NUR 511 Exam 1
ACEs - correct answer-End in "pril". Used to prevent kidney damage, prevent remodeling of
heart, and reduce BP.
Acute disease or injury related malnutrition - correct answer-Marked inflammatory response.
Associated with acute disease or injury (burns, trauma, major infection).
Aortic regurgitation - correct answer-Backflow of blood from ascending aorta into LV during
diastole. LV volume overload, increased LA pressure, pulmonary congestion/hypertension,
results in right side failure.
Acute: cardiovascular collapse (severe hypotension, CP, dyspnea)
Chronic: s/s HF, throbbing pulse in neck, deMisset's sign (head bob), diastolic murmur, s3
and s4, widened pulse pressure, unresponsive angina.
No nitro!!!
Treatments: same as HF with addition of anticoagulants and prophylactic antibiotics.
Aortic stenosis - correct answer-Obstructs blood flow from LV to aorta during systole. LV has
to work harder, hypertrophies.
Increased workload, causes ischemia.
Pressure backs up causing pulmonary congestion/edema.
Left sided HF.
Symptoms: DOE, angina, Exertional syncope! (Know these)
Narrowed pulse pressure, harsh systolic murmur, diminishe for absent S2, s3 and s4,
BNP - correct answer-Levels over 700pg/mL indicate decompensated HF.
Cardiac tamponade - correct answer-Compression of heart from fluid built up in pericardial
sac.
See significant pulses paradoxus (deep breath lose pulse), confusion, agitation,
restlessness, tachycardia, tachypnea, dyspnea, chest pain, low CO state, JVD
(PROFOUND!), narrowed pulse pressure, muffled heart sounds, mottled skin.
Chronic disease related malnutrition (secondary PCM) - correct answer-Sustained
inflammation of mild mod degree. Tissue needs not met even when dietary intake would
normally be adequate. (Chronic/long term conditions)
Compensatory mechanisms - correct answer-SNS activation- catacholamine release
(increase HR, BP, vasoconstriction in periphery, workload on heart)
RAAS- hold onto water and salt, increase volume and vasoconstriction
ADH- hold onto water and salt
Natriuretic peptide- diuretic and vasodilation properties= BNP= specific marker for HF.
, Hypertrophic- can't fill
Dilation- can't squeeze
Dilated cardiomyopathy - correct answer-Can't squeeze, most common type, cause of
sudden cardiac death, big boggy heart.
Caused by cardiotoxic agents (alcohol), infections, diseases, pregnancy.
HF symptoms, S3 and S4, at risk for blood clots!
Blood clot right side- pulmonary embolism
Blood clot left side- brain (stroke), legs, kidneys
Treat by stopping alcohol/drugs, same mess as HF, anticoagulants
Avoid alcohol, infections/crowds, family should learn CPR.
Edema - correct answer-Caused by deprecated albumin and prealbumin
Edema scale - correct answer-+1 is slight: rapidly returns to normal
+2 : normal in 10-15 sec
+3: normal in 1-2 min
+4: normal in 2-5 min
Ejection fraction - correct answer-Greater than 60 is normal
40-60 moderate HF
20-40 mod to severe HF
Less than 20 severe HF
Enteral feeding - correct answer-HOB at least 30 degrees.
Confirm initial placement with X-ray, pH testing best, air bolts still used. Look at color and
amount of residual, chef insertion length regularly.
Check residual every 4 hr, and return to patient.
If residual greater than 250 mL, often hold or decrease tube feeding.
Don't check residual on J tubes.
Flush with at least 30 mL every 4 hr.
Stomach pH less than 4.
Jejunum pH greater than 6.
Use 15mL water with each med.
Change feeding bag every 24 hr. Sterile formula no greater than 8 hr.
Refeeding syndrome: check electrolytes and VS frequently.
HF classifications - correct answer-Low numbers good, high bad. A is good, D is bad.
HF diagnosis - correct answer-BNP elevated, BUN and creatinine elevated,
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