ACUTE EXAM #2 Questions & Answers 100%
For patients with valvular disease, what is prescribed to prevent endocarditis?
This valvular disorder leads to blood back up in the right atrium, causing pressure to build up
The higher the _____________ of blood, the higher the ____________.
What is ...
this valvular disorder leads to blood back up in the right atrium
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NUR 3463 (NUR3463)
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ACUTE EXAM #2 Questions & Answers
100%
Quiz:> For patients with valvular disease, what is prescribed to prevent endocarditis?
{{{Answer}}} (Prophylactic antibiotics)
Quiz:> This valvular disorder leads to blood back up in the right atrium, causing
pressure to build up
{{{Answer}}} (Mitral valve stenosis)
Quiz:> The higher the _____________ of blood, the higher the ____________.
{{{Answer}}} (Volume, pressure)
Quiz:> What is the normal diameter of a valve?
{{{Answer}}} (3 fingers width in diameter)
Quiz:> What is the approximate diameter of a patient's valve with stenosis?
{{{Answer}}} (Diameter of a pencil/pen)
Quiz:> What diagnostic test will indicate narrowing of the valves?
{{{Answer}}} (ECG)
Quiz:> What does an abnormal radial pulse upon assessment indicate?
{{{Answer}}} (An arrhythmia or possible a-fib)
Quiz:> What is the normal ejection fraction of the heart?
{{{Answer}}} (60-65%)
Quiz:> What disease during young adulthood could cause mitral valve stenosis later in
life once an older adult?
{{{Answer}}} (Syphilis)
Quiz:> What complication can mitral stenosis lead to?
{{{Answer}}} (Pulmonary HTN)
Quiz:> What are teaching points for the patient with mitral stenosis that also has
regurgitation?
{{{Answer}}} (- Patient may have CHF, treat the heart failure
- Minimize risk of contracting infection: Endocarditis will be prevented by adherence to
prophylactic antibiotics
- Include periods of rest after periods of energy exertion
- Avoid strenuous activities)
,Quiz:> A disorder defined as when one of the valves stretches; More common in
women; Asymptomatic, hereditary
{{{Answer}}} (Mitral valve prolapse)
Quiz:> What valvular disorder is hereditary, asymptomatic, and more common in
women?
{{{Answer}}} (Mitral valve prolapse)
Quiz:> In mitral valve prolapse, who should get an EKG if a sibling is diagnosed?
{{{Answer}}} (First line brothers and sisters)
Quiz:> What are some teaching points to go over for a patient diagnosed with mitral
valve prolapse?
{{{Answer}}} (- Avoid stimulants
- Avoid alcohol
- Smoking cessation, avoid tobacco
- Avoid alcohol containing mouth washes
- Avoid ephedrine containing cough medicines (can cause HTN))
Quiz:> If chest pain is not relieved by ________________, is it not angina and this
needs further investigation
{{{Answer}}} (Nitroglycerin)
Quiz:> Valvular disorder defined as when blood goes back as it continues to move
forward; Backing up of blood
{{{Answer}}} (Mitral valve regurgitation)
Quiz:> What will mitral valve regurgitation eventually lead to?{
{{Answer}}} (Right sided heart failure)
Quiz:> What illness will impact the mitral valve?
{{{Answer}}} (Rheumatic fever)
Quiz:> What are s/s of worsening mitral valve regurgitation?
{{{Answer}}} (- SOB (due to pulmonary congestion
- Cough
- Fatigue
- Possible a- fib)
Quiz:> In mitral valve regurgitation, if the radial pulse is irregular upon assessment,
what is the nurse's next step?
{{{Answer}}} (Assess the apical pulse!)
Quiz:> In mitral valve regurgitation, if the radial & apical pulses have both been
assessed & both are irregular, what is the nurse's next step?
, {{{Answer}}} (Get an EKG STAT)
Quiz:> What is the aim of treatment for mitral valve regurgitation?
{{{Answer}}} (Reduce after load; want to decrease resistance of blood flow)
Quiz:> What is the medication regimen that a patient with mitral valve regurgitation will
be prescribed?
{{{Answer}}} (Possible ACE, ARB, hydrazine or BB)
Quiz:> In mitral valve regurgitation, if an ACE inhibitor is un-tolerated due to constant
dry cough, what is the next line medication that will be prescribed?
{{{Answer}}} (Hydralazine, a direct vasodilator which will reduce after load)
Quiz:> What is patient teaching that is required with hydralazine?
{{{Answer}}} (- Orthostatic hypotension (due to vasodilating effects)
- Avoid grapefruit juice
- "Dangle" feet on edge of bed before getting up
- Change positions slowly when moving from sitting to standing etc)
Quiz:> What does aortic stenosis lead to?
{{{Answer}}} (Hypertrophy and vasodilation; Similar to what happens in atherosclerosis)
Quiz:> What medication regimen will be prescribed for a patient with aortic stenosis?
{{{Answer}}} (Digoxin, BB, ACE inhibitor; looking for vasodilation)
Quiz:> Patient admitted with strep infection is worried that their heart may be affected.
What diagnostic tests will be done at this time?
{{{Answer}}} (- Blood culture (CBC) --> Looking at WBC's
- ECG --> Monitoring HR and rhythm
- TEE --> Trans-esophageal echo)
Quiz:> What is the result of an untreated streptococcal infection?
{{{Answer}}} (Infective endocarditis)
Quiz:> If a patient undergoes a valve replacement, what medications will they be on
long term?
{{{Answer}}} (Long term anticoagulant therapy as well as prophylactic antibiotics)
Quiz:> Under what two circumstances should a patient with previous valve replacement
ensure they take prophylactic antibiotics?
{{{Answer}}} (Before visits to the dentist & before surgical procedures)
Quiz:> What medication would a patient with atrial fibrillation need to be on long term?
{{{Answer}}} (Coumadin (Warfarin))
Quiz:> Why do patients with history of a-fib need to be on anticoagulant therapy?
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