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Med Surg Topics Final Exam (Autosaved)
Genetics For Nursing Practice (NUR 4160)
Nova Southeastern University
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MED SURG FINAL EXAM TOPICS
100 Questions
Chest tubes
Alzheimer’s
Asthma
ABG’s
Emphysema
Bronchoscopy
COPD
Strokes
Meniere’s disease
Encephalitis
Meningitis
Cataracts
ICP
Amputation
Osteoarthritis/Osteoporosis
TB
Seizures
Pneumothorax
Guillen barre syndrome
Retinal detachment
Bone scans
MRI
Parkinson’s
Pneumonia
PVD & PAD
Hypertension
MI
CHF
Valves
Speciic Valvular Disorders Mitral valve prolapse – AV valve In this condiion a porion of one or both mitral valve lealets balloons back into the atrium during systole this is the prolapse piece. Blood will then regurgitate from the let ventricle back into the let atrium Eiology: Hereditary Clinical Manifestaions: SOB, faigue, lightheadedness, dizziness, syncope, palpitaions, chest pain, or anxiety Some may be asymptomaic May hear a systolic click in a high-level pracice. This is an early s/s of this prolapse and can result in HF What do we tell the paient? Stop cafeine, alcohol, and tobacco Treatment:
Aniarrhythmic medicaions Control s/s No anibioic prior dental treatments required Nitrates, CCB, or beta blockers Complicaions: The paient can develop infecive endocardiis and the paient may need anibioic therapy
Mitral regurgitaion There is blood back low from the let ventricle into the let atrium during systole. With each beat of the ventricle blood is forced back into the let atrium and we get hypertrophy and the lungs will become congested and we develop systolic HF Eiology: Mitral valve prolapse Rheumaic heart disease Clinical Manifestaions: Paient can be asymptomaic Severe congesive HF Dyspnea, faigue, weakness, palpitaions, SOB on exerion, and cough Paient may have a systolic murmur Pulse deicit can occur What can we do for the paient? Echocardiogram which can determine if the condiion is progressing Management: Similar to HF Aterload reducion medicaions o ACE inhibitor, ARBS, and beta-blockers Complicaions: HF
Mitral stenosis Obstrucion of blood lowing from the let atrium into the let ventricle. The lealets fuse in this case. We have an OPENING issue the diameter will narrow, and the LA has diiculty moving blood and we have decrease cardiac output. This will afect perfusion and the HR will increase and CO decreases and pulmonary pressure increases Eiology: Rheumaic endocardiis Clinical Manifestaions: The paient may present with A ib and be at risk for clots Dyspnea on exerion, dry cough, wheezing, progressive faigue, exercise intolerance, hemoptysis, palpitaions, orthopnea, PND, repeated respiratory infecions Diagnosic : Echo is used to diagnose how stenoic the valve is ECG Exercise tesing Cardiac catheterizaion Management: Anicoagulants necessary to decrease the chance of atrial thrombus If Aib develops cardioversion Control ventricular HR with beta-blockers, digoxin, or CCB Avoid aciviies that can increase HR
Aoric regurgitaion We have a closing problem this is the low of blood back into the LV from the aorta during diastole Eiology: It can be caused by inlammaion Infecive or rheumaic endocardiis Clinical Manifestaions: Many paients will have no s/s Some may feel a forceful HB Visible or palpable pulsaion we would look for a heave or lit
Lealet repair Chordoplasty
Valve Replacement Before surgery the heart has goten used to the issue. It is compensated someimes surgery will abruptly correct the way is blood is lowing abnormally and someimes the paient can have complicaions related to the sudden changes in internal pressures This is a foreign enity in the body Mechanical o This is one type o Require long term use for anicoagulants at risk for thrombi emboli Tissue o This is one type | long term anicoagulaion may not be required Types of issue: ́ Bioprosthesis Do not need anicoagulaion therapy for this procedure ́ Homograts Tissue comes from a cadaver ́ Autograts The paient’s own issue Most common in children Nursing Management: Valvuloplasty and Valve Replacement: Balloon valvuloplasty this is a bridge o Monitor for heart failure and emboli Not able to ind a pulse? Obtain a doppler BEFORE (TO DOUBLE CHECK) noifying a physician o Assess heart sounds every 4 hours If the paient has HF we would hear S Before we call the physician? ALWAYS ASSESS THE PATIENT o Same care as ater cardiac catheterizaion Monitor for pulse and dysrhythmia because we have opened the vessel Hematoma formaion Small one is just pressure and it can be reabsorbed A big hematoma is not life threatening unless it blocks the low and creates a condiion in which there is a vascular issue Surgical valvuloplasty or valve replacements o Focus is hemodynamic stability and recovery from anesthesia o Frequent assessments with atenion to neurologic, respiratory, and cardiovascular systems Neuro: dizziness, syncope Resp: orthopnea, DOE Cardio: angina and anicoagulaion therapy Paient educaion o Anicoagulaion therapy paient should monitor blood vessels o Prevenion of infecive endocardiis o Follow up o Repeat echocardiograms
Med Surg Topics Final Exam (Autosaved)
Course: Genetics For Nursing Practice (NUR 4160)
University: Nova Southeastern University
