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Week of November 6-12

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1 Week of November 6-12 on Mon Nov 14, 2011 4:23 pm

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1.Blood flowing into the cardiac veins enters the _______ next.
Coronary Sinus
Left Ventricle
Right Ventricle
Left Atrium
2.Which of the following occurs during ventricular systole?
Increased aortic pressure
Increased ventricular volume
Dup heart sound
P wave
3.Which of the following occurs during ventricular diastole?
Increased aortic pressure
Increased ventricular volume
Lub heart sound
T wave
4.Cardiac output is the product of ____ and ____.
HR and Disastolic pressure
HR and Stroke Volume
HR and EF
Diastolic and Systolic pressure
5.Pulmonary edema is most like associated with a failing?
Right atrium
Left atrium
Right ventricle
Left ventricle
6.Pulse pressure (pp) is considered the _____.
Difference between the systolic and diastolic pressure
The sum of the systolic and diastolic pressure
The inverse of the blood pressure
Half of the systolic pressure
Answers
1.Coronary Sinus
2.Increased aortic pressure
3.Increased ventricular volume
4.HR and Stroke Volume
5.Left ventricle
6.Difference between the systolic and diastolic pressure








Interventions/Rationales

Perfusion: Circulatory Care (81 year old male patient)
1.I: Observe for atypical pain, elderly often have jaw pain instead of chest pain or may have silent myocardial infarctions with symptoms of dyspnea or fatigue.
R: The elderly have altered pain pathways and often do not experience the usual chest pain of cardiac patients.
2.I: Observe for syncope, dizziness, palpitations, or feelings of weakness associated with a irregular heart rhythm.
R: Dysrhythmias are common in the elderly.
3. I: Observe for side effects from cardiac medications.
R: The elderly have difficulty with metabolism and excretion of medications due to decreased function of the liver and kidneys; therefore toxic side effects are more common.
4. I: Monitor for symptoms of heart failure and decreased cardiac output, including diminished quality of peripheral pulses, cool skin and extremities, increased respiratory rate, presence of paroxysmal nocturnal dyspnea or orthopnea, increased heart rate, neck vein distention, decreased level of consciousness, and presence of edema.
R: As these symptoms of heart failure progress, cardiac output declines.
5.I: If chest pain is present, have client lie down, monitor cardiac rhythm, give oxygen, run a strip, medicate for pain, and notify the physician.
R: These actions can increase oxygen delivery to the coronary arteries and improve client prognosis.
6.I: Monitor hemodynamic parameters for an increase in pulmonary wedge pressure, an increase in systemic vascular resistance, or a decrease in cardiac output and index.
R: Hemodynamic parameters give a good indication of cardiac function.

Cellular Regulation: Ineffective Airway Clearance
1.I: Encourage to take several deep breaths.
R: Deep breathing promotes oxygenation before controlled coughing.
2.I:Encourage to take a deep breath, hold for 2 seconds,cough two or three times in succession.
R: Controlled coughing is accomplished by closure of the glottis and the explosive expulsion of air from the lungs by the work of abdominal and chest muscles.
3. I: Encourage use of incentive spirometry, as appropriate.
R: Breathing exercises help maximize ventilation.
4.I: Promote systemic fluid hydration, as appropriate.
R: Adequate fluid intake enhances liquefaction of pulmonary secretions and facilitates expectoration of mucus.
5.I: Monitor rate, rhythm, depth, and effort of respirations.
R: Provides a basis for evaluating adequacy of ventilation.
6.I: Note chest movement, watching for symmetry, use of accessory muscles, and supraclavicular and intercostal muscle retractions.
R: Presence of nasal flaring and use of accessory muscles of respirations may occur in response to ineffective ventilation.


A patient with an INR of 4, would likely be placed on Coumadin.

I: Teach to avoid green, leafy vegetables
R: They increase the risk of clotting
I: Observe for easy bruising and bleeding
R: These may indication Coumadin dose is too high
I: Check VS, and bloodwork including: platelet count, PT, PTT, INR levels
R: Monitor bleeding and clotting time

2 Re: Week of November 6-12 on Mon Nov 14, 2011 10:17 pm

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Guest
Good job with the test questions it looks like you took some great notes today in class Smile She did a real good job about teaching us I just hope its like your kind of questions when it comes to the test. Great job!

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