NURSING > STUDY GUIDE > PN2 - Adult 2 Final Exam Study Guide. (All)

PN2 - Adult 2 Final Exam Study Guide.

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 What do we teach a patient about angiocardiogram: o Patient will be NPO o Assess for hypersensitivity to iodine, radiologic contrast, or seafood o Record baseline vitals o Assess cath site for bleeding or hematoma o Maintain bed rest  What is contraindicated in heart failure: o Alcohol o Cocaine o Antiarrhythmic agents except for amiodarone o Calcium channel blockers except for amlodipine o NSAIDs o Thiazolidinediones (may cause fluid retention) o Metformin  Diet restrictions for heart failure: o Fluid restriction (1500 mL) o Sodium restriction (Na 2g)  Nursing Diagnosis for Infective endocarditis: o Activity intolerance related to compromised oxygen transport system secondary to heart muscle dysfunction o Risk for ineffective breathing pattern related to decreased respiratory depth secondary to pain o Pain related to friction rub and inflammatory process  Signs and Symptoms related to Right-sided heart failure:o Jugular vein distention o Ascending dependent edema (legs, ankles, sacrum) o Abdominal distention, ascites o Fatigue, weakness o Nausea and anorexia o Polyuria at rest (nocturnal) o Liver enlargement (hepatomegaly) and tenderness o Weight gain  Signs and Symptoms for rheumatic heart disease o Asymptomatic until late in the progression of the disease o A murmur is heard with turbulent blood flow o Left-sided valve damage causes increased pulmonary artery pressure, left ventricular hypertrophy, and decreased cardiac output, resulting in orthopnea, paroxysmal nocturnal dyspnea, and fatigue  Sinoatrial Node function: o Primary pacemaker of the heart – rate at 60-100 beats per minute  Medications given for post valve replacement: o Warfarin (Coumadin)  Lab Tests for cardiac damage: o Myoglobin – earliest marker of injury to cardiac or skeletal muscle; levels no longer evident after 24 hours o Creatine kinase-MB – Peaks around 24 hours after onset of chest pain; levels no longer evident after 3 days o Troponin I or T – any positive value indicates damage to cardiac tissue  Normal and abnormal things to see on an EKG o Normal – sinus rhythm o Abnormal – atrial fib, PVCs, V-tach, V-fib  Know about A-flutter: o Occurs as a result of an ectopic focus in the atrial tissue that generates an impulse at such a high speed that it becomes the dominant pacemakero Caused by: right atrial hypertrophy, open-heart surgery, CHF, MI, Hyperthyroidism o Treated with Amiodarone, adenosine, Verapamil, or synchronized cardioversion  Know the treatment for SVT o Amiodarone, adenosine, and verapamil, ablation, synchronized cardioversion (only will shock when matches R wave)

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