Examl 2:l NSGl 430/l NSG430l (Latestl 2025/l
2026l Update)l Adultl Healthl Nursingl IIl Completel Guide|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l GCU
Q:l mechanicall circulatoryl supportl devices
Answer:
usedl tol decreasel thel workl ofl thel heartl andl improvel perfusion
1.l Shortl Term:
-IABP -ECMO -continuall flowl pumps
2.l Longl Term:
-VAD
-PVAD:l percutaneousl ventricularl assistivel devicel
-implanted:l LVAD,l BiVAD
-usedl whenl recoveryl froml acutel injury,l stabilizingl beforel surgery,l awaitingl heartl transplant
Q:l Intraorticl Balloonl Pump
Answer:
-usedl temporarilyl tol improvel circulationl byl decreasingl afterloadl -balloonl insertedl intol thel femorall arteryl andl placedl inl thel descendingl thoracicl aorta >usel anl xl rayl tol confirml placementl -itl usesl counterpressure:l anl ecgl isl usedl tol inflatel thel baloonl oppositel ofl contractionsl byl usingl thel heartbeatl >balloonl deflatesl inl contraction,l inflatesl inl diastolel
COMPLICATIONS
-thrombusl orl embolus -ischemial tol periphery,l kidneys,l bowels
-balloonl leak:l immediatelyl removed 1 / 4
-improperl timingl ofl inflation -malfunction
-infection:l givenl prophylacticl antibioticsl
-thrombocytopenia CARE
-keepl patientl immobile:l sidel lyingl orl supine,l HOBl lessl thanl 45
-frequentl assessment -weanl theml offl slowly
Q:l ventricularl assistivel device
Answer:
longl terml orl shortl terml forl thel failingl heart -usedl withl endl stagel heartl disease -shuntsl bloodl froml leftl atrial orl ventriclel tol thel aortal -eitherl placedl internallyl orl externally -allowsl forl morel mobility
1.l Bridgel tol Transplant:
-peoplel usel thisl whenl theyl arel waitingl forl al transplant,l inl somel casesl thisl canl restorel al failingl al heartl andl preventl thel needl forl al transplant
2.l Destinationl therapy:
-somel peoplel whol arel notl candidatesl forl al heartl transplantl canl havel onel ofl thesel placedl longl term
Q:l implantablel artificiall heart
Answer:
fullyl implanted,l canl sustainl thel bodiesl circl system
1.l bridgel tol transplant:l receivel thisl whilel waitingl
2.l replacementl heartl inl thosel notl eligiblel forl heartl transplantl
-dontl needl immunosuppressivel therapy,l willl needl lifelongl anticoagulantsl RISKS -infection -thrombus -stroke
Q:l nursingl managementl ofl artificiall circl devices
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Answer:
assessl for...-infection -VTE -cardiacl tamponade -vl failure -bleeding -dysrhythmia -renall failure -hemolysis
Q:l heartl transplant
Answer:
donel inl thosel withl endl stagel heartl failure
-1l yearl survival:l 85-90%
-3l yearl survival:l 75%
SELECTION
-recipientsl arel chosenl basedl onl howl welll theyl wouldl benefitl froml thel heart ->oncel chosenl undergol physicall exam,l diagnostics,l andl ptl andl caregiverl undergol psychologicall testing >coping,l supportl systems,l abilityl tol followl regimenl -peoplel waitl al longl timel forl al heart,l mostl diel waiting
-ifl stable:l waitl atl home
-unstable:l waitl atl hospitall
PROCESS
1.l removel heartl froml donor 2.l removel heartl froml recipientl leavingl partsl ofl atrial andl ventricularl connectionsl 3.l connection ABSOLUTEl CONTRAINDICATIONS -activel infection,l HIV -chronologicall agel overl 70l orl physiologicl agel overl 65 -advancedl cerebrall orl peripherall vascularl diseasel -lifel threateningl illnessl thatl willl limitl lifel tol lessl thanl 5l yearsl -severel lungl diseasel thatl willl causel thel patientl tol bel ventilatorl dependentl afterl surgeryl RELATIVEl CONTRAINDICATIONS -severel obesity -psychologicall impairmentl -evidencel ofl nonl compliancel wl medicall therapyl -activel substancel use -irreversiblel kidneyl orl liverl failurel -uncontrolledl diabetesl 3 / 4
-lackl supportl system -unrealisticl expectationsl POSTl TRANSPLANT
-monitoring:
>infection >acutel rejection >cancersl rtl tol immunosuppression
>cardiacl vasculopathy:l accell CADl
IMMUNOSUPRESSIVE l AGENTS
-calcineurinl inhib:l cyclosporine,l tacrolimus
>grapefruitl decreasesl theirl metabolism,l increasesl theirl toxicity
-corticosteroids:l prednisonel
-mycophenolatel -purinel synthesisl inhib -sirolimus
*standardl isl triplel therapy:l CS,l mycophenolate,l calcineurinl inhibl
DETECTl REJCETION wl endomyocardiall biopsy
-1l mo:l weekly
-6l mo:l monthly
-yearly
Q:l infectivel endocarditis
Answer:
bacteriall infectionl ofl thel endocardiuml orl heartl valves -increasingl casesl bcl increasedl IVl drugl use -poorl prognosis,l decreasesl lifel expectancy
CLASSIFICATION
1.l cause:l IVl drugl use,l fungall IE
2.l sitel ofl involvement:l prostheticl valvel endocaritis
3.l acutel orl subacute:
-subacute:l occursl wl priorl valvel disease
-acute:l wl healthyl valve,l veryl progressivel
ETIOLOGY
-bloodl flowl bringsl pathogenl tol alreadyl damagedl valvel orl endotheliall cells
-cause:
>s.l aureus:l 50%
>streptococcusl viridans >coagulosel negativel staphylococcil
-HACEK:l forml al biofilm
RISKl FACTORS
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