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NURS 470 > Perfusion > Flashcards

Perfusion Flashcards

1
Q

What does the pulmonary circuit include

?

A

right side of the heart, the pulmonary arteries, lungs, and the pulmonary capillaries

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2
Q

Why can an increase in pressure in the left side of the heart cause increased pulmonary vascular pressures and pulmonary edema?

A

Pulmonary veins have no valves and blood can back up into the lungs through the pulmonary veins

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3
Q

Which layer of a blood vessel prevents clotting and damage to blood cells?

A

tunica intima (specifically the smooth muscle in the endothelium)

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4
Q

Which layer of arteries is much thicker than veins?

A

tunica media

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5
Q

What is a major purpose of the pulmonary circuit?

A

Facilitate external gas exchange

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6
Q

What kind of system is seen in the systemic circuit?

A

a high-pressure system

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7
Q

Which blood vessel layer interfaces directly with the blood?

A

Tunica intima

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8
Q

The large arteries are able to adjust their size in response to the cardiac cycle for which reason?

A

An abundance of elastic fibers in the tunica media

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9
Q

Which atrium receives deoxygenated blood from the body?

A

Right atrium

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10
Q

Which atrium will receive oxygenated blood from the lungs?

A

left atrium

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11
Q

What is the innermost layer of the heart?

A

endocardium

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12
Q

What are the two layers of the pericardial sac?

A

parietal pericardium and visceral pericardium

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13
Q

What are the first vessels to receive CO after blood is leaving the left ventricle?

A

coronary arteries

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14
Q

Which coronary artery supplies the right ventricle?

A

right coronary artery

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15
Q

What does the left anterior descending artery supply?

A

the anterior aspect of the left ventricle and septum

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16
Q

What regulates the blood flow through the coronary arteries and the perfusion of the myocardium?

A

aortic pressure

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17
Q

The endocardium has which major function?

A

Provide a protective surface for direct exposure to blood cells

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18
Q

What is a unique property of cardiac muscle?

A

It has an abundant amount of myoglobin.

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19
Q

What is the major purpose of the heart valves?

A

Prevent the backward flow of blood

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20
Q

How is the term cardiac cycle best defined?

A

Heart muscle activities during one complete heartbeat

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21
Q

What does CI (cardiac index) take into account that CO does not?

A

BSA

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22
Q

4 determinants of CO

A

heart rate, preload, after load, and contractility

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23
Q

What is stroke volume?

A

the volume of blood pumped with each heartbeat

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24
Q

What is the stretch in the myocardial fibers at the end of diastole? And what does it represent?

A

preload, represents the volume of blood in the ventricle at the end of diastole

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25
Q

What is the Frank-Starling law of the heart?

A

the heart will pump the amount of blood it receives with each beat (until it meets the physiological limit)

The more the cardiac muscle is stretched during diastole, the stronger the contraction is during systole

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26
Q

What is afterload?

A

the resistance against which the ventricles must overcome to pump blood

the ventricular pressure after systole

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27
Q

What is Ohm’s law?

A

Pressure= Flow x Resistance

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28
Q

If calcium is increased, what will happen to the heart’s contraction?

A

it will result in a greater contraction

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29
Q

What are factors that influence contractility known as?

A

inotropes

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30
Q

If after load increases, stroke volume _____.

A

decreases

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31
Q

What is the measure of the percent of blood ejected with each stroke volume known as?

A

Ejection fraction

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32
Q

A client has developed a heart rate of 150 bpm. This would have which effect on cardiac output?

A

Decrease

33
Q

A client with a normal heart has developed increased preload. This will result in which hemodynamic change?

A

Increase in stroke volume

34
Q

In a client with normal heart function, if blood pressure decreases and flow remains unchanged, peripheral resistance will change in which way to increase the blood pressure?

A

It will increase

35
Q

Which conditions, if present in the client, can result in decreased afterload?

A

Septic shock
Depressed sympathetic NS
Vasodilating drugs

36
Q

How is arterial pressure calculated?

A

peripheral resistance times cardiac output

37
Q

Why does renin go up when blood pressure decreases?

A

the kidneys cannot be perfused well and this triggers renin release

38
Q

How can the kidneys alter BP?

A

the RAAS system and through retention of water

39
Q

How is the term systemic filling pressure best defined?

A

The amount of force available to return blood to the heart

40
Q

Which statement correctly describes how the renin-angiotensin-aldosterone system (RAAS) alters blood pressure?

A

Angiotensin II stimulates the release of aldosterone

41
Q

When baroreceptors sense a blood pressure that is below the individual’s normal preset level, which set of actions is triggered?

A

Increased heart rate, vasoconstriction

42
Q

What is often described as a “skipping” or “thumping” of the heart by the patient?

A

palpitations

43
Q

What is used to estimate the 10 year risk of atherosclerotic cardiovascular disease?

A

Pooled Cohort equations

44
Q

What is the precordium?

A

the region of the thorax immediately in front of the heart

45
Q

Why does jugular venous distention happen?

A

backflow through the vena cava as a result of retention of blood in the right side of the heart during right sided HF

46
Q

What value will increase after an MI? How long does it take for this increase to happen?

A

CK-MB within 4-6 hours following an MI

47
Q

What is the leading laboratory value that assesses for myocardial damage?

A

troponin

48
Q

When is C-reactive protein released?

A

during systemic inflammation, infection, and tissue damage

49
Q

What is a high BNP associated with?

A

HF

50
Q

S3 heart sound caused by decreased ventricular compliance are called what?

A

ventricular gallop

51
Q

he nurse is assessing a client who is complaining of chest pain, using the PQRST assessment format. The “S” in this mnemonic refers to which assessments?

A

Timing and treatment strategies

52
Q

Which cardiac enzyme appears in the blood within 3 hours of myocardial cell death?

A

Troponin

53
Q

Decreased contractility is manifested by which signs?

A

Diminished pulse pressure

53
Q

Which signs indicate possible increased afterload for the left ventricle?

A

Cool, clammy extremities, non-healing wounds, HTN, thick, brittle nails, slow cap refill

54
Q

What does stress testing assess?

A

the heart’s response to increased oxygen demand

55
Q

What are 3 invasive diagnostic procedures used to assess cardiac health?

A

transesophageal echocardiogram (TEE), cardiac catheterization, and electrophysiology study (EPS)

56
Q

the procedure of choice to detect clots in the left atrium, atrial septal defects, infections on valve leaflets, and valve dysfunction.

A

Transesophageal Echocardiogram (TEE)

57
Q

gold standard for assessment of coronary arteries

A

Cardiac Catheterization

58
Q

Left-heart catheterization is performed primarily to determine what?

A

the patency of the coronary vessels

59
Q

The findings from this study help to determine if the patient would benefit from further interventions, such as drug therapy, implanted pacemaker or implantable cardio-defibrillator, or ablation

A

Electrophysiology Study (EPS)

60
Q

What happens during an EPS?

A

Under fluoroscopy, electrode catheters are inserted into the heart. These catheters conduct electrical impulses to and from the heart to trigger abnormal heart rhythms; these dysrhythmias usually disappear after removal of the electrical stimuli

61
Q

The nurse preparing a client for cardiac catheterization must notify the cardiologist with which information?

A

The client reports an allergy to shellfish.

62
Q

After a cardiac catheterization, the nurse must monitor for which primary complication?

A

Bleeding

63
Q

The electrophysiology study (EPS) is used for which purpose?

A

To classify and locate cardiac arrhythmias

64
Q

What are the 3 components of stroke volume?

A

preload, after load, contractility

65
Q

What is PVR

A

the after load of the right side of the heart

66
Q

What is the normal CO?

A

4-8L/min

67
Q

What is the normal CI?

A

2.4-4.0L/min

68
Q

How is CI measured?

A

CO/BSA

69
Q

What is stroke volume?

A

volume of blood pumped with each heartbeat (60-70mL per contraction)

70
Q

Which heart rhythms will influence CO?

A

Tachycardia, Afib, Bradycardia, Asystole, and Vtach

71
Q

How will Afib affect CO?

A

CO decrease by 30% followed by hypotension

72
Q

How will Vtach affect CO?

A

won’t allow ventricles to fill, decrease CO

73
Q

What is the first thing that needs to be done if Vtach or Afib is seen in terms of CO?

A

take BP

74
Q

What are 4 things that affect preload?

A

venous return, total blood volume, atrial kick, and stiffness/thickness of ventricular wall

(volume and compliance)

75
Q

What do alpha receptors do? and beta?

A

alpha constricts and beta dilates

76
Q

4 factors that affect afterload

A

aortic impedance, blood viscosity, blood volume, vascular tone

77
Q

What is SVR?

A

the afterload of the left side of the heart

NURS 470 (33 decks)

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