NURSING MED SURG MS EXAM 2 [100% verified]

Exam 2 review Section B Focus points for Exam 2-This is everything we discussed in class last week-nothing new has been added. Thrombolytic meds- know side effects – remember -caution in patients with a history of gas ...

Exam 2 review Section B Focus points for Exam 2-This is everything we discussed in class last week-nothing new has been added. Thrombolytic meds- know side effects – remember -caution in patients with a history of gastric ulcers Know ventricular tachycardia and procedure for AED (automatic external defibrillator)First degree block nurse would- Document the finding and continue to monitor the patient. Treatment for PACs— limit or abstain caffeine. Second degree type 1 strip and patient is symptomatic-- Administer 1mg Atropine intravenously Above strip is also called a “Fireman’s hat”—pathological Q wave—what medication would the nurse administer STAT?. The patient has 10/10 chest pain- radiating to the jaw for the last three days. The EKG Strip shows Sinus Tachycardia- what action would the nurse take? Hint-address increased demand for oxygen with tachycardia and also patient pain. Assisting with CPR on a pt. without a pulse, the nurse and doctor note that the patient's heart rate suddenly changed to a sinus rhythm at a rate of 30..What action would the nurse take next? Pt. has supraventricular tachycardia (SVT) and is complaining of palpitations. When preparing to for appropriate administration of Adenosine (adenocard)- what must the nurse ensure? Pacer questions---the telemetry monitor reveals spikes on every P wave and QRS complex-and the patient's heart rate is normal sinus rhythm. How should the nurse interpret these findings? The patient is receiving positive and expiratory pressure (PEEP) and has a Swan Ganz catheter. What hemodynamic measurement will the nurse assess in order to determine the hemodynamic status of this patient? If a patient is displaying asynchrony (delivered ventilator breaths are not synchronous with patients breathing) with the ventilator breaths secondary to anxiety. What is the nurse's initial action? A patient with an oral endotracheal tube (ET) has a nursing diagnosis of risk for aspiration related to the presence of an artificial airway. What is the most appropriate nursing intervention for the nurse to implement for this patient? A patient has unrelieved chest pain for the last week-what does the nurse do first? placement Best MI cardiac markers = troponin levels Aflutter 3- treatment in symptomatic patients is cardioversion Post Cardiac Cath: teach patients to keep leg straight; nurse also assesses for bleeding at catheter site Atropine-can give for second degree heart block. To check effectiveness of atropine = pt. should have an increased HR MI priority care -A patient who was just admitted and is complaining of chest pain with no EKG changes is a priority. Know the side effects of nitroglycerin (Nitrostat) CABG complications: eg. patient could experience a stroke, know diagnostic interventions to R/O stroke complications such as an intracranial bleed. Treatment for Asystole - administer CPR In order to R/O MI - nurse needs to see cardiac markers that remain unchanged for 12 to 72 hours (Priortizing care) Who does the nurse see first?) Example---a patient whose defibrillator fired 3 times in one day. Patient has symptomatic V-Tachycardia- the nurse would administer—epinephrine- Epinephrine is primarily used for is vasoconstrictive effects. Vasoconstriction is important during CPR because it will help increase blood flow to the brain and heart. Remember CPR and rapid defibrillation with 360 joules are first line of treatment followed by epinephrine if defibrillation is unsuccessful. Patient is experiencing chest pain-what action would the nurse take? Administer an aspirin orally and apply oxygen via a nasal cannula. Recognize ventricular bigeminy – so on the monitor, the nurse would see every other QRS complex is wide and starts prematurely. Regular heart rate of 128 beats/min- nurse would see a decrease in cardiac output and blood pressure