Cardiac - Jarvis book

Question 1

Pregnant women and cardiac changes

pg 467

Answer 1

• Blood volume increases (most occurs during 2nd trimester)
• increase in stroke volume
• increase in cardiac output
• increase in pulse rate
• decrease in arterial BP (due to peripheral dilation)

Question 2

infants and children
- cardiac

pg 468

Answer 2

• foramen ovale closes within first hour
• ductus arterioles closes later (10-15hours)
• hearts position is more horizontal
• apex is higher (4th intercostal space, reaches adult position at age 7)

Question 3

hemodynamic changes with aging

pg 469

Answer 3

• increase in systolic BP
• arteries thicken and stiffen
• overall size of the heart does not increase
• left ventricular wall thickness increases
• diastolic BP may decrease after 6th decade
• decreased ability of the heart to augment cardiac output with exercise
• increase in muscle fatigue, decrease skeletal muscle performance, increase in dyspnea

Question 4

Abnormal findings while auscultating the carotid artery

Answer 4

• can hear bruit (indicates turbulence)
• audible when lumen is occluded by 1/2 to 3/4
• absence of a bruit does not indicate it is clear, as bruit disappears if totally occluded

Question 5

abnormal findings with measuring jugular vein distention

Answer 5

elevated press greater than 3cm while person is 45 degrees.

occurs with HF, cardiac tamponade, constrictive pericarditis

Question 6

pulse deficit

• what is it
• what causes it

Answer 6

• signals a weak contraction of the ventricles
• when difference between apical pulse and radial pulse
• A. fib, premature beats, HF

Question 7

S4

• when is it
• what can it mean

Answer 7

atrial gallop

occurs with CAD

Question 8

S3

- what is it

Answer 8

ventricular gallop

occurs with HF and volume overload

Question 9

the most important signs of HF in an infant are:

Answer 9

persistent tachycardia
tachypnea
liver enlargement
engorged veins
gallop rhythm
plusus alternan

Question 10

cardiac output equals

Answer 10

the stroke volume (or blood volume in each systole) times the rate (or beats per minute)

Question 11

preload

Answer 11

is the venous return that builds during diastole

Question 12

after load

Answer 12

is the opposing pressure that the ventricle must generate to open the aortic valve against the higher aortic pressure.