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CV Review Test #2

CV Review Test #2. Hypertension Diuretics Valvular Disease Inflammatory Diseases of the Heart Heart Failure. MC. Hypertension is defined as sustained systolic and diastolic blood pressure greater than: A. 120/90 B. 140/90 C. 136/80 D. 122/70. MC.

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CV Review Test #2

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  1. CV Review Test #2 Hypertension Diuretics ValvularDisease Inflammatory Diseases of the Heart Heart Failure

  2. MC • Hypertension is defined as sustained systolic and diastolic blood pressure greater than: • A. 120/90 • B. 140/90 • C. 136/80 • D. 122/70

  3. MC • Systolic pre-hypertensive range is between ______ and ______. • A. 113-119 • B. 131 – 139 • C. 121 – 139 • D. 131 - 141

  4. MC • There are 2 main types of hypertension. These are: • A. Stage 1 and 2 • B. Mild and severe • C. primary and secondary • D. malignant and benign

  5. T/F • Primary hypertension is also called essential hypertension.

  6. Complete • List 4 non-modifiable risk factors for hypertension:

  7. Complete • List 6 modifiable risk factors for hypertension.

  8. MR • Secondary hypertension is attributed to an identifiable medical diagnosis. Identify contributing diagnoses below: • A. Renal Vascular disease • B. Adrenal Cortex disease • C. Co-arctation of the Aorta • D. PIH

  9. Complete • List 3 other causes of secondary hypertension.

  10. MR • Prolonged hypertension can damage the heart. Identify the negative effect of prolonged hypertension below: • A. increases the workload of the heart • B. Damages the endothelial lining of the arteries • C. accelerates atherosclerosis • D. weakens blood vessel valves

  11. Fill In • Malignant Hypertension refers to a systolic blood pressure of > ______ mm/Hg and a diastolic blood pressure of ______ mm/Hg.

  12. T/F • High blood pressure is a disease without symptoms until vascular changes in the heart, brain, eyes, or kidneys.

  13. MR • Clinical manifestations of high blood pressure may include which of the following: • A. Awakening with a headache • B. Awakening with clenched teeth • C. nosebleed • D. blurred vision

  14. MC • Which of the following would be included in objective data collection for a client being evaluated for high blood pressure? • A. client description of headache • B. client report of headache • C. VS check by the nurse • D. Height and weight check by the nurse • E. C and D only

  15. Complete • List 3 diagnostic tests that would be checked for a client being evaluated for high blood pressure:

  16. Complete • Management of hypertension by modifying risk factors is considered the first line of therapy. The nurse can participate in patient education for which risk factors: • List 4.

  17. Complete • List 5 categories of medications that might be used in the management of hypertension and name an example for each category:

  18. MR • When applying the diagnosis of “knowledge deficit” to a client with hypertension, the nurse will assess the client’s understanding of which two issues first? • A. medication administration • B. exercise program • C. understanding of hypertension • D. understanding of management of hypertension

  19. MC • If the diameter of the arteries becomes narrow, the artery loses some elasticity,the blood becomes thicker, and the total blood volume increases, what is the effect on the blood pressure? • A. decreases • B. increases • C. no change • D. becomes irratic

  20. MC • Knowing that a nephron is the functioning unit in the kidney that filters the blood, one of the nephron’s primary jobs is to excrete and reabsorb sodium. Where sodium goes, _______ goes also. • A. circulating fluid • B. water • C. lymph • D. White blood cells

  21. MC • Medication that is given to release the fluid from the body is called a/an: • A. analgesic • B. aminoglycoside • C. diuretic • D. alpha or beta blocker

  22. Complete • Different classes of diruetics work on different parts of the nephron. List these 3 parts:

  23. MC • When a patient is on Digoxin and also taking a diuretic, the nurse should monitor the client for s/sx of: • A. thirst • B. enhanced cardiac response • C. digoxin toxicity • D. nephrotoxicity

  24. Complete • List 4 signs of Digoxin toxicity.

  25. MR • Which of the following are basic nursing measures to implement when monitoring a patient on a diuretic? • A. daily weights (preferably in the morning) • B. Teach client to take the diuretic in the morning • C. Teach the client s/sx of other medication toxicity to report to the doctor (digoxin, lithium, etc.) • D. Teach the client s/sx of dehydration and to contact the MD

  26. Complete • Aldosterone, is a _________ ________ produced by the adrenal gland, and acts on the kidney nephron to _______ sodium, _______ water retention, ________ (get rid of) potassium, and ____________ blood pressure.

  27. Complete • When discussing antihypertensive medications, the following terms may be used: onset of action, peak of action, and half-life. Define each of these terms.

  28. Match – drug/action Drug Action Prevents Angiotensin 1 from converting to Angiotensin II and therefore causes vasodilation ↓ BP ↑ Na+ and water excretion by stopping Na+ reabsorption in the distal tubule of kidneys Stops Na+ and Cl- reabsorption from loop of Henle and distal tubule in kidneys Act on the distal tubule of the kidneys to promote Na+ and H20 excretion and retention of K+ • Thiazide Diuretic • Loop Diuretic • Osmotic Diuretic • Potassium – sparing diuretic • ACE - Inhibitor

  29. Complete • List one common drug associated with each category of diuretic: • Thiazide Diuretic • Loop Diuretic • Osmotic Diuretic • Potassium-sparing Diuretic • ACE-Inhibitor

  30. MR • Nursing management of clients on diuretics include which of the following actions: • A. Daily weight (morning • B. Intake and Output record • C. VS, esp. BP • D. Watch for s/sxdigoxin and lithium toxicity • E. Watch for development of a cough • F. Watch for s/sx renal failure

  31. MC • Clients on diruetics also need to be observed for: • A. s/sx of low potassium • B. low sodium • C. s/sx dehydration • D. All of the above

  32. MC • Beta blocking medications block the release of epinephrine and nor-epinephrine which will have which effect? • A. Stimulate alpha-receptors in the CNS to inhibit vasoconstriction • B. Interrupts the flow of calcium into cells of cardiac muscle and vascular smooth muscle relaxation of smooth muscle • C. Block the release of epinephrine and norepinephrine ↓ heart rate and BP • D. Directly dilates peripheral arterioles  ↓ BP

  33. Complete • List 3 nursing actions for the nursing diagnosis: risk for fluid volume deficit

  34. Fill In • Heart valves operate by passively opening and closing in response to _______ changes in the heart. Valvular disease occurs when the valves are compromised and don’t ________ and __________ properly.

  35. MC • Valvular heart disease is usually in one of 2 categories. When the valve tissue become thick, they also become narrow. This condition is referred to as: • A. Stenosis • B. Sclerosis • C. Hypertrophied • D. shrinkage

  36. MC • Valvular insufficiency occurs when valves are: • A. unable to close completely • B. too relaxed to function properly • C. too tight to open adequately • D. unable to flex in either direction to open or close

  37. MR • In Mitral Stenosis when the flow of blood from the LA to the LV is obstructed, what results will the nurse find? • A. lower extremity pitting edema • B. Crackles, rales, rhonchi in the lungs • C. Low BP and low cardiac output • D. LV hypertrophy

  38. MR • When a patient has a diagnosis of mitral insufficiency, the blood from the LV flows back into the LA during systole, it results in which of the following? • A. LA dilation • B. lower extremity edema • C. left-sided heart failure • D. right-sided heart failure

  39. MC • Which one of the following valvular conditions would cause a “click” sound when cusps of the valve prolapse into LA during systole? • A. Aortic Stenosis • B. Mitral Stenosis • C. PulmonicStenosis • D. Mitral Valve Prolapse

  40. MC • In this condition, the valvular opening is narrowed and obstructs blood flow from the LV to the aorta. Consequently, this causes pressure to increase in the LV. This condition is known as: • A. Aortic regurgitation • B. Aortic stenosis • C. Pulmonicstenosis • D. Mitral insufficiency

  41. MR • When LV pressure increases, the following results are observed: • A. increase workload on the heart • B. Left-sided heart failure • C. Poor coronary artery perfusion • D. RV hypertrophy

  42. Fill In • During pulmonicstenosis the ___ outflow is obstructed and causes ________ sided heart failure.

  43. Complete • Diagnostic tests for valvular disease include: • List 3:

  44. Complete • Medical treatment of valvular disorders include treating heart failure. List 3 medical measures that may be used to treat heart failure:

  45. Complete • Open heart surgery is one of the treatments for valvular disorders. What kind of surgical procedures can be used to treat these disorders?

  46. MR • Goals of nursing interventions with valvular disorders include: • A. Symptomatic relief/ promote comfort • B. Assist with ADL’s • C. Support vigorous exercise program starting on the 1st day post op • D. all of the above

  47. Complete • List nursing tasks that you would do in a nursing assessment for a patient who is one day post-op valve repair.

  48. MR • An infection or inflammation of the inner membranous lining of the heart, esp. valves is known as: • A. Pericarditis • B. Rhematic heart disease • C. myocarditis • D. Endocarditis

  49. Other • Describe the effect of inflammation in the endocarial lining of the heart. See lecture slide #7.

  50. Complete • List 5 diagnostic tests used to determine endocarditis:

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