Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. How does the blood flow through the heart? (valves?)
A fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).


2. What is pericarditis?
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.
An inflammation of the pericardium. It may result in MI.
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).


3. What should you teach your patient about MRI?
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
Second right intercostal space
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip


4. Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in the right atrium?
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Close the open catheter lumen with the clamp - and place the pt on their left side in trendelenburg to move the air embolus away from the pulmonic valve. If you hear a churning sound in his chest (a classic sign of air embolus) and the patient starts
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
The internal jugular veins (external are less reliable).


5. What is defibrillation?
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
Nitrates - Beta blockers - and Calcium channel blockers
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
Second right intercostal space


6. How is angina treated?

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7. What will be the treatment for an acute episode of life threatening tamponade?
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
Open up blood vessels
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.


8. A femoral artery compression device ______be assigned to an NA?
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Cannot
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
They may feel a slight stinging under there tongue when they are dissolving - and they should get a HA (if no HA may not be good bc the pills only last for 6 months). Keep with you at all times.


9. What does plan of care include?
(S1 - S2) Third left intercostal space
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
Old truck driver or someone on bed rest or with pelvic trauma.
It is calculated by checking the brachial BP and the ankle BP. The ankle systolic pressure is divided by the brachial systolic. The NA can perform. 0.97-1 is normal anything below indicates ischemia.


10. What are all the S&S of pericarditis?
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Cannot


11. If a victim is choking but can cough - speak - or breath what should you do?

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12. For what disease should you do the Allen's test?

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13. What should you do if the PT value is 45 sec?
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
D/C the med and call the doctor.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Hematuria (tea or coca cola colored) - nosebleeds - gingival bleeding (no medicated mouth wash - flossing - or lemon glycerin swabs) - and bruising (assess for abuse w/o caregiver).


14. What are the nursing interventions for a pt. with ventricular tachycardia?
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.


15. What drugs are most commonly used for angina?
Elderly - hypothyroidism - renal dysfunction - dehydration - HYPOKALEMIA - hypomagnesemia - or hypercalcemia. Patients with abnormal potassium levels have a higher risk because hypokalemia makes the heart more sensitive to digoxin.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
Nitrates - Beta blockers - and Calcium channel blockers
It is an elective procedure - where the client is awake - it is synchronized with 'QRS' - the patient is sedated - a consent form must be signed prior to - they are placed on an EKG monitor - and they are shocked with 50-200 Joules.


16. What are the S&S of superior vena cava syndrome?
Feeling of fullness in head - tightness around shirt collar - or rings/jewelry that suddenly seem tight - swelling in face - hands - arms - and swollen/cyanotic lips - dyspnea - coughing - hoarseness - chest pain - hemotysis - visable collateral ches
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip


17. What should you teach your patient about a holter monitor?

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18. What could happen without immediate intervention for a hematoma?
The patient may suffer significant blood loss or femoral nerve compression.
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip


19. What is INR?
Steroid treatment or a pregnant woman who is retaining water.
In fatty areas or over major muscles - large breasts - or bony prominences.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Protamine Sulfate


20. What are the two common complications of pericarditis?
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Clip hair if necessary - abrade the skin (use abrader pads or fine sandpaper and lightly rub skin using 2 or 3 brisk strokes - improves tracings) - dry skin if necessary - and attach the lead wires to the electrodes before you apply them to the patie
(S1 - S2) Third left intercostal space
Right sided heart failure


21. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
A life threatening emergency that involves a tear in the aorta's intimal layer allowing blood to flow through a false lumen creating a hematoma or false aneurysm.
Second right intercostal space
It is calculated by checking the brachial BP and the ankle BP. The ankle systolic pressure is divided by the brachial systolic. The NA can perform. 0.97-1 is normal anything below indicates ischemia.
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea


22. Should the tubing for a venous access port be included under the dressing site?

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23. What are the nursing interventions for a patient in atrial fibrillation?
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).


24. What would make someone more at risk for digoxin toxicity?
Second left intercostal space
BIRTH CONTROL PILL (LEADING CAUSE of HTN In YOUNG WOMEN-45=STILL YOUNG) - BLACK Male (then white male - than black female - then white female) - obesity - smoking - stress - high Na diet - lack of exercise - age - sex - race - or noncompliance.
To inhibit thrombus and clot formation.
Elderly - hypothyroidism - renal dysfunction - dehydration - HYPOKALEMIA - hypomagnesemia - or hypercalcemia. Patients with abnormal potassium levels have a higher risk because hypokalemia makes the heart more sensitive to digoxin.


25. Test ending in Gram=?
Iodine
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
Exercise and use graduated compression devices as directed - don't stand for long period of time - to avoid dislodging blood clots don't rub or massage your legs.


26. What are the five areas for listening to the heart?

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27. What will a leg with arterial insufficiency look like?
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
Ask patient to make a tight fist - using your index and middle fingers compress both the radial and ulnar arteries to obstruct blood flow to hand - ask pt to relax hand (hand and palm should appear blanched bc flow stopped) - release pressure on ulna
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
Fat - Air - DVT - or Amniotic


28. What is characteristic of atrial fibrillation?
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
Don a protective gown - gloves - and goggles - call Dr - hand pt. emesis basin and raise the HOB 45* (at this angle he can spit out blood and prevent N&V/aspiration - have another nurse firmly press on his nose just below bony part (apply pressure at
Rescuer arrives with AED - turn AED on - select proper pads and apply - clear victim to analyze - clear victim to shock/press shock - resume chest compressions after 1 shock - delivers cycle of compressions at correct rate - pause to allow other resc


29. What is CVP? Normal?
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).


30. What is the treatment for atrial fibrillation?
This noninvasive test takes 24 hours and causes no discomfort. Electrodes are applied to your body - you need to log your activities for a 24 hour period (walking - sleeping - urinating - physical symptoms - and medications). Don't tamper with the mo
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Direct current cardioversion and digoxin/propranolol (inderal).
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.


31. What should you do frequently for someone with a central line to help prevent pulmonary emboli?
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO
Leg pain that is brought on by exercise and relieved by rest. It is characteristic of peripheral artery occlusion/ arterial insufficiency. It is dull or cramp like and consistently occurs in the same area of the leg and with same amount of distance.
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.


32. What does an Allen's test determine?
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
A monitor with four dual electrodes that are applied to the patients neck and thorax.
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
Whether the patients ulnar and radial arteries are patent.


33. If you see a NA placing a patient with DVT in sitting position with legs dependent what should you do?
A nosebleed
Steroid treatment or a pregnant woman who is retaining water.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Only for a few hours


34. What should you do immediately if you suspect someone of developing a hematoma?
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
Using both gloved hands - apply firm pressure just above the skin puncture site and over the hematoma to compress the area. Wait at least 15 mins before removing pressure and reassessing the site. Then notify the health care provider.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.


35. What should you do when applying a femoral artery compression device?
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.


36. Where is the aortic valve landmark on the chest?
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
Second right intercostal space


37. If 2 liters of fluid is left in the pericardial sac (cardiac tamponade) and goes untreated what could it cause?
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
D/C the med and call the doctor.
The internal jugular veins (external are less reliable).
Right sided heart failure


38. What body systems are affected by digoxin toxicity? S&S?
D/C the med and call the doctor.
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm


39. What is the antidote for heparin?
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Lower left sternal border
Protamine Sulfate
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.


40. What is a nursing diagnosis for arterial occlusion? Tx
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images
A fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
A complication from a venous access device or port. It is a blockage of the superior vena cava preventing superior blood flow from reaching the heart.


41. What is an aortic dissection?

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42. What is the treatments for hypertension?
Chronic arteriosclerotic disease.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
Before


43. What places someone at risk for an aortic dissection?
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
Include rest periods prior to any activity.
Check for response - activate ERS and AED - open airway with head tilt chin lift - checking breathing (5-10 sec) - give 2 breaths (1 sec each) - check carotid pulse (5-10 sec) - locate CPR hand position - deliver first cycle of compressions (30 compr
Poorly controlled hypertension


44. What should you observe for in someone on bleeding precautions?
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Hematuria (tea or coca cola colored) - nosebleeds - gingival bleeding (no medicated mouth wash - flossing - or lemon glycerin swabs) - and bruising (assess for abuse w/o caregiver).
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.


45. What is the treatment for someone in ventricular fibrillation?
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Feeling warm (fire) or tin can taste is expected and will pass.
Use sterile gloves and aseptic technique - clean skin over port with alcohol or iodine - insert a 21 or 22 gauge HUBER needle (noncoring - won't break apart) attached to syringe or tubing into the middle of the port until rigid back of port is palpab
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.


46. What is the purpose of compression devices?
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
Chest pain or discomfort that occurs when your heart doesn't get enough blood and oxygen. Stable: the feeling comes and goes at expected times. Unstable: the pattern of your pain has changed (longer - hurts more - etc.)
If feel more than 3 shocks in a row or develop signs of infection at the site.


47. What is the proper way to access and implanted venous access port (IVAP) (Mediport)?

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48. What should be checked in a patient on a beta blocker?
BP is elevated or decreased depending on activity.
Pulse before and after giving.
Whether the patients ulnar and radial arteries are patent.
Pulmonary edema


49. For which heart sounds should the diaphragm be used?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
Pneumothorax and will end up with chest tube to help reinflate lung.


50. What condition can cause left sided heart failure?
This noninvasive test takes 24 hours and causes no discomfort. Electrodes are applied to your body - you need to log your activities for a 24 hour period (walking - sleeping - urinating - physical symptoms - and medications). Don't tamper with the mo
Vascular - artery disease causing fluid to back up into the lungs.
Second Left intercostal space
Fat - Air - DVT - or Amniotic