Exam 3 - Cardio + PVD Flashcards
regardless of race or ethnicity, adults in the United States are more likely to die from ___ ___ than any other cause
heart disease
area on chest that covers the great and great vessels
precordium
T or F. female hearts are smaller and weigh less than male hearts
true
where is the apex of the heart?
bottom
where is the base of the heart?
top
outer layer of the heart
epicaridum
thick, innermost layer of the heart
myocardium
innermost layer of the heart
endocardium
___ means internal organ
visceral
cardiac cycle
tri, mitral valves open protodiastolic filling presystole AV valves close (S1) ventricles contract Semilunar valves open Semilunar valves close (S2)
atria contract to push more blood into ventricles
presystole
first, rapid filling phase
blood pours into ventricles
prodiastolic filling
the heart sits ___ or slanted
obliquely
if heart valves are competent, blood flow will be ___
unidirectional
where is “lub, dub” and semilunar valves heard best
at the base of the heart / precordium
S3, S4 are commonly associated with ___ ___
MI
occurs when ventricles reach its elastic limit, rapidly causing blood flow from the atrium to slow
blood flow from the ventricles cause vibrations
S3
sounds associated with active atrial contractions that cause late ventricular filling
S4
S4 is aka
atrial gallop
when is an S4 heard
before S1
cause of S4
uncontrolled HTN
long standing aortic stenosis
post MI fibrosis
cardiomyopathies
can be heard in well conditioned athletes and children
S3 is aka
ventricle gallop
S3 is heard with pt who have ___ ___ ___ or ___
CHF
cardiomyopathy
when is S3 heard
after S2
S3 is a normal finding in these indiviuduals
children
young adults
pregnancy, 3rd trimester
S3 is heard best is which position
apex, L lateral position
S4 is heard best in which position
apex, bell of stethoscope, L lateral position
S4 sounds like which state
Tennessee
S3 sounds like
Kentucky
what are the 4 main coronary arteries
L main
R
L anterior descending
circumflex
what does an EKG determine
electrical activity
cardiac conduction system order
SA node intra-atrial conducting pathway AV node Bundle of His -R, L bundle branches purkinjie fibers
electrolytes that impact electrical problems
Calcium
Potassium
Sodium
SA node rate
60-100 bpm
if SA node fails, which picks up?
AV node
AV node rate
60 bpm
AV node fails, which picks up?
Purkinje fibers
Purkinje fiber rate
40-60 bpm
average time for each cardiac cycle
0.8 seconds
average HR
72 bpm
one complete heartbeat which is the contraction and relaxation of the atria and ventricles
cardiac cycle
3 periods of ventricular filling
filling
systole
isovolumetric relaxation
straight horizontal line means the absence of electrical activity and the pt is
dead
if a pt is in asystole, how many leads must it be confirmed in
2
this is correlated with a higher incidence of HTN, especially in adult females
socioeconomic status
stress stimulates which system?
sympathetic = increase systemic vascular resistance = increase workload of the heart
race with the high risk of HTN and stroke
African Americans
race with the highest risk factor of obesity and diabetes
Hispanics, Latinos
25% less likely to die from cardiovascular disease than Caucasians
SBP, DBP changes during pregnancy induced HTN/preelampsia
rise in SBP 30 or DBP 15
pregnancy resting HR changes
increase 10-15 bpm
a BP of 150/60 in a normal finding in ___ ___
older adults
PVC are r/t
caffeine
stimulant drugs
which drug is known to cause coronary artery spasms
cocaine
alcohol can lead to ___ and ___ ___
cardiomyopathy
afib
chest pain that occurs when the heart can’t keep up with the metabolic demands
angina
illness of inflammation that can damage the heart valves permanently
Rheumatic fever
untreated strep
medical processes that can cause aniga
DM PVD CVA MI HTN high cholesterol Rheumatic fever
inflammation of the costal cartilage causes from coughing
costochondritis
pt reports they wake up at night or can’t sleep d/t developing dysnea, the nurse should inquire about…
heart or lung problems
edema r/t cardio is unilateral or bilateral
bilateral
worse at night, better with elevation
dependent edema is caused by
CHF
where is S2 loudest
aortic (2nd R ICS)
pulmonic (2nd L ICS)
S1 is loudest where?
tricupsid apical area (5th ICS MCL)
S1, S2 are heard equally where?
Erb’s point (3rd L ICS)
how to compare carotid and apical pulse
palpate carotid while auscultating the apical pulse
positioning for auscultating heart
sitting
lean forward
supine, lateral
heart murmur grading is #’s __ to __
1-6
heart murmur grading 1
barely audible
heart murmur grading 2
faint
heart murmur grading 3
moderately loud
heart murmur grading 4
loud, thrill
heart murmur grading 5
very loud; head of stethoscope off of chest wall
heart murmur grading 6
loudest
s/sx of ventricular septal defect
poor weight gain
delay physical, mental development
cyanosis, tachypnea when feeding
**corrected with sx
contracting skeletal muscles, especially ___ muscles, help move blood ___ towards the heart
calf; distally
what must be done before an ABG
collateral circulation or Allen Test
+ Allen test
no blood return within 8 seconds
how to perform an Allen test
hand held higher than heart
pressure applied to radial, ulnar arteries until distal blood is occluded
dorsalis pedis pulse location
over the dorsum of foot
lateral to extensor tendon of big toe
s/sx of varicose veins
ache
burn
heaviness
how long does it take for claudication pain to go away
2 minutes after rest
Is Raynaud a symptom or disease?
symptom r/t to underlying cause such as sclerodoma
varicose vein risk factors
Irish, German decent family hx sedentary lifestyle obesity multiple pregnancies
greatest risk:
jobs require standing most of the day: hairdressers, cashier; desk jobs
