Questions and Answers
Which sign is commonly associated with heart rate exceeding 100 beats per minute?
In which type of dysrhythmia would you expect the heart rate to be less than 60 bpm?
What is a critical nursing intervention for a patient experiencing dyspnea due to heart failure?
Which characteristic defines sinus tachycardia on an ECG?
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Which symptom is typically associated with left-sided heart failure?
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What does a normal PR interval range from?
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What is indicated if a patient has an increased volume and pressure in the venous system?
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Which intervention is necessary if a patient's oxygen saturation falls below 94%?
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What is the CD4 count threshold indicating significant immune suppression in Stage III (AIDS)?
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Which of the following is NOT a common opportunistic pathogen in HIV patients during Stage I and II?
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During an occupational exposure to HIV, when should Post-Exposure Prophylaxis (PEP) ideally be initiated?
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What type of anemia is primarily due to dietary deficiency of iron?
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Which assessment is NOT included when evaluating HIV risk in a patient's sexual history?
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Which nursing intervention is most appropriate for a patient experiencing dyspnea?
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What is a common sign of chronic obstructive pulmonary disease (COPD)?
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What should be assessed in a patient with mitral valve prolapse?
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What is the main function of the first chamber in a three-chamber drainage system?
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Which test can detect HIV antibodies as early as 2-6 weeks after exposure?
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Which medication category is commonly administered for managing pulmonary edema?
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What symptom is most likely to be observed in a patient with chronic bronchitis?
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Which item is NOT essential to keep within reach for emergencies related to a chest drainage system?
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Which assessment finding would suggest worsening respiratory function in a COPD patient?
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What is the primary method of HIV transmission?
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Which food is NOT recommended for increasing oral iron intake?
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Which sign indicates a potential respiratory distress in a patient with a chest tube drainage system?
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What test result indicates hypoxemia in a patient?
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What is a common treatment option for severe iron deficiency anemia?
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Which of the following is NOT a rich source of Vitamin B12?
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What type of white blood cells does HIV predominantly destroy?
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Which of the following is a nursing priority in managing a patient with decreased gas exchange?
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Which of the following is NOT a responsibility of the nurse managing a chest drainage system?
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What distinguishes sickle cell disease from normal hemoglobin?
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Which pain management approach is NOT recommended for severe pain in sickle cell disease?
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Which form of HIV is the most common subtype globally?
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To prevent a sickle cell crisis, patients should increase their daily liquid intake to at least how many liters?
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What should patients with sickle cell disease avoid to reduce the risk of crisis?
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Which method is NOT a common treatment for Vitamin B12 anemia?
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Study Notes
Chapter 28: Dysrhythmias (Arrhythmia)
- Signs and symptoms include palpitations, chest discomfort, shortness of breath, dizziness, fatigue, anxiety, confusion, and sweating.
- Nursing interventions should involve monitoring vital signs, administering medications, providing oxygen if saturation is below 94%, and applying a 12-lead ECG.
- In cases of inadequate heart rate increase, prepare for transcutaneous/transvenous pacing; permanent pacemaker may be needed for persistent dysrhythmias.
Sinus Tachycardia
- Heart rate exceeds 100 bpm but typically under 180 bpm; rhythm is regular with well-defined P waves preceding each QRS complex.
- PR interval remains consistent at 0.12 to 0.20 seconds; QRS complex duration is under 0.12 seconds.
Sinus Bradycardia
- Characterized by a heart rate below 60 bpm; maintains normal, upright P waves in lead II.
- PR interval is 0.12 to 0.20 seconds, indicating consistency.
Chapter 29: Cardiac Conditions
Heart Failure
- Left-sided heart failure symptoms include pulmonary edema, dyspnea, fatigue, weakness, and chest pain; right-sided symptoms include jugular venous distension (JVD), ascites, and peripheral edema.
- Nursing teaching focuses on lifestyle modifications, medication adherence, and recognizing common signs/symptoms.
- Interventions include monitoring respiratory rate, auscultating breath sounds, positioning for comfort, medication administration (ACE inhibitors, diuretics), and daily weight checks.
Mitral Valve Prolapse
- Enlarge and prolapse of leaflets into the left atrium, often asymptomatic; may cause chest pain, palpitations, or a midsystolic click.
- Nursing interventions include vital sign assessment, auscultation, and symptom monitoring.
Chronic Obstructive Pulmonary Disease (COPD)
- Symptoms include dyspnea, productive cough, hypoxemia, barrel chest, and cyanosis.
- Laboratory evaluations consist of hematocrit levels, sputum cultures, ABGs (PaO2 < 80; PaCO2 > 45), PFTs, and chest x-rays.
- Pathophysiology includes chronic bronchitis (mucus overproduction) and emphysema (over-distended alveoli).
- Risk factors involve smoking, air pollution exposure, and history of respiratory infections.
Chest Tube Management
- Priority of care includes monitoring vital signs (O2 saturation and respiratory rate), frequent position changes, and assessing for leakage.
- Utilize a three-chamber drainage system: drainage collection, water seal, and suction control.
- Nurse responsibilities include ensuring patency of tubes, monitoring for respiratory distress, and maintaining documentation of output.
Chapter 17: Human Immunodeficiency Virus (HIV)
- HIV attacks the immune system, specifically CD4 T-helper cells; AIDS is the most severe stage with significant immunosuppression.
- Transmission occurs via blood, sex, and breast milk; two main types are HIV-1 (common) and HIV-2.
Laboratory Diagnosis
- Serologic tests (ELISA, Western Blot) typically positive within 3-12 weeks; 4th generation tests can detect earlier (2-6 weeks).
- Virologic tests measure the virus directly (HIV RNA, DNA tests).
Signs and Symptoms
- Stage I and II may be asymptomatic or present with flu-like symptoms; opportunistic infections are assessable.
- Stage III (AIDS) exhibits severe immune suppression with CD4 counts below 200 cells/mm³ and significant weight loss.
Occupational Needlestick Protocol
- Cleanse the wound and report the incident; perform risk assessment and initiate PEP within 1-2 hours.
- Follow with baseline and follow-up testing for HIV, Hepatitis B, and Hepatitis C.
Chapter 34: Hematology Conditions
Anemia
- Defined as a reduction in RBC count, hemoglobin, or hematocrit; it signals various health issues.
- Nutritional anemias include iron, vitamin B12, and folic acid deficiencies.
Nutritional Anemia Management
- Iron deficiency: Increase iron-rich foods and consider oral or parenteral iron supplements.
- Vitamin B12 deficiency: Focus on animal proteins and consider injections, oral, or nasal forms.
- Folic acid deficiency: Maintain a diet rich in folate and B12.
Sickle Cell Disease
- Genetic disorder causing abnormal hemoglobin formation; results in distorted red blood cells that can obstruct blood flow.
- Symptoms include pain crises managed with IV analgesics and hydration; educate on lifestyle adjustments to prevent crises.
- Monitoring includes HPLC and hemoglobin S testing.
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Description
Prepare for Exam #1 in NURS 222 with this focused study guide on dysrhythmias. Review essential signs and symptoms, as well as critical nursing interventions necessary for effective patient care. This guide serves as a comprehensive tool for understanding arrhythmias in nursing practice.
