Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Health Assessment > PrepU Cardiovascular Disorders > Flashcards

PrepU Cardiovascular Disorders Flashcards

1
Q

The nurse is caring for a client who is scheduled for a transesophageal echocardiogram. What is the priority nursing intervention after procedure?

A

Elevate bed 45 degrees and keep NPO until return of gag reflex.
-This help so avoid aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Location of pulse assessment for a client with cardiovascular disorder?

A

auscultation at the apex
- a second nurse will palpate and count radial pulse for a full minute. Difference = pulse deficit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the pulse quality refer to?

A

palpated volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

—- —– is the pattern of the pulsations and pauses between them

A

pulse rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The student nurse is preparing a teaching plan for a client being discharged status post MI. What should the nurse include in the teaching plan (SATA)
A. need for careful monitoring for cardiac symptoms
B. need for carefully regulated exercise
C. need for dietary modifications
D. need for early resumption of prediagnosis activity
E. need for increased fluid intake

A

A, B, C.
-Dietary mod., exercise, weight loss, and careful monitoring are important strategies for managing three major cardiovascular risk factors: hyperlipidemia, hypertension, and diabetes.
-No need for fluid increase and activity should be slowly and deliberately increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When straining during defecation, the patient bears down (the Valsalva maneuver), which momentarily increases pressure on the baroreceptors. What nerve response does this trigger?

A

Vagal response = heart rate slows and results in syncope in some patients.
Straining during urination can also have the same effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What will a pt. experience with an abdominal aortic aneurysm?

A

Back or abdominal pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Urine output is an important indicator of cardiac function. What does low urine output mean?

A

Inability of the heart to generate enough cardiac output, leading to reduced blood flow to the brain and other vital organs such as the kidneys.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does high urine output indicate?

A

Endocrine problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The nurse is calculating a cardiac client’s pulse pressure. If the client’s blood pressure is 122/76 mm Hg, what is the client’s pulse pressure?

A

46 mm Hg
- difference between the systolic and diastolic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is enhanced by circulating catecholamines, sympathetic neuronal activity, and certain medications, like Lanoxin?

A

Contractility = increased stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What indicates chronic hemoglobin desaturation (decreased oxygen supply) and is associated with congenital heart disease?

A

Clubbing of the fingers and toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should a nurse assess in a ct. with clubbing of fingers and toes?

A

O2 sat, intervene as directed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What medication class decreases automaticity?

A

Beta-blockers
EX: metoprolol
May receive prior to a scan to control heart rate and rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The exchange of ions creates a positively charged intracellular space and a negatively charged extracellular space that characterizes the period known as —–

A

depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Once depolarization is complete, the exchange of ions reverts to its resting state— a period known as ?

A

repolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The repeated cycle of depolarization and repolarization is called —- —- —–

A

cardiac action potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A ct.’s declining cardiac status has been attributed to decreased cardiac action potential. Interventions should be aimed at restoring what aspect of cardiac physiology?

A

The cycle of depolarization and repolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Actions to complete when applying cardiac electrodes in preparation for an ECG on a male client?

A

1: clip (do not shave) hair from around the electrode site
2. if client is diaphoretic (sweaty), apply a small amount of benzoin to the skin, avoiding area under the center of the electrode
3. debride the skin surface of dead cells with soap and water and dry well
4. change the electrodes every 24 to 48 hours (or as recommended by manufacturer
5. examine skin for irritation and apply the electrodes to dif. locations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should be expressed to the patient when auscultating heart sounds?

A

Nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

After a physical exam, the provider diagnosed a patient with a grade 4 heart murmur. During assessment the nurse expects to hear a murmur that is:

A

Loud and may be associated with a thrill sound similar to (a purring cat).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What instruction should the nurse include in discharge instructions for a ct. who underwent a left groin cardiac catheterization 8 hours ago?

A

-Do not bend at the waist, strain, or lift heavy objects for the next 24 hours.
-Cant primary provider if swelling, new bruising or pain from the procedure puncture site occurs
-Report to provider if fever of 101 or more occurs
-If there is a large amount of bleeding, call 911. (Do not drive to the hospital)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which term describes the amount of blood ejected per hearbeat?

A

stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is stoke volume determined?

A

preload, afterload, and contractility of the heart.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What term is characterized by the amount of blood pumped by each ventricle during a given period?

A

Cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is cardiac output determined?

A

Multiply stroke volume of the heart by the heart rate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What term of cardiac function is characterized by the percentage of the end-diastolic volume that is ejected with each stroke?

A

Ejection fraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the normal ejection fraction percentage of the heart?

A

42-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What cardiac functional term is characterized by the pressure that the ventricular myocardium must overcome to eject blood during systole and is one of the determinants of stroke volume?

A

Afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When assessing a client’s pulse before outpatient diagnostic testing, what are the three things the nurse should document?

A

Rate, quality, and rhythm
Assess apical and radial pulses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the name of the primary pacemaker of the heart:

A

sinoatrial node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A normal resting hear has an inherent firing rate of the sinoatrial node of

A

60-100 pulses per minute

33
Q

Rate changes of the sinoatrial mode respond to what demands of the body?

A

Metabolic demands

34
Q

What should you ask a client during an outpatient test being done for cardiac problems? What symptoms are we looking for?

A

Have you had any episodes of dizziness or fainting?
-dyspnea
-dizziness
-fainting

35
Q

The nurse is administering a stool softener to a client who experienced a myocardial infarction. The client says, “I had a heart attack; I don’t have a problem with constipation.” What explanation will the nurse use to answer the client’s question?

A

If you strain to have bowel movement, you can cause a drop in your heart rate that can be dangerous.

36
Q

Heart rate is determined by myocardial cells with the fastest inherent firing rate. Under normal circumstances, where are these cells located?

A

SA node

37
Q

What does decreased pulse pressure reflect?

A

reduced stroke volume & ejection velocity OR obstruction to blood flow during systole.

38
Q

What does increased pulse pressure indicate?

A

Reduced distensibility of the arteries, along with bradycardia

39
Q

What is vital to assess in pt. and family of the pt. understanding in education about a new diagnosis of coronary artery disease?

A

Whether pt. and family members are able to recognize symptoms of acute cardiac problems and respond appropriately. Time is life.

40
Q

A brain (B-type) natriuretic peptide (BNP) sample drawn from ct. experiencing vital fatigue and shortness of breath allows investigation of what possible diagnosis?

A

HF. Level of BNP in blood increases as ventricular walls expand from increased pressure caused by HF.

41
Q

Electrical conduction of the heart originates in the SA node and then proceeds in what sequence?

A

SA node to AV node to bundle of HIS to Purkinje fibers

42
Q

Preparation for transesophageal echocardiography (TEE), patient must know:

A

-Pt. will have BP and ECG monitoring throughout the test
-NPO 6 hours before procedure
-Pt. will be sedated
-IV line will be initiated pre-procedure

43
Q

Elevated LDL and lowered HDL levels increases risk of?

A

coronary artery disease

44
Q

Checking lab values on a client who has crackles in the lower lobes, 2 + pitting edema, and dyspnea with minimal exertion. Which lab value do I expect to be abnormal?

A

-B-type natriuretic peptide (BNP): released from ventricles when ventricles experience increased pressure and stretch, as in HF.

45
Q

What BNP level is commonly associated with mild heart failure?

A

51 pg/ml or greater. Severity of HF determined by increase in BNP levels

46
Q

Which lab value is an indicator of inflammation and coronary artery disease?

A

CRP

47
Q

Abnormal platelet counts would lead to what symptom in a ct.?

A

Bleeding abnormalities

48
Q

A ct. with coronary artery disease (CAD) experienced a significant increase in heart rate during physical therapy. I recognize that a heart rate in a client with CAD may result in which outcome?

A

Myocardial ischemia:
coronary arteries, unlike other arteries, are perfused during diastole. An increase in HR shortens diastole and can decrease myocardial perfusion.

49
Q

Which cardiac defect is congenital?

A

Atrial-septal defects

50
Q

I review a client’s lab results and note a serum calcium level of 7.9 mg/dL. What condition should I monitor the client for?

A

impaired myocardial contractility.
hypocalcemia is associated with slow nodal functioning and impaired myocardial contractility

51
Q

What is the normal serum calcium levels?

A

8.9-10.3 mg/dL

52
Q

Hypocalcemia increases the risk of what?

A

HF

53
Q

Results of a high-sensitivity C-reactive protein (hs-CRP) allows me to evaluate the role of what process the is implicated in the development of atherosclerosis?

A

Inflammation: hs-CRP protein is produced by liver in response to systemic inflammation, thought to play a role in development and progression of atherosclerosis

54
Q

Which assessments should a nurse perform when caring for a client following a cardiac catheterization? (SATA)
A. Palpate the insertion site for tenderness
B. Monitor BP and pulse frequently
C. Inspect the color in every extremity
D. Palpate the pulse in different locations
E. Inspect pressure dressing for signs of bleeding

A

B, D, E:
only check color and temp of affected extremity to confirm good blood circulation.

55
Q

Which diagnostic test yields a two-dimensional rendering of the heart’s structure and mechanical function?

A

echocardiogram: allows to assess structure and size of heart

56
Q

What are angiography and cardiac catheterization tests used for to assess in a pt?

A

patency of coronary arteries

57
Q

Which test indicates the heart’s electrical activity?

A

ECG

58
Q

I am caring for a client with an elevated bp and no previous history of hypertension. At 0900, bp was 158/90. At 0930, the bp is 142/82 mm Hg. I am most correct when relating the fall in bp to which structure?

A

Baroreceptors: senses pressure in nerve endings in the wall of the atria a major blood vessels. They respond accordingly to raise or lower blood pressure.

59
Q

Which nerve slows the heart rate?

A

Vegus

60
Q

My client is going to have a stress test. What radionuclide would most likely be used to diagnose ischemic heart disease during this test?

A

Thallium-201: diagnoses ischemic heart disease during a stress test

61
Q

Which radionuclide is used to detect areas of myocardial damage by injection before or after a stress test?

A

technetium-99m

62
Q

I observe a client during an exercise stress test (bicycle). Which finding indicates a positive test and the need for further diagnostic testing?

A

ST-segment changes on the ECG: may warrant cardiac catheterization and stop of the stress testW

63
Q

What symptoms during an ECG stress test may warrant cardiac catheterization, further diagnostic testing, and halting of the stress test?

A

decrease in bp or pulse rate, serious dysrhythmias (ST-segment changes)

64
Q

During a stress test, what is monitored?

A

ECG leads for heart rate, rhythm, and ischemic changes;
- BP
- skin temp
-physical appearance
-perceived exertion

65
Q

What symptoms are assessed for during a ECG stress exercise test?

A

chest pain, dyspnea, dizziness, leg cramping and fatigue

66
Q

When is the exercise stress test terminated?

A

when target hear rate is achieved or client experiences signs of myocardial ischemia (chest pain, extreme fatigue, decrease in bp or pulse rate, serious dysrhythmias

67
Q

I care for a client with an intra-arterial blood pressure monitoring device. I recognize the most preventable complication associated with hemodynamic monitoring includes which condition?

A

catheter-related bloodstream infections (CRBSIs). Most common preventable complication associated with hemodynamic monitoring systems.

68
Q

What are uncommon complications from use of hemodynamic monitoring systems?

A

-pneumothorax
-infection
-air embolism

69
Q

When may a pneumothorax occur during us of a hemodynamic monitoring system?

A

May occur during insertion of catheters using a central venous approach (CVP and pulmonary artery catheters).

70
Q

What can cause an air emboli to be introduced into the vascular system during use of a hemodynamic monitoring system?

A

If stopcocks attached to the pressure transducers are mishandled during blood drawing, admin of meds. or other procedures that require opening the system to air

71
Q

I am assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would I document this?

A

S3 (“DUB”). Hear early in diastole during period of rapid ventricular filling as blood flows from the atrium into a noncompliant ventricle. Heart immediately after S2 “Lub-dub-DUB” imitates abnormal sound of a beating heart when an S3 is present.

72
Q

I am caring for a client who is suspected of having cardiovascular disease who has a stress test ordered. The client has a co-morbidity of MS, so I know the stress test will be drug-induced. What drug will be used to dilate coronary arteries?

A

-Dobutamine, dipyridamole, or adenosine
-dilates arteries similar to vasodilation that occurs during exercise - increases heart muscle’s blood supply

73
Q

Which area of theheart is located at the third intercostal (IC) space to left of the sternum?

A

erb point

74
Q

Which area of the heart is located at the second IC space to the right of the sternum?

A

aortic area

75
Q

Which area of the heart is located at the second IC space to the left of the sternum?

A

pulmonic area

76
Q

Where is the epigastric area of the heart located?

A

below the xiphoid process

77
Q
A
78
Q
A

Health Assessment (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions