Ch 33 Cardiovascular system

Question 1

THE CLOSING OF THE TRICUSPID AND MITRAL (SEMILUNAR VALVES) THE LUB SOUND

Answer 1

S1

Question 2

THE CLOSING OF THE ATRIOVENTRICULAR VALVE

Answer 2

S2

Question 3

SA NODE

Answer 3

PACEMAKER OF THE HEART

Question 4

What happens to the muscles

Answer 4

CONSTRICT_____ the vessels, whereas relaxation of the muscles results in vessel DILATE_______________.

Question 5

How are carbon dioxide and other metabolic wastes eliminated

Answer 5

Respiratory and urinary system

Question 6

Angiotensin II is a potent

Answer 6

vasoconstrictor

Question 7

Stimulation of the sympathetic nervous system by either physiological or psychological stress triggers the adrenal glands to release

Answer 7

epinephrine

norepinephrine

Question 8

What is homan’s sign

Answer 8

a test used for thrombosis. Dorsiflecting feet quickly. Its not reliable but it is used out there. (deep vein thrombosis).

Question 9

What is hemoconcentration

Answer 9

An increase in RBCs or a decrease in body water

Question 10

Arteriosclerosis

Answer 10

Stiffening of the vessel walls
Delivery of oxygen and nutrients to tissues is compromised
Buildup of waste products in tissue

Question 11

What occurs when there is a loss of elasticity in the peripheral vessels?

Answer 11

Loss of elasticity in the peripheral vessels increases peripheral resistance which impairs blood flow and results in increased left ventricular workload.

Question 12

Stroke volume

Answer 12

is the amount of blood ejected with each ventricular contraction.

Question 13

Changes associated with peripheral vascular disease (PVD):

Answer 13

Thick, brittle nails
Shiny, taut, scaly, dry skin
Skin temperature variations
Skin ulcerations
Muscle atrophy
Localized redness and hardness
Hair loss on the extremities (Learn to ask about hair distribution)

Question 14

Intermittent Claudication

Answer 14

Associated with decreased perfusion
Aggravated by exercise and relieved by rest
Can affect any major muscle group distal to the occlusion

Question 15

Sign and symptoms of intermittent claudication

Answer 15

“tightness, burning, fatigue, aching, or cramping”

Question 16

What is rest pain

Answer 16

Indicates severe arterial occlusion
The occlusion causes tissue ischemia in the extremity
Pain is relieved with a dependent position that promotes blood flow by gravity

Question 17

These patients sleep best in a chair or with the feet in a dependent position

Answer 17

Rest pain

Question 18

Vascular disorder pain

Answer 18

a typical description is tenderness, heaviness, or fullness in an extremity.

Question 19

What are the 6 p’s

Answer 19

pain, pulselessness, poikilothermy, pallor, paresthesia, and paralysis

Question 20

probe in inserted through the esophagus into the stomach (behind the heart); the throat will be anesthetized

Answer 20

Transesophageal echocardiogram

Question 21

Nursing care for transesophageal echocardiogram

Answer 21

Signed consent is required
monitor VS and gag reflex
If sedated monitor LOC

Question 22

Informed consent is required even though it is noninvasive

Answer 22

Stress test

Question 23

Cardiac Catheterization

Answer 23

Signed consent is required
Assess for allergies to seafood and shellfish
Inform the patient to expect a flushing sensation when the dye is injected

Question 24

Post procedure for cardiac catheterization

Answer 24

Monitor the puncture site for bleeding
Monitor VS
Enforce bed rest as ordered

Question 25

Cardiac markers(troponin I)

Answer 25

Proteins released from cardiac muscle when the muscle is damaged eg from acute mi Levels elevate in 3 hours after myocardial injury

Question 26

Peak in 12 hours Remain in circulation for 10-14 days Drawn in the ED Even slight elevation is treated aggressively

Answer 26

Troponin I

Question 27

Slow the HR and increase the force of myocardial contraction

Answer 27

Digoxin (Cardiac glycosides)

Question 28

Hold if < 60 bpm and contact the physician

Answer 28

Digoxin

Question 29

Require close monitoring | Check apical pulse prior to administration

Answer 29

Digoxin

Question 30

Teach patient to take pulse if long term therapy is indicated

Answer 30

Digoxin

Question 31

Nitrates aka nitroglycerin (treat actual angina episodes and to prevent angina

Answer 31

Antianginal

Question 32

Antiplatelet agent agent

Answer 32

Often used after an AMI to prevent additional myocardial infarction and strokes

Question 33

What are the types of antiplatelet agent

Answer 33

Aspirin, Ticlid, Plavix

Question 34

Teaching about antiplatelet agent

Answer 34

Remember 81mg of baby aspiring for older adults

Question 35

Heparin

Answer 35

interferes with factor III in the clotting process Administered IV drip or subQ Adjusted based on the PTT

Question 36

Warfarin

Answer 36

Oral | Regulated by the PT and the INR

Question 37

Patient education on anticoagulant use

Answer 37

Teach patients to reduce the risk of bleeding (i.e. soft toothbrush, electric razor)

Question 38

lowering legs improves

Answer 38

Arterial flow

Question 39

elevating legs improves

Answer 39

venous return

Question 40

Buerger-Allen

Answer 40

Elevate and support the legs at a 45- to 90-degree angle for 2 to 3 minutes or until the skin blanches. Sit with feet in a dependent position so the skin turns red. Support the legs in this position for 5 to 10 minutes. Then flex, extend, pronate, and supinate each foot three times. Finally, lie flat in a supine position for 10 minutes. These help with PVD

Question 41

Buerger test

Answer 41

A noninvasive bedside test to assess the adequacy of arterial blood flow into the legs. While the patients is lying flat and supine, both legs are elevated to a 45 degree angle. Loss of the normal perfused color of either leg suggests that its arterial blood flow is compromised because a normal artery can pump blood against gravity without difficulty.

Question 42

When is the best time to apply elastic stockings?

Answer 42

In the morning before getting out of bed.

Question 43

What does elastic stockings do

Answer 43

Elastic stockings provide sustained, consistently distributed pressure over the entire surface of the calves and thighs to promote venous return.