Cardiac-Vascular Nursing Flashcards

For individuals with asymptomatic peripheral artery disease, the following cardiovascular event prophylaxis should be utilized under the ACCP Antithrombotic Therapy and Prevention of Thrombosis:

Answer: ASA 75-100 mg daily

For individuals with asymptomatic peripheral artery disease (PAD), the ACCP (American College of Chest Physicians) guidelines recommend antiplatelet therapy to reduce the risk of cardiovascular events. Aspirin (ASA) 75-100 mg daily is the standard first-line treatment for this purpose. Combination therapy with clopidogrel or warfarin is typically reserved for symptomatic PAD or specific high-risk scenarios, not routine asymptomatic prophylaxis.

A patient with permanent pacemaker reports feeling worn out, having palpitations, and being lightheaded. Upon examination, it was discovered that the patient exhibited hypotension, jugular venous distention, and neck pulsations. The following is the root of the problem:

Answer: Pacemaker syndrome

Pacemaker syndrome occurs when there is a loss of normal atrioventricular (AV) synchrony due to ventricular pacing, leading to retrograde atrial activation. This causes the atria to contract against closed AV valves, resulting in symptoms like fatigue, palpitations, lightheadedness, hypotension, jugular venous distention, and characteristic neck pulsations (cannon A waves). This specific cluster of symptoms is indicative of pacemaker syndrome.

If the heart rate is at or above this level, a correction (cQT) should be made when determining the QT interval.

Answer: 60 bpm

The QT interval on an electrocardiogram (ECG) is highly dependent on heart rate, shortening with faster rates and lengthening with slower rates. To accurately assess the QT interval for potential abnormalities and standardize its measurement, it must be corrected (cQT) for heart rate variations. This correction is typically applied when the heart rate is at or above 60 bpm, as significant rate dependency becomes apparent.

What distinguishes an advance directive from a POLST form in particular?

Answer: The POLST form is intended only for those with serious life-threatening illness

A POLST (Physician Orders for Life-Sustaining Treatment) form is a specific medical order designed for individuals with serious, life-limiting illnesses, translating their wishes into actionable instructions for healthcare providers. In contrast, an advance directive (like a living will) is a broader document for any adult to express future healthcare preferences, regardless of their current health status, but it is not a direct medical order.

Which of the following is a crucial component of a real interdisciplinary team?

Answer: Collective goal

A crucial component of a true interdisciplinary team is a collective or shared goal. While individual expertise and leadership are important, the team's effectiveness hinges on all members collaborating towards a common objective. This shared purpose ensures coordinated care, integrated planning, and optimal patient outcomes, distinguishing it from groups with only individual goals.

A person with severe heart failure breathes during sleep in a Cheyne-Stokes pattern. Typically leading to:

Answer: Hypoxemia

Cheyne-Stokes respiration is a breathing pattern characterized by periods of deep, rapid breathing followed by periods of apnea, commonly observed in severe heart failure. The apneic phases lead to reduced oxygen intake, which typically results in hypoxemia (low blood oxygen levels). While carbon dioxide levels can also fluctuate, hypoxemia is the direct and primary consequence of the intermittent cessation of breathing.

Suppose a patient experiences an increased heart rate after receiving nitroglycerin for angina. The following is the root issue:

Answer: Reflex tachycardia

Nitroglycerin is a potent vasodilator that reduces preload and afterload, thereby decreasing myocardial oxygen demand and relieving angina. However, this vasodilation can cause a drop in systemic blood pressure, which triggers the baroreceptor reflex. This reflex response leads to an increase in heart rate (tachycardia) as the body attempts to compensate for the decreased blood pressure, known as reflex tachycardia.