260 test 2

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1

what is Na+ expected range ?

136 to 145 mEq/L

2

what is Ca expected range ?

9 to 10.5 mEq/L

3

What is K expected range?

3.5 to 5 mEq/L

4

what is Mg expected range ?

1.3 to 2.1 mEq/L

5

what is Cl expected range ?

98 to 106 mEq/L

6

what is Phosphorus expected range ?

3 to 4.5 mEq/L

7

what is hyponatremia ?

Na+ levels are less then 136 mEq/L

8

What are sign of FVE?

Ascities, crackles in lungs, dyspnea, edema, weight gain

9

What are signs of FVD?

Dark urine,high specific gravity,dry MM, low urine output ,Thirst, weight loss, poor skin turgor

10

What is hypernatremia?

Sodiun levels are over 145 mEq/L

11

What population is at high risk for Hypernatremia?

Breastfed infants and the elderly

12

What is hyperkalemia?

Potassium levels greater then 5.2 mEq/L

13

What is Hypokalemia?

Potassium levels less then 3.5 mEq/

14

What is Sinus bradycardia?

is a dysrhythmia that proceeds normally through the conduction pathway but at a slower than usual (less than60 beats/minute) rate.

15

When is immediate defibrillation used ?

used during pulseless ventricular tachycardia and ventricular fibrillation.

16

What is a Elective electrical cardioversion?

a nonemergency procedure done by a physician to stop rapid, but not necessarily life-threatening, atrial dysrhythmias.

17

What is a cardiac rhythm?

refers to the pattern (or pace) of the heartbeat

18

What is arterial flutter?

occurs because of a conduction defect in the atrium and causes a rapid, regular atrial rate, usually between 250 and 400 bpm and results in P waves that are saw-toothed.

19

What is syncope?

temporary loss of consciousness caused by a fall in blood pressure.

20

what the P-R interval represents?

It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node."

21

What is a transvenous pacemaker?

is a temporary pulse-generating device that sometimes is necessary to manage transient bradydysrhythmias such as those that occur during acute MIs or after coronary artery bypass graft surgery, or to override tachydysrhythmias.

22

What is a electrocardiogram?

is used to identify normal and abnormal cardiac rhythms.

23

What is the P wave?

depicts atrial depolarization, or spread of the electrical impulse from the sinoatrial node through the atria.

24

What is the PR interval?

epresents spread of the impulse through the interatrial and internodal fibers, atrioventricular node, bundle of His, and Purkinje fibers. The QRS complex represents ventricular depolarization

25

What is the T wave?

depicts the relative refractory period, representing ventricular repolarization.
Reference:

26

Clients with persistent______________ are prescribed anticoagulation therapy to reduce the risk of emboli formation associated with ineffective circulation.

atrial fibrillation

27

what is hemodynamics?

is the flow of blood through the body

28

about ___% of the adult body is fluid

60

29

amount of fluid in the body varies with these 3 things:

age,size,gender

30

intracellular fluid makes up ___% of the human body, which is skeletal muscle mass

40

31

extracellular fluid makes up ___% of body fluid

20

32

name 4 intravascular flui types:

plasma, erythrocytes, leukocytes, thrombocytes

33

name 1 interstitial fluid type

lymph

34

name 3 transcellular fluid types:

cerebrospinal, pericardial, synovial

35

what are electrolytes?

active chemicals that carry positive [cation] and negative [anion] electrical charges

36

name 5 cations in electrolytes:

sodium, potassium, calcium, magnesium, hydrogen

37

name 5 anions in electrolytes:

chloride, bicarbonate, phosphate, sulfate, proteinate ions

38

what is the measurement for electrolytes?

mEq [milliequivalents]

39

how to gain fluids:

eating and drinking

40

daily I&O of water are equal to___?

fluid balance

41

loss of fluids happens by these 4 means:

kidneys, lungs, skin, GI tract

42

what is the urine output of a normal kidney?

1ml/ kg/ hr

43

how much water/ fluid does your lungs use everyday [ greater with increased RR]?

300mL

44

clinical manifestations of fluid imbalance may be ____

subtle

45

symptoms of fluid loss include:

delirium, cardiac reserve, reduced renal function, dehydration, thinning of skin/elasticity

46

is dehydration the same as FVD [fluid volume deficit]?

no

47

name the Abnormal fluid loss causes in fluid volume deficit:

vomiting, diarrhea, sweating, GI suctioning

48

name the decrease intake reasons of fluids in FVD:

nausea, lack of access to fluids

49

name a third- space fluid shift:

ascites, burns

50

can diabetes insipidus, adrenal insufficiency, or hemorrhage also cause fluid volume deficit?

yes

51

isotonic expansion of the extracellular fluid is caused by:

abnormal retention of water and sodium

52

fluid overload or diminished homeostatic mechanisms can lead to:

FVE

53

heart failure, kidney injury, and cirrhosis of the liver can also cause:

FVE [ fluid volume excess]

54

will consumption if excessive amounts of table salt or other sodiums lead to FVE?

yes

55

when long stays in nursing care getting regular fluid treatments, it is important to keep in mind this:

possibility of administering excessive amounts of sodium- containing fluids

56

name a few things to nursing management of FVE:

I&O daily weights, lung sounds, edema, monitor other symptoms, monitor meds like diuretics, promote fluid restrictions related to sodium

57

fluid volume excess FVE is AKA:

hypervolemia

58

serum sodium less than ____________ can cause hyponatremia:

135mEq/L

59

fluid overload of a surgical patient can acutely cause this:

hyponatremia

60

causes of sodium loss are:

h2o imbalance, vomiting, diarrhea, sweating, diuretics, adrenal insufficiency, SIADH

61

manifestations of low sodium are:

poor skin turgor, dry MM, headache, decrease salivation, decrease BP, nausea, abd. cramping, neurologic changes

62

name 4 tx or management of hyponatremia [low sodium]

treat underlying issue, sodium replacement, water restriction, medication

63

What is hypernatremia?

high/ excessive sodium

64

a person has hypernatremia is serum sodium is greater than__________:

145 mEq/ L

65

the 3 people likely to get hypernatremia are:

very old, very young, cognitively impaired

66

causes of hypernatremia [ incr sodium]:

fluid deprivation, excess sodium admin., diabetes insipidus, heat stroke, hypertonic iv solutions

67

thirst and elevated temperatures are manifestations of__:

hypernatremia

68

gradually lowering serum sodium levels via infusion of hypotonic electrolyte solution is a treatment for this:

hypernatremia

69

when treating hypernatremia, it is important to talk to the patient about this:

over- the- counter sources of sodium

70

Hypokalemia is this:

decreased potassium

71

serum potassium level is considered hypokalemic at this level:

under 3.5 mEq/L

72

can hypokalemia occur even with normal potassium levels?

yes, when alkalosis is present, a temp shift or potassium into cells occurs

73

some causes of hypokalemia include:

GI losses, meds, prolonged GI suctioning, recent ileostomy, intestinal tumor, poor diet, hyperaldosteronism

74

ECG changes, dysrhythmias, dilute urine, excessive thirst, fatigue, anorexia,muscle weakness, decrease bowel motility and paresthesias are all manifestations of this:

hypokalemia [low potassium]

75

it is important to monitor for this in patients with hypokalemia:

alkalosis

76

in hypokalemic patients, it is important to watch for toxicity if they are taking ____:

digitalis

77

IV potassium can only be administered after adequate ____ has been established:

urine output

78

**IV potassium is NEVER administered THIS WAY :

IV BOLUS

79

Hyperkalemia is:

too much potassium in the body

80

hyperkalemia happens when potassium serum levels are greater than:

5.0 mEq/L

81

Hyperkalemia seldomly occurs in patients with:

normal renal function

82

hyperkalemia risk is greater in these patients:

older adults

83

cardiac arrest is frequently associated with this:

hyperkalemia

84

Signs of hyperkalemia are this:

MURDER

Muscle cramps, Urine abnormalities, Respiratory distress, Decrease cardiac contractility, EKG changes, Reflexes

85

1 in 4 people die from this type of disease:

cardiovascular disease

86

this is the most common type of heart disease accounting for 370k deaths annually

CAD

87

this percent of sudden cardiac deaths occur outside of the hospital:

47%

88

what was the objective of the framingham heart study?

identify common risk factors that contribute to the development of cardiovascular disease

89

name the 3 layers of the heart:

endocardium, myocardium, epicardium

90

name the 4 heart chambers

right atrium, right ventricle, left atrium, left ventricle

91

and the 2 atrioventricular valves:

tricuspid & mitral

92

name the semilunar valves

aortic and pulmonic

93

what is depolarization?

electrical activation of a cell caused by influx of sodium into cells while potassium exits the cells

94

the return of cells to resting state caused by re-entry of potassium into cells while sodium exits is called:

repolarization

95

there are 2 refractory periods, name them:

effective and relative

96

this refractory period is a phase in which cells are incapable of depolarizing:

effective

97

this refractory period is a phase in which cells require stronger than normal stimulus to depolarize:

relative

98

each cardiac cycle has 3 major sequential events..:

diastole, atrial systole, ventricular systole

99

this is the amount of blood ejected with each heartbeat:

SV [stroke volume]

100

this is the degree of stretch of cardiac muscle fibers at end of diastole:

preload

101

resistance to ejection of blood from a ventricle is called:

afterload

102

ability of cardiac muscle to shorten in response to electrical impulse is called:

contractility

103

percent of end diastolic volume ejected with each heartbeat [left ventricle] with normal being between 55-70%

ejection fraction

104

what is cardiac output definition:

amount of blood pumped by ventricle in liters per minute

105

what is the formula for cardiac output:

CO= SV x HR

106

contractility can be increased by 3 things:

catecholamines, sympathetic nervous system, certain medications

107

increased contractility results in increased ___:

stroke volume

108

contractility is decreased by these 3:

hypoxemia, acidosis, certain medications

109

can demographics or family genetics affect cardiovascular system?

yes

110

can cultural or social factors play a role in cardiovascular disease?

yes

111

name some lab tests assessing cardi system:

hematology/ coagulation/ blood chem, lipid profiles, brain natriuretic peptide, c-reactive protein, homocysteine

112

PT walking on treadmill with intensity progressing according to protocols is called this test:

cardiac stress testing

113

what is pharmacologic stress testing?

when medications like vasodilating agents are given to mimic exercise

114

this noninvasive ultrasound test is used to measure the ejection fraction of the heart, examine size, shape, and motion of cardiac structures

transthoracic echocardiogram

115

which of the following is the primary pacemaker for the myocardium?

sinoatrial node

116

which of the best defines stroke volume?

the amount of blood ejected with each heartbeat

117

Digoxin toxicity is

visual disturbances (e.g., flickering flashes of light, colored or halo vision, photophobia, blurring, diplopia, and scotomata), central nervous system abnormalities (e.g., headache, fatigue, lethargy, depression, irritability and, if profound, seizures, delusions, hallucinations, and memory loss), and cardiovascular abnormalities (e.g., abnormal heart rate, arrhythmias).

118

what is classic sign of cardiogenic shock?

is manifested as cerebral hypoxia (restlessness, confusion, agitation). Low blood pressure is a classic sign of cardiogenic shock.

119

Frequently, what is the earliest symptom of left-sided heart failure?

Dyspnea on exertion