NSG 210 EXAM QUESTIONS ANSWERED CORRECTLY SET TO SCORE A+

NSG 210 EXAM QUESTIONS ANSWERED CORRECTLY SET TO SCORE A+ When HF patients are admitted or come to the hospital - Answer-a BNP (100 pg/mL) will be done It is released from the left ventricles in response to elevated blood volume It is a good marker for HF Digitalis - Answer-Improves contractility of the heart Monitor for toxicity esp in patients with hypokalemia IV meds indicated for hospitalized patients admitted with acute de compensated HF HF and Gerontological considerations - Answer-May present with S/S of fatigue, weakness, somnolence, decreased renal function More resistant to diurectics More sensitive to volume changes Administered to older men monitor for bladder distention caused by urethral obstruction from prostate gland enlargement Focus of caring for HF patient - Answer-Improve functional status Extend life expectancy Relieve symptoms Improve quality of life Positioning for HF patient - Answer-Elevate the head of the bed to facilitate breathing and rest and support arms Education for HF patient - Answer-Meds Monitor for S/S fluid overload like hypotension S/S of exacerbation including daily weights, exercise and activity programs and prevention of infection Potential complications of HF - Answer-Hypotension or poor perfusion cardiogenic shock dysrhythmias thromboembolism pericardial effusion cardiac tamponade What relieves S/S of HF? - Answer-Ace Inhibitors They improve exercise intolerance How is Heart failure managed? - Answer-With lifestyle changes, and medications Heart failure patient with A fib and low left ventricle ejection fraction - Answer-Will be put on a blood thinner to prevent possible thrombus formation Which classification of meds plays a pivotal role in the management of HF? - Answer-Ace inhibitiors because it helps by causing vasodilation and decrease in myocardial workload and decreases preload and afterload Assessing HF patient - Answer-Assess mental status Lung sounds (crackles, wheezes Heart sounds (S3) Fluid status S/S fluid overload (Do daily weights, accurate I&Os) Assess for response to meds Goals for HF patients and family - Answer-Promote activity Reduce fatigue Relieve fluid overload symptoms decrease anxiety Increase ability to manage anxiety encourage verbalization to make decisions and influence outcomes Management of therapeutic regimen HF patient with acute exacerbation and activity intolerance - Answer-would be prescribed bed rest encourage physical activity 30 to 45 minutes a day exercise training pacing of activities wait 2 hours after eating for physical activities avoid activities in extreme weather modify activities to conserve energy Manifestations of Right Sided Heart Failure - Answer-*Viscera and peripheral congestion *Jugular venous distention (JVD) *Dependent edema *HepatomegalyAb distention, *Ascities *Weight gain Polyuria at rest (nocturnal) Fatigue Weakness Nausea and anorexia Manifestations of Left Sided Heart Failure - Answer-*Pulmonary congestion, crackles*S3 or "ventricular gallop" *Dyspnea on exertion (DOE) *Low O2 sat *Dry, nonproductive cough initially *Oliguria Hypertrophy (displaced apical pulse) Orthopnea Nocturnal dyspnea Fatigue Frothy sputum Altered mental status Diastole heart failure - Answer-Ejection fraction normal Preload - Answer-How much blood is returned to the heart prior to the contraction Systole heart failure - Answer-Ejection fraction is severely reduced afterload - Answer-the pressure required to open your aortic valve Calcium Channel Blockers - Answer-Blocks Calcium from Hear tDecreases AV and SA node conduction Decreases HR and contractions by increasing myocardial O2 supply Amlodipine (Norvasc) Diltiazem (Cardizem) given for chronic Afib S/S lower extremity edema Nitropusside (Nitropress) - Answer-Vasodilator Reduces preload and afterload Reduces O2 demand of heart Nitropusside (Nitropress) is given to - Answer-lower BP in patients with hypothermia, shivering and HTN after a cardiac surgery procedure Severe decompensated HF Aneurysms Hypertensive crisis Nitropusside (Nitropress) IV - Answer-Rapid onset Short action of duration Easily titrated peripheral vasodilation by relaxing smooth muscle Nitropusside (Nitropress) IV - Answer-Contraindications: Sepsis Azotemia (abnormally high levels of nitrogen-containing compounds (such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds) in the blood) Increased intracranial pressure HF with reduced peripheral resistance AV shunt Use with caution in liver and kidney diseases, hypothyroidism, hypovolemia, fluid and electrolyte imbalances and older adults