GN ATI Pharmacology for Nursing Final exam NCLEX EXAM LATEST 2023/2024 A+ GRADE
1.Heart Failure- Etiology: Risk factors: HTN and CAD
HF cause: any
... [Show More] interference with normal mechanisms regulating Cardiac Output (CO)
Any changes in preload, afterload, HR, & contractility lead to HF Primary Causes
Precipitating causes- increase workload of heart -> acute condition and decreased heart function
2.Left-sided Heart Failure: Most common form
Inability of left ventricle (LV) to adequately empty during systole or fill during diastole
Types: Systolic, diastolic, or mixed systolic and diastolic
3.Systolic Heart Failure: Inability of heart to pump blood effectively Decreased ejection fraction (EF)
LV becomes dilated and hypertrophied due to not enough pressure to eject blood through aorta
LV failure, blood backs up into left atrium -> fluid in lungs -> pulmonary edema and congestion
4.Diastolic Heart Failure: Inability of ventricles to relax and fill during diastole Main Cause: HTN
High filling pressures due to stiff ventricles; decreased filling of the ventricles -> decreased stroke volume (SV) and CO -> pulmonary congestion
Diagnosed:
-S&S of HF
-Normal EF
-LV diastolic dysfunction evidence
5.Mixed Systolic and Diastolic HF: Dilated cardiomyopathy Low EF, high pulmonary pressure, biventricular failure
Low: BP, CO, and poor renal perfusion
6.Right sided Heart Failure (Cor Pulmonale): Right ventricle (RV) fails to pump effectively
RV failure -> Venous system fluid back up-> movement of fluids into tissues & organs
Most common cause: Left sided HF
7.Left-sided HF Clinical manifestations: LV heaves; alternating pulses; ‘ HR; LV hypertrophy; “ PaO2, slight ‘ PaCO2; Crackles; S3 & S4; Pleural effusion; changes in mental status; restlessness/ confusion
Weakness, fatigue; anxiety, depression; dyspnea; shallow respirations; paroxysmal nocturnal dyspnea; orthopnea; dry hacking cough; nocturia; frothy, pink-tinged sputum
8.Right sided HF Clinical manifestations: RV heaves; murmurs; JVD; edema; weight gain; ‘ HR; Ascites; Anasarca; Hepatomegaly
Fatigue; anxiety,depression; dependent, bilateral edema; RUQ pain; anorexia and GI bloating; Nausea
9.HF: Goals: Decrease pt. symptoms Improve LV function
Reverse ventricular remodeling Improve quality of life
Decrease mortality and morbidity
10.HF: Implementation: High fowlers position Supplemental oxygen or ventilatory support Continuous ECG monitoring
Decrease intravascular volume
11.HF: Nutrition: Diet and weight reduction: individual reccomendations DASH diet
Sodium restricted to 2.5 g/ day
Fluid restriction not generally required
Daily Weights- same time and clothing each day
*Weight gain of 3 lbs. over 2 days or a 3-5 lbs. weight gain over a week needs to be reported to a health care provider
12.A patient has 40 mg of oral furosemide prescribed twice a day. What time will you instruct the patient to take the medication?
A.8 am and 8 pm
B.8 am and 2 pm
C.12 pm and 6 pm: B. 8 am and 2 pm
13.Which classification of medication is used to decrease intravascular volume in HF?
A.Potassium Supplements
B.ACE Inhibitors
C.Beta Blockers
D.Diuretics: D. Diuretics [Show Less]