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Health Assessment > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Diastole

A

The AV valves are open and the ventricles are relaxed

Higher the pressure in the atria causes the blood to rush through the atria into the ventricles

The atria contract and complete the emptying of blood out of the upper chamber by sending it to the ventricles

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2
Q

Atrial Kick

A

towards the end of diastole the atria contract and push out the last of the blood into the ventricles (25% of the stroke volume)

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3
Q

Atrial fibrillation

A

Patients with atrial fibrillation lose this atrial kick which represents a 20-30% decrease in cardiac output

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4
Q

Signs and symptoms of Atrial fibrillation

A

palpitations (feeling like something is wrong with the heart beats), anxiety, fatigue, malaise, exercise intolerance, and nausea

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5
Q

Systole

A

The ventricles now contain a large amount of blood causing the pressure to be higher in the ventricles than atria

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6
Q

Systole in the AV valves

A

causes AV valves (mitral and tricuspid) to snap shut causing the “S1” heart sound or lub and this is the start of systole

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7
Q

Higher pressure…

A

the higher pressure inside the ventricles cause the aortic and pulmonic valves to open

blood is ejected rapidly though these valves

when the ventricles empty the closure makes the s2 or dub sound

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8
Q

S1 “Lub”

A

the result of closure of the AV valves: mitral and tricuspid

correlates the beginning of systole

heard best at the apex. Left MCL, 5th ICS

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9
Q

S2 “dub”

A

the result of closure of the semilunar valves (aortic and pulmonic)

Correlates with the beginning of diastole

best heard at the base of the heart

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10
Q

what conditions in S4 in?

A

Cardiac Atherosclerotic disease, pulmonic stenosis, hypertension, or aortic stenosis

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11
Q

Murmurs

A

blood usually flows silently through the heart

turbulent blood flow will make a sound

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12
Q

Conditions that contribute to turbulent blood flows or murmurs

A

increased blood velocity

structural valve defects

valve malfunction

abnormal chaser opening (like a septal defect)—abnormal connection between the lower chambers of the heart

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13
Q

Systolic murmurs

A

Mitral regurgitation

physiologic murmurs

aortic stenosis

mitral valve prolapse

tricuspid regurgitation

septal defects

pulmonic stenosis

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14
Q

Diastolic Murmurs

A

Aortic Regurgitation

mitral stenosis

Pulmonic regurgitation

tricuspid stenosis

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15
Q

Cardiac output

A

the amount of blood pumped by the ventricles during a given period of time (usually a minute)

CO is determined by the stroke volume

SV x HR= CO

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16
Q

Stroke Volume

A

The amount of blood pumped from the heart with each contraction

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17
Q

Factors influencing Stroke Volume

A

(preload). Increased preload=increased SV

(after load). Increased afterload=decreased SV

Synchronization of the contractions

compliance of the ventricles

contractility or the force of the contractions

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18
Q

Neck vessels

A

The Carotid Artery and Jugular Veins

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19
Q

Carotid Artery

A

a central artery which means it is close to the heart in location

in timing coincides with ventricular systole

located between the trachea and sternomastoid muscle

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20
Q

Jugular Veins

A

empty directly into the right atrium

Indicates the function of the right side of the heart
[internal jugular lies deep

external jugular is more superficial. it lies lateral to the sternomastoid muscle about the clavicle

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21
Q

Heave or lift

A

a diffuse lifting during systole at the left lower sternal border is associated with right ventricular hypertrophy caused by pulmonic valve disease, pulmonic hypertension and chronic lung disease

a lift or heave palpated at the apex may be cause by left ventricular hypertrophy

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22
Q

Thrill

A

Palpate over the right second and third ICS for a thrill which indicates aortic stenosis and systemic hypertension

a thrill palpated over the left second and third ICS may indicate pulmonic stenosis and pulmonic hypertension

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23
Q

Pulse rate deficit

A

If you detect an irregular rhythm, subulate for a pulse rate deficit

the radial and apical pulse rates should be identical

pulse deficit is the difference between apical and the peripheral/radial pulses

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24
Q

what does pulse rate deficit indicate?

A

atrial fibrillation, atrial flutter, premature ventricular contractions, and varying degrees of heart block

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25
Q

Second right ICS

A

aortic valve area

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26
Q

Second left ICS

A

pulmonic valve area

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27
Q

Third left ICS

A

Erb’s Point

28
Q

Left lower sternal border

A

tricuspid valve area

29
Q

Fifth ICS

A

at around left midclavicular line: mitral valve area

30
Q

S3 Ventricular Gallop

A

“Kentucky or Sloshing in” Ventricular gallop

Can be heard early in diastole after s2 and seen in heart failure and fluid overload

caused by blood hitting(ventricular vibration) the heart wall during rapid ventricular filling

normal in young children, pregnant or well condition athletes

usually associated with decreased myocardial contractility, myocardial failure, congestive heart failure and volume overload ju

31
Q

S4 Atrial Gallop

A

“ten-nes-see or A stiff one” Can be heard late in diastole, just before S1

caused by blood flowing into a non-compliant ventricle or ventricular resistance (noncompliance during atrial contraction (Same thing)

usually an abnormal finding

associated with coronary artery disease, hypertension, aortic and pulmonic stenosis and acute MI

32
Q

Summation Gallop

A

Simultaneous occurrence of s3 and s4

usually accompanied by tachycardia

associated with severe heart disease

33
Q

Causes of CVD

A

Genetics, environmental or lifestyle factors

34
Q

Risk factors for Cardiac Risk

A
  • Hyperlipidemia
  • Smoking
  • Hypertension
  • Diabetes
  • abdominal obesity
  • Psychosocial factors
  • inadequate consumption of fruits and veggies
  • alcohol use
  • lack of physical activity
35
Q

Heart Failure

A

Heart failure usually begins with the left ventricle

the right side of the heart will try to compensate but will not be able to undertake the workload-and will enlarge and fail

36
Q

Left-sided Heart failure

A

the left ventricle of the heart is larger than the right ventricle and does most of the heart’s pumping work

occurs when the left ventricle does not pump efficiently and your body does not receive oxygen rich blood

blood instead backs up into your lungs, causing shortness of breath and fluid accumulation that causes crackles

causes hypertension

37
Q

Right-sided Heart Failure

A

Affects the right side, or right ventricle of the heart

usually results from left-sided heart failure, but it can also be a result of damage to the right ventricle from a heart attack

when the left ventricle fails increased fluid pressure is forced back through the lungs damaging the hearts right side

with the right side loss of pumping power blood backs up in the veins, causing the swelling in the body such as in ankles and legs

pulmonic and tricuspid valve malfunction causes right sided heart failure

38
Q

Angina

A

cardiac chest pain

usually described as sensation of squeezing around the heart

severe and steady pain and sense of pressure

39
Q

Cardiac pain radiation

A

cardiac pain may radiate to the left shoulder and down the left arm or to the jaw

40
Q

Associated factors with Angina

A

Diaphoresis, dyspnea, pallor, nausea, palpitations

41
Q

Tachycardia within the heart

A

Tachycardia can be seen with weak heart muscles as the heart makes an attempt to increase cardiac output

42
Q

Palpitations

A

the sense the heart is racing, pounding, fluttering, or skipping a beast. Usually never a sign of heart disease

seen with anxiety

may occur with an abnormality of the hearts conduction system (arrhythmias) or during the hearts attempt to increase cardiac output by increasing the heart rate

43
Q

Fatigue

A

may result from compromised cardiac output

related to decreased cardiac output is worse in the evening or as the day progresses

44
Q

Dyspnea and the heart

A

May result from congestive heart failure, pulmonary disorders, coronary artery disease, myocardial ischemia and myocardial infarction

can occur at rest, during sleep or with mild moderate or extreme exertion

45
Q

Orthnopnea and the heart

A

The need to sit more upright to breath easily due to fluid accumulation in the lungs

46
Q

Paroxysmal nocturnal dyspnea

A

waking up from dyspnea during the night and is seen with heart failure due to redistribution of fluid from the ankles to the lungs when one lays down

47
Q

Mucous

A

fluid accumulation in the lungs from heart failure can cause one to cough up white or pink sputum

48
Q

Dizziness

A

Dizziness may indicate decreased blood flow to the brain due to myocardial damage

there are several causes of dizziness such as inner ear syndromes, decreased circulation, and hypotension

49
Q

Nocturia

A

waking up in the middle of the night to urinate

increased renal perfusion during periods of rest or recumbent positions may cause nocturne which occurs with heart failure

50
Q

Edema

A

Swelling in the lower extremities at night is seen in heart failure due to reduction of blood flow out of the heart, causing blood returning to the heart to back up in the organs and dependent areas of the body

51
Q

Heartburn

A

cardiac pain may be misinterpreted as GI problems

Gi pain usually occurs after meals and is relieved with antacids

cardiac pain may occur anytime and is not relied with antacids and worsens with activities

52
Q

Dsylipidemia

A

abnormal amount of lipids in the blood

presents the greatest risk for developing coronary artery disease

elevated cholesterol levels are linked to atherosclerosis

53
Q

Afterload

A

The force against which the ventricle must expel blood

pressure against which the heart muscle has to eject blood during the contraction

increased afterload leads to decreased stroke volume

54
Q

Preload

A

degree of stretch of the heart muscle before the contraction

the volume of blood in the ventricle at the end of diastole

increased preload leads to increase stroke volume

55
Q

Common symptoms of myocardial infarction?

A

chest pain is the most common symptom resulting of deprivation of oxygen to the heart

Dyspnea is the second most common symptom due to the increased metabolic needs of the body during an MI

edema is a later sign of heart failure, often seen after MI

56
Q

Palpitations

A

result from reduced cardiac output, producing arrhythmias

57
Q

Cardiac pains and respiration

A

cardiac pains do not change with respiration

cardiac pains are not considered knife like

58
Q

After the ECG monitor and administering oxygen what should the nurse do next?

A

Start an IV

afterwards you can call the doctor, obtain a radiograph, and draw blood

59
Q

First intervention for a client experiencing MI?

A

Administering supplemental oxygen to the client is the first priority of care

the myocardium is deprived of oxygen during an infarction, so additional oxygen is administered to assist in oxygenation and prevent further damage

after oxygen you can use morphine and nitro

60
Q

Jugular vein distention

A

Elevated venous pressure in the jugular indicates a failure of the heart to pump

MI does not cause JVD!!!!

61
Q

most Common associated with left-side heart failure

A

crackles in the lung are a classic sign of left-sided heart failure

sounds are caused by fluid backing up into the pulmonary system

62
Q

Arrhythmias are associated with

A

right and left sided heart failure

63
Q

Pulmonary Edema

A

since the left ventricle is responsible for the majority of force for the cardiac output. If the left ventricle is damaged, the output decreases and fluid accumulated hence the pulmonary edema

64
Q

If someone is unresponsive due to angina what do you do?

A

You immediately activate the resuscitation team if someone is unresponsive

65
Q

If the apical pulse below the 5th intercostal space

A

means left ventricular enlargement

Health Assessment (9 decks)

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