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Cardiac Physiology and Nursing Interventions: Exam 1 Questions and Answers, Exams of Advanced Education

A comprehensive set of questions and answers related to cardiac physiology and nursing interventions. It covers key concepts such as heart rate, rhythm, and conduction, as well as common cardiac conditions and their management. Particularly useful for nursing students preparing for exams or clinical practice.

Typology: Exams

2024/2025

Available from 01/08/2025

eric-kariuki
eric-kariuki 🇺🇸

5

(2)

4.5K documents

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Download Cardiac Physiology and Nursing Interventions: Exam 1 Questions and Answers and more Exams Advanced Education in PDF only on Docsity!

AH EXAM 1 QUESTIONS WITH

CORRECT ANSWERS 100% 2024

PR interval indicates - CORRECT ANSWERS-AV conduction time (atria to AV) Normal PR interval time - CORRECT ANSWERS-0.12-0.20 seconds QRS complex represents - CORRECT ANSWERS-ventricular depolarization ST segment represents - CORRECT ANSWERS-time between ventricular depolarization and depolarization (resting stage) ST impulse generated early can cause - CORRECT ANSWERS-lethal arrhythmia (tach) ST elevation = - CORRECT ANSWERS-infarction St depression = - CORRECT ANSWERS-ischemia T wave represents - CORRECT ANSWERS-Ventricular repolarization (resting) Tall t waves can be sign of - CORRECT ANSWERS-ST elevated myocardial infarction Narrow T waves indicate - CORRECT ANSWERS-hyperkalemia Flattened T waves indicate - CORRECT ANSWERS-hypokalemia sinus bradycardia - CORRECT ANSWERS-slow heart rate that arises from SA nodes (less than 60) sinus bradycardia; if symptomatic what medication can be given? - CORRECT ANSWERS-atropine max 3mg (0.5x6) symptoms of sinus bradycardia - CORRECT ANSWERS-fatigue, confusion, pallor, decreased O2, cool, clammy, dizziness/syncope (1st symptom) - not perfusing sinus bradycardia asymptomatic - CORRECT ANSWERS-just monitor sinus tachycardia - CORRECT ANSWERS-HR greater than 100 Sinus tachycardia nursing considerations - CORRECT ANSWERS-assess underlying cause: oxygenation, hydration, fever, medication, caffeine, anxiety assess VS

AV block 1st degree - CORRECT ANSWERS-delay in conduction from SA node PR interval length for Av block 1st degree - CORRECT ANSWERS-greater gab. seconds Assessment AV block 1st degree - CORRECT ANSWERS-ventricular rate? symptomatic? Treatment for AV block 1st degree - CORRECT ANSWERS-HR really low - atropine no treamtent until symptomatic Sinus arrest - CORRECT ANSWERS-SA node doesn't fire Sinus arrest can lead to - CORRECT ANSWERS-decreases HR and perfusion Sinus arrest nursing considerations - CORRECT ANSWERS-monitor, call provider, document & treat if continues Treatment for sinus arrest - CORRECT ANSWERS-atropine, pacemaker Atrial fibrillation - CORRECT ANSWERS-atrial tissues contracts in a irregular, chaotic, and disorganized rhythm (quivering) why can a fib lead to systemic and pulmonary emboli? - CORRECT ANSWERS-blood pulls on walls of atria What medications should a patient with a fib be on? - CORRECT ANSWERS- anticoagulants (heparin/warfarin, levaquin) Amiodarone non pharmaceutical treatment for a fib? - CORRECT ANSWERS-new onset - cardioversion ventricular tachycardia - CORRECT ANSWERS-no atrial activity 100+ rate v tach nursing considerations - CORRECT ANSWERS-assess HR ( can be w/ pulse or pulseless) check underlying cause (oxygenation, electrolyte imbalance K+) v tach w/ patient awake - CORRECT ANSWERS-call code, O2, Amiodarone v tach patient w/ no pulse - CORRECT ANSWERS-call code, defibrillate (none - CPR), call for defibrillator, airway epinephrine, reassess v tach no pulse - CORRECT ANSWERS-defibrillation

v tach w/ pulse - CORRECT ANSWERS-CPR cardioversion drug for pulseless rhythm - CORRECT ANSWERS-epinephrine - no max v fib - CORRECT ANSWERS-electrical activity but no regular form and no muscle activity v fib is ALWAYS - CORRECT ANSWERS-pulseless v fib treatment - CORRECT ANSWERS-defibrillate ASAP (CPR) epinephrine (no max) Amiodarone asystole - CORRECT ANSWERS-no electrical activity asystole nursing considerations - CORRECT ANSWERS-assess patient CPR defibrilate (if rhythm) epinephrine vasopressin atropine Look for underlying cause: electrolyte imbalance, hypoxia, hypovolemia, hypothermia, acidosis, drug OD, cardiac tamponade, tension pneumothorax, pulmonary emboli Why no defibrillation for asystole - CORRECT ANSWERS-no electrical activity - nothing to defibrillate indicator of HF - CORRECT ANSWERS-BNP left sided HF symptoms (left - lung - pulmonary) - CORRECT ANSWERS-crackles, dyspnea, orthopnea, hacking cough, pink frothy sputum, gallop right sided HF symptoms - body rods with fluid - CORRECT ANSWERS-edema, JVD, weight gain, swollen hands and fingers, enlarged liver and spleen HF interventions - CORRECT ANSWERS-Diet: low sodium, high fiber fluid restriction daily weight exercise as tolerated no smoking decrease alcohol compression socks (edema) monitor BP gold standard for how valves are functioning and pumping - CORRECT ANSWERS- ECG

Priority nursing interventions for HF - CORRECT ANSWERS-HOB 40+ oxygen diuretics - furosemide decrease sodium and fluids hallmark symptom pulmonary edema - CORRECT ANSWERS-pink frothy blood tinged sputum mitral stenosis - CORRECT ANSWERS-narrowing/restriction rom LA to LV mitral regurgitation - CORRECT ANSWERS-backflow form LV to LA (valve not closing all the way) aortic stenosis - CORRECT ANSWERS-narrowing opening between left ventricle and aorta aortic regurgitation - CORRECT ANSWERS-back flow from aorta to LV (enlarged LV b/c overflow) key nursing care for valve disorders - CORRECT ANSWERS-monitor complications - incision mechanical valve replacement (lifelong anticoagulants) prophylactic use of antibiotics why lifelong coagulants for mechanic valve replacement - CORRECT ANSWERS- increase rx clots, stroke, PE b/c valve (monitor PT/INR, decrease bleeding risks) infective endocarditis - CORRECT ANSWERS-infection caused by bacteria that enters the blood stream and settles in heart valve/lining clinical manifestations of infective endocarditis - CORRECT ANSWERS-petechiae (mouth/ocular area, palate) Osler nodes/janeway lesions on hands and feet crackles fever assessment diagnostics for infective endocarditis - CORRECT ANSWERS-+ blood culture or + culture of vegetation (prime diagnostic) infection endocarditis prevention - CORRECT ANSWERS-prophylactic endocarditis - prior to dental, resp, oral, esophageal procedures myocarditis - CORRECT ANSWERS-inflammation of heart muscle - viral

medical management of myocarditis - CORRECT ANSWERS-avoid NSAIDS - can make worse by retaining water and increase inflammation myocarditis diagnostics - CORRECT ANSWERS-elevated WBC and ESR enlarged heart on echo pericarditis - CORRECT ANSWERS-swelling or irritation of saclike membrane surrounding the heart clinical manifestations of pericarditis - CORRECT ANSWERS-chest pain pericardial tub dispnea st elevation or PR depression medical management for pericarditis - CORRECT ANSWERS-treat cause analgesics corticosteroids - decrease inflammation pericardiocentesis pericardial window pericardiocentesis - CORRECT ANSWERS-remove fluids and relieve pressure on heart pericardial window - CORRECT ANSWERS-removal of portion of pericardium to permit excessive pericardial fluid to drain in the pleural space nursing management for pericarditis - CORRECT ANSWERS-pain management VS supportive care monitor complications - cardiac tamponade Cardiac tamponade - CORRECT ANSWERS-occurs when fluid accumulates in the pericardial sac - blood can't get out or in signs of cardiac tamponade - CORRECT ANSWERS-drop in BO distended neck beins muffled heart sounds pulses paradoxus care of client with cardiac tamponade - CORRECT ANSWERS-100% nonrebreather IV line EKG - look like MI CXR meds - dobutamine pericardiocentesis pericardial window

When to use cardioversion - CORRECT ANSWERS-SVT not responding to meds onset a fib v fib v tach w/ pulse nursing considerations cardioversion - CORRECT ANSWERS-sedation stop digoxin synchronize monitor O2, rhythm, VS labs and diagnostics pre-op thoracotomy - CORRECT ANSWERS-CBC, electrolytes, BUN/creatininte, PFT, bronchoscopy, CXR, ABGs lobectomy postop - CORRECT ANSWERS-can turn on either side pneumonectomy - CORRECT ANSWERS-only turn from back to operative side purpose of chest tube - CORRECT ANSWERS-drain fluid and blood; re-expand lungs, restore negative pressure With chest tube: no more than ____ ml/hr urine output - CORRECT ANSWERS- intermittent bubbling in water seal chamber indicates - CORRECT ANSWERS-good sign - normal continuing bubbles in water seal chamber indicates - CORRECT ANSWERS-air leak how to assess for air leak in water seal chamber - CORRECT ANSWERS-check drainage system and inspect monitor lung expansion no bubbling in water seal chamber indicates what 2 possible reasons - CORRECT ANSWERS-no need for chest tube kinked tube what to do if patient pulls out chest tube - CORRECT ANSWERS-sterile water community acquired pneumonia diagnosed - CORRECT ANSWERS-within 48 hours after admission hospital acquired pneumonia diagnosed - CORRECT ANSWERS-after 48 hours in the hospital nursing interventions for pneumonia - CORRECT ANSWERS-sputum culture then antibiotics prevent sepsis

small frequent high carb/protein meals crackles - diuretics wheezes - bronchodilator decrease pneumonia in community - CORRECT ANSWERS-encourage vaccinations to all especially vulnerable pulmonary embolism - CORRECT ANSWERS-clot breaks lose and blocks a pulmonary artery clinical manifestations of PE - CORRECT ANSWERS-hemoptysis dyspnea tachycardia anxiety feeling of impending doom Nursing management of PE - CORRECT ANSWERS-anticoagulant meds / heparin and alteplase assess bleeding assess for hep induced thrombocytopenia )plt below 150,000) IVC filter respiratory failure - CORRECT ANSWERS-lungs failure to oxygenate the arterial blood adequately signs of resp failure - ABGs - CORRECT ANSWERS-PaO2 less than 60 PaCo2 more than 50 gold standard gold standard for examining adequate ventilation - CORRECT ANSWERS-PaCO Clinical presentation of ARDS - CORRECT ANSWERS-lung compliance is reduced increased peak inspiratory pressure ABG result despite O2 therapy position for ARDS? - CORRECT ANSWERS-prone oropharyngeal important nursing considerations - CORRECT ANSWERS-unconscious, no gag reflex - vomit and aspirate ARDS endotracheal tube placement - CORRECT ANSWERS-above vapircation/carina of bronchus (2nd intercostal space) how to check patience of artificial airways - CORRECT ANSWERS-suction, breath sounds

what to do when suctioning patient and can't get it - CORRECT ANSWERS-whole trach will need to be removed b/c blocked mucus plug**can be lavage but can lead to pneumonia Interventions following tracheostomy - CORRECT ANSWERS-TCDB suction - patency oxygenate before suctioning suction no longer than 10 seconds NEVER apply suction inserting predisposing factors for VAP - CORRECT ANSWERS-supine position lack of gut integrity (bacterial translocation) what's the nurses rile post-intubation - CORRECT ANSWERS-bilateral breath sounds cuff secured and inflated mark inserted monitor VS give meds calm/support patient document mark advocate nursing care of intubated patient - CORRECT ANSWERS-identify and document ETT safety HOB 30 or greater frequent mouth care endotracheal cuff between 20 - 25 analgesics standard precautions respiratory assessment airway communication techniques - notes, nods, hold up finger assess vent setting and troubleshoot alarms assists control - all breaths are - CORRECT ANSWERS-machine breaths full support mode rate/tidal volume pre set FiO2 pre set if patient is on AV of 10 and tidal volume of 700 ml, and is breathing a total of 16 times per minute. what is happening? - CORRECT ANSWERS-patient is breathing 6 extra times at 700ml TV synchronized intermittent mandatory ventilation (SIMV) - what is preset - CORRECT ANSWERS-machine breaths TV

FIO

What can patient do with SIMV - CORRECT ANSWERS-extra spontaneous breaths and pull their own tidal volume If a patient is on SIMV 10, VT 700, and is breathing a total of 16 times per mine. what is happening? - CORRECT ANSWERS-6 of ow*if TV low then not ready to be off SIMV - CORRECT ANSWERS-used when wanting to wean of ventilation positive end expiratory pressure - CORRECT ANSWERS-occurs during expiration (H2o range 5-15) PEEP helps with gas exchange b/c - CORRECT ANSWERS-helps keep alveoli open all the time CPAP - CORRECT ANSWERS-gives positive pressure to alveoli throughout the entire respiratory cycle (set 5-15) BiPAP - CORRECT ANSWERS-provides two levels of pressure (inspiratory and expiratory) CPAP and BiPAP benefit the patient by? - CORRECT ANSWERS-improving gas exchange PIP limit alarm sets off because? - CORRECT ANSWERS-secretions, coughing obstructed, biting tube, pneumothorax PIP alarm stops the breath if - CORRECT ANSWERS-pressure in the airway gets too high low exhaled volume alarms if - CORRECT ANSWERS-tidal volume goes too low what sets off the low exhaled volume alarm? - CORRECT ANSWERS-patient disconnected from tube, tubing loose, machine malfunctions, loss of volume pressure somewhere in the vent apnea alarm alarms if - CORRECT ANSWERS-the patient doesn't breath in a certain amount of time what sets off the apnea alarm - CORRECT ANSWERS-patient because apnea (due to medical issue, disconnected, over sedated) ventilator alarms: patient coughing nurse does what? PIP - CORRECT ANSWERS- auscultate breath sounds and suction

ventilator alarms: patient disconnected grin machine or hose lose, nurse does what? - CORRECT ANSWERS-place back on the vent and call RT ventilator alarms: ETT or trash obstructed with mucus, nurse should? - CORRECT ANSWERS-suction ventilator alarms: ETT tube dislodged, nurse should?*low exhale - CORRECT ANSWERS- ventilator alarms: is the tube down the right mainstream bronchus, how will the nurse know? - CORRECT ANSWERS-auscultate (need bilateral breath sounds unless lung removed) ventilator alarms: do not know how to solve the problem, nurse should? - CORRECT ANSWERS-take off vent and bag 100% and call RT important when traveling with vent - CORRECT ANSWERS-RT can assist take ambulance man (bed not vent) enough O no O2 MRI monitor cardiac rhythm