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FNP > test 1 module 4 cardiac > Flashcards

test 1 module 4 cardiac Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

What is the location and shape of the mediastinum

A

behind and left of the sternum, above the diaphragm, between the lungs (where the heart is); cone shaped

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2
Q

Where is the base and apex of the heart

A

upper portion- base;
lower portion-apex

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3
Q

what are the 4 layers surrounding the heart?

A

1 pericardium: outer sac
2 epicardium: outer surface
3 myocardium: muscle layer
4 endocardium: inner lining

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4
Q

What are the atrioventricular valves of the heart

A

tricuspid and mitral

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4
Q

4 chambers of the heart

A

Right atria, left atria, right ventricle, left ventricle

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4
Q

what are the semilunar valves of the heart

A

pulmonic and aortic

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5
Q

What is the cardiac cycle

A

sa node > atria contraction > AV junction > His-purkinje > ventricular contraction > S1 > systole > s2 > diastole > s3, s4

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6
Q

what is the electrical activation of the heart?

A

Sa node > AV node > Bundle of His > Left and right bundle branches > Purkinje fibers

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7
Q

What does the p-wave indicate on EKG?

A

atrial depolarization

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8
Q

what does the PR interval indicate on EKG?

A

Atrioventricular conduction

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9
Q

what does the QRS complex indicate on EKG?

A

ventricular depolarization

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10
Q

what does the ST segment & T wave indicate on EKG?

A

ventricular repolarization

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11
Q

What does the U wave indicate on ekg?

A

final phase of ventricular repolarization

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12
Q

what is the blood flow order through the heart?

A

R atrium > R ventricle > lungs > L atrium > L ventricle > body

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13
Q

Does the blood flow through the lungs in fetusus?

A

no

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14
Q

Is the apex of the heart higher or lower in infants?

A

higher (apex = bottom of heart)

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15
Q

What does the ductus venosus shunt blood through in a fetus? and when should it close?

A

Diverts blood from the right ventricle > aorta > body > fetal gas exchanger. closes within 12-14 hours of birth

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16
Q

What is the foramen ovale and how does it close?

A

It allows deoxygenated blood to flow from the RA (where it came from the placenta) and oxygenated blood to flow through the LA ;closes due to shifting pressure in right and left side of heart

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17
Q

what does the ductus arteriosis shunt blood to in a fetus?

A

Allows maternal blood flow from the placenta to fetus IVC

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18
Q

How many hours should the shunts close after birth?

A

24-48 hours

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19
Q

4 things that happen to circulation in pregnancy

A

1 blood volume increases
2 HR increases
3 BP increases
4 ankle edema
(all because the heart is working harder)

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20
Q

What 5 things happen to our hearts as we age?

A

1 heart size decreases
2 L ventricle thickens
3 Valves calcify
4 decreases in pacing
5 delayed myocardium contractility

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21
Q

Normal order of cardiac exam

A

Inspection, palpation, auscultation

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22
Q

what age range should you change order or exam to inspection, auscultation, palpation?

A

infant > 3 years; because of anxiety and fearfulness

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23
Q

Where is the expected apical pulse located in adults and children?

A

MCL (midclavicular line) & 5th ICS (intercostal space) in adults and medial to nipple and 4th ICS in children

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24
Q

What are the appropriate ranges of normal respiratory rate for a 0-3 month old?

A

35-55 breaths/min

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25
Q

What are the appropriate ranges of normal respiratory rate for a 3-6 month old?

A

30-45 breaths/min

26
Q

What are the appropriate ranges of normal respiratory rate for a 6-12 month old?

A

22-38 breaths/min

27
Q

What are the appropriate ranges of normal respiratory rate for a 1-3 year old?

A

22-30 breaths/min

28
Q

What are the appropriate ranges of normal respiratory rate for a 3-6 year old?

A

20-24 breaths/min

29
Q

What are the appropriate ranges of normal respiratory rate for a 6-12 year old?

A

16-22 breaths/min

30
Q

Where is S1 heard? and what pulse does it coincide with?

A

S1 is heard at the apex of the heart and coincides with the rise of the carotid pulse

31
Q

What kind of pitch does the sound of S1 have? S2?

A

S1 has a lower pitch and S2 has a higher pitch

32
Q

Is the sound of S1 or S2 longer in duration?

A

S1 is longer than S2

33
Q

Where is S2 heard?

A

S2 is heard in the aortic and pulmonic area > base of heart

34
Q

What is the name of S3 and what characteristics does it have?

A

S3 is a ventricular gallop and is quiet, low pitched, heard at apex. Pathologic in adults > 40, but normal in children.

35
Q

What is the name of S4 and what characteristics does it have?

A

S4 is an atrial gallop, low pitched and best heard at apex. If heard, its pathologic

36
Q

When do systolic murmurs start and end?

A

Begin with or after S1 and end before S2

37
Q

When do diastolic murmurs start and end?

A

Begin with or after S2 and end at or before S1

38
Q

What are the 6 systolic murmurs?

A

1 Mitral valve regurgitation 2 tricuspid valve regurgitation 3 aortic stenosis 4 pulmonic stenosis 5 ventral septal defect (VSD) 6 mitral valve prolapse (MVP)

39
Q

What are the 4 diastolic murmurs?

A

1 aortic regurgitation 2 pulmonic regurgitation 3 mitral valve stenosis 4 tricuspid valve stenosis

40
Q

Signs of venous insufficiency

A

pale bluish change in skin color, ulcers, varicosity

41
Q

Signs of arterial insufficiency

A

shiny skin on legs, skin color change, slow nail and hair growth, non healing wounds

42
Q

vascular changes in pregnancy

A

palmar erythema, spider telangiectasis, decrease in SBP, dependent edema, varicose veins

43
Q

What are the three components of virchow’s triad?

A

Stasis, Vascular damage, hypercoagulability

44
Q

Ventricular septal defect (VSD) in children objective and subjective s/s

A

Subjective: recurrent respiratory infections, rapid breathing, poor growth s/s CHF. Objective: arterial pulse is small, jugular venous pulse not affected

45
Q

Tetralogy of Fallot in children subjective and objective s/s:

A

subjective: dyspnea with feeding, poor growth, exercise intolerance. objective: parasternal heave, precordial prominence, can have clubbing of finger/toes

46
Q

Patent Ductus Arteriosis in children subjective and objective s/s:

A

subjective: small = asymptomatic, large = dyspnea on exertion. objective: dilated and pulsatile neck vessels, wide pulse pressure

47
Q

Atrial septal defect (ASD) subjective and objective s/s

A

subjective: asymptomatic, heart failure can occur in adults. objective: systolic thrill, palpable parasternal thrust

48
Q

coarctation of the aorta objective and subjective s/s:

A

subjective: can be asymptomatic, HTN or s/s of heat failure and vascular insufficiency. objective: differences in systolic BP between arm and leg; femoral pulses are weaker than radial pulses or absent

49
Q

Rheumatic fever subjective and objective s/s:

A

subjective: fever, inflamed swollen joints, erythema marginatum, chorea, small painless nodules under the skin, chest pain, palpitations, fatigue, shortness of breath. objective: murmurs of mitral regurgitation and aortic insufficiency, cardiomegaly, pericarditis friction rub, signs of CHF

50
Q

Kawasaki Disease subjective and objective s/s:

A

subjective: fever 5+ days, weight loss, fatigue, myalgias, arthritis. objective: fever, conjunctival infection, strawberry tongue, edema in hands and feet, lymphadenopathy, polymorphous non -vesicular rashes

51
Q

what does systole mean

A

the period of ventricular contraction

52
Q

what does diastole mean

A

the period of ventricular filling and relaxation

53
Q

When does S1 sound occur

A

when the mitral and tricuspid valves are closed from the pressure generated by ventricular contraction. (lub)

54
Q

when does S2 sound occur

A

when the aortic and pulmonic valves close following ventricular contraction. (dub)

55
Q

what can an S3 sound in adults indicate?

A

ventricular failure or myocardial ischemia

56
Q

What can S4 indicate in adults? and when is S4 heard?

A

ventricular dysfunction (usually stiffness) and is heard right before S1

57
Q

What 3 high cardiac output states can a BENIGN murmur happen that is unalarming?

A

pregnancy, fever, and anemia

58
Q

is a murmur in a child alarming?

A

No, nearly all murmurs in children are benign and they will grow out of them as they get olderw

59
Q

what are the two types of mumurs?

A

stenosis and regurgitation

60
Q

Where are aortic valve murmurs heard normally?

A

at the cardiac base and right second intercostal space

61
Q

Where are mitral valve murmurs normally heard?

A

near cardiac apex

62
Q

where are tricuspid valve murmurs usually heard?

A

lower aspect of the left sternal border

63
Q

where are pulmonary valve murmurs usually heard?

A

left second intercostal space

64
Q
A

FNP (14 decks)

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