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EXAM 2 ADN 420 (GRIEF
AND LOSS &
PERFUSION)QUESTIONS
WITH 100% CORRECT
ANSWERS
Kubler-Rossbstagesbofbgriefb-bcorrectbanswer-1.bDenial- bShockbandbdisbeliefbregardingbloss 2.bAnger- bmaybbebexpressedbtowardsbGod,brelatives,bfriends,borbhealthbcarebproviders 3.bBargaining- bOccursbwhenbthebpersonbasksbGodborbfatebforbmorebtimebtobdelaybthebinevitableblo ss 4.bDepression-bwhenbthebawarenessbofbtheblossbbecomesbacute. 5.bAcceptance-bwhenbthebpersonbshowsbevidencebofbcomingbtobtermbwithbdeath Bowlby'sbtheorybonbgriefbandblossb-bcorrectbanswer-1.Numbnessborbprotest- bThebclientbisbinbdenialboverbtheblossbandbexperiencesbfeelingsbofbshock. 2.Disequilibrium- bThebclientbfocusesbonbtheblossbandbhasbanbintensebdesirebtobregainbwhatbwasblost. 3.DisorganizationbandbDespair- bThebclientbfeelsbhopelessnessbwhichbimpactsbthebclientsbabilitybtobcarryboutbtasksbo fbdailybliving. 4.bReorganization-Thebclientbreachesbacceptancebofbthebloss.
Engel'sbFivebStagesbofbGriefb-bcorrectbanswer-1.bShockbandbdisbelief- bThebclientbexperiencesbabsensebofbnumbnessbandbdenialboverbthebloss.b 2.bDevelopingbawareness- bThebclientbbecomesbawarebofbthebrealitybofbthebloss,bresultingbinbintensebfeelingsbo fbgrief.b(Beginsbwithinbhoursbofbthebloss) 3.bRestitution-bThebclientbcarriesboutbcultural/ religiousbritualsb(abfuneral)bfollowingbthebloss. 4.bResolvingbthebloss-bThebclientbisbpreoccupiedbwithbthebloss.bOverbaboutbab12- monthbperiodbthisbpreoccupationbgraduallybdecreases. 5.bRecovery-bThebclientbmovesbpastbthebpreoccupationbandbforwardbwithblife. Horowitz'sbStagesbofbLossbandbAdaptationb-bcorrectbanswer-1.Outcry- bFirstbrealizationbofbthebloss.bOutcrybmaybbeboutward,bexpressedbbybscreaming,byell ing,bcrying,borbcollapse.bOutcrybfeelingbcanbalsobbebsuppressedbasbthebpersonbappe arsbstoic,btryingbtobmaintainbemotionalbcontrol.bEitherbway,boutcrybfeelingsbtakebabgr eatbdealbofbenergybtobsustainbandbtendbtobbebshort-lived. 2.Denialbandbintrusion- bPeoplebmovebbackbandbforthbduringbthisbstagebbetweenbdenialbandbintrusion.bDurin gbdenial,bthebpersonbbecomesbsobdistractedborbinvolvedbinbactivitiesbthatbheborbsheb sometimesbisn'tbthinkingbaboutbthebloss.bAtbotherbtimes,btheblossbandballbitbrepresen tsbintrudesbintobeverybmomentbandbactivity,bandbfeelingsbarebquitebintensebagain. 3.Workingbthrough- bAsbtimebpasses,bthebpersonbspendsblessbtimebbouncingbbackbandbforthbbetweenbd enialbandbintrusion,bandbthebemotionsbarebnotbasbintensebandboverwhelming.bThebp ersonbstillbthinksbaboutbthebloss,bbutbalsobbeginsbtobfindbnewbwaysbofbmanagingblife bafterbloss. 4.Completion- bLifebbeginsbtobfeelb"normal"bagain,bthoughblifebisbdifferentbafterbthebloss.bMemoriesb areblessbpainfulbandbdobnotbregularlybinterferebwithbday-to- dayblife.bEpisodesbofbintensebfeelingsbmayboccur,bespeciallybaroundbanniversarybdat esbbutbarebtransientbinbnature. TypesbofbGriefb-bcorrectbanswer-Normal,banticipatory,bandbcomplicated NormalbGriefb-bcorrectbanswer- Consideredbuncomplicated.bEmotionsbcanbincludebanger,bresentment,bwithdrawal,bh opelessness,bandbguiltbbutbshouldbchangebtobacceptancebwithbtime.bShouldbachieve bacceptancebbyb 6 bmonthsbafterbthebloss.bSomaticbmanifestationsbcanbincludebchestb pain,bpalpations,bheadaches,bnausea,bchangesbinbsleepbpatterns,borbfatigue. AnticipatorybGriefb-bcorrectbanswer- Impliesbtheb"lettingbgo"bofbanbobjectborbpersonbbeforebthebloss,basbinbthebcasebofbter minalbillness.bIndividualsbhavebthebopportunitybtobgrievebbeforebthebactualbloss. ComplicatedbGriefb-bcorrectbanswer-·bDelayedborbinhibitedbgrief Clientbdoesbnotbdemonstratebthebexpectedbbehaviorsbofbthebnormalbgriefbprocess.b Culturalbcanbinfluencebdevelopment.bCanbremainbinbdenialbstagebforbprolongedbperi od.
10.bSelf-actualization ·bAnbexternalborbinternalbcrisisbthatbblocksborbinhibitsbstrivingbtowardbfulfillmentbmayb threatenbpersonalbgoalsbandbindividualbpotential.bAbpersonbwhobwantedbtobgobtobcol lege,bwritebbooks,bandbteachbatbabuniversitybreachesbabpointbinblifebwhenbitbbecome sbevidentbthatbthosebplansbwillbneverbmaterialize,borbabpersonblosesbhopebthatbhebor bshebwillbfindbabmatebandbha EndbofblifebCareb-bcorrectbanswer-palliativebcarebandbhospicebcare PalliativebCareb-bcorrectbanswer- Philosophybofbandbsystembforbdeliveringbcarebthatbexpandsbonbtraditionalbmedicalbc arebforbserious,bprogressivebillnessbtobincludebabfocusbonbqualitybofblife,bfunction,bde cisionbmaking,bandbopportunitiesbforbpersonalbgrowth PalliativebCarebInterventionsb-bcorrectbanswer- ·bPromotebcontinuitybofbcarebandbcommunicationbbyblimitingbassignedbstaffbchanges ·bAssistbthebclientbandbfamiliesbtobsetbprioritiesbforbend-of-lifebcare bPhysicalbCare obAdministerbmedicationsb(morphine) obPerformbassessmentsbtobdeterminebeffectivenessbofbtreatment obManagebadversebsidebeffectsbofbmedication obProvidebcaringbtouch obPromotebdecisionbmaking Psychosocial obProvidebcarebandbfosterbsupportbtobthebclientbandbfamily obUsebtherapeuticbcommunication obFacilitatebcommunicationbbetweenbclient,bthebfamily,bandbthebprovider obEncouragebthebclientbtobparticipatebinbreligiousbpractices obDiscussbspecificbconcernsbthebclientbandbfamilybmightbhave Preventionbofbabandonmentbandbisolation obPreventbfearbofbdyingbalone obMakebyourbpresencebknown obAllowbfamilybmembersbtobstaybthebnight obDeterminebwherebclientbisbmostbcomfortable obKeepbthebclientbinformed bSupportbforbthebgrievingbfamily obSuggestbfamilybmembersbtobplanbvisitsbtobpromotebclientsbrest obProvidebprivacy obAllowbfamilybtobexpressbfeelings obEducatebfamilybaboutbphysicalbchangesbtobexpectbasbthebclientbmovesbcloserbtobd eath HospicebCareb-bcorrectbanswer- Abcoordinatedbprogrambofbinterdisciplinarybcarebandbservicesbforbterminallybillbpatien tsbandbtheirbfamiliesbthatbinbthebUnitedbStatesbisbprovidedbprimarilybinbthebhome.bHo spicebisbanboutpatientbpalliativebcare.
NursingbInterventionsbtobfacilitatebMourningb-bcorrectbanswer- ·bAllowbtimebforbgrievingbprocess ·bIdentifybexpectedbgrievingbbehaviorsb(crying,bsomaticbmanifestations,bandbanxiety) ·bUsebtherapeuticbcommunicationbrelatedbtobthebclientsbstagebofbgrief ·bUsebactiveblistening ·bUsebsilencebandbpersonalbpresence ·bAssistbthebgrievingbindividualbtobacceptbthebrealitybofbthebloss ·bSupportbeffortsbtob"movebon"binbthebfacebofbloss ·bEncouragebbuildingbofbnewbrelationships ·bAssessbforbevidencebofbineffectivebcoping ·bSharebinformationbaboutbthebtaskbandbstagesbofbmourning DVTb(deepbveinbthrombosis)b-bcorrectbanswer- ·bFormationbinboneborbmorebdeepbveins,busuallybinbtheblowerbextremities DVTbRiskbFactorsb-bcorrectbanswer-·bOralbcontraceptivebuse ·bTrauma ·bObesity ·bSmoking ·bAgeboverb 60 ·bProlongedbperiodsbofbsitting ·bDehydration DVTbS/Sb-bcorrectbanswer-·bUnilateralbcalfbedema ·bErythema ·bTenderness ·bWarmth Painborbtendernessbinbcalf DVTbDiagnosticbProceduresb-bcorrectbanswer-·bD-dimer ·bCoagulationbstudies ·bUltrasound ·bVenography NursingbCarebforbabpersonbwithbDVTb-bcorrectbanswer-·bAdministerbanticoagulation ·bElevatebaffectedblimb ·bMonitorbsignsbandbsymptomsbforbPE ·bInspectbaffectedblimb ·bAssessbforbthrombocytopenia MedicationsbforbabpersonbwithbDVTb-bcorrectbanswer-·bLow- molecularbweightbheparinb(EnoxaparinbSodium) ·bBivalirudin ·bCalciumbandbVitaminbD ComplicationsbofbabDVTb-bcorrectbanswer-·bPulmonarybemboli ·bRecurrentbDVT
·bPreventbcomplicationbfrombimmobility ·bEncouragebROM ·bMaintainbsafebenvironment MedicationsbforbabpersonbwithbCVAb-bcorrectbanswer- ·bThrombolyticbmedicationsbreteplasebrecombinantb(TPA) Givebwithinb4.5bhoursbofbinitialbmanifestationsbforbclientsbexperiencingbischemicbstro kebduebtobembolicbeventbasbevidencedbbybCTbscanbresults. ·bAnticoagulantsb(warfarinb(Coumadin),bHeparin,bandbEnoxaparinb(Lovenox) WarfarinbisbindicatedbforbclientsbwhobhavebatrialbfibrillationbwithbabtargetbINR.bNotbus edbinbhemorrhagicbstroke. ·bNovelboralbanticoagulationb(NOACs)b(Dabigatran,bApixaban,bRivaroxaban) Alternativebmedicationsbtobwarfarinbtherapybforbclientsbexperiencingbatrialbfibrillation ·bAntiplateletsb(Aspirin,bDipyridamole,bClopidogrel) Lowbdoesbaspirinbisbgivenbwithinb 24 btob 48 bhoursbfollowingbanbischemicbstrokebtobpr eventbfurtherbclotbformation. Plateletbinhibitorsb(Dipyridamole,bClopidogrel)bcanbbebgivenbtobclientsbwhobhavebex periencedbthromboticborbembolicbstate. ·bAntiepilepticb(Phenytoin,bGabapentin) Thesebmedicationsbarebnotbcommonlybgivenbfollowingbabstrokebunlessbthebclientbde velopsbseizures. Gabapentinbcanbbebgivenbforbparentheticbpainbinbanbaffectedbextremity. ·bMannitolb(LoopbDiuretic) Helpsbcerebralbedema ComplicationsbofbCVAb-bcorrectbanswer-·bDysphagia ·bAspiration ·bUnilateralbneglect;bisbtheblossbofbawarenessbofbthebsidebaffectedbbybthebstroke. PEb(pulmonarybembolism)b-bcorrectbanswer- ·bOccursbwhenbabsubstancebentersbvenousbcirculationbandbformsbabblockagebinbtheb pulmonarybvasculature. *bloodbclotbinbtheblung PEbriskbfactorsb-bcorrectbanswer-·bLongbtermbimmobility ·bOralbcontraceptivebusebandbestrogenbtherapy ·bPregnancy ·bTobaccobUse ·bObesity ·bA-fib ·bAdvancedbage ·bSurgery ·bTrauma ·bCancer
PEbS/Sb-bcorrectbanswer-·bCyanosis ·bTachycardia ·bTachypnea ·bHypotension ·bCough ·bDyspneabandbairbhunger ·bSuddenbonsetbofbchestbpressure ·bFeelingsbofbimpendingbdoom ·bHeartbmurmurbS3bandbS ·bCracklesbinblungs ·bDistendedbneckbveins ·bLow-gradebfever PEbDiagnosticbProcedures,bLabs,bandbTherapeuticbProceduresb-bcorrectbanswer- DiagnosticbProcedures ·bCTbscan ·bVentilation-perfusionbscan ·bPulmonarybangiography ·bChestbX-ray Labs ABG'sbanalysis PaCO2-bNormalbisb 35 btob 45 bmmbHg.bLevelsbareblow. D-dimer-bNormalbisblessbthanb0.4bmcg/mL.bLevelbarebelevated bTherapeuticbProcedures Embolectomy VenabCavabfilter NursingbCarebforbabpersonbwithbPEb-bcorrectbanswer-·bAdministerboxygen ·bInitiatebandbmaintainbIVbaccess ·bAdministerbmedication ·bAssessbrespiratorybstatus ·bAssessbcardiacbstatus ·bProvidebemotionalbsupportbandbcomfortbclientbanxiety ·bMonitorbchangesbinblevelbconsciousnessbandbmentalbstatus MedicationsbforbabpersonbwithbPEb-bcorrectbanswer-·bAnticoagulation- bpreventbclotsbfrombformingbandbfrombfuturebclotsbformingb(Unfractionatedbandblowb molecularbweightbheparinsbandbenoxaparin) Nursingbactions- bAssessbforbcomplicationsb(activebbleeding,bpepticbulcerbdisease,bhistorybofbstroke,b andbrecentbtrauma).bMonitorbbleedingbtimes;bprothrombinbtimeb(PT)bandbinternation albnormalizedbratiob(INR)bforbwarfarin,bandbpartialbthromboplastinbtimeb(aPTT)bforbh eparin,bandbabCBC.bMonitorbforbadversebeffectsbofbanticoagulantsb(thrombocytopeni a,banemia,bandbhemorrhage) ·bDirectbfactorbXabInhibitor- bInhibitsbproductionbofbthrombinb(Rivaroxaban,bapixaban,bandbfondaparinux) Nursingbactions- bAssessbforbbleedingbfrombanybciteb(Clientsbhavebexperiencedbepiduralbhematomas,
·bS/S- CHFbisbcommon Loudbholosystolicbmurmur ·bTreatment- Leftbtobrightbshunt Pulmonarybarterybbandingborbsurgicalbrepair ·bComplications- Atbhighbriskbforbbacterialbendocarditis patentbductusbarteriosusb(PDA)b-bcorrectbanswer-·bAcyanotic ·bFailurebofbthebductusbarteriosusbtobclosebinbfirstbweeksbofblife ·bIncreasesbworkloadbonbthebleftbventricle ·bS/S- MaybbebasymptomaticborbshowbsignsbofbCHF Murmur;bmachineryblike Widenedbpulsebpressure Boundingbpulses ·bTreatment- Prostaglandinbinhibitor-b(Indomethacin);bclosesbPDA Leftbtobrightbshuntb(aortabtobpulmonarybartery) ·bComplications- Increasedbriskbforbbacterialbendocarditisbandbpulmonarybvascularbobstructivebdiseas e coarctationbofbthebaortab(CoA)b-bcorrectbanswer-·bAcyanotic ·bLocalizedbnarrowingbofbthebaortabnearbthebductusbarteriosus ·bIncreasedbpressurebtobhead/upperbextremities ·bReducedbpressureblowerbextremitiesbandbabdomen ·bS/S- SignsbofbCHFbinbinfants,bacidosis,bhypotension Olderbchildrenbhavebdizziness,bheadaches,bfainting,bepistaxisb(HTN) ·bComplications- HTN Rupturedbaorta Aneurysm Stroke AorticbStenosisb-bcorrectbanswer-·bAcyanotic ·bNarrowingbofbthebaorticbvalve ·bResistancebtobbloodbflowbinbthebLV,bdecreasedbCO,bLVH,bandbpulmonarybvascular bcongestion. ·bPulmonarybcongestion ·bS/S- InfantsbshowbSignsbofblowbCO,bweakbpulses,bhypotension,btachycardia,bpoorbfeedin g
Childrenbshowbexercisebintolerance,bchestbpain,bdizzinessbwhenbstandingbinbplace Systolicbmurmur ·bTreatment- Balloonbangioplastyborbsurgicalbrepair ·bComplications- Atbriskbforbbacterialbendocarditis PulmonicbStenosisb-bcorrectbanswer-·bAcyanotic ·bNarrowingbentrancebtobpulmonarybartery ·bRVbhypertrophiedbandbdecreasebinbpulmonarybflow ·bS/S- Maybbebasymptomatic, Mildbcyanosis CHFb(systemicbcongestion) Systolicbmurmur Cardiomegaly ·bTreatment- Balloonbangioplastyborbsurgicalbrepair ·bComplications- Atbriskbforbbacterialbendocarditis TetralogybofbFallotb-bcorrectbanswer-·bCyanotic ·b 4 bdefects;bVSD,bPulmonicbstenosis,boverridingbaorta,bandbrightbventricularbhypertr ophy ·bS/S- Cyanosis Systolicbmurmur Bluebspellsb(occurbmostbfrequentlybafterbcryingborbfeeding) ·bTreatment- Surgicalbrepairborbpalliativebshuntb(shuntbdependsbonbpressuresbinbpulmonarybandbs ystemicbcirculation) ·bComplications- Seizures,bLOC,bsuddenbdeathbandbemboli TranspositionbofbthebGreaterbVesselsb-bcorrectbanswer-·bCyanotic ·bS/S- Severebcyanosisbfirstbdaysbofblife CHFbthereafter Ifbseptalbdefect,bcyanosisblessbsevere Cardiomegalybevident ·bTreatment- Surgicalbrepair-barterialbswitchbprocedure
Pulmonarybcongestion-bTachypnea/ dyspnea,bRetractionbandbnasalbflaring,bandbExercisebintolerance Systemicbvenousbcongestion-bEdema,bWeightbgain, Ascites,bandbJVD Right- bFatigue,bLethargy,bEdema,bAbdominalbdistention,bAnorexia,bDyspnea,bandbRightbu pperbquadrantbpain Left-bDyspnea,bChestbpainborbtightness,bOrthopnea,bPalpitations,bPND- ParoxysmalbNocturnalbDyspnea,bEdema,bNocturia,bCough,bandbPulmonarybedema MedicalbManagementbofbCongenitalbHeartbDefectsb-bcorrectbanswer- ·bImprovebcardiacbfunction Pacemaker-bBiventricularbpacing Digoxin-belixirb0.5mg/mL,bweightbbased Heldbinbinfants/youngbchildrenbforbHRb<b90-110,bAP HeldbinbolderbchildrenbforbHRb<b70,bAP Monitorbbloodblevelsbforbtoxicity Sidebeffects-bN/V,banorexia,bbradycardia,bandbdysrhythmias ACEbInhibitorsb(Angiotensinbconvertingbenzymebinhibitors)- Sidebeffects-bhypotension,bcough,brenalbdysfunction Carvedilol-Beta-blockers Blocksbabandbbbadrenergicbreceptors,bandbdecreasedbHR,bBP,bandbvasodilation ·bRemovebexcessbfluid/Na Diuretics Furosemideb(Lasix)-bblocksbreabsorptionbofbNabandbwaterbinbproximalbtubules. LoopbdiureticbandbneedsbK+breplacement Chlorothiazideb(Diuril)-bactsbonbdistalbtubules- bdecreasebNa,bwater,bK+,bCl,bandbbicarbbabsorption Spironolactoneb(Aldactone)-bblocksbaldosterone,bretainsbNabandbexcretesbK+ ·bFluidbrestriction ·bNabrestriction ·bDecreasebcardiacbdemands- Bedrest Restorebnormalbbodybtemp Treatbinfection Reducebstressbofbventilation-semi-fowlers Possiblebsedationbifbirritable ·bImprovebtissueboxygenation Humidification Supplementalboxygen- Servesbasbabpulmonarybvascularbdilator
Hemorrhagicbdisordersb-bcorrectbanswer-Bleedingbinbabpartbofbthebbody S/Sbofbhemorrhagicbdisordersb-bcorrectbanswer-·bHypotension ·bTachycardia ·bWeakbandbthreadbpulses ·bDisorientation ·bRestlessness ·bOliguria ·bCool,bpalebskin LocationsbandbVisibilitybofbhemorrhagicbdisordersb-bcorrectbanswer-Locations ·bCapillary-bslow,boozingbtypebofbbleeding ·bVenous-bdarkbcoloredbblood,bflowbisbquick ·bArterial-bbrightbredbblood,bspurtingbappearancebthatbcorrelatesbwithbHR bVisibility ·bEvident-bbodybsurface ·bConcealed-bwithinbabcavityborborgan Hemorrhagicbdisorderbdiagnosticbproceduresb-bcorrectbanswer-·bHemoglobin ·bHematocrit ·bPlateletbcount ·bUltrasound ·bX-ray ·bMRI ·bCTbScan NursingbCarebandbInterventionsbofbabpersonbwithbhemorrhagicbdisorderb- bcorrectbanswer-1.bNursingbCare ·bAssessments- VSàbmostbimportantbisbbloodbpressurebandbpulse Circulatory Respiratory Pain Neuro Trauma Targetedblikebfundalborblochia 2.bInterventions ·bStopbthebbleedingb(directbpressure,bmeds,bmassage) ·bOxygenate ·bSupportbcirculationb(headbofbbedbdownbandbfootbofbbedbup) ·bReplacebvolumeb(Crystalloids,bvolumebexpanders-bhespan,bandbbloodbtransfusion) ·bSurgicalbrepair ·bPreventbcollateralbdamageb(brain)
§bAssessbuterinebtonebandbvaginalbbleeding.bDobnotbadministerbtobclientsbwhobhave bhypertension. §bMonitorbforbadversebreactions,bincludingbhypertension,bnausea,bvomiting,bandbhea dache ·bMisoprostolb(Rectally) obClassification-bUterinebstimulant obTherapeuticbintent-bControlsbpostpartumbhemorrhage obNursingbactions- §bAssessbuterinebtonebandbvaginalbbleeding ·bCarboprostbtromethamineb(IM) obClassification-bUterinebstimulant obTherapeuticbintent-bControlsbpostpartumbhemorrhage obNursingbactions- §bAssessbuterinebtonebandbvaginalbbleeding §bMonitorbadversebreactions,bincludingbfever,bhypertension,bchills,bheadache,bnause a,bvomiting,bandbdiarrhea ClientbeducationbforbabpersonbwithbPPHb-bcorrectbanswer- ·bLimitbphysicalbactivitybtobconservebenergy ·bIncreasebironbandbproteinbintakebtobpromotebrebuildingbofbRBCbvolume ·bTakebironbwithbvitaminbCbtobenhancebabsorption EKGbBasicsb-bcorrectbanswer-PbWave- b0.06btob0.11bseconds,bFirstbdeflectionbandbisbnormallybabpositiveb(upward)bwavefor m.bItbindicatesbatrialbdepolarization.bPRb0.12btob0.20bseconds QRSbcomplex- b0.06btob0.12bseconds,bFollowsbthebPbwave.bItbnormallybbeginsbwithbabdownwardbd eflection.bRepresentsbventricularbdepolarizationbandbcontraction. ·bQ-bablargerbupwardbdeflection ·bR-bthenbthebpoint ·bS-bdownward QTbinterval-b0.36btob0.44bseconds bTbwave- bSTbintervalb0.08bseconds,bNormallybabmodestbupwardbwaveform,brepresentingbven tricularbrepolarization,b bUbWave- IndicatesbthebrecoverybofbthebPurkinjebconductionbfibers.bThisbwavebcomponentbma ybnotbbebobservable. TbWaveb-bcorrectbanswer-1.bWhatbelectrolytebaffectsbthebTbwave? ·bPotassium 2.bWhatbelsebdoesbTbwavebtellbus?
·bIfbthebcardiacbmusclebisbgettingboxygen 3.bWhatbdoesbthebwaveblookbatbwithbhighbandblowbpotassium? ·bPeakedbisbhyperkalemia ·bFlat/sunkenbisbhypokalemia 4.bAbnormalbTbwaves ·bTbwavebisbdownwardbischemiabisbhappening.bThebcardiacbmusclebisbhavingbpoorb bloodbflow ·bTbwavebisbupward,borbtombstonebappearancebmeansbinfraction.bCardiacbmusclebc an'tbgetbrepolarized. 5.bThreebTbwavebshaped ·bUpright,bflatborbinverted StressbTestingb-bcorrectbanswer-·bWhatbitbevaluates- bExercisebcardiacbmusclesbbybwalkingbonbabtreadmill.bProvidesbinformationbonbworkl oadbofbheart.bTestbisbd/cboncebHRbreachesbabcertainbrate. ·bIndications-bAngina,bHeartbFailure,bMI,bDysrhythmia ·bPre-procedure- bAssistbproviderbwithbconsentbform.bExplainbthatbtheybwillbbebwalkingbonbtreadmill.b Wearbcomfortablebclothingbandbshoes.b- Fastb 2 btob 4 bhoursbAvoidbtobacco,balcoholbandbcaffeinebbeforebtest.bAdequatebrestbt hebnightbbeforebthebprocedure. ·bIntra-procedure-bApplyb12- leadbECGbmonitorbforbHRbduringbtest.bMonitor:bDysrhythmiasbInstructbclientbtobrepor tbchestbpain,bSOB,borbDizzinessbduring. ·bPost-procedure-bMonitorb12- leadbECG,bBPbfrequentlybuntilbclientbisbstable.bProviderbreviewsbfindingsbwithbclient. HemodynamicbMonitoringb-bcorrectbanswer-·bWhatbitbevaluates- bSpecialbindwellingbcatheters,bwhichbprovidebinfobaboutbbloodbvolume,bperfusion,bflu idbstatus,bandbhowbwellbthebheartbisbpumping. ·bInterpretationbFindings CVP-b 2 btob 6 bmmbHg PAWP-b 6 btob 15 bmmbHg Electrocardiographyb(12bLeads)/EKG/ECGb-bcorrectbanswer-·bIndications Sinusbbradyborbtach,bAVbblocks,bAfib,bVentricularbasystole,bPACs,bPVCs,bsupravent ricularbtachycardia,bVtach,bVfib ·bPresentation CVbdisease,bMI,bhypoxia,bacid- basebimbalances,belectrolytebdisturbances,bkidneybfailure,bliverborblungbdisease,bper icarditis,bdrugborbalcoholbuse,bhypovolemiabandbshock
Expectedbrange-blessbthanb0.1bng/mL Elevatedblevelsbfirstbdetectablebfollowingbmyocardialbinjury-b 2 btob 3 bhours Expectedbdurationbofbelevatedblevels-b 10 btob 14 bdays TroponinbIb-bcorrectbanswer-Expectedbrange-blessbthanb0.03bng/mL Elevatedblevelsbfirstbdetectablebfollowingbmyocardialbinjury-b 2 btob 3 bhours Expectedbdurationbofbelevatedblevels-b 7 btob 10 bdays Myoglobinb-bcorrectbanswer-Expectedbrange-blessbthanb 90 bmcg/L Elevatedblevelsbfirstbdetectablebfollowingbmyocardialbinjury-b 2 btob 3 bhours Expectedbdurationbofbelevatedblevels-b 24 bhours CardiacbTestsb-bcorrectbanswer-Cholesterol- bLDL,bHDL,btriglycerides,btotalbcholesterolb< BrainbNatureticbPeptideb(BNPborbNT-probBNP) CholesterolbTotalb-bcorrectbanswer-Purpose-bScreeningbforbheartbdisease. ExpectedbRange-bLessbthanb 200 bmg/dL LDLb-bcorrectbanswer-Purpose-b"Bad"bCholesterolbtobthebbody'sbcellsbfrombthebliver. ExpectedbRange-bLessbthanb 130 bmg/dL HDLb-bcorrectbanswer-Purpose- b"Good"bcholesterolbProtectsbcoronarybarteriesbfrombheartbdiseasebbybtransportingbc holesterolbfrombthebbody'sbcellsbtobthebliver. ExpectedbRange-bFemales:bgreaterbthanb55mg/dL Males:bgreaterbthanb45mg/dL Triglyceridesb-bcorrectbanswer-Purpose- bEvaluatesbthebclient'sbriskbforbheartbdisease. ExpectedbRange-bMales:b 40 btob 160 bmg/dL Females:b 35 btob 135 bmg/dL BloodbLabbValuesb-bcorrectbanswer- PTT,bPT,bINR,bCBC,bElectrolytebPanel,bandbBNP PTTb(partialbthromboplastinbtime)b-bcorrectbanswer- ·bIsbabbloodbtestbthatblooksbatbhowblongbitbtakesbforbbloodbtobclot ·bNormal-b 30 btob 40 bseconds
·bHeparinbtherapy-b1.5btob2.5btimesbthebcontrolbvalue PTb(prothrombinbtime)b-bcorrectbanswer- ·bTestbusedbtobhelpbdetectbandbdiagnosebabbleedingbdisorderborbexcessivebclottingb disorder ·bNormal-b 11 btob12.5bseconds INRb-bcorrectbanswer- ·bInternationalbnormalizedbratiobisbabtypebofbcalculationbbasedbonbPTbtestbresults ·bNormal-b0.8btob1. ·bWarfarinbtherapy-b 2 btob 3 CBCb(completebbloodbcount)b-bcorrectbanswer- Isbabgroupbofbtestsbthatbevaluatebthebcellsbthatbcirculatebinbblood,bincludingbredbbloo dbcells,bwhitebbloodbcells,bandbplatelets ElectrolytebPanelb-bcorrectbanswer- Abbloodbtestbthatbmeasuresblevelsbofbthebbody'sbmainbelectrolytes:bsodium,bchloride ,bpotassium,bandbbicarbonate BNPb-bcorrectbanswer-B- typebnatriureticbpeptide.bIt'sbmadebinsidebthebpumpingbchambersbofbyourbheartbwhe nbpressurebbuildsbupbfrombheartbfailure. Normal-blessbthanb 125 bpg/mL Heparinb-bcorrectbanswer-1.bHeparin ·bClassification-bAnticoagulant ·bTherapeuticbUse- bConditionsbnecessitatingbpromptbanticoagulationbactivityb(evolvingbstroke,bpulmonar ybembolismbPE,bmassivebdeep-veinbthrombosis). ·bComplications- bToxicity,bhemorrhagebsecondarybtobheparinbtoxicityborbotherbfactors,bepiduralborbspi nalbhematoma,bandbheparin-inducedbthrombocytopenia ·bNursingbAdministration- bObtainbbaselinebvitalbsigns,bObtainbbaselinebandbmonitorbaPTT,bplateletbcount,band bhematocritblevels,breadblabelbcarefully,busebanbinfusionbpumpbforbcontinuousbIVbad ministration,bcheckbdosagesbwithbanotherbnurse,badministerbdeepbsubcutaneousbinj ections,badvisebclientsbtobusebanbelectricbrazorbforbshavingbandbtobbrushbwithbabsoft btoothbbrush
