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Nurs212 > N212 Lecture 9 > Flashcards

N212 Lecture 9 Flashcards

1
Q

What are the 3 steps in the process of oxygenation

A

ventilation, perfusion and diffusion

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2
Q

The exchange of respiratory gases occur between which 2 things?

A

environment and blood

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3
Q

Respiration is the exchange between oxygen and co2 during cellular metabolism, true or false

A

true

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4
Q

The process of moving gases into and out of the lungs is called

A

Ventilation

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5
Q

the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs is called

A

perfusion

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6
Q

exchange of respiratory gases in the alveoli and capillaries is called

A

Diffusion

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7
Q

for ventilation, it requires coordination of the muscular and elastic properties of the lung and thorax, true or false

A

true

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8
Q

diffusion is responsible for moving the respiratory gases from one are to another by concentration gradients, true or false

A

true

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9
Q

for exchange of respiratory gases to occur what needs to be intact

A

the organs, nerves and muscle of respiration along with the CNS being able to regulate the cycle

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10
Q

the active process stimulated by chemical receptors in the aorta is called

A

inspiration

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11
Q

the passive process that depends on the elastic recoil properties of the lungs requiring little or no muscle work is called

A

expiration

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12
Q

the chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing is called

A

surfactant

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13
Q

patients with advanced COPD lose elastic recoil of the lungs and thorax, results in increase of breathing, true or false

A

true

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14
Q

the collapse of the alveoli that prevents normal exchange of oxygen and co2 is called

A

atelectasis

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15
Q

ability for the lungs to expand is called

A

compliance

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16
Q

the increase in pressure that occurs as the diameter of the airways decreases from mouth/nose to alveoli is called

A

airway resistance

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17
Q

decreased lung compliance, increased airway resistance, and the increased use of accessory muscles increase the work of breathing, true or false

A

True

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18
Q

The process for the exchange of respiratory gases in the alveoli and the lungs and the capillaries of the body tissues is called

A

diffusion

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19
Q

the thickness of the membrane affects the rate of diffusion, true or false

A

true

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20
Q

what type of patients have slow diffusion, slow exchange of respiratory gases and decreased delivery of oxygen to tissues ?

A

patients with pulmonary edema, pulmonary infiltrates or pulmonary effusion due to thickened membrane

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21
Q

what alters the amount of alveolar capillary membrane surface area

A

chronic diseases (emphysema), acute diseases (pneumothorax) and surgical processes (lobectomy)

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22
Q

the oxygen transport system consist of what 2 things

A

lungs and cardiovascular system

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23
Q

what 3 things influence the capacity of the blood to carry oxygen

A

the amount of dissolved oxygen in the plasma, the amount of hemoglobin, and the ability of hemoglobin to bind with oxygen

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24
Q

the regulation of respiration is necessary to ensure sufficient oxygen intake and co2 elimination to meet the demands of the body, true or false

A

true

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25
Q

neural and chemical regulators control what?

A

the process of respiration

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26
Q

the neural regulation includes the CNS control of respiratory rate, depth, and rhythm, true or false

A

true

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27
Q

chemical regulation maintains the appropriate rate and depth of respirations based on changes of co2, o2, and hydrogen ion concentrations pH in the blood, true or false

A

true

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28
Q

the amount of blood ejected from the left ventricle each minute is called

A

cardiac output

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29
Q

amount of blood ejected from the left ventricle with each contraction is called

A

stroke volume

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30
Q

stroke volume (SV) x heart rate (HR) =

A

cardiac output (CO)

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31
Q

resistance to left ventricular ejection is called

A

afterload

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32
Q

the normal cardiac output in a healthy adult at rest is from

A

4-8L/min

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33
Q

the circulating volume of blood changes according to the oxygen and metabolic needs of the body, true or false

A

true

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34
Q

stroke volume is affected by preload, afterload, and myocardial contractility, true or false

A

true

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35
Q

the amount of blood in the left ventricle at the end of diastole, often referred to as end diastolic volume is called

A

preload

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36
Q

the more stretch on the ventricular muscle, the greater the contraction and the greater the volume( starlings law), true or false

A

true

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37
Q

the resistance to left ventricular ejection is called

A

afterload

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38
Q

the diastolic aortic pressure is a good clinical measure of afterload, true or false

A

true

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39
Q

in hypertension the afterload increases, making cardiac workload also increase, true or false

A

true

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40
Q

what affects stroke volume and cardiac output

A

myocardial contractility

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41
Q

the myocardium of the older adult is stiffer with a slower ventricular filling rate and prolonged contraction time, true or false

A

true

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42
Q

what influences the rate of impulse generation and the speed of transmission through the conductive pathway and the strength of atrial and ventricular contractions

A

autonomic nervous system

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43
Q

what generates the rhythmic relaxation and contraction of the atria and ventricles

A

cardiac conduction system

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44
Q

what innervates all parts of the atria, ventricles and the sinoatrial(AV) and atrioventricular (AV) nodes

A

sympathetic and parasympathetic nerve fibers

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45
Q

sympathetic fibers increase the rate of impulse generation and speed of transmission, true or false

A

true

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46
Q

the parasympathetic fibers originate from the vagus nerve decrease the rate, true or false

A

true

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47
Q

the conduction system originates with the SA node “ pacemaker” of the heart, true or false

A

true

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48
Q

in an adult at rest the impulses at the SA node are initiated at an intrinsic rate of 60 to 100 cardiac action potentials per minute, true or false

A

true

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49
Q

the AV node mediates impulses between the atria and the ventricles, true or false

A

true

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50
Q

what reflects the electrical activity of the conduction system

A

electrocardiogram ( ECG)

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51
Q

ECG monitors the regularity and path of the electrical impulse through the conduction system, true or false

A

true

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52
Q

ECG does not reflect the muscular work of the heart, true or false

A

true

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53
Q

what is called the normal sequence on the ECG

A

normal sinus rhythm (NSR)

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54
Q

NSR implies that the impulse originates at the SA node and follows the normal sequence through the conduction system, true or false

A

true

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55
Q

what represents the electrical conduction through both atria

A

the P wave, atrial contraction follows the P wave

56
Q

what represents the impulse travel time from the SA node through the AV node, through the bundle of His and to the Purkinje fibers

A

The PR interval

57
Q

the normal length of the PR interval is

A

0.12 to 0.2 seconds

58
Q

an increase in the time greater than 0.2 sec indicates a block in the impulse transmission through the AV node, true or false

59
Q

a decrease of less than 0.12 sec indicates the initiation of the electrical impulse from ta source other than the SA node, true or false

60
Q

what indicates the electrical impulse traveled through the ventricles

A

the QRS complex

61
Q

normal QRS duration is between

A

0.06 to0.1 seconds

62
Q

an increase in QRS duration indicates a delay in conduction time through the ventricles, true or false

63
Q

what contraction usually follows the QRS complex

A

ventricular contraction

64
Q

what represents the time needed for ventricular depolarization and repolarization

A

The QT interval

65
Q

the normal QT interval is from

A

0.12 to 0.42 sec

66
Q

this interval varies inversely with changes in heart rate, true or false

67
Q

what causes conduction disturbances

A

electrical impulses that do not originate from the SA node

68
Q

what is called when theres a deviation from the normal sinus heart rhythm, are classified by cardiac response and site of impulse origin

A

dysrhythmias

69
Q

tachycardia is more than 100 bpm and bradycardia less than 60 bpm, true or false

70
Q

the electrical impulse in atria is chaotic comes from multiple sites is called

A

atrial fibrillation

71
Q

a sudden, rapid onset of tachycardia originating above the AV node is called

A

paroxysmal supraventricular tachycardia

72
Q

a ectopic site of impulse formation within the ventricles which are life threatening rhythms that require immediate intervention is called

A

ventricular dysrhythmias (causes decreased cardiac output and sudden death)

73
Q

rhythm disturbances are called dysrhythmias which means a deviation from the normal sinus heart rhythm, true or false

74
Q

dysrhythmias occur as a primary conduction disturbance such as in response to ischemia; valvular abnormality; anxiety; drug toxicity; caffeine; alcohol or tobacco use or a complication of acid base or electrolyte imbalance, true or false

75
Q

what is classified by cardiac response and site of impulse origin

A

dysrhythmias

76
Q

what causes lower cardiac output and blood pressure

A

tachydysrhythmias and bradydysrhythmias

77
Q

what reduces cardiac output by decreasing diastolic filling time

A

tachydysrhythmias

78
Q

what lowers cardiac output because of the decreased heart rate

A

bradydysrhthmias

79
Q

whats a common dysrhythmia in older adults

A

atrial fibrillation (afib)

80
Q

abnormal impulses originating above the ventricles are called

A

supraventricular dysrhythmias

81
Q

a sudden, rapid onset of tachycardia originating above the AV node is called

A

paroxysmal supraventricular tachycardia

82
Q

paroxysmal supraventricular tachycardia often begins and ends spontaneously which is caused by excitement, fatigue, caffeine, smoking, or alcohol, true or false

83
Q

an ectopic site( originates in the ventricle) of impulse formation within the ventricles is called

A

ventricular dysrhythmias

84
Q

these life threatening rhythms require immediate intervention are called

A

ventricular tachycardia and ventricular fibrillation

85
Q

if the ventricular failure is significant, the amount of blood rejected from left ventricle drops which decreases cardiac output, true or false

86
Q

when the left ventricle continues to fail, blood begins to pool in the pulmonary circulation causing ?

A

pulmonary congestion

87
Q

left sided heart failure symptoms are crackles in the bases of the lungs on auscultation, hypoxia, sob on exertion, cough and paroxysmal nocturnal dyspnea, true or false

88
Q

the impaired functioning of the right ventricle and more commonly from pulmonary disease or as a result of long term left sided failure is from?

A

right sided heat failure

89
Q

the primary pathological factor in right sided failure is elevated ?

A

pulmonary vascular resistance (PVR)

90
Q

for PVR the oxygen demand of the heart increases and the amount of blood ejected from the right ventricle declines causing blood to “ back up” in the systemic circulation, true or false

91
Q

with PVR the patient has weight gain, distended neck veins, hepatomegaly, splenomegaly and dependent peripheral edema, true or false

92
Q

an acquired or congenital disorder of a cardiac valve that causes either hardening (stenosis) or impaired closure (regurgitation) of the valves is called

A

Valvular heart disease

93
Q

when ventricles contract the blood escapes back into the atria causing a murmur or “ whooshing” sound, true or false

94
Q

a transient imbalance between myocardial oxygen supply and demand is called

A

angina pectoris

95
Q

angina pectoris results in chest pain that is aching, sharp, tingling, burning or like pressure, true or false

96
Q

chest pain is typically left sided or substernal and radiates to the left or both arms, the jaw, neck and back and usually relieved with rest and coronary vasodilators, the most common being nitroglycerin preparation, true or false

97
Q

sudden decrease in coronary blood flow or an increase in myocardial oxygen demand without adequate coronary perfusion is called ?

A

Myocardial Infarction (MI) or acute coronary syndrome (ACS)

98
Q

infarction occurs because ischemia is not reversed, true or false

99
Q

cellular death occurs after 20 minutes of myocardial ischemia, true or false

100
Q

chest pain associated with MI in men are described as crushing, squeezing or stabbing, true or false

101
Q

mens MI pain is often in the left chest and sternal are, may be felt in the back and radiates down the left arm to the neck, jaws, teeth, epigastric area, back, and occurs at rest or exertion and lasts more then 20 minutes, true or false

102
Q

rest, position change or sublingual nitroglycerin administration might not relive MI pain, true or false

103
Q

women’s symptoms for MI are angina but also atypical symptoms such as fatigue, indigestion, sob, back or jaw pain, and have 2x the risk of dying within the first year after a heart attack than men, true or false

104
Q

hypertension is often asymptomatic, true or false

105
Q

prehypertension is diagnosed in adults when an average of 2 or more readings of past two visits of 120 and 129 systolic and greater than 80 diastolic, true or false

106
Q

diastolic readings greater than 90 and systolic greater than 140 define hypertension, true or false

107
Q

what is associated with thickening and loss of elasticity in the arterial walls

A

hypertension

108
Q

peripheral vascular resistance increases within thick and inelastic vessels, true or false

109
Q

the dilation of the arteries in the vascular bed, the loss of a substantial amount of blood volume or the failure of the heart muscle to pump adequately is ?

A

hypotension

110
Q

what is associated with pallor, skin mottling, clamminess, confusion, increased HR, or decreased urine output

A

hypotension

111
Q

a normotensive person develops symptoms and a drop in systolic pressure by at least 20mm hg or a drop in diastolic pressure by at least 10 mm hg within 3 minutes of arising to an upright position is

A

orthostatic hypotension/postural hypotension

112
Q

patients who are dehydrated, anemic or have been on bed rest or recent blood loss are at risk for orthostatic hypotension particularly in the morning, true or false

113
Q

orthostatic readings taken within 3 minutes of patient changing positions, true or false

114
Q

low levels of arterial oxygen is called

115
Q

anemia causes decreased oxygen carrying capacity and inhalation of toxic substances, true or false

116
Q

carbon monoxide is the most common toxic inhalant decreasing the oxygen carrying capacity of blood, true or false

117
Q

conditions such as shock and severe dehydration causes extracellular fluid loss and reduce circulating blood volume is called

A

hypovolemia

118
Q

decreasing circular blood volume results in hypoxia to body tissue, true or false

119
Q

when fever persists the metabolic rate remains high and the body begins to break down protein stores, true or false

120
Q

oxygenation decreases as a direct consequence of chronic lung disease, true or false

121
Q

the normal arterial co2 tension is between 35 to 45 mm hg, true or false

122
Q

the normal arterial o2 tension is between 80 to 100 mm hg, true or false

123
Q

hypoventilation and hyperventilation are often determined by arterial blood gas analysis, true or false

124
Q

when alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate sufficient co2 is called

A

hypoventilation

125
Q

the resulting hypoventilation causes excessive retention of co2 which can lead to respiratory acidosis and respiratory arrest, true or false

126
Q

signs and symptoms of hypoventilation include mental status change, dysrhythmias, and potential cardiac arrest, true or false

127
Q

signs and symptoms of hyperventilation are rapid respirations, sighing breaths, numbness and tingling of hands/feet, lightheadedness and loss of consciousness, true or false

128
Q

refers to a decrease in the amount of arterial oxygen is called

129
Q

normal spo2 is greater than or equal to 95%, true or false

130
Q

causes of hypoxia include 1) decreased hemoglobin level and lowered oxygen carrying capacity of the blood 2) a diminished concentration of inspired oxygen 3) the inability of the tissues to extract oxygen from the blood, as with cyanide poisoning 4) decreased diffusion of o2from the alveoli to the blood as in pneumonia 5) poor tissue perfusion with o2 blood as with shock 6) impaired ventilation as with multiple rib fractures, true or false

131
Q

symptoms of apprehension, restlessness, inability to concentrate, decreased level of consciousness, dizziness and behavioral changes are causes of

132
Q

blue discoloration of the skin and mucous membrane caused by the presence of desaturated hemoglobin in capillaries is called

133
Q

central cyanosis observed in the tongue, soft palate and conjunctiva of the eye indicates hypoxemia, true or false

134
Q

peripheral cyanosis seen in extremities, nail beds, earlobes is a result of vasoconstriction and stagnant blood flow, true or false

135
Q

pulse oximetry provides instant feedback about the patients level of oxygenation, true or false

136
Q

Xray, blood work such as arterial blood gases and TB test help with reviewing patients oxygenation levels, true or false

Nurs212 (8 decks)

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