta
what are the signs and symptoms of afib? - <<<ANSWER>>>palpitations or chest
discomfort
polyuria
fatigue
dyspnea
lightheadedness
what is the treatment for afib? - <<<ANSWER>>>Drugs to control ventricular rate
and/or convert to sinus rhythym (amiodarone and ibutilide are the most
common)Electrical cardioversionAnticoagulationRadiofrequency ablationMaze
procedure with cryoablation
what is a normal INR? - <<<ANSWER>>>Normal INR = 1.0, normal INR on blood
thinners = 2-3. Otherwise >3 = supratherapeutic (too much coumadin), <2
=subtherapeutic (not enough coumadin)
,what is angina? - <<<ANSWER>>>chest pain caused by reduced blood flow to the
heart
The pain of typical angina subsides with _____ or _____. - <<<ANSWER>>>rest or
NTG
Unstable angina is characterized by... - <<<ANSWER>>>increased frequency and
severity and is not relieved by rest and NTG. Requires medical intervention!
what are nursing interventions for angina? - <<<ANSWER>>>-patient is to stop all
activity and sit or rest in bed
-get VS, look for respiratory distress, and assess pain
assess ECG
-give meds as ordered, usually NTG up to 3 doses
-give 2L oxygen by nasal cannula
define STEMI - <<<ANSWER>>>ECG evidence of acute MI, characteristic changes in 2
continuous leads on a 12 lead ECG
-there is significant damage to myocardium
define NSTEMI - <<<ANSWER>>>elevated cardiac biomarkers (e.g troponin) but no
ECG evidence of acute MI
-may be less damage to the myocardium
MI interventions - <<<ANSWER>>>MONAVOMIT
-morphine
-oxygen
-nitrates
-aspirin
-vitals
-oxygen
-monitor
-IV access
-time to decide
what lab studies are we going to look at for MI - <<<ANSWER>>>TROPONIN
cardiac enzymes
creatine kinase (released when there is muscle damage)
myoglobin
normal troponin - <<<ANSWER>>>Tropinin I- <0.5
Tropinin T <0.1
manifestations of MI - <<<ANSWER>>>Sudden severe chest pain; may radiate
Nausea, vomiting
, Diaphoresis
Dyspnea
*Women may be different: they may just be fatigued or have stomach pain
patient teaching for ICD - <<<ANSWER>>>Implantable cardiac defirillator teaching:
-follow up appointments
-incision care-arm restrictions (don't lift anything above the head or anything heavy)
-sexual activity (wait a week and see how you feel)
-driving (don't drive for 2 weeks)
-avoid direct blows (ex. turn back to the shower water)
-avoid large magnets, MRI-air travel (must be wanded)
-avoid antitheft devices
-what to do if ICD fires
-medic alert ID
-ICD id card
-caregivers should learn CPR
what are the signs of TB - <<<ANSWER>>>BLOODY SPUTUM
-cough
-chest pain
-weight loss
-fever
-night sweats
-dark urine
Besides TB, when will you also see bloody sputum - <<<ANSWER>>>left sided heart
failure
How do we administer eye drops? - <<<ANSWER>>>When administering eye drops,
have the patient tilt their head back slightly and use your hand to pull down the lower
eyelid. Then, hold the dropper close to the eyes and squeeze the prescribed number of
drops in the conjunctival sac. Then close the patient's eye for a minute to make sure the
medication does not leave the eye
Explain the Rinne hearing test - <<<ANSWER>>>With the Rinne test, a tuning fork is
used and is placed first 2 inches from the ear canal opening and then on the mastoid
bone. During the position change, the patient should be able to recognize that the ear
canal position is louder
Explain the Weber Test - <<<ANSWER>>>With the Weber test, a tuning fork is used
and placed on the forehead of the patient to see if the patient hears the sound equally in
both ears.
