NURS 5354 Final Exam Questions With Correct Answers
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Course
NURS 5354
Institution
NURS 5354
NURS 5354 Final Exam Questions With
Correct Answers
RCRI (Revised cardiac Risk index) - answerA risk assessment tool to assess for an elevated
risk for cardiac complications
What predictors are part of the RCRI (revised cardiac risk index)? - answerintrathoracic,
intraperitoneal or suprainguin...
BRIGHTSTARS EXAM STUDY SOLUTIONS 8/15/2024 2:05 PM
NURS 5354 Final Exam Questions With
Correct Answers
RCRI (Revised cardiac Risk index) - answer✔✔A risk assessment tool to assess for an elevated
risk for cardiac complications
What predictors are part of the RCRI (revised cardiac risk index)? - answer✔✔intrathoracic,
intraperitoneal or suprainguinal vascular surgery
hx of iscehmic heart disease
history of heart failure
insulin treatment for DM
serum creatinine level >2
hx of cerebrovascular disease
What test should be done if patient has at least one RCRI risk? - answer✔✔a resting ECG
Which lab level directly correlates with an increase in perioperative cardiac complications? -
answer✔✔BNP or N-terminal fragment of proBNP
BNP >92 or NT-proBNP of 300 or higher before noncardiac sx were associated with a fourfold
increase in 30-day mortality and MI.
What medications should be continued perioperatively? - answer✔✔antianginal, BB, ca channel
and nitrates.
BB only in high risk cardiac patients. do not start day of sx.
Which medication should a patient undergoing vascular surgery or a pt with high risk for cardiac
complications? - answer✔✔a statin.
if already taking, continue dose.
if not,start on a moderate dose of 20 mg at least 30 days prior.
, BRIGHTSTARS EXAM STUDY SOLUTIONS 8/15/2024 2:05 PM
Which medication should alwasy be held preop? - answer✔✔aspirin, for increased risk of
bleeding.
Which operations are not necessary preoperative before a vascular surgery? - answer✔✔CABG
or PCI.
these may be done if pt meets guidelines independently of the planned noncardiac operation.
How long should elective sx be deferred after cardiac stent placement? - answer✔✔bare-metal
stent (30 days)
drug-eluting stent (6 months) ( 3 months if needing sx for ca)
Signs of de compensated HF, HOLD sx. - answer✔✔JVD, audible s3, or pulmonary edema.
HF patients undergoing sx - answer✔✔if dyspnea or deteriorating HF- get an echo prior to sx to
assess LV function
When does an MI posoperative usually happen? - answer✔✔within 3 days
S/S's are hypotension, hypoxemia, and delirium.
MI is usually asymptomatic.
Stenotic or regurgitant valvular disease should have what preop test? - answer✔✔echo within 1
year of sx.
-if needing valvular sx, have it prior to non cardiac sx.
Rhythm disturbance with no underlying heart disease - answer✔✔are at low risk for
perioperative cardiac complications
Hypertension preop - answer✔✔BP >180/110, sx should be held.
these pts are at greater risk of MI and HF.
Causes of post-op hypertension - answer✔✔elevated sympathetic tone due to injury or pain,
volume overload from IV fluids, hypercarbia, urine retention and with-holding long term
antihypertensive medication.
Risk factors for post-op pulmonary complications - answer✔✔location of sx (cardiac, thoracic
and upper abdominal cases), prolonged anesthesia, and emergency cases, age >60, COPD, HF,
severe systemic disease, tobacco use, impaired cognition, prior stroke, functional dependency,
preop sepsis, low albumin, OSA.
Unexplained S/S's in pts undergoing abd or cardiothoracic sx - answer✔✔get a PFT prior.
if lung disease already diagnosed, PFT is non informational.
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