ch 21 Flashcards

1
Q

Pressures in all of the chambers are the lowest during

A

diastole, which facilitates ventricular filling

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2
Q

parasympathetic leads to vagus nerve, which

A

slows down heart

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3
Q

sympathetic speeds up heart via

A

beta 1 receptors in SA node

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4
Q

HR also influenced by baroreceptors - high bp

A

detect change in BP. if hypertension, they increase impulses to cerebral medulla which activates the parasympathetic system, slows down the heart.

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5
Q

baroreceptors - low bp

A

use vasoconstriction and increased HR

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6
Q

Stroke volume is primarily determined by three factors: (stroke before, after, and contract)

A

preload, afterload, and contractility.

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7
Q

Preload refers to the degree

A

of stretch of the ventricular cardiac muscle fibers at the end of diastole. last second of diastole when vetricles are totally full, before contraction. this is frank starling.

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8
Q

Afterload

A

resistance to ejection of blood from the ventricle

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9
Q

relationship between afterload and stroke volume (after is over)

A

inverse

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10
Q

symptoms of aging heart in older adults - (for peet’s sake, I have symptoms)

A

fatigue, shortness of breath, or palpitations and present with new physical examination findings

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11
Q

benefits of estrogen (ester is good for cholesterol)

A

(1) an increase in high-density lipoprotein (HDL) that transports cholesterol out of arteries; (2) a reduction in low-density lipoprotein (LDL) that deposits cholesterol in the artery; and (3) dilation of the blood vessels

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12
Q

common symptoms of CVD - don’t forget weight

A

chest pain, SOB or dypnea, peripheral edema or weight gain, palpitations, fatigue, dizzy, sycope, LOC

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13
Q

chest pain - not what it seems

A

The location of chest symptoms is not well correlated with the cause of the pain

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14
Q

severity of chest pain..

A

does not predict the seriousness of its cause.

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15
Q

Because many cardiac medications can cause gastrointestinal side effects or bleeding, the nurse asks about (anything to do with gastro)

A

bloating, diarrhea, constipation, stomach upset, heartburn, loss of appetite, nausea, and vomiting

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16
Q

Patients with worsening HF often experience (you’ve got it)

A

orthopnea, a term used to indicate the need to sit upright or stand to avoid feeling short of breath. use extra pillows.

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17
Q

pulse contour - the contour is either stiff or insufficient

A

aortic valve stenosis = weak pulse
aortic insufficiency = valve doesn’t close and backflow, excess blood so pulse is strong

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18
Q

right side heart function can be assessed by (pass the jug on the right hand side)

A

jugular, which is central venous pressure.

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19
Q

Obvious distention of the veins with the patient’s head elevated 45 to 90 degrees

A

indicates an abnormal increase in CVP (central venous pressure)

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20
Q

gallop (slow and low gallop)

A

diastole, very low-frequency sounds S3 or S4

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21
Q

S3 - normal up to what ages? and when is it heard?

A

early diastole. normal up to 35 - 40 years old. in older adult indicates HF

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22
Q

S4 (4 is always resistant)

A

late diastole, caused by ventricle resistance.

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23
Q

murmur

A

Murmurs are created by turbulent flow of blood in the heart

24
Q

friction rub best heard in what position? (leather up!)

A

with the patient sitting up and leaning forward.

25
Q

PTT - for what drug? (ptty about hep)

A

heparin

26
Q

PT - what drug? (the other)

A

warafin

27
Q

INR - always do with what other test?

A

always test with PT

28
Q

hematocrit (hypocrit at 36 and 42)

A

men 42-52%
women 36-48%

29
Q

hemoglobin (heman was cool from 12 to 14)

A

male - 14 - 17.4 g/dL
female 12 -16 g/dL

30
Q

WBC count

A

4500 - 11000

31
Q

homocysteine - promotes what? (H thrombing)

A

high levels linked to damage the endothelial lining of arteries and promote thrombus formation

32
Q

12-lead ECG is used to diagnose (12 is the largest without O2, give me a heart attack)

A

arrhythmias, conduction abnormalities, and chamber enlargement, as well as myocardial ischemia, injury, or infarction.

33
Q

cardiac stress test procedures

A

—the exercise stress test, pharmacologic stress test, and radionucleotide imaging studies—are noninvasive ways to evaluate if there is myocardial ischemia and higher myocardial oxygen requirement during these tests.

34
Q

stress test - fast for how long before test and avoid what foods? (fasting is no stress with a stress test)

A

fast for several hours before the test and to avoid stimulants such as tobacco and caffeine. Medications may be taken with sips of water.

35
Q

pharacologist stress test - how long to avoid chocolate or caffeine?

A

instructed not to eat or drink anything for at least 3 hours before the test. refrain from eating any liquid or food that contain chocolate or caffeine for 24 hours and to avoid taking medications that contain caffeine.

36
Q

cardiac cathertization - blood tests (Cathy tests my electrolytes, sugar, and kidneys. it’s a pitty, my CBC also)

A

before - blood tests performed to evaluate metabolic function (electrolytes and glucose) and renal function (blood urea nitrogen and creatinine level. PTT, PT and INR. CBC.

37
Q

catherization nursing interventions - how long to fast before? (Cathy can sure fast)

A

fast 8-12 hrs. lying on hard table less than 2 hrs.

38
Q

catherization nursing responsibilities - what pulses?

A

observe site for bleeding - pulses - dorsalis pedis and posterior tibial pulses in the lower extremity, radial pulse in the upper extremity

39
Q

arterial problem gets

A

cold, pale

40
Q

venous problem gets

A

edema

41
Q

if your kindeys aren’t being perfused

A

you can’t pee - this is a sign of a lack of perfusion

42
Q

how long to hold meds before stress test? (stressing about my meds for 2 days now)

A

hold meds up to 48 hours.

43
Q

how long to monitor pt after stress test?

A

monitored for 15 min after until vital signs are back to normal.

44
Q

pharmacologic stress test - when to stop meds before?

A

stop meds 24 to 48 hrs before.

45
Q

bed rest how long after catheterization?

A

After bed rest for 2-6 hrs.

46
Q

catheterization - are palpitations normal?

A

palpations are normal during procedure.

47
Q

catheterization - how often to assess pulses? (cathy’s pulse was in 1534)

A

every 15 minutes for 1 hour, every 30 minutes for 1 hour, and hourly for 4 hours or until discharge.

48
Q

catheterization - check what vital signs and how long to restrict activity?

A

temp, cap refill. screen for arhtymias. activity restriction for 2 -6 hrs.

49
Q

catherization - HOB

A

HOB no greater than 30 degrees

50
Q

catheterization - if it’s the femoral artery?

A

if femoral artery - leg straight.

51
Q

how long to avoid activities after catherization? and report what to provider?

A

avoid strenous activites for several days. report chest pain or bleeding.

52
Q

electrophysiology (EP) studies and possible ablation for treatment of atrial tachycardia involves what?

A

the dysrhythmia will be reproduced under controlled conditions

53
Q

P-R inteveral is what?

A

it shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node.

54
Q

Which ECG waveform characterizes conduction of an electrical impulse through the left ventricle?

A

QRS complex

55
Q

what to do if a pt has a third-degree heart block

A

alert provider

56
Q

where do cardiac arrhythmias NOT originate in the heart?

A

Bundle of His