NP1 cardiac Flashcards
What are the primary factors responsible for Blood Pressure?
- Blood Volume
- Fluid loss
- Dehydration
- Fluid retention
- Aldosterone
- ADH
- Peripheral Resistance
- Sympathetic nervous system activity
- Renin/angiotensin II
- Increased blood viscosity
- Cardiac Output
What is the classification for Normal blood pressure?
- Systolic: Less than 120
- Diastolic: Less than 80
What defines Prehypertension according to?
- Systolic: 120-139
- Diastolic: 80-89
What characterizes Stage 1 Hypertension?
- Systolic: 140-159
- Diastolic: 90-99
What defines Stage 2 Hypertension?
- Systolic: 160 or higher
- Diastolic: 100 or higher
What are the factors contributing to Hypertension?
- Dysfunction of autonomic nervous system
- Increased sympathetic nervous system activity
- ↑ renal reabsorption of sodium, chloride, and water
- Stimulation of renin-angiotensin-aldosterone system
- Endothelial mechanical problems
- Age
- Insulin resistance
True or False: Hypertension is often referred to as ‘The Silent Killer’.
True
What are the signs/symptoms that may indicate high blood pressure or target organ damage?
- Chest pain
- Headache
- Shortness of breath
- Speech problems
- Epistaxis
- Nocturia
- Dizziness
What are the common symptoms of a Hypertensive Crisis?
- Severe headache
- Extremely high blood pressure
- Dizzy and blurred vision
- Shortness of breath
- Epistaxis
- Severe anxiety
What are the risk factors for Atherosclerosis?
- Low HDL and high LDL
- Increased triglycerides
- Genetic predisposition
- Diabetes mellitus
- Obesity
- Smoking
- Sedentary lifestyle
- Stress
- African American or Hispanic ethnicity
- Elderly
What are the clinical manifestations of Peripheral Arterial Disease (PAD)?
- Intermittent claudication
- Rest pain
- Loss of hair on lower calf, ankle, and foot
- Dry, scaly, dusky, pale, or mottled skin
- Thick toenails
- Pallor when extremity is elevated
- Rubor when extremity is lowered
- Muscle atrophy
What is the most sensitive indicator in the assessment of PAD?
Posterior tibial pulse
Fill in the blank: The most common cause of Abdominal Aortic Aneurysm is _______.
[atherosclerosis]
What is Virchow’s triad related to Venous Thromboembolism (VTE)?
- Stasis of blood
- Vessel wall injury
- Altered blood coagulation
What are the signs/symptoms of Chronic Venous Insufficiency?
- Edema
- Altered pigmentation
- Pain
- Stasis dermatitis
What are common interventions for managing VTE?
- Measure the circumference of the leg
- Rest
- Anticoagulant therapy
- Warm, moist soaks
- Elevate legs when sitting
- Compression therapy
What are the signs of Acute Peripheral Arterial Occlusion?
- Pain
- Pallor
- Pulselessness
- Paresthesia
- Paralysis
- Poikilothermy
What is the treatment for a ruptured abdominal aortic aneurysm?
- Hypotension management
- Diaphoresis
- Decreased LOC
- Oliguria
- No pulse distal to rupture
- Dysrhythmias
What lifestyle modifications can help control blood pressure?
- Weight control
- Exercise
- Smoking cessation
What are common side effects of statins used in treating Atherosclerosis?
- Muscle cramping
- Elevated liver enzymes
What should patients with PAD be taught about managing pain?
Walk until pain begins and rest
True or False: Varicose veins are more common in younger people.
False
What are the characteristics of venous ulcers?
- Most serious complication of chronic venous insufficiency
- Caused by small veins rupturing
- Skin gets dry, cracks, and itches
What is Valvular Heart Disease?
A condition involving damage to one or more of the heart valves.
What causes Mitral Stenosis?
Most commonly caused by rheumatic fever.
What are the pathophysiological changes in Mitral Stenosis?
Valve thickening by fibrosis and calcification; leaflets fuse, stiffen, and opening narrows.
What are the common complications of Mitral Stenosis?
- Pulmonary congestion
- Right-sided heart failure (HF)
- Decreased cardiac output (CO)
What are the signs and symptoms of Mitral Stenosis?
- Fatigue
- Dyspnea on exertion (DOE)
- Orthopnea
- Paroxysmal nocturnal dyspnea (PND)
- Hemoptysis
- Hepatomegaly
- Neck vein distention
- Pitting edema
- Atrial fibrillation (AF)
- Fumbling, apical diastolic murmur
What is the pathophysiology of Mitral Valve Prolapse?
Valvular leaflet enlargement with prolapse into the atrium during systole.
What are the complications associated with Mitral Valve Prolapse?
- Syncope
- Exercise intolerance
- Atrial or Ventricular dysrhythmias
What are the signs and symptoms of Mitral Valve Prolapse?
- Atypical chest pain
- Dizziness
- Syncope
- Palpitations
- Atrial tachycardia
- Mid-systolic click
- Systolic murmur
- Normal HR and BP
What is the most common valve disorder?
Aortic Stenosis.
What are the complications of Aortic Stenosis?
- Ventricular hypertrophy
- Cardiac output becomes fixed
- Left ventricular failure (LVF)
- Pulmonary congestion
- Right-sided failure
What are the signs and symptoms of Aortic Stenosis?
- Dyspnea on exertion
- Angina
- Syncope on exertion
- Fatigue
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Harsh systolic crescendo-decrescendo murmur
What is the purpose of valvuloplasty?
Repair of the valve, not replacement.
What is the nursing priority after a valvuloplasty?
- Observe for bleeding at site
- Observe for signs of regurgitant valve
- Observe for signs of thrombi
What is Infective Endocarditis?
Microbial infection of the endothelial surface of the heart.
What are the risk factors for Infective Endocarditis?
- IV drug users
- Hemodialysis
- Systemic infection
- Dental procedures
- Body piercings
What are the signs and symptoms of Infective Endocarditis?
- Recurrent fever of unknown origin
- Heart murmur
- Petechiae
- Splinter hemorrhages
- Osler’s nodes
- Janeway’s lesions
- Malaise
- Anorexia
- Weight loss
- Cough
- Joint pain
What is the treatment for Infective Endocarditis?
- Antimicrobials IV for 4-6 weeks
- Possible surgery for large vegetations
- Balance rest and activity
What are the complications of Infective Endocarditis?
- Heart failure
- Arterial emboli
- Splenic infarction
- Renal infarction
- Mesenteric emboli
- Neurologic changes
- Pulmonary infarction
What is Acute Pericarditis?
Inflammation of the membranous sac around the heart.
What are the common signs and symptoms of Acute Pericarditis?
- Substernal precordial pain
- Pain aggravated by coughing, swallowing, and breathing
- Worsened in supine position
- Relieved by sitting up and leaning forward
- Fever
- EKG changes
What is Cardiac Tamponade?
Compression of the heart due to accumulation of fluid in the pericardial sac.
What are the cardinal symptoms of Cardiac Tamponade?
- Falling systolic blood pressure
- Narrowing pulse pressure
- Rising venous pressure (JVD)
- Distant or muffled heart sounds
What is the management for Cardiac Tamponade?
- Pericardiocentesis
- Emergency resuscitation equipment available
- Monitor for complications
What causes Rheumatic Endocarditis?
Caused by an upper respiratory infection with group A beta-hemolytic streptococci.
What are the signs and symptoms of Rheumatic Endocarditis?
- Tachycardia
- Cardiomegaly
- New or changed murmur
- Friction rub
- Precordial pain
- EKG changes
- Heart failure
What are the four types of Cardiomyopathy?
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy (nonobstructed and obstructed)
- Restrictive cardiomyopathy
- Arrhythmogenic RV cardiomyopathy
What is the effect of decreased stroke volume in Cardiomyopathy?
Stimulates sympathetic nervous system and renin-angiotensin-aldosterone response, leading to fluid retention and increased workload on the heart.
What is the priority concept for patients with cardiac conditions?
Perfusion
What are the interrelated concepts for patients with cardiac conditions?
- Gas exchange
- Comfort
- Infection
What are the major types of heart failure?
- Left-sided
- Right-sided
- High-output
What are typical causes of heart failure?
- Hypertension
- Coronary artery disease
- Valvular disease
What are the two types of heart failure?
- Systolic
- Diastolic
What causes left-sided heart failure?
- Left ventricular failure
- Right ventricular MI
- Pulmonary hypertension
What are common symptoms of left-sided heart failure?
- Dyspnea
- Exertional dyspnea
- Paroxysmal nocturnal dyspnea
- Fatigue
- Weakness
- Chest pain or palpitations
What characterizes right-sided heart failure?
Cardiac output remains normal or above normal
What are causes of high-output heart failure?
- Septicemia
- High fever
- Anemia
- Hyperthyroidism
What are the NYHA classification stages for heart failure?
- Class I: High risk but no symptoms
- Class II: Mild symptoms
- Class III: Moderate symptoms
- Class IV: Severe symptoms
What compensatory mechanisms are activated when cardiac output is insufficient?
- Sympathetic nervous system stimulation
- Renin–angiotensin system activation
- Myocardial hypertrophy
What is the incidence of heart failure in the U.S.?
6 million people
What demographic has an increased risk for heart failure?
Black adults
What is the most reliable indicator of fluid gain/loss in heart failure patients?
Weight
What laboratory assessments are important in heart failure?
- Serum electrolytes
- Hemoglobin and hematocrit
- BNP
- Urinalysis
- ABGs
What imaging assessments are used for heart failure?
- CXR
- Echocardiography
- Radionucleotide studies
- MUGA
What are the goals for evaluating outcomes in heart failure management?
- Adequate pulmonary tissue perfusion
- Increased cardiac pump effectiveness
- Freedom from pulmonary edema
What is the most common cause of mitral stenosis?
Rheumatic fever
What symptoms may indicate mitral regurgitation?
- Fatigue
- Chronic weakness
- Anxiety
- Atrial fibrillation
What is a common symptom of aortic stenosis?
Exertional dyspnea
What are the signs of infective endocarditis?
- Petechiae
- Splinter hemorrhages
- Osler nodes
- Janeway lesions
- Roth spots
What is the primary prevention for rheumatic carditis?
Penicillin or erythromycin
What are the types of cardiomyopathy?
- Dilated cardiomyopathy (DCM)
- Hypertrophic cardiomyopathy (HCM)
- Restrictive cardiomyopathy
- Arrhythmogenic right ventricular cardiomyopathy
What nursing action should be taken for a client with heart failure experiencing shortness of breath?
Replace the nasal cannula
What nursing intervention is appropriate for a client with heart failure who shows signs of fatigue?
Energy management
Which medications may be ordered for a client with an ejection fraction of 30%?
- Lisinopril
- Digoxin
- Furosemide
True or False: Right-sided heart failure is associated with pulmonary congestion.
False
Fill in the blank: The most common valve dysfunction in the U.S. is _______.
Aortic stenosis
What is the priority concept in the assessment of the cardiovascular system?
Perfusion
What is the interrelated concept in this chapter?
Fluid and electrolyte balance
What are the AV valves of the heart?
- Tricuspid valve
- Mitral valve
What are the semilunar valves of the heart?
- Pulmonic valve
- Aortic valve
What is the mean arterial pressure (MAP) range to maintain adequate perfusion?
60 to 70 mm Hg
List the sequence of events during the cardiac cycle.
- Mitral and tricuspid (AV) valves close
- Aortic and pulmonic (semilunar) valves open
- Isovolumetric contraction
- Ventricular ejection
- Isovolumetric relaxation
- Aortic and pulmonic (semilunar) valves close
- Mitral and tricuspid (AV) valves open
What are the mechanical properties of the heart?
- Cardiac output
- Heart rate
- Stroke volume
- Preload
- Afterload
Define cardiac output (CO).
Amount of blood pumped from left ventricle per minute
How is cardiac output (CO) calculated?
CO = Heart rate × Stroke volume
What are the purposes of the vascular system?
- Provides a route for blood to travel from the heart to nourish tissues
- Carries cellular wastes to excretory organs
- Allows lymphatic flow to drain tissue fluid back into circulation
- Returns blood to the heart for recirculation
What is the primary function of the venous system?
To complete circulation of blood by returning blood from capillaries to the right side of the heart
What cardiovascular changes are associated with aging?
- Cardiac valves
- Conduction system
- Left ventricle
- Aorta and other large arteries
- Baroreceptors
What factors should be included in the history assessment for cardiovascular risk?
- Modifiable and nonmodifiable risk factors
- Psychological factors
- Medical history
- Previous treatment for CVD
- Drug history
- Social history
- Nutrition
- Family history and genetic risk
- Current health problems
- Functional history
What components are included in a physical assessment of the cardiovascular system?
- General appearance
- Skin color and temperature
- Extremities
- Blood pressure
- Venous and arterial pulses
- Precordium
- Inspection
- Palpation
- Percussion
- Auscultation
What laboratory assessments are important for cardiovascular evaluation?
- Serum cardiac enzymes
- Troponin T and I
- Serum lipids
- Total cholesterol
- Triglycerides
- HDL
- LDL
- Other laboratory tests
What are some diagnostic assessments for the cardiovascular system?
- PA and lateral CXR
- Angiography (arteriography)
- Cardiac catheterization
- ECG
- EPS
- Exercise electrocardiography
- Echocardiography
- Transesophageal echocardiography
- Myocardial nuclear perfusion imaging (MNPI)
- CT, MRI
Fill in the blank: The primary function of the venous system is to complete circulation of blood by returning blood from capillaries to the _______.
right side of the heart
True or False: Low HDL values indicate an increased risk for coronary artery disease (CAD).
True
What action should a nurse take when having difficulty auscultating the first heart sound, S1?
Direct the client to lay on their left side
What is a major risk factor for cardiovascular disease (CVD) related to smoking?
Smoking increases risks for heart disease
