NRNP 6566 WEEK 3 KNOWLEDGE CHECK (LATEST 2022/2023 ALREADY GRADED A), Exams of Nursing

Download NRNP 6566 WEEK 3 KNOWLEDGE CHECK (LATEST 2022/2023 ALREADY GRADED A) and more Exams Nursing in PDF only on Docsity! • Question B2 NRNP B6566 BWEEK B3 BKNOWLEDGE BCHECK Mrs. BFranklin Bis Ba B68-year-old Bwoman Bwith Blong-standing, Bpersistent BAF Bbeing Bmanaged Bwith Brhythm Bcontrol Bon Bdofetilide. BShe Balso Bhas Btype B2 Bdiabetes Bmellitus B(T2DM), Bhypertension, Band Ba Bmyocardial Binfarction B3 Byears Bago. What Bis Bher BCHADS2 Band BCHA2DS2-VASc Bscore? BHow Bwould Byou Binterpret Bthose Bscores Bin Bdeciding Bon Btreatment Bfor BMrs. BFranklin? Correct BAnswer : CHADS2 Bscore=2 B(HTN, BT2DM) A Bscore Bof Bgreater Bthan B2 Bis Bconsidered Bhigh Brisk Bfor Bstroke. CHA2DS2-VASc Bscore=5 B(age B>65, Bfemale, BHTN, BT2DM, Bcoronary Bartery Bdisease B[CAD]) A Bscore Bof Bgreater Bthan B2 Bis Bconsidered Bhigh Brisk Bfor Bstroke. Many Bpatients Bare Bhesitant Bto Bbegin Banticoagulation Bdue Bto Bthe Bexpense Band Binconvenience. BHowever, Bafter Bunderstanding Bthat Ba B4% Bannual Brisk Bfor Bstroke B(if Bthe BCHA2DS2-VASc BScore Bis B4) Bequates Bto B40% Brisk Bover B10 Byears, Bpatients Bare Bmore Bwilling Bto Bcomply. A B58-year-old Bmale Bcomplains Bof Ba Bgalloping Bheart Brate Band Bshortness Bof Bbreath. BVital Bsigns Bare BBP B110/74, BP B156, BRR B22 BOxygen Bsat Bis B96%. BContinuous BEKG Bmonitoring Bidentifies Bperiods Bof Bsinus Btachycardia Bas Bwell Bas Bepisodes Bof Batrial Bfibrillation. BLaboratory Bresults Bfor Bthis Bpatient Bshow: Hemoglobin B13.3 Bg/dl Hematocrit B39% WBC B8.7 Platelets B172,000 Sodium B140 Potassium B 3.7 TSH B0.0 BmIU/L T4 B3 Bmg/dl T3 B6.6 Bpg/ml What Bis Byour Bworking Bdiagnosis Band Bwhat Btwo Binitial Bmedications Bwould Byou Bprescribe Bfor Bthis Bpatient? Correct Answer: B The Blow BTSH Bcombined Bwith Bthe Bhigh BT4 Band BT3 Bare Bindicative Bof Bhyperthyroidism. BA Bcommon Bside Beffect Bof Bthe Bhypermetabolic Bstate Bis Batrial • Question B1 Bfibrillation. BTwo Bmedications Bthat Bshould Bbe Bconsidered Bfor Binitial Btreatment Bare • Question B7 • Question B8 Answer: The Bdecision Bregarding Buse Bof Boral Banticoagulation Bshould Balways Binvolve careful Bconsideration Bof Bthe Brisks Band Bbenefits, Band Bthe Bpatient Bshould Bbe Binvolved Bin Bthat Bdecision. BIt Bis Bsuggested Bto Bcalculate Bboth Ba Bpatient’s Brisk Bof Bstroke Band Brisk Bof Bbleeding Band Buse Bthese Bdata Bto Bcommunicate Byour Breasons Bfor Bsuggesting Byour Brecommended Btherapy. Consider Busing Ba BHAS-BLED Bscore Bas Ba Btool Bto Bpotentially Bguide Bthe Bdecision Bto Bstart Banticoagulation Bin Bpatients Bwith Batrial Bfibrillation. BCompare Bthe Brisk Bfor Bmajor Bbleeding B(HAS-BLED) Bto Bthe Brisk Bfor Bthromboembolic Bevents B(CHADS2 Bor BCHA2DS2-VAS) Bto Bdetermine Bthe Bbenefit Bof Banticoagulation. For Bexample: BThe Bpatient, Bhaving Bparoxysmal BAF Bwith Byour Bcurrent Brisk Bfactors Bfor Bstroke Bputs Byou Bat Ba B6.7% Brisk Bof Bstroke Bper Byear. BAt Bthis Brisk, Byou Bwould Bbenefit Bfrom Boral Banticoagulation B(warfarin, Bdabigatran, Brivaroxaban), Bwhich Bwould Breduce Byour Brisk Bof Bstroke Bby Bapproximately B66% Bor Bdecrease Byour Brisk Bfrom B6.7% Bto Bapproximately B2.2% Bper Byear. BYour Brisk Bof Bmajor Bbleeding B(intracranial Bhemorrhage, Bhospitalization Bfor Bbleeding, Bdrop Bin Bhemoglobin Bby B2 Bg/dL, Bor Brequiring Ba Bblood Btransfusion) Bwhile Bon Boral Banticoagulation Bis B5.8%, Bwhich Bis Blower Bthan Byour Brisk Bof Bstroke Bwithout Btreatment. BWe Bgenerally Brecommend Boral Banticoagulation Bwhen Ban Bindividual’s Brisk Bof Bstroke Bexceeds Bthe Brisk Bof Bbleeding. What Bis Byour Binterpretation Bof Bthis B12-lead BEKG? Correct Answer: Acute BAnteroseptal BSTEMI ST Belevation Bis Bmaximal Bin Bthe Banteroseptal Bleads B(V1-4). Q Bwaves Bare Bpresent Bin Bthe Bseptal Bleads B(V1-2). There Bis Balso Bsome Bsubtle BSTE Bin BI, BaVL Band BV5, Bwith Breciprocal BST Bdepression Bin Blead BIII. A B59-year-old Bmale Bcomplains Bof Bdizziness, Bpalpitations, Bweakness, Band Bchest Btightness. • Question B9 EKG Bshows Batrial Bfibrillation Bwith Brapid Bventricular Bresponse. BHis Bblood Bpressure Bis Bvery Blabile, Bwith Breadings Bof B70/42 Bto B110/66. BHeart Brate Branges Bfrom B150—210. BBecause Bhe Bis Bhemodynamically Bunstable, Bimmediate Belectric Bcardioversion Bis Bconsidered. BPrior Bto Bthe Bprocedure, Bwhat Btesting Bis Bessential Bto Bcomplete? Correct BAnswer : A BTransesophageal Becho B(TEE) Bis Bessential Bto Bcomplete Bprior Bto Bcardioversion along Bwith Ba BProthrombin Btime B(PT). BPatients Bin Batrial Bfibrillation Bare Bat Bhigh Brisk Bfor Bdeveloping Bclots Bin Btheir Batria Bthat Bcan Bbe Bdislodged Bwith Bcardioversion Bleading Bto Ba Bstroke Bor Bpulmonary Bembolism. BA BTEE Bwill Bidentify Bthe Bpresence Bof Bany Batrial Bblood Bclots. BIf Bclots Bare Bpresent, Bchemical Bcardioversion Bshould Bbe Bconsidered. A BPT Bis Balso Bessential Bto Bevaluate Bfor Bany Bevidence Bof Bbleeding Babnormalities Bpresent Bin Bthe Bpatient. A B79-year-old Bmale Bwith Ba Bhistory Bof Batrial Bfibrillation Bis Btaking Bthe Bfollowing Bmedications: B rilenta B60 Bmg Bpo Bbid Lisinopril B20 Bmg Bpo Bdaily BAmiodarone B400 Bmg Bpo Bdaily BPrilosec B20 Bmg Bpo Bdaily Daily Blabs Bfor Bthis Bpatient Bshow: Sodium B137 Potassium B 4.2 Creatinine B0.9 BUN B22 Alkaline Bphosphatase: B202 ALT B60 AST B44 What Bmedication Bcould Bcause Bthese Blab Bresults? Correct Answer: BSodium B137 B– Bnormal B(135–145) Potassium B4.2 B– Bnormal B(3.5–4.5) Creatinine B0.9 B– Bnormal B(0.8–1.2) BUN B22 B– Belevated B(6–20) Alkaline Bphosphatase: B202 B– Belevated B(20–130) ALT B60 B– Belevated B(4–36) AST B44 B– Belevated B(8–33) These Bresults Bindicate Belevated Bliver Benzymes, Bwhich Bis Ba Bside Beffect Bof Bamiodarone. BLiver Binjury Bfrom Bamiodarone Bis Buncommon Bbut Bnot Brare. BSerum Benzyme Belevations Bare Breported Bto Boccur Bin B15% Bto B50% Bof Bpatients Bon Blong- Bterm Btherapy. BPatients Btaking Bamiodarone Bare Brecommended Bto Bhave BALT