Heart Failure
Swelling in the legs, ankles, and feet is a common symptom of this type of heart failure.
What is Right sided heart failure?
Which of the following ABG values are normal?
A. pH: 7.40, PaCO₂: 45 mmHg, HCO₃⁻: 18 mEq/L
B. pH: 7.35, PaCO₂: 50 mmHg, HCO₃⁻: 26 mEq/L
C. pH: 7.45, PaCO₂: 35 mmHg, HCO₃⁻: 28 mEq/L
D. pH: 7.38, PaCO₂: 40 mmHg, HCO₃⁻: 24 mEq/L
D. pH: 7.38, PaCO₂: 40 mmHg, HCO₃⁻: 24 mEq/L
Rationale: All values fall within normal ranges:
pH: 7.35–7.45
PaCO₂: 35–45 mmHg
HCO₃⁻: 22–26 mEq/L
This electrolyte imbalance may present with Chvostek’s and Trousseau’s signs, tetany, and seizures.
What is hypocalcemia?
This infection is the primary cause of rheumatic heart disease.
What is untreated strep throat?
A patient receiving digoxin is at risk for toxicity if they develop which electrolyte imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Rationale: Hypokalemia potentiates digoxin toxicity.
Daily monitoring of this helps detect fluid retention early.
What is daily weight
A patient with severe diarrhea has the following ABG:
pH: 7.28 PaCO₂: 38 mmHg HCO₃⁻: 18 mEq/L
What is the most likely diagnosis?
A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
B. Metabolic acidosis
Rationale: pH < 7.35 =acidosis; HCO₃⁻ < 22 =metabolic cause; PaCO₂is normal
Peaked T-waves and muscle weakness are signs of this electrolyte imbalance
what is hyperkalemia?
Foods to avoid: Potassium Rich
Foods:
Chocolate, Dried fruits/nuts/seeds, Oranges, apricots, cantaloupe, bananas, tomatoes, carrots,
potatoes, mushrooms
This type of valve replacement is more durable but has a higher risk of thromboembolism.
What is a synthetic valve?
Which of the following is a priority nursing assessment for a patient with mitral valve regurgitation?
A. Peripheral pulses
B. Lung sounds
C. Bowel sounds
D. Skin turgor
B lung sounds
Rationale: Mitral regurgitation can cause pulmonary congestion; lung sounds help assess fluid status.
A patient has suddenonset breathlessness,sense of suffocation, Pink frothly sputum, tachypneic with low oxygen sats, increased HR and JVD
What is pulmonary edema - page 798
A patient with metabolic alkalosis is vomiting continuously. What is the best nursing action?
A. Administer potassium chloride
B. Encourage hyperventilation
C. Administer sodium bicarbonate
D. Monitor for hypokalemia
D. Monitor for hypokalemia
Rationale: Vomiting causes loss of H⁺ and K⁺ → metabolic alkalosis and hypokalemia risk.
Page 244
Pt presents with Irritability, apprehension, confusion, tremors, seizures, coma. Postural hypotension, rapid thready pulse, tachycardia, decreased Central venous pressure, decreased jugular = venous filling, N&V, wt loss, dry mucous membranes - Is at risk for what electrolyte imbalance?
What is hyponatremia? - Nursing management would be I/Os, daily weights, monitoring for GI S/S, CNS changes, assess for certain predisposing factors: tap water enemas, lithium, IV fluids and Na containing foods
Pt presents with vague Signs and Symptoms:
Fever , Chills , Night Sweats, Fatigue, Anorexia, Weight Loss
What is Infective Endocarditis?
A nurse is caring for a patient with right-sided heart failure. Which of the following findings should the nurse expect?
A. Crackles in the lungs
B. Orthopnea
C. Peripheral edema
D. Dyspnea on exertion
C Peripheral edeam
Rationale: Right-sided heart failure leads to systemic venous congestion, causing peripheral edema.
Patients with HF and reduced EF generally treated with one of these
What is a Ace, ARBS, ARNI,Beta blockers, K sparing Diuretic or sodium- glucoseco-transporter 2 inhibitor?
-discussed in PPT
- Page 800
80-year-old female presents with two-day hx of vomiting. She is lethargic, weak and having myalgias. Dry mucous membranes and cap refill > than 4 seconds noted
ABG: ph=7.5; CO2=45; HCO3=37
This would be?
What is metabolic alkalosis?
ABG recording
– no compensation – IV fluids, antiemetic
A patient with numbness, tingling, and decreased reflexes may have this magnesium imbalance.
What is hypermagnesemia?
-Monitor
- VS, assess for decrease in reflexes, change in LOC
-Avoid Mag Rich Foods
Chocolate - Dry beans & peas - Green leafy vegetables - Meats - Nuts - Seafood -Whole grain
A patient with a history of coronary artery disease is being treated for a myocardial infarction. During treatment, the patient develops acute mitral valve regurgitation. What is the most likely cause of this acute valve dysfunction?
A. Infective endocarditis
B. Ventricular fibrillation
C. Rupture of the chordae tendineae
D. Atherosclerosis
C. Rupture of the chordae tendineae
Rationale:
Acute mitral regurgitation during an MI is often caused by rupture of the chordae tendineae, which support the mitral valve leaflets. This structural damage leads to sudden backflow of blood into the left atrium, causing pulmonary edema and hemodynamic instability.
A patient’s ABG results are:
pH: 7.32 PaCO₂: 48 mmHg HCO₃⁻: 25 mEq/L
What is the correct interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
B
Rationale: pH < 7.35 and PaCO₂ > 45 indicate respiratory acidosis.
Which of the following patients are MOST at risk for developing heart failure? - Select all that apply.
A 69-year-old male with a history of alcohol abuse recovering from a myocardial infarction
B. 55-year-old female with asthma and hypoparathyroidism
C. A 30-year-old male with endocarditis and severe mitral stenosis
D. A 45-year-old female with stage 2 lung cancer
E. A 58-year-old female with uncontrolled hypertension and influenza
A, C, E
A postoperative client has a nasogastric (NG) tube set to continuous low suction. The client reports feeling dizzy and has a positive Chvostek's sign. The ABG analysis shows: pH 7.54, PaCO2 43 mmHg, HCO335 mEq/L. The nurse interprets this as which imbalance?
A – Fully compensated metabolic alkalosis
B – Uncompensated Respiratory alkalosis
C – uncompensated metabolic alkalosis
D – Partially compensated metabolic alkalosis
C – uncompensated metabolic alkalosis
To interpret these ABG results, follow these steps:
Analyze the pH: The pH is 7.54, which is higher than 7.45. This indicates alkalosis.
Analyze the HCO3: The HCO3 is 35 mEq/L, which is higher than 26 mEq/L. A high HCO3 (a base) causes alkalosis. This matches the pH, so the primary problem is metabolic. NG suction removes large amounts of hydrochloric acid from the stomach, leading to a metabolic alkalosis. The positive Chvostek's sign indicates hypocalcemia, which can accompany this imbalance.
Analyze the PaCO2: The PaCO2 is 43 mmHg,
Therefore, the interpretation is uncompensated metabolic alkalosis.
Organ meats, eggs, and dried beans are high in this nutrient.
What is phosphate?
A patient is diagnosed with aortic stenosis. Which of the following findings is most consistent with this condition?
A. Bounding peripheral pulses
B. Narrow pulse pressure and murmur
C. hypotension
D. Jugular vein distention and hepatomegaly
B Narrow pulse pressure and systolic murmur
Rationale: Aortic stenosis causes a systolic murmur and narrow pulse pressure due to reduced cardiac output.
Which of the following is a common symptom of aortic regurgitation?
A. Narrow pulse pressure
B. Bounding peripheral pulses
C. Jugular vein distention
D. Cyanosis
B bounding peripheral pulses
Rationale: Aortic regurgitation causes increased stroke volume and wide pulse pressure, resulting in bounding pulses.