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REX-PN EXAM STUDY GUIDE LATEST UPDATED
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REX-PN EXAM STUDY GUIDE LATESTUPDATED
Surgery: CABG, ventricular assist device, cardiomyoplasty.
Drugs include thrombolytics, analgesics, nitrates, vasodilators, diuretics, sedatives,
and anticoagulants.
PVD, or peripheral vascular disease
A condition in which the legs, feet, arms, or hands do not receive adequate blood
circulation.
Common peripheral vascular disorders that reduce blood flow include PAD,
Raynaud's disease, thrombosis, phlebothrombosis, and embolism.
Peripheral Artery Disease (PAD)
A type of peripheral vascular disease characterized by partial or complete blockage
of an artery, typically going to a leg or arm.
Obesity, high blood pressure, hyperlipidemia, diabetes, chronic smoking, family
history of heart disease, and atherosclerotic illnesses are all risk factors.
Intermittent claudication in thigh, calf, or buttock muscles during activity, cold +
numbness lower limbs, weariness, slow healing skin lesions, hair and toe nails, legs
red till raised, lower extremities pulse difficult to identify, erectile dysfunction.
Dx - check lower extremities, blood test, ankle-brachial index, doppler ultrasound,
and angiography using CT or MRI.
,Treatments include weight loss, exercise, quitting smoking, normal blood sugar
levels, and percutaneous and surgical revascularization.
Drugs: antihypertensives, lipid-lowering, antiplatelet, antithrombotic
Varicose Veins
Dilated convoluted veins with defective valves cause blood to collect rather than
return to the heart. Congestion extends the veins, preventing them from recoiling
and remaining swollen.
s/s - legs feel heavy and fatigued after standing; activity or elevation relieves
discomfort; veins seem swollen and convoluted; dark blue or purple snakelike
elevations; edema; aberrant capillary refill.
Dx: Brodie-Trendelenburg test, ultrasonography.
Tx: exercise, weight loss, elastic support stockings, prevent extended standing or
sitting, laser treatment, endovascular radiofrequency, vein ligation with or without
stripping.
Aneurysm
A swelling or expansion of a blood vessel's wall caused by wall weakness.
Commonly seen in the aorta, but may also be in other arteries (for example, the legs
and the brain).
s/s - may go unreported until found by MD or massive hemorrhage occurs; some
induce discomfort and pressure on adjacent structures.
Dx: radiograph, aortography.
Tx - operation fixed with bypass or replacement grafting.
,Drugs: antihypertensives
Cardiac dysrhythms
Any cardiac rhythm that deviates from typical sinus rhythm can originate in the
atria, AV nodes, or ventricles.
Atria dysrhythmias.
Sinus bradycardia is characterized by a normal conduction channel but a slower
pace of less than 60 beats per minute. It is commonly seen in athletes and patients
with ICP, hypothyroidism, or digitalis toxicity.
Sinus tachycardia - occurs normally through the conduction route but at a greater
pace than typical (100-150 bpm); observed in patients with anxiety, discomfort,
fever, hyperthyroidism, hemorrhage, shock, hypoxemia, or intense exercise
Premature atrial contraction (PAC) is an abnormality in the underlying rhythm
caused by excessive coffee intake, nicotine, or other SNS stimulants, or in reaction
to cardiac or metabolic diseases.
Supraventricular tachycardia (SVT) - continuous high rhythm (> 150 bpm) causes
angina, hypotension, syncope, decreased renal output, low cardiac output, and
imminent heart failure.
Atrial flutter - A single atrial impulse outside the SA node causes the atria to
contract at an exceedingly high rate (200-400 contractions per minute).
Atrial fibrillation occurs when numerous locations in the right atrium initiate
impulses, resulting in chaotic, fast activity that causes the atria to quiver instead of
constrict. Ventricles respond sporadically, resulting in abnormal ventricular HR.
palpitations, weariness, exertional dyspnea, chest pain, lightheadedness, anxiety
, AV Node Dysrhythmias
Heart block is a condition in which the conduction pathway is disrupted, preventing
impulses from being transmitted from the SA node to the ventricles. In the first and
second degree, the impulse is delayed; in the third/complete heart block, the atrial
impulse never gets through, and the ventricles form their own rhythm.
ventricular dysrhythmias
Premature ventricular contraction (PVC) - ventricular contraction that occurs early
and independently in the cardiac cycle before the SA node generates an electrical
impulse.
Ventricular tachycardia is caused by a single, irritable focus in the ventricles that
commences and then continues in the same repeated pattern (150-250 bpm), and
decreased cardiac output; it frequently requires defibrillation and may proceed to
ventricular fibrillation.
Ventricular fibrillation - ventricles do not contract properly and no cardiac output;
need for rapid CPR and defibrillation.
Dysrhythmia Types:
Sinus bradycardia refers to a steady rhythm of less than 60 beats per minute.
Sinus tachycardia - regular rhythm (100-150 bpm)
Premature atrial contraction - erratic rhythm (60-100 bpm)
Supraventricular tachycardia - regular rhythm (150-250 bpm)
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