Chapter 31 - Assement of the Cardiovascular System Flashcards
The nurse is providing care for a pt who has decreases cardiac output due to heart failure. As a basis for planning care, what should the nurse understand about CO?
A. CO is calculated by multiplying the pts stroke volume by the heart rate
B. CO is the average amount of blood ejected during one complete cardiac cycle
C. CO is determined by measuring the electrical activity of the heart and the heart rate
D. CO is the pts average resting heart rate multiplied by the mean arterial blood pressure
A. CO is calculated by multiplying the pts stroke volume by the heart rate
This identifies how much blood is pumped by the heart over 1 min
A pt is being admitted for a valve replacement surgery. Which assessment finding is indicative of aortic valve stenosis? A. Pulse deficit B. Systolic murmur C. Distended neck veins D. Splinter hemorrhages
B. Systolic murmur
-A turbulent blood flow across a diseased valve results in a murmur
What is an appropriate explanation for the nurse to give to a pt about the purpose of intermittent pneumatic compression devices after a surgical procedure?
A. The devices keep the legs warm while the pt is not moving much
B. The devices maintain the blood flow to the legs while the pr is on bed rest
C. The devices keep the blood pressure down while the pt is stressed after surgery
D. The devices provide compression of the veins to keep the blood moving back to the heart
D. The devices provide compression of the veins to keep the blood moving back to the heart
-Intermittent pneumatic compression devices provide compression of the veins while the pt is not using skeletal muscles to compress the veins, which keeps the blood moving back to the heart and prevents blood pooling in the legs that could cause deep vein thrombosis
The nurse is admitting a pt who is scheduled to undergo a cardiac cath. What allergy information is most important for the nurse to assess and document before this procedure? A. Iron B. Iodine C. Aspirin D. Penicillin
B. Iodine
-The provider will usually use an iodine-based contract to perform this procedure. It is important to know if the pt is allergic to iodine or shellfish
A nurse is caring for a pt immediately following a TEE. Which assessments are appropriate for this pt? (Select all that apply)
A. Asses for return of gag reflex
B. Asses groin for hematoma or bleeding
C. Monitor vital signs and oxygen saturation
D. Position pt supine with head of bed flat
E. Asses lower extremities for circulatory compromise
A. Asses for return of gag reflex
C. Monitor vital signs and oxygen saturation
What position should the nurse place the pt in to auscultate for signs of acute pericarditis? A. Supine without a pillow B. Sitting and leaning forward C. Left lateral side-lying position D. Head of bed at a 45-degree angle
B. Sitting and leaning forward
-A pericardial friction rub indicates pericarditis. To auscultate a pericardial friction rub, the pt should be sitting and leaning forward
The nurse determines that a pts pedal pulses are absent. What factor could contribute to this finding? A. Atherosclerosis B. Hyperthyroidism C. Atrial dysrhythmias D. Arteriocenois fistula
A. Atherosclerosis
Atherosclerosis can cause an absent peripheral pulse. The feet would also be cool and may be discolored
The pt tells the nurse that he does not understand how there can be a blockage in the left anterior descending artery, but there is damage to the right ventricle. What is the best response by the nurse?
A. One coronary vessel curves around and supplies the entire heart muscle
B. The LAD supples blood to the left side of the heart and part of the right ventricle
C. The right ventricle is supplies during systole primarily by the right coronary artery
D. It is actually on the right side of the heart, but we call it the left anterior descending vessel
B. The LAD supples blood to the left side of the heart and part of the right ventricle
Which action should the nurse implement with auscultation during a patients cardiovascular assessment?
A. Position the patient supine
B. Ask the patient to hold their breath
C. Palpate the radial pulse with auscultating the apical pulse
D. Use the bell of the stethoscope when auscultating S1 and @2
C. Palpate the radial use with auscultating the apical pulse
-to detect a pulse deficit, simultaneously palpate the radial pulse when auscultating the apical area
Which anatomic feature of the heart directly stimulates ventricular contractions? A. SA node B. AV node C. Bundle of His D. Purkinje fibers
D. Purkinje fibers
-The purkinje fibers move the electrical impulse or action potential through the walls of both ventricles triggering synchronized right and left ventricular contraction
Which aspect of the hearts action doe the QRS complex on the ECG represent?
A. Depolarization of the atria
B. Depolarization of the ventricles
C. Depolarization from atrioventricular (AV) node throughout ventricles
D. The length of time is takes for the impulse to travel from the atria to the ventricles
C. Depolarization from AV node throughout ventricles
-The QRS recorded on the ECG represents depolarization from the AV node throughout the ventricles
A nurse preparing to teach a group of women in a community volunteer group about heart disease. What should the nurse include in the teaching?
A. Women are less likely to delay seeking treatment than men
B. Women are more likely to have no cardiac symptoms of heart disease
C. Women are often less ill when presenting fro treatment of heart disease
D. Women have more symptoms of heart disease at a younger age than men
B. Women are more likely to have no cardiac symptoms of heart disease
-Women often have atypical angina symptoms and no pain symptoms. They experience the onset of heart disease about 10 years later than men.
A patient with history of myocardial infarction is schedules for a transesophageal echo to visualize a suspected clot in the left atrium. What info should the nurse include when teaching the patient about this diagnostic study?
A. IV sedation may be administered to help the patient relax
B. Food and fluids are restricted for 2 hrs before the procedure
C. Ambulatory is restricted for up to 6 hrs before the procedure
D. Contrast medium is injected into the esophagus to enhance images
A. IV sedation may be administered to help the pt relax
-IV sedation is administered to help the pt relax and ease the insertion of the tube into the esophagus. Food and fluids are restricted at least 6 hr prior to the procedure.
A patient presents to the ED reporting chest pain for 3 hr. What component of the blood work is most clearly indicative of a myocardial infarction (MI)? A. CK-MB B. Troponin C. Myoglobin D. C-reactive protein
B. Troponin
-Troponin is the bio marker of choice in the dx of MI, with sensitivity and specificity that exceed those of CK-MB and myoglobin
CRP levels are not used to dx acute MI
The blood pressure of an older adult admitted with pneumonia is 160/70. What is an age-related change that contributes to this finding?
A. Stenosis of the heart valves
B. Decreases adrenergic sensitivity
C. Increase parasympathetic activity
D. Loss of elasticity in arterial vessels
D. Loss of elasticity in arterial vessels
-An age-related change that increases the risk of systolic HTN is a loss of elasticity in the arterial walls. Because of the increasing resistance to flow, pressure is increased within the blood vessel, and HTN results
