Labs
Normal sodium range
135-145
Your patient has a blood pressure of 134/76. What is their MAP?
95
What class of medication is digoxin? What assessment should be completed prior to giving this medication?
Cardiac glycosides: HR >60
What mask provides the highest concentration of oxygen to a spontaneously breathing patient?
Non-rebreather mask
to assess the effectiveness of a vasodilator administered to a client, what should the nurse assess?
Blood pressure, vasodilators lower blood pressure- increases blood flow to the myocardium
Lab that measures extent of heart failure. This protein is released in response to changes in pressure inside the heart.
BNP= Brain natriuretic peptide
What is a normal ejection fraction?
Between 50 and 70%
Your patient is being discharged on spironolactone, what education should you provide your patient?
-Monitor weight
-Monitor blood pressure
-Monitor potassium intake
-DO not skip medication, take on daily basis
-Take in the morning
Clubbing of the nails could indicate (abnormal, rounded shape of nail bed)
Decreased perfusion
Usually from COPD, lung disease, cystic fibrosis
Which assessment finding would alert the nurse that the patient is experiencing issues with perfusion?
1. BP 100/60
2. Apical HR 80, radial HR 68
3. RR of 22
4. Temp: 101.2
1. BP 100/60
2. Apical HR 80, radial HR 68
3. RR of 22
4. Temp: 101.2
Group of proteins found in skeletal and heart muscle fibers that regulate muscular contraction. Typically not found in the blood but it is released when the heart muscles are damaged.
Troponin
You are caring for a patient with right sided heart failure, would you expect their central venous pressure to be decreased or elevated?
Elevated
Your patient, who takes daily Digoxin, comes to the clinic with GI upset, N/V, changes in vision (blurry and seeing halos around bright objects), and is having palpitations. What is occurring?
Digoxin toxicity
-Life-threatening condition, can induce arrhythmia and death
What is are caring for a patient admitted with heart failure. The patient's vital signs are: BP 160/80, HR 64, R 18, T 97.6°F. You auscultate coarse crackles bilaterally and palpate 3+ edema to the lower extremities. What do you suspect in occurring with this patient?
Excessive fluid overload
Which of the following is an expected outcome of a patient receiving IV furosemide?
1. increased blood pressure
2. increased urine output
3. deceased pain
4. decreased PVC's
Increased urine output
This is a protein made by the liver- it is sent into the blood stream in response to inflammation.
CRP- C-reactive protein
What is a normal range for a lactate level? What does an elevated lactate indicate?
<2. measures hypoxic insult in many conditions such as hypo perfusion to tissues.
This type of diuretic prevents the body from absorbing too much salt and keeps your potassium levels from getting too low- often used to treat heart failure, HTN, or hypokalemia
Potassium sparing diuretic
Process by which oxygenated capillary blood passes through body tissues
Perfussion
Your patient comes to the clinic and states his left calf is sore, red, and swollen. He is tachycardic with a low O2 rate, he appears anxious and is having difficulty breathing. What is happening?
He probably had a DVT in leg, which moved to the lungs (PE)
This is an enzyme from heart muscle, increased amounts occur when there is muscle damage to the myocardium.
Ck-MB - Creatine kinase
When performing CPR on a patient, what does the end tidal Co2 (ETCO2) indicate?
If above 10-15- quality CPR- monitors the effectiveness of CPR for perfusion-
A patient taking Lisinopril (has been for 10 years), calls the clinic and reports a dry cough but no other symptoms. They are wondering if they should come in to clinic, what do you tell them?
Yes, the dry cough could be caused by taking Lisinopril, doctor needs to determine if medication should be discontinued.
In an EKG, what does the P wave represent?
represents discharge of SA node and depolarization of both atria- upper heart champers (atria)
Which patient is highest risk for coronary artery disease?
1. 32 year old with mitral valve prolapse who quit smoking 10 years ago.
2. a 43 yo male with a family hx of CAD and cholesterol level of 158.
3. a 56 yo with HDL of 60 who takes Lipitor.
4. a 65- yo female who is obese with a LDL of 188
4. a 65- yo female who is obese with a LDL of 188