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Exam 3 med surg > exam 3 > Flashcards

exam 3 Flashcards

1
Q

Normal abdominal percussion sound is?

A

tympanic

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2
Q

where would you not percuss over in a pregnant patient?

A

uterus

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3
Q

rare kidney cancer in children ages 3-4

A

wilms’ tumor

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4
Q

pheochromocytoma is a

A

benign adrenal gland tumor

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5
Q

are benign tumors cancer?

A

no

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6
Q

signs of appendicitis

A

RLQ abdominal pain
Migrating abdominal pain
loss of appetite
malaise
nausea/vomiting
diarrhea

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7
Q

what is mcburney’s point?

A

base of the appendix

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8
Q

what is a positive mcburneys?

A

severe pain when pressure is released after palpation

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9
Q

causes of stomatitis

A

flora imbalance
infection
inhaled glucocorticoids

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10
Q

important patient education for stomatitis

A

brush 4x a day (minimum 2x a day)

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11
Q

erythroplakia is a

A

red, flat or raised area

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12
Q

thick, white patches on inside of mouth is called?

A

leukoplakia

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13
Q

types of intestinal obstruction

A

mechanical
non-mechanical (paralytic ileus)

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14
Q

colorectal cancer S/S

A

vomiting
changes in bowel habits
rectal bleeding
anemia
pain
incomplete evacuation

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15
Q

the pulse located at the left 5th intercostal space in the mitral area is

A

the apical pulse

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16
Q

the point of maximal impulse is

A

the apical pulse

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17
Q

receptors that are stimulated when arterial walls are stretched by increased blood pressure

A

baroreceptors

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18
Q

swishing sound from unsteady blood flow in narrowed arteries

A

bruit

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19
Q

bruit can be heard via?

A

auscultation or doppler

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20
Q

involves passing small catheter into heart & injecting contrast to diagnose heart disease

A

cardiac catheterization

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21
Q

the most definitive but most invasive test to diagnose heart disease

A

cardiac catheterization

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22
Q

calculation of cardiac output requirements to account for different body sizes

A

cardiac index

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23
Q

the volume of blood ejected by the heart each minute

A

cardiac output

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24
Q

serum lipid that includes high density lipoproteins and low-density lipoproteins

A

cholesterol

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25
Q

phase of cardiac cycle that consists of relaxation

A

diastole

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26
Q

amount of pressure against arterial walls during relaxation of cardiac cycle

A

diastolic blood pressure

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27
Q

use of ultrasound waves to assess cardiac structure and mobility in the heart valves

A

echocardiography

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28
Q

procedure which causes dysrhythmias to evaluate, diagnose and accurately treat them

A

electrophysiologic study (EPS)

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29
Q

an EPS is what kind of procedure

A

invasive

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30
Q

test to assess cardio response to increased workload

A

stress test (exercise electrocardiography)

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31
Q

number of times ventricles contract each minute

A

heart rate

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32
Q

part of total cholesterol value that is considered “good” cholesterol

A

HDL (high-density lipoproteins)

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33
Q

HDL for men should be

A

higher than 45 mm/dL ( >0.75 mmol/L)

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34
Q

HDL for women should be

A

more than 55 mg/dL (>0.91 mmol/L)

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35
Q

serum marker of inflammation and component of development of atherosclerosis

A

hsCRP (highly sensitive C-reactive protein)

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36
Q

buildup of fats, cholesterol and other substances in and on the artery walls

A

atherosclerosis

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37
Q

amino acid that is produced when proteins break down

A

homocysteine

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38
Q

elevated homocysteine can be a risk factor for?

A

cardiovascular disease

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39
Q

Part of total cholesterol that is considered “bad”?

A

LDL

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40
Q

LDL should be

A

lower than 130 mg/dL

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41
Q

arterial blood pressure necessary to maintain perfusion of major body organs

A

MAP (mean arterial pressure)

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42
Q

range of arterial blood pressure necessary to maintain perfusion of major organs

A

60-70 mm Hg

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43
Q

abnormal heart sound that reflects unsteady blood flow through valves

A

murmur

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44
Q

use of radionuclide techniques in cardiovascular assessment

A

MNPI (myocardial nuclear perfusion imaging)

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45
Q

the heart muscle

A

myocardium

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46
Q

decrease in blood pressure after changing from sitting or lying position to standing position

A

orthostatic hypotension

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47
Q

exaggerated decrease in systolic pressure by more than 10 mm Hg during inspiratory phase of respiratory cycle

A

paradoxical blood pressure

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48
Q

abnormal sound from pericardial sac that happens with movements of heart during cardiac cycle

A

pericardial friction rub

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49
Q

degree of myocardial fiber stretch at end of diastole and just before contraction

A

preload

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50
Q

difference between systolic and diastolic pressures

A

pulse pressure

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51
Q

amount of blood ejected by left ventricle during each contraction

A

stroke volume (SV)

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52
Q

phase of cardiac cycle that consists of contraction and emptying of atria and ventricles

A

systole

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53
Q

amount of pressure or force generated by left ventricle to distribute blood into the aorta with each heart contraction

A

systolic blood pressure

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54
Q

form of echocardiography performed through esophagus that examines cardiac structure and function

A

transesophageal echocardiography (TEE)

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55
Q

serum lipid profile that includes measurement of cholesterol and lipoproteins

A

triglycerides

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56
Q

myocardial muscle protein released into the bloodstream with injury to the myocardial muscle

A

troponin

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57
Q

passage of fluid or blood vessels to an organ

A

perfusion

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58
Q

the cardiovascular system is made up of

A

the heart and blood vessels

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59
Q

muscular wall that separates the heart into 2 halves

A

septum

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60
Q

valves that separate the atria from the ventricles

A

AV valves

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61
Q

valve that separates the right atrium from the right ventricle

A

tricuspid valve

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62
Q

valve that separates the left atrium from the left ventricle

A

mitral valve (bicuspid)

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63
Q

when does coronary artery blood flow to the myocardium occur

A

during diastole

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64
Q

durig diastole the heart is

A

filling (relaxing)

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65
Q

during systole the heart is

A

emptying (contracting)

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66
Q

what happens to cardiac muscles when calcium ions are pumped back into the heart

A

it relaxes

67
Q

what happens to the heart when calcium ions leave the cardiac muscles

A

it contracts

68
Q

the amount of blood pumped from the left ventricle each minute

A

cardiac output

69
Q

cardiac output depends on?

A

heart rate and stroke volume

70
Q

cardiac output range in adults

A

3-6 L/min

71
Q

cardiac index range

A

2.8-4.2 L/min/m^2

72
Q

you can find the cardiac index by

A

cardiac output divided by body surface area

73
Q

number of time ventricles contract each minute

A

heart rate

74
Q

normal resting heart rate

A

60-100 bpm

75
Q

nerve that slows the heart rate

A

vagus nerve

76
Q

system that slows the heart rate

A

parasympathetic system

77
Q

system that increases the heart rate

A

sympathetic system

78
Q

epinephrine and norepinephrine do what to the heart

A

increases heart rate and contractibility

79
Q

which cardiovascular drugs block the fight or flight pattern by decreasing the heart rate

A

beta blockers

80
Q

fight or flight system

A

sympathetic system

81
Q

variables that influence the stroke volume and cardiac output

A

heart rate
preload
afterload
contractibility

82
Q

myocardial fiber stretch at end of diastole and just before contraction

A

preload

83
Q

venous system is on which side of the heart

A

right side of the heart

84
Q

which side of the heart is the pulmonary system on?

A

left side of the heart

85
Q

pressure that the heart has to overcome to open aortic valve is called

A

impedance

86
Q

purposes of vascular system

A

blood route from heart to get to tissues
carries cell waste to excretory organs
drains tissue fluid back into circulation
returns blood to heart

87
Q

function of arterial system

A

deliver oxygen and nutrients to body tissues

88
Q

anything that increases cardiac output also increases

A

blood pressure

89
Q

the 3 mechanisms that regulate blood pressure

A

autonomic nervous system (ANS)
kidneys
endocrine system

90
Q

how do the kidneys regulate blood pressure

A

active renin-angiotensin-aldosterone mechanism when there is a change in blood flow

91
Q

how does the endocrine system regulate blood pressure

A

releases hormones to stimulate sympathetic nervous system in the tissues

92
Q

what hormones does the endocrine system release to stimulate the sympathetic nervous system in tissues

A

serotonin
histamine
kinins
catecholamine

93
Q

what are catecholamines

A

epinephrine
norepinephrine
dopamine

94
Q

balance of what systems regulate blood pressure

A

sympathetic and parasympathetic systems

95
Q

fluid causes blood pressure to do what?

A

rise

96
Q

antidiuretic hormone that regulates vascular volume

A

vasopressin

97
Q

female gender specific risks of CAD

A

pregnancy
menopause

98
Q

obesity is a BMI of over

A

30

99
Q

recurrence of these can cause abnormal heart valves

A

tonsillitis
streptococcal infections
rheumatic fever

100
Q

rheumatic fever is caused by

A

poorly treated strep throat or scarlet fever

101
Q

The nurse is conducting an admission assessment on a male client. Which assessment data does the nurse identify as a risk factor for cardiovascular disease? Select all that apply.
A. BMI of 26
B. BP of 120/66 mm Hg
C. Triglycerides 140 mg/dL
D. Moderate exercise for 20 to 30 minutes weekly E. Exposure to secondhand cigare e smoke
F. History of repeated streptococcal tonsillitis
G. Family history of cardiovascular disease

A

A. BMI of 26
D. Moderate exercise for 20 to 30 minutes weekly
E. Exposure to secondhand cigaree smoke
G. Family history of cardiovascular disease

102
Q

nutrition history includes

A

food and fluid intake over 24 hrs

103
Q

a bmi over what is considered overweight

A

25

104
Q

ischemia is

A

not enough blood flow to heart

105
Q

descriptions of chest pain caused by cardiac ischemia

A

discomfort
heaviness
pressure
indigestion

106
Q

indigestion is discomfort where?

A

in upper abdomen

107
Q

triad of symptoms for women with chest pain

A

indigestion/abdominal fullness
dyspnea
chronic fatigue

108
Q

early symptom of heart failure and can be the only symptom felt by women

A

dyspnea on exertion

109
Q

orthopnea is a sign of what?

A

advanced heart disease

110
Q

a patient with orthopnea would require what to sleep comfortably

A

several pillows to elevate head and chest

111
Q

the number of what a patient uses can be used to measure the severity of orthopnea

A

number of pillows pt uses to sleep

112
Q

orthopnea can be resolved in minutes by the patient

A

sitting up or standing

113
Q

orthopnea is?

A

dyspnea when a patient lies flat

114
Q

paroxysmal nocturnal dyspnea occurs

A

when pt has been lying down for several hours

115
Q

paroxysmal nocturnal dyspnea is caused by

A

blood from LE being redistributed to venous system which increases venous return to the heart which causes pulmonary congestion

116
Q

what will happen to a patient who is experiencing paroxysmal nocturnal dyspnea

A

they will abruptly wake up w/ suffocating feeling and panic

117
Q

how is paroxysmal nocturnal dyspnea relieved

A

by dangling legs over side of bed

118
Q

how long can the sensation of paroxysmal dyspnea last

A

20 mins

119
Q

when is fatigue cased by decreased cardiac output worse

A

in the evening

120
Q

most common cause of syncope is

A

decreased perfusion to the brain

121
Q

dizziness where you cant maintain an upright position is called

A

near syncope

122
Q

conditions that can trigger syncope

A

cardiac rhythm disturbances
ventricular dysrhythmias
valvular disorders
aortic stenosis

123
Q

aortic stenosis is

A

narrowing of valve between left lower heart and aorta

124
Q

pressure to carotid arteries can result in

A

syncope

125
Q

pressure can be applied to carotid arteries by what movements

A

turning head
shrugging shoulders
performing valsalva maneuver

126
Q

what is the valsava maneuver haha @sammy

A

bearing down during defecation

127
Q

a decrease in what can cause syncope

A

blood pressure and heart rate

128
Q

extremity pain related to heart problems can be caused by what 2 conditions

A

ischemia from atherosclerosis
venous insufficiency of peripheral blood vessels

129
Q

pts with mod-severe cramping in legs or butt after walking have

A

intermittent claudication caused by decreased arterial tissue perfusion

130
Q

claudication is

A

leg pain during exercise caused by not enough blood flow

131
Q

The nurse is assessing a client with heart failure. Which assessment data are the best indicator of fluid balance?
a. Blood pressure 144/79 mm Hg
b. Urine output 200 mL in the last 4 hours
c. Weight increase of 9 lb in the past week
d. Generalized edema in the lower extremities

A

c. Weight increase of 9 lb in the past week

132
Q

sudden weight gain can be caused by

A

excess fluid

133
Q

what is the best indicator of fluid balance

A

weight

134
Q

how much weight gain can occur until edema is apparent

A

10-15 lbs

135
Q

class I cardiovascular disability is defined by

A

pt with cardiac disease but no bad effects like fatigue, palpitations, dyspnea or anginal pain

136
Q

class II cardiovascular disability would be

A

-cardiac disease w slight limitation w physical activity
- comfortable at rest
- fatigue, palp, dyspnea, anginal pain during activity

137
Q

class III cardiovascular disabiltiy would be

A

-cardiac disease w marked limitation of physical activity
-comfortable at rest
- less than ordinary physical activity causes fatigue, palp, dyspnea or anginal pain

138
Q

class IV cardiovascular disability would be

A
  • cardiac disease resulting in inability to carry out physical activity
  • uncomfortable at rest
  • increased discomfort with any physical activity
139
Q

late signs of severe right sided heart failure

A

ascites
jaundice
anasarca

140
Q

ascites is

A

abdominal swelling caused by excess fluid in the abdomen

141
Q

anasarca is

A

generalized edema

142
Q

skin signs of decreased perfusion

A

cool
pale
moist

143
Q

cyanosis in dark skinned pts can appear as

A

graying of skin and mucous membranes

144
Q

arterial blood pressure is measured by

A

sphygmonanometry

145
Q

weak pulse that indicates narrow pulse pressure

A

hypokinetic pulse

146
Q

hypokinetic pulses can be found in patients with

A

hypovolemia
aortic stenosis
decreased cardiac output

147
Q

large “bounding” pulse caused by increased injection of blood

A

hyperkinetic pulse

148
Q

bruits are asessed by

A

placing stethoscope bell on neck over carotid artery while patient holds their breath

149
Q

a normal carotid artery with uninterrupted blood flow will have what kind of sound?

A

no sound

150
Q

what happens to the sound of a bruit if vessel is blocked 90% or more

A

bruit cant be heard

151
Q

the first heart sound is

A

s1

152
Q

s1 heart sounds are created by

A

closure of mitral and tricuspid valves

153
Q

s1 marks the beginning of what

A

ventricular systole

154
Q

on an ECG where does s1 occur

A

after the QRS complex

155
Q

decrease in s1 sound intensity is caused by

A

mitral regurgitation
heart failure

156
Q

the second heart sound is

A

s2

157
Q

s2 heart sound is caused by

A

closing of aortic and pulmonic valves

158
Q

paradoxic splitting is caused by

A

myocardial infarction
left bundle branch block
aortic stenosis
aortic regurgitation
right ventricular pacing

159
Q

pericardial friction rub can be heard in patients with

A

pericarditis from an MI, cardiac tamponade or after a thoracotomy

160
Q

cardiac tamponade is

A

when fluid/blood fills up in sac around heart causing pressure on the heart

161
Q

thoractomy is

A

cut made to see/reach organs in chest or thorax

162
Q

protein released into blood stream when heart is injured

A

troponin

163
Q

which troponins arent found in healthy patients

A

troponin T and I ( a healthy person wont know TI)

164
Q

an increase of troponin T and I can indicate

A

acute MI
cardiac necrosis

Exam 3 med surg (2 decks)

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