Case Studies and Review

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Case Studies and Review
2010-03-20 20:37:30
Case Studies

MS1 Midterm
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  1. Digoxin
    • Normal range 0.5 - 2.0
    • Atrial Dysrhythmia w/ dig toxicity (A-Fib at 180)
    • Signs of toxicity= N/ Anorexia/ Blurred vision
    • Watch out for renal insufficiency
    • Quinidine and Digoxin make Dig toxic
  2. PT of patient 39, ctrl 27. Dose is too low. Target is 1.5-2.5 ctrl. So, titrate drip.
    Patient report is 110, 2 hours later.
    Now, too high. Protamine
    Sulfate is antidote to Heparin.
    She goes back on Coumadin bc she goes home with it. 3-5 days therapeutic. Target INR is 2-3. Stay on Coumadin for 6 mo atleast. Keep going on Heparin
    till INR is at target. If stopped too soon, could dislodge clot. Hep is short half live, Coumadin is few days.
    Follow up lab tests are PT/INR. Teach to watch for bruising/bleeding. Vit K foods maintain consistent consumptions. Spinach, greens. No high risk activities.

    FFP for acute hemorrhage on Coumadin

    Reverse coag w/ Vit K
  3. Cardioverted Nursing Implications
    • How long in A-fib?
    • If longer than 48 hrs than need anticoagulating.

    • hr control by Valsalva, Try BB, Carotid massage – if still
    • tachy, cardiovert

    • informed consent understanding,
    • anesthesia/airway,
    • Turn sync switch on. No shocking on T wave
  4. Test prior to compression of venous stasis ulcer
  5. Complications from anterior MI
    acute mitral regurge bc of capillary muscle rupture
  6. Pulseless v-tach
  7. assess before AceI admin
    BP, BUN, creat, K and Na
  8. Valv heart disease results in this cardiac complication?
    L vent. Hypertrophy, LVH to HF
  9. IVC filter for prevention of?
    PE in DVT
  10. 3rd degree heart block needs?
    emergent pacing
  11. mechanical Prosthetic heart valves need?
    Anticoag, and Ab endocarditis prophy….target INR is 2.5-3.5 for mech. Valves
  12. AV node bpm?
  13. prolong survival of HF
    ACEI and BB
  14. assess therap effect of Warfarin (Coumadin)
  15. MI diagnosis
    TPN and CKMB
  16. HF diagnosis
  17. Aortic dissection from limbs
    unequal perfusion of limbs
  18. HTN is ?
  19. with A-Fib, at risk for?
  20. Left HF
    congestion in lungs
  21. Best indicator of renal perfusion after AAA
    urine output
  22. Pre-diabetic =
    insulin resistance, hyperlipidemia, albinuria