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NRSG 357 Exam 2: Questions & Complete Answers
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NRSG 357 Exam 2: Questions & Complete Answers
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NRSG 357 Exam 2: Questions & Complete AnswersWhat is heart failure? Right Ans - -clinical syndrome that results in the
inability of the heart to provide sufficient blood to meet the O2 needs of
tissues and organs
-either a defect of ventricular filling (diastolic dysfunction) or ventricular
ejection (systolic dysfunction)
What are the risk factors for HF? Right Ans - -hypertension
-CAD
-MI
-other co-morbidities: DM, metabolic syndrome, increased age, tobacco use,
other vascular diseases
What are the complications of HF? Right Ans - -pleural effusion
-dysrhythmias
-left ventricular thrombus
-hepatomegaly
-renal failure
What is pleural effusion? Right Ans - -occurs when excess fluid builds up in
pleural cavity of lungs secondary to increasing pressure in pleural capallaries
What are the symptoms of pleural effusion? Right Ans - -dyspnea
-chest pain
-cough
What are dysrhythmias? Right Ans - -enlargement of heart can cause
changes in normal electrical pathways
-prevalence of atrial fib is increased=puts pt at increased risk for stroke
-ventricular dysrhythmias occur
What causes a left ventricular thrombus? Right Ans - -due to enlarged LV
and decreased CO
What does a left ventricular thrombus cause? Right Ans - -thrombus
forms=decrease LV contractility + decrease CO + worsen pts perfusion =
greater risk of stroke
,What occurs with hepatomegaly? Right Ans - eventually liver cells die,
fibrosis occurs, and cirrhosis can develop
How/why does renal failure? Right Ans - decreased CO=decreased
perfusion to kidneys=renal insufficiency or failure
What labs are important to monitor in a pt with HF? Right Ans - -
electrolytes (K)
-BUN
-creatinine
-liver function
-BNP
-NP
*ECG
*6 min walk test, MUGA scan, cardiopulmonary exercise stress test, heart
catheterization, EMB
*obstructive sleep apnea
What are the interventions for HF? Right Ans - -supplemental O2
-decrease anxiety
-VS, O2 sat, weight, I&O
-place in high fowlers position
Which meds are given for HF? Right Ans - -diuretics (furosemide)
-opioids (morphine)
-beta blockers (metoprolol)
-glycosides (digoxin)
-sympathomimetic/inotropic agents (dobutamine)
What is the MA of diuretics? Right Ans - -decrease volume in overload
(preload)
-decrease pulmonary venous pressure and edema
-relieve symptoms of HF
-promotes sodium and water excretion
What is the MA of opioids (morphine)? Right Ans - -decrease anxiety and
dyspnea
-decreases preload and afterload
,What is the MA of beta blockers (metoprolol)? Right Ans - -protect heart
for excessive sympathetic stimulation/block neg affects of SNS on heart
-protect again dysrhythmias
What is the MA of gylcosides (Digoxin)? Right Ans - -increase force of
cardiac contraction + decrease HR = more complete emptying of ventricles,
reduce volume in ventricles during diastole
-increase stroke volume and CO
-promote vasodilation
What is the MA of sympathomimetic/inotropic agents (dobutamine)? Right
Ans - -increase myocardial contractility
-increase CO
Atherosclerosis Right Ans - -soft deposits of fat that harden with age
-hardening of the arteries
-major cause of coronary artery disease
Atherosclerosis Right Ans - stages:
-chronic endothelial injury
-fatty streak
-fibrous plaque
-complicated lesion
Fatty streak Right Ans - earliest lesions of atherosclerosis are characterized
by lipid-filled smooth muscle cells
Fibrous plaque Right Ans - is the beginning of progressive changes in the
endothelium of the arterial wall
Complicated lesion Right Ans - as the fibrous plaque grows, continued
inflammation can result in plaque instability, ulceration, and rupture. A
thrombus can result from this and cause total occlusion of the artery
importance of cholesterol Right Ans - -cell membrane component
-hormone synthesis
-synthesis of bile salt
Atherosclerosis Right Ans - risk factors:
, - Nonmodifiable: age, gender, ethnicity, family history genetics
- Modifiable: elevated serum lipids, elevated BP, tobacco use, physical
inactivity, obesity, diabetes, metabolic syndrome, psychologic states, elevated
homocysteine level
- Middle aged men have the highest rate (white men to be specific)
- African American women are at higher rates as well
health promotion atherosclerosis Right Ans - - Prevention and early
treatment
- Environmental factors: eating habits, type of diet, level of exercise
- Psychosocial history: tobacco use, alcohol intake, recent stressful events
- Employment: activity, exposure to pollutants, toxins, stress
- Prescribed medications
diet changes/TLC diet Right Ans - A decrease in saturated fat and
cholesterol and an increase in complex carbohydrates (ex: whole grains, fruit,
veggies) and fiber. Fat intake should be about 25-35% of total calories Red
meat, egg yolk, and whole milk products should be reduced or eliminated
from diets. Omega-3 fatty acids reduce risk and include salmon and tuna. Tofu,
soybean, canola, walnut, and flaxseed becomes omega-3 fatty acid in the body.
weight management Right Ans - Maintaining an ideal body weight, getting
adequate physical exercise, reducing intake of saturated fats, and avoiding
tobacco and drugs.
physical activity/exercise Right Ans - Get at least 30 minutes of moderate
physical activity on most days. Strength training at least twice a week.
smoking cessation Right Ans - Chronic exposure to environmental tobacco
also increases risk. Encourage house members to stop smoking.
statins Right Ans - Use: inhibits the synthesis of cholesterol in the liver so
the liver is able to remove more LDLs from the blood.
statins Right Ans - Side effects: liver damage and myopathy that can
progress to rhabdomyloysis (breakdown of skeletal muscle).
statins Right Ans - Liver enzymes (AST and ALT) need to be monitored.
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