Pharmacology for Cardiovascular Health

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Questions and Answers

Because use of ______ can prevent adequate BP control, the patient may need to avoid the use of ibuprofen.

NSAIDs

A multivitamin tablet will help supply vitamin ______, which may help lower BP.

D

The purpose for ______ in patients with chronic stable angina who are at high risk for a cardiac event is to decrease ventricular remodeling.

ACE inhibitors

Captopril can cause ______, especially after the initial dose, so it is important that the patient not get up out of bed without assistance until the nurse has had a chance to evaluate the effect of the first dose.

<p>hypotension</p> Signup and view all the answers

The ______ are potassium sparing, and the nurse should not teach the patient to purposely increase sources of dietary potassium.

<p>ACE inhibitors</p> Signup and view all the answers

The other teaching by the new RN is appropriate for a patient with newly diagnosed ______ who has just started therapy with enalapril.

<p>hypertension</p> Signup and view all the answers

The nurse is caring for a 70-yr-old patient who takes hydrochlorothiazide and ______ (Norvasc).

<p>enalapril</p> Signup and view all the answers

A hospitalized patient with chronic heart failure has a new order for ______ 12.5 mg PO.

<p>captopril</p> Signup and view all the answers

A patient is admitted to the PACU after ______ abdominal surgery.

<p>major</p> Signup and view all the answers

Scrub from elbows to ______

<p>hands</p> Signup and view all the answers

Which factors in positioning a patient for surgery increase the risk of ______ injury?

<p>patient</p> Signup and view all the answers

During the postoperative care of a 76-year-old patient, the nurse monitors the patient’s intake and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances primarily because older adults are more likely than younger adults to lose ______ fluid during surgeries.

<p>extracellular</p> Signup and view all the answers

Why is IV induction for general anesthesia the method of choice for most ______?

<p>patients</p> Signup and view all the answers

During administration of a ______ IV solution, the mechanism involved in equalizing the fluid concentration between ECF and the cells is osmosis.

<p>hypertonic</p> Signup and view all the answers

Which actions would the nurse prioritize when admitting a patient to the ______?

<p>PACU</p> Signup and view all the answers

The major body fluid compartments include ______ fluid and intracellular fluid.

<p>extracellular</p> Signup and view all the answers

The movement of water and electrolytes between body fluid compartments is regulated by processes such as osmosis, diffusion, and ______ transport.

<p>active</p> Signup and view all the answers

The nurse prioritizes ______ the surgical site, noting presence and character of drainage.

<p>assessing</p> Signup and view all the answers

Fluid volume deficit, a type of extracellular fluid volume imbalance, is characterized by a decrease in ______ fluid volume.

<p>extracellular</p> Signup and view all the answers

During the initial assessment, the patient tells the nurse, “I think I am going to throw up.” Which is the priority ______?

<p>intervention</p> Signup and view all the answers

Hypernatremia, a sodium imbalance, refers to an elevated serum ______ concentration.

<p>sodium</p> Signup and view all the answers

After admitting a postoperative patient to the clinical unit, which assessment data require ______ first?

<p>attention</p> Signup and view all the answers

Hypokalemia, a potassium imbalance, is characterized by a low serum ______ level.

<p>potassium</p> Signup and view all the answers

Central venous access devices (CVADs) are used for ______ administration of fluids and medications.

<p>intravenous</p> Signup and view all the answers

The ______ survey begins after addressing each step of the primary survey and starting any lifesaving interventions.

<p>secondary</p> Signup and view all the answers

The ______ survey is a brief, systematic process that aims to identify all injuries.

<p>secondary</p> Signup and view all the answers

The secondary survey is helpful for discovering unknown problems in patients with a poor or ______ history.

<p>confusing</p> Signup and view all the answers

Obtain a history and ______ of the injury or illness.

<p>mechanism</p> Signup and view all the answers

The patient may not be able to give a history. However, caregivers, friends, bystanders, and ______ personnel can often provide the necessary information.

<p>prehospital</p> Signup and view all the answers

The secondary survey is a process that aims to identify all ______.

<p>injuries</p> Signup and view all the answers

The secondary survey is helpful for discovering unknown problems in patients with a poor or confusing ______.

<p>history</p> Signup and view all the answers

Obtain a history and mechanism of the injury or ______.

<p>illness</p> Signup and view all the answers

A common breathing technique used to help improve airflow in patients with COPD is ______ breathing.

<p>pursed-lip</p> Signup and view all the answers

The removal of an endotracheal tube is known as ______.

<p>extubation</p> Signup and view all the answers

Patients with COPD may benefit from ______ ventilation as a non-invasive way to support their breathing.

<p>noninvasive</p> Signup and view all the answers

______ ventilation is a mode of mechanical ventilation where the ventilator delivers a set volume of air with each breath.

<p>Volume</p> Signup and view all the answers

A ______ is a surgical procedure where an opening is created in the trachea to facilitate breathing.

<p>tracheostomy</p> Signup and view all the answers

In ______ ventilation, the ventilator delivers a set amount of pressure to the lungs, allowing the patient to control their own breathing rate and volume.

<p>pressure</p> Signup and view all the answers

The process of inserting an ______ tube into the trachea to provide a mechanical airway is called intubation.

<p>endotracheal</p> Signup and view all the answers

A Venturi mask delivers a precise concentration of oxygen, making it valuable for patients who require ______ oxygen therapy.

<p>controlled</p> Signup and view all the answers

The nurse in urgent care suspects an ankle ______ when a patient describes twisting his ankle while running bases during a baseball game.

<p>sprain</p> Signup and view all the answers

A patient with a humeral fracture is returning for a 4-week checkup. The nurse explains that initial evidence of healing on x-ray is indicated by ______ formation.

<p>callus</p> Signup and view all the answers

A patient with a comminuted fracture of the tibia is to have an open reduction with internal fixation (ORIF) of the fracture. The nurse explains that ORIF is indicated when other nonsurgical methods cannot achieve adequate ______.

<p>alignment</p> Signup and view all the answers

The nurse suspects a neurovascular problem based on assessment of decreased ______ distal to the fracture site.

<p>sensation</p> Signup and view all the answers

A patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. The nurse suspects early compartment syndrome when the patient has increasing ______ of the limb.

<p>edema</p> Signup and view all the answers

Flashcards

Enalapril therapy

A medication regimen for treating hypertension.

Ibuprofen effect on BP

Use of NSAIDs like ibuprofen can hinder blood pressure control.

BP monitoring time

Blood pressure is typically lowest when checked in the morning.

Captopril purpose

Captopril primarily prevents changes in heart muscle function.

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ACE inhibitors and angina

ACE inhibitors do not directly reduce chest pain frequency.

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Post-dose caution for Captopril

Patients may experience hypotension; assistance is needed to get up.

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Potassium in diet with Captopril

Patients on Captopril should avoid increasing potassium intake.

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Medication with food

Taking Captopril with food can affect its absorption; patients may think it helps.

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Scrubbing method for surgery

Scrub from elbows to hands without mechanical friction for a minimum of 10 minutes.

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Patient positioning injury risks

Factors that increase patient injury include loss of pain perception, incorrect musculoskeletal alignment, and inability to sense pressure over bony prominences.

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IV induction benefits

IV induction for general anesthesia is preferred due to rapid and controlled onset.

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Postanesthesia care priorities

Nursing responsibilities in the PACU include managing safety and preventing complications.

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Airway obstruction

A condition where the airway is blocked, impacting breathing and oxygen supply.

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Postoperative ileus (POI)

A condition where the intestines do not work properly after surgery, causing discomfort.

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Priority PACU interventions

Initial focus in the PACU should be on assessing airway patency and vital signs.

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Priority action for nausea

If a postoperative patient feels nauseous, the priority intervention is to position them in a lateral recovery position.

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Body fluid compartments

Major areas in the body containing fluids, mainly intracellular and extracellular fluid.

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Fluid volume deficit

A condition where there is insufficient fluid in the extracellular compartment.

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Hypernatremia

An electrolyte imbalance characterized by high sodium levels in the blood.

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Hypokalemia

A condition marked by low potassium levels in the blood, affecting muscle function.

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Acid-base balance

The processes maintaining the pH level within the body; critical for normal cell function.

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Hypercalcemia

An electrolyte imbalance where calcium levels in the blood are elevated.

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Isotonic solutions

IV fluid solutions that have the same osmotic pressure as body fluids, promoting balance.

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Central venous access devices (CVADs)

Medical devices used for long-term intravenous access to the central venous system.

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Postoperative urine output

Average urine output post-surgery should be monitored; <30 mL/hr needs investigation.

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Bladder ultrasound scan

An imaging test to assess urinary retention or volume in the bladder.

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Discharge criteria for Phase II

Factors ensuring patient stability for discharge from post-anesthesia care.

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Primary survey

Initial assessment to identify life-threatening conditions.

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Secondary survey

Detailed assessment conducted after the primary survey to identify all injuries.

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History and Head-to-Toe Assessment

Gathering patient history and systematically examining the body for injuries.

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Mass casualty incident (MCI)

An event causing a large number of casualties requiring emergency response.

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Triage

Prioritizing patient treatment based on the severity of their condition.

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Assist-control (AC) ventilation

A mode of mechanical ventilation that supports each breath the patient initiates.

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Continuous positive airway pressure (CPAP)

A method that uses mild air pressure to keep airways open in breathing disorders.

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Intubation

The process of inserting an endotracheal tube to maintain airway patency.

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Extubation

The process of removing an endotracheal tube after airway stabilization.

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Pursed-lip breathing (PLB)

Breathing technique that helps improve ventilation and oxygenation.

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Noninvasive ventilation (NIV)

Ventilation assistance without the need for endotracheal intubation.

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Volume ventilation

Mechanical ventilation that delivers a set volume of air with each breath.

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Weaning

The process of gradually reducing ventilatory support in patients.

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Fracture healing process

The sequence of physiological events leading to the repair of bone fractures.

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Closed reduction

A non-surgical procedure to realign fractured bones without an incision.

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Open reduction

A surgical procedure to fix fractured bones using internal fixation devices.

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Compartment syndrome

A dangerous condition where swelling compresses muscles and nerves, reducing blood flow.

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Amputation indications

Reasons for limb removal due to issues like severe trauma, infection, or lack of blood flow.

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Joint replacement types

Surgical procedures to replace damaged joints, commonly hip and knee replacements.

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Neurovascular assessment

Evaluation of nerve and blood vessel function in an injured limb to detect complications.

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Fat embolism syndrome (FES)

A serious condition where fat globules enter blood circulation, usually after fracture.

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Study Notes

Adult Health Exam 1

  • Kahoot Topics: Calcium Channel Blockers, ACE Inhibitors, Chest Tubes, Chapter 17 (Fluid and Electrolyte Balances), Chapter 18 (Preoperative Care), Chapter 19 (Intraoperative Care), Chapter 20 (Postoperative Care), Chapter 21 (Emergency and Disaster Nursing), Chapter 26 (Burns), Chapter 28 (Supporting Ventilation), Chapter 44 (Nutrition Problems), Chapter 67 (Musculoskeletal Trauma and Orthopedic Surgery).

Carbon Monoxide (CO) Poisoning

  • Symptoms: Ranging from dizziness and headache to unconsciousness and death.
  • Hemoglobin Affinity: CO has a much higher affinity for hemoglobin than oxygen (200-250 times greater).
  • Treatment: Initiate 100% oxygen immediately.
  • Myocardial Injury: Possible myocardial injury in patients hospitalized with moderate to severe CO poisoning.
  • Pseudocholinesterase Deficiency: People with this deficiency have difficulty metabolizing succinylcholine and mivacurium.

Ineffective Cough

  • Causes: Muscle weakness, impaired chest mobility, increased mucus viscosity, and ciliary dysfunction.
  • Aspiration Risk: If the airway isn't protected, aspiration can occur. Intubation may be necessary.

Important considerations for burn patients

  • Early enteral nutrition is important to reduce pneumonia and mortality, with the goal of feeding within 24 hours. -Prealbumin is an indicator of protein synthesis and catabolism, useful in monitoring burn patients.

Nutritional Goals

  • Lipids: Triglyceride levels must be monitored during lipid administration
  • Parentral Nutrition (TPN): Medications are not administered through TPN/lipid lines
  • Risks: Elevated blood sugar, infection, and volume overload. glucose monitoring.
  • Ventricular Tachycardia: Rapid, life-threatening dysrhythmia. Assessment: Assess vitals, check for kinks in lines, check O2 ,flush iv. Possible interventions; call rapid team, consider chemical conversion or synchronized cardioversion if alive.

Other Important Points

  • Chest Tubes: Drainage, insertion, complications (e.g., stops draining within 24 hours, increased drainage, cloudy drainage etc...), pneumothorax
  • Hyperkalemia: Crushing injuries can lead to life-threatening cardiac arrest, needing prompt treatment.
  • Premature Ventricular Contractions (PVC): Generated by ectopic cardiac pacemaker located in the ventricle
  • Intubation: May be used in cases where airway protection is compromised.
  • Patient Safety: Wear protective equipment (gown, mask, gloves) when entering burn patient rooms.
  • Urinary Output (UOP): Minimum 30 mL/hour in burn patients is crucial for adequate kidney perfusion..
  • Pain Management in burn patients requires considerations for severe pain and prompt interventions.

Other

  • Hematoma: Blood collects in the pleural space.
  • Pneumothorax: Air in the chest cavity.
  • DVT risk factors: Family history of blood clots, excessive blood clotting, sedentary lifestyle, long-term indwelling catheter, and trauma.
  • Transcutaneous pacing: A temporary method of pacing for symptomatic bradyarrhythmias; fast and efficient method avoiding invasive access.
  • Therapeutic Hypothermia (TH): Used in cases of global ischemia and severe head injuries to protect the brain.
  • Pain and Injury Related Diagnoses: Neurovascular compromise, acute pain, anxiety.
  • Other considerations: Risk factors for complications, infection prevention, wound care, etc.
  • Comprehensive Patient Care: Includes all aspects of physical, emotional and psychosocial care in a holistic and compassionate manner for all patients.

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