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Med Surg Exam 3 > Ch 33 Cardiovascular system > Flashcards

Ch 33 Cardiovascular system Flashcards

1
Q

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

A

S1

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2
Q

THE CLOSING OF THE ATRIOVENTRICULAR VALVE

A

S2

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3
Q

SA NODE

A

PACEMAKER OF THE HEART

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4
Q

What happens to the muscles

A

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

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5
Q

How are carbon dioxide and other metabolic wastes eliminated

A

Respiratory and urinary system

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6
Q

Angiotensin II is a potent

A

vasoconstrictor

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7
Q

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

A

epinephrine

norepinephrine

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8
Q

What is homan’s sign

A

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

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9
Q

What is hemoconcentration

A

An increase in RBCs or a decrease in body water

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10
Q

Arteriosclerosis

A

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

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11
Q

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

A

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

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12
Q

Stroke volume

A

is the amount of blood ejected with each ventricular contraction.

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13
Q

Changes associated with peripheral vascular disease (PVD):

A 
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)
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14
Q

Intermittent Claudication

A

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

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15
Q

Sign and symptoms of intermittent claudication

A

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

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16
Q

What is rest pain

A

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

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17
Q

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

A

Rest pain

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18
Q

Vascular disorder pain

A

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

19
Q

What are the 6 p’s

A

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

20
Q

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

A

Transesophageal echocardiogram

21
Q

Nursing care for transesophageal echocardiogram

A

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

22
Q

Informed consent is required even though it is noninvasive

A

Stress test

23
Q

Cardiac Catheterization

A

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

24
Q

Post procedure for cardiac catheterization

A

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

25
Q

Cardiac markers(troponin I)

A

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

26
Q

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

A

Troponin I

27
Q

Slow the HR and increase the force of myocardial contraction

A

Digoxin (Cardiac glycosides)

28
Q

Hold if < 60 bpm and contact the physician

A

Digoxin

29
Q

Require close monitoring

Check apical pulse prior to administration

A

Digoxin

30
Q

Teach patient to take pulse if long term therapy is indicated

A

Digoxin

31
Q

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

A

Antianginal

32
Q

Antiplatelet agent agent

A

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

33
Q

What are the types of antiplatelet agent

A

Aspirin, Ticlid, Plavix

34
Q

Teaching about antiplatelet agent

A

Remember 81mg of baby aspiring for older adults

35
Q

Heparin

A

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

36
Q

Warfarin

A

Oral

Regulated by the PT and the INR

37
Q

Patient education on anticoagulant use

A

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

38
Q

lowering legs improves

A

Arterial flow

39
Q

elevating legs improves

A

venous return

40
Q

Buerger-Allen

A

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

41
Q

Buerger test

A

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.

42
Q

When is the best time to apply elastic stockings?

A

In the morning before getting out of bed.

43
Q

What does elastic stockings do

A

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

Med Surg Exam 3 (6 decks)

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