NSG 430 EXAM 2
1. What are mechanical circulatory support devices used for: to decreasecardiac work and
improve organ perfusion
2. Short term mechanical circulatory support devices are: IABPs, ECMO, andcontinuous
flow pumps
3. Long term mechanical circulatory support devices: ventricular assist de-vices (VADs)
include percutaneous devices (PVAD and transplanted devices (LVADs, BiVADs)
4. Intraaortic balloon pump (IABP) provides: temporary circulatory assistance by reducing
afterload
5. Benefits of IABP is it: decreases ventricular workload, increased myocardial perfusion,
augment circulation
6. How does a IABP work: a balloon is inserted into femoral artery and placed in descending
thoracic aorta, the balloon inflates and deflates with the heart beat
7. Complications of IABP: thrombus and embolus formation, thrombocytopenia, ischemia to
periphery, kidney, bowel, infection, improper timing of balloon inflation, balloon leak,
malfunction of balloon or console
8. A VADs: shunts blood from left atrium or ventricle to device, then to the aorta
9. Benefits of a VADs: allows more mobility than IABP
10. When is a VADs used: bridge to transplant or they will have it for the rest of their life
(destination therapy)
11. Implantable artificial heart is a: fully implantable heart, can sustain the body's circulation
system, usually used as a bridge to transplant or in a pt who is not eligiblefor a transplant
12. Risk of an implantable artificial heart: infection, thrombus, stroke
13. Nursing management for VAD: observations of bleeding, cardiac tamponade, ventricular
failure, infection, dysrhythmias, renal failure, hemolysis, VTE
14. Heart transplantation is the gold standard for: suitable patient in end stageHF
15. Posttransplantation monitoring: acute rejection, infection, risk of cancer relat-ed
immunosuppressive therapy, cardiac vasculopathy
16. Nursing care for a post transplant pt: promoting pt adaptation to the transplantprocess,
monitor cardiac output and function, detecting subtle signs or symptoms of complications
(cancer), managing lifestyle changes, ongoing teaching
17. Infective endocarditis (IE) is: a disease of the endocardium and the heartvalves, have a
poor prognosis
18. Risk factors of infective endocarditis: history of IE, IV drug use, prostheticvalve, renal
dialysis
,19. Three stages of IE: bacteremia, adhesion, vegetation
20. CM of IE: fever, chills, weakness, malaise, fatigue, anorexia, night sweats
21. Subacute for of IE CM: arthralgias, myalgias, back pain, abdominal discomfort,weight
loss, headache, clubbing of fingers
22. Dx studies for IE: heat history 3-6 months/dental, surgical, gyn, IVDA, implants,infections,
dialysis, lab test (blood cultures, CBC, ERS, echos
23. Interprofessional care for IE: prophylactics antibiotics for high risk clients likeheart
conditions, post procedures (dental, surgery)
24. Tx for active infections of IE: identify the organisms with blood cultures, IV antibiotics
(usually long term), repeat blood culture, valve replacement, antipyretics,fluids, rest
25. Clinical problems for IE: impaired cardiac output, infection, fatigue, substanceuse
26. Health promotions for IE: identify those at risk, assess hx and understandingof disease
process, teach importance of adherence to tr
27. Patient teaching for IE: stress need to avoid people with infections, avoidanceof stress and
fatigue, plan rest periods, food oral hygiene, schedule regular dental visits, prophylactic
antibiotics, drug rehab, monitor body temp
28. Pericarditis is: pericardial sac inflammation and fluid accumulation
29. What causes pericarditis: infectious-bacterial, fungal, viral noninfectious-MI,cancer,
aortic dissection, renal failure, trauma, autoimmune meds
30. What is dressler syndrome: post MI irritations and fluid 4-6 weeks after
31. CM of pericarditis: chest pain, worse with deep inspirations and laying flat, radiating pain
the arm shoulder upper back, tachypnea, shallow breathing, cough,hiccups, pericardial friction
32. Complications of pericarditis: pericardial effusion leading to tamponade (com-pression of
the heart preventing filling sounds) medical emergency
33. Dx of pericarditis: EKG, chest x ray (enlarged), echo, CT/MRI, labs (CBC, CRP,ESR,
troponin, pericardial fluid test culture, biopsy)
34. Tx of pericarditis: treat the cause, antibiotics, NSAIDS (initially), corticosteroids
(autoimmune)
35. Nursing management of pericarditis: pain management , elevate the HOB to45 degrees,
monitor VS and CO for tamponade
36. Types of valvular heart disease are: stenosis or regurgitation
37. What are the two atrioventricular valves: mitral (most important) and tricuspid
38. What are the two semilunar valves: aortic and pulmonic
39. Stenosis is when there is: constriction or narrowing of the valve opening, forward blood
, flow is impeded, pressure differences in the two sides of the valvereflect degree of stenosis
40. Regurgitations is: incompetence of insufficiency, incomplete closure of valveleaflets,
results in backwards flow of blood
41. Mitral valve stenosis common cause: rheumatic heart disease, scarring andcontractures
42. Mitral valve stenosis results in: decreased blood flow from the left atrium tothe left
ventricle
43. What does decrease cardiac output lead to: decreased tissue perfusion, im-paired gas
exchange, fluid imbalance, and decreased functional ability
44. What is left ventricular ejection fraction: the percentage of blood pumped outof the left
ventricle with next systole
45. The most common reason for hospitalization in adults over 65: heart failure
46. Risk factors for HF: HTN, CAD
47. What are the comorbidities that contribute to the development of HF: dia-betes,
metabolic syndrome, advanced age, tobacco use, and vascular disease
48. Etiology of HF: any interference with mechanisms regulating cardiac output(preload
[fill], afterload [empty], HR, contractility)
49. Precipitating causes of HF: conditions that increase workload of the heart(reduced
cardiac output)
50. Left side HF is the inability to: empty adequately during systole or fill adequateduring
diastole
51. Where does the blood go during left sided HF: backs up into the left atrium
52. Left sided HF causes: pulmonary congestion and edema, decrease in leftventricle ejection
factor
53. Right sided HF is when the: RV does not pump effectively
54. Where does the blood go on right sided HF: backs up into the venous system,the fluid moves
into the tissues and organs
55. What is the most common cause of right sided HF: left sided HF
56. Compensated HF occurs when: compensatory mechanisms succeed in main- taining an
adequate CO that is needed for tissue perfusion
57. Decompensated HF occurs when: these mechanisms can no longer maintain adequate CO
and inadequate tissue perfusion results
58. Remodeling is: change in the structure of the heat caused by continuous activa- tion of neuor-
hormonal responses, hypertrophy of ventricular myocytes , ventricles become larger by less
effective
1. What are mechanical circulatory support devices used for: to decreasecardiac work and
improve organ perfusion
2. Short term mechanical circulatory support devices are: IABPs, ECMO, andcontinuous
flow pumps
3. Long term mechanical circulatory support devices: ventricular assist de-vices (VADs)
include percutaneous devices (PVAD and transplanted devices (LVADs, BiVADs)
4. Intraaortic balloon pump (IABP) provides: temporary circulatory assistance by reducing
afterload
5. Benefits of IABP is it: decreases ventricular workload, increased myocardial perfusion,
augment circulation
6. How does a IABP work: a balloon is inserted into femoral artery and placed in descending
thoracic aorta, the balloon inflates and deflates with the heart beat
7. Complications of IABP: thrombus and embolus formation, thrombocytopenia, ischemia to
periphery, kidney, bowel, infection, improper timing of balloon inflation, balloon leak,
malfunction of balloon or console
8. A VADs: shunts blood from left atrium or ventricle to device, then to the aorta
9. Benefits of a VADs: allows more mobility than IABP
10. When is a VADs used: bridge to transplant or they will have it for the rest of their life
(destination therapy)
11. Implantable artificial heart is a: fully implantable heart, can sustain the body's circulation
system, usually used as a bridge to transplant or in a pt who is not eligiblefor a transplant
12. Risk of an implantable artificial heart: infection, thrombus, stroke
13. Nursing management for VAD: observations of bleeding, cardiac tamponade, ventricular
failure, infection, dysrhythmias, renal failure, hemolysis, VTE
14. Heart transplantation is the gold standard for: suitable patient in end stageHF
15. Posttransplantation monitoring: acute rejection, infection, risk of cancer relat-ed
immunosuppressive therapy, cardiac vasculopathy
16. Nursing care for a post transplant pt: promoting pt adaptation to the transplantprocess,
monitor cardiac output and function, detecting subtle signs or symptoms of complications
(cancer), managing lifestyle changes, ongoing teaching
17. Infective endocarditis (IE) is: a disease of the endocardium and the heartvalves, have a
poor prognosis
18. Risk factors of infective endocarditis: history of IE, IV drug use, prostheticvalve, renal
dialysis
,19. Three stages of IE: bacteremia, adhesion, vegetation
20. CM of IE: fever, chills, weakness, malaise, fatigue, anorexia, night sweats
21. Subacute for of IE CM: arthralgias, myalgias, back pain, abdominal discomfort,weight
loss, headache, clubbing of fingers
22. Dx studies for IE: heat history 3-6 months/dental, surgical, gyn, IVDA, implants,infections,
dialysis, lab test (blood cultures, CBC, ERS, echos
23. Interprofessional care for IE: prophylactics antibiotics for high risk clients likeheart
conditions, post procedures (dental, surgery)
24. Tx for active infections of IE: identify the organisms with blood cultures, IV antibiotics
(usually long term), repeat blood culture, valve replacement, antipyretics,fluids, rest
25. Clinical problems for IE: impaired cardiac output, infection, fatigue, substanceuse
26. Health promotions for IE: identify those at risk, assess hx and understandingof disease
process, teach importance of adherence to tr
27. Patient teaching for IE: stress need to avoid people with infections, avoidanceof stress and
fatigue, plan rest periods, food oral hygiene, schedule regular dental visits, prophylactic
antibiotics, drug rehab, monitor body temp
28. Pericarditis is: pericardial sac inflammation and fluid accumulation
29. What causes pericarditis: infectious-bacterial, fungal, viral noninfectious-MI,cancer,
aortic dissection, renal failure, trauma, autoimmune meds
30. What is dressler syndrome: post MI irritations and fluid 4-6 weeks after
31. CM of pericarditis: chest pain, worse with deep inspirations and laying flat, radiating pain
the arm shoulder upper back, tachypnea, shallow breathing, cough,hiccups, pericardial friction
32. Complications of pericarditis: pericardial effusion leading to tamponade (com-pression of
the heart preventing filling sounds) medical emergency
33. Dx of pericarditis: EKG, chest x ray (enlarged), echo, CT/MRI, labs (CBC, CRP,ESR,
troponin, pericardial fluid test culture, biopsy)
34. Tx of pericarditis: treat the cause, antibiotics, NSAIDS (initially), corticosteroids
(autoimmune)
35. Nursing management of pericarditis: pain management , elevate the HOB to45 degrees,
monitor VS and CO for tamponade
36. Types of valvular heart disease are: stenosis or regurgitation
37. What are the two atrioventricular valves: mitral (most important) and tricuspid
38. What are the two semilunar valves: aortic and pulmonic
39. Stenosis is when there is: constriction or narrowing of the valve opening, forward blood
, flow is impeded, pressure differences in the two sides of the valvereflect degree of stenosis
40. Regurgitations is: incompetence of insufficiency, incomplete closure of valveleaflets,
results in backwards flow of blood
41. Mitral valve stenosis common cause: rheumatic heart disease, scarring andcontractures
42. Mitral valve stenosis results in: decreased blood flow from the left atrium tothe left
ventricle
43. What does decrease cardiac output lead to: decreased tissue perfusion, im-paired gas
exchange, fluid imbalance, and decreased functional ability
44. What is left ventricular ejection fraction: the percentage of blood pumped outof the left
ventricle with next systole
45. The most common reason for hospitalization in adults over 65: heart failure
46. Risk factors for HF: HTN, CAD
47. What are the comorbidities that contribute to the development of HF: dia-betes,
metabolic syndrome, advanced age, tobacco use, and vascular disease
48. Etiology of HF: any interference with mechanisms regulating cardiac output(preload
[fill], afterload [empty], HR, contractility)
49. Precipitating causes of HF: conditions that increase workload of the heart(reduced
cardiac output)
50. Left side HF is the inability to: empty adequately during systole or fill adequateduring
diastole
51. Where does the blood go during left sided HF: backs up into the left atrium
52. Left sided HF causes: pulmonary congestion and edema, decrease in leftventricle ejection
factor
53. Right sided HF is when the: RV does not pump effectively
54. Where does the blood go on right sided HF: backs up into the venous system,the fluid moves
into the tissues and organs
55. What is the most common cause of right sided HF: left sided HF
56. Compensated HF occurs when: compensatory mechanisms succeed in main- taining an
adequate CO that is needed for tissue perfusion
57. Decompensated HF occurs when: these mechanisms can no longer maintain adequate CO
and inadequate tissue perfusion results
58. Remodeling is: change in the structure of the heat caused by continuous activa- tion of neuor-
hormonal responses, hypertrophy of ventricular myocytes , ventricles become larger by less
effective
