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NSG 300 7-9 EXAM 11/9 > TOPIC 8 > Flashcards

TOPIC 8 Flashcards

1
Q

right side of the heart has

A

deoxygenated blood

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2
Q

left side of the heart has

A

oxygenated blood

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3
Q

What are early signs of hypoxia?

A

Restlessness, headache, fatigue, SOB.

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4
Q

the ventricles ____ with blood during diastole

A

fill

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5
Q

the ventricles ______ with blood during systole

A

empty

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6
Q

stroke volume

A

The volume of blood ejected from the ventricles during systole

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7
Q

sterlings law

A

As the myocardium stretches, the strength of the subsequent contraction increases

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8
Q

S1 heart sound “Lub”

A

mitral and tricuspid valves close

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9
Q

s2 heart sound “dub”

A

aortic and pulmonic close

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10
Q

cardiac output

A

The volume of blood ejected from the left ventricle each minute.

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11
Q

what is normal cardiac output

A

4 to 6 L/min

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12
Q

stroke volume

A

Amount of blood ejected from the left ventricle with each contraction

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13
Q

Cardiac output equation

A

CO = HR(heart rate) x S(stroke volume)

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14
Q

the circulating blood volume changes according to the….

A

oxygen and metabolic needs of the body

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15
Q

preload

A

The amount of blood in the left ventricle at the end of diastole, often referred to as end-diastolic volume.

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16
Q

afterload

A

Resistance to left ventricular ejection

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17
Q

myocardial contractility

A

The ability of the heart muscle to contract.

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18
Q

what can affect myocardial contractility

A

o Injury to the myocardial muscle such as an acute MI causes a decrease in myocardial contractility.
o The myocardium of the older adult is stiffer with a slower ventricular filling rate and prolonged contraction time.

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19
Q

where should electrical impulses originate from

A

SA node (if they don’t start in the SA node it can cause conduction disturbances)

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20
Q

dysrhythmias

A

Rhythm disturbances, meaning a deviation from the normal sinus heart rhythm

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21
Q

tachycardia

A

greater than 100 bpm (fast HR)

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22
Q

bradycardia

A

less than 60 bpm (slow HR)

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23
Q

Tachydysrhythmias and bradydysrhythmias lower…

A

cardiac output and blood pressure.

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24
Q

atrial fibrillation

A

rapid, random, ineffective contractions of the atrium “quivering”

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25
Q

Paroxysmal supraventricular tachycardia

A

A sudden, rapid onset of tachycardia originating above the AV node.
-It often begins and ends spontaneously. Sometimes excitement, fatigue, caffeine, smoking, or alcohol use precipitates paroxysmal supraventricular tachycardia

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26
Q

Ventricular tachycardia and ventricular fibrillation are…

A

life-threatening rhythms that require immediate intervention.

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27
Q

Ventricular tachycardia is a life-threatening dysrhythmia because

A

the decreased cardiac output and the potential to deteriorate into ventricular fibrillation or sudden cardiac death.

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28
Q

Left-sided heart failure s/s

A

fatigue, breathlessness, dizziness, and confusion as a result of tissue hypoxia from the diminished cardiac output.

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29
Q

Left-sided heart failure clinical findings

A

crackles in the bases of the lungs on auscultation, hypoxia, shortness of breath on exertion, cough, and paroxysmal nocturnal dyspnea.

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30
Q

Right-sided heart failure clinical findings

A

weight gain, distended neck veins, hepatomegaly and splenomegaly, and dependent peripheral edema.

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31
Q

Myocardial ischemia

A

results when the supply of blood to the myocardium from the coronary arteries is insufficient to meet myocardial oxygen demands.

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32
Q

Valvular heart disease

A

an acquired or congenital disorder of a cardiac valve that causes either hardening (stenosis) or impaired closure (regurgitation) of the valves. When stenosis occurs, the flow of blood through the valves is obstructed. When the ventricles contract, blood escapes back into the atria, causing a murmur, or “whooshing” sound.

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33
Q

Angina pectoris

A

a transient imbalance between myocardial oxygen supply and demand, resulting in chest pain that is aching, sharp, tingling, or burning or that feels like pressure.

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34
Q

Chest pain associated with MI in men

A

described as crushing, squeezing, or stabbing. The pain is often in the left chest and sternal area; may be felt in the back; and radiates down the left arm to the neck, jaws, teeth, epigastric area, and back

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35
Q

The most common initial symptom in women (MI)

A

angina, but they also present with atypical symptoms such as fatigue, indigestion, shortness of breath, and back or jaw pain.

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36
Q

what labs would you order to check cardiopulmonary function?

A

O2 saturation and hemoglobin (RBCs count)

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37
Q

Pulse oximetry provides…

A

instant feedback about the patient’s level of oxygenation.

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38
Q

Capnography

A

also known as end title CO2 monitoring

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39
Q

Kussmaul respirations

A

Deep, rapid breathing; to compensate by decreasing CO2 levels

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40
Q

apnea

A

the absence of respirations for lasting for 15 seconds or longer.

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41
Q

Cheyne-Stokes respiration

A

repeated breathing pattern characterized by fluctuation in the depth of respiration: first deeply, then shallow, then not at all

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42
Q

When does the cheyne stokes respiration pattern occur?

A

when there is decreased blood flow or injury to the brainstem.

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43
Q

edema scale

A
  • 1+ Mild pitting, slight indentation, no perceptible swelling of the leg
  • 2+ Moderate pitting, indentation, subsides rapidly
  • 3+ Deep pitting, indentation remains for a short time, leg looks swollen
  • 4+ Very deep pitting, indentation lasts a long time, leg is very swollen
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44
Q

pulse scale

A

0-absent,
1-barely palpable, intermittent,
2-weak, possibly thready, but constantly palpable and with consistent quality,
3- normal strength and quality,
4-bounding, easily palpable, may be visible

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45
Q

Cardiopulmonary resuscitation (CPR)

A

the attempt to restore cardiac and pulmonary function
1. circulation
2. airway
3. breathing

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46
Q

Permanent heart, brain, and other tissue damage occur within how many minutes

A

4-6 minutes

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47
Q

Defibrillation (automatic external defibrillator [AED])

A

Is needed to stop an abnormal heart rhythm

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48
Q

when can you NEVER use and AED on a patient

A

-if the patient has a pulse
-if they are flat line

49
Q

what are situations you can use a defibrillator

A

-v-fib: ventricular fibrillation (quiver)
-v-tach: ventricular tachycardia (beating fast)

50
Q

cardiopulmonary rehabilitation includes…

A

maintaining an optimal level of health through controlled physical exercise, nutrition counseling, relaxation and stress-management techniques, and prescribed medications and oxygen.

51
Q

what are the three basic techniques for breathing exercises?

A

-deep-breathing and coughing exercises
-pursed-lip breathing
-diaphragmatic breathing

52
Q

Pursed-lip breathing

A

deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse. While sitting up, instruct the patient to take a deep breath and exhale slowly through pursed lips as if blowing through a straw.

53
Q

Diaphragmatic breathing

A

useful for patients with pulmonary disease, postoperative patients, and women in labor to promote relaxation and provide pain control. The exercise improves efficiency of breathing by decreasing air trapping and reducing the WOB.

54
Q

circadiam rhythm

A

Biological time clock by which the body functions, most familiar rhythm is the 24-hour, day-night cycle

55
Q

what is circadian rhythm affected by?

A

light, temperature, social activities, and work routines.

56
Q

what biological and behavioral factors does the circadian rhythm influence?

A

changing of body temperature, heart rate, blood pressure, hormone secretion, sensory acuity, and mood

57
Q

electroencephalogram (EEG) measures…

A

electrical activity in the cerebral cortex

58
Q

electromyogram (EMG) measures…

A

muscle tone

59
Q

the electrooculogram (EOG) measures…

A

eye movements provide information about some structural physiological aspects of sleep.

60
Q

where is the major sleep center int he body

A

hypothalamus

61
Q

Hypocreatins (ovexins)

A

secreted from the hypothalamus and Promote wakefulness and rapid eye movement (REM) sleep

62
Q

Reticular activating system (RAS)

A

Located in the upper brainstem contains special cells that maintain alertness and wakefulness.

63
Q

Homeostatic process (Process S)

A

primarily regulates the length and depth of sleep; and the circadian rhythms (Process C: “biological time clocks”)

64
Q

NREM

A

non rapid eye movement

65
Q

REM

A

rapid eye movement

66
Q

what are the two sleep phases

A

REM & NREM

67
Q

how many stages of NREM sleep are there

A

4

68
Q

N1 (stage 1)

A

lightest stage of sleep lasting a few minutes

69
Q

N2 (stage 2)

A

-Stage of sound sleep during which relaxation progresses.
-Arousal is still relatively easy.

70
Q

N3 (stage 3 and 4)

A

-Called slow-wave sleep.
-Deepest stage of sleep.
-Sleeper is difficult to arouse and rarely moves.

71
Q

how long does the presleep period last

A

10-30mins

72
Q

if a person has difficulty falling asleep, how long does this period last?

A

an hour or more

73
Q

how many complete sleep cycles does a person pass through in a night

A

4-5

74
Q

how many minutes does it take a person to reach REM sleep

A

90 minutes

75
Q

How long do sleep cycles last?

A

90-100minutes

76
Q

purpose of sleep: physiological and psychological restoration

A

-NREM sleep contributes to body tissue restoration.
-During sleep the heart rate falls to 60 beats/min or less, which benefits cardiac function. Other biological functions decreased during sleep are respirations, blood pressure, and muscle tone.

77
Q

the dreams of _______ sleep are more vivid and elaborate

A

REM

78
Q

physical illnesses that disturb sleep

A

-hypertension
-respiratory disorders
-nocturia
-restless leg syndrome

79
Q

restless leg syndrome symptoms

A

recurrent, rhythmical movements of the feet and legs. Patients feel an itching sensation deep in the muscles

80
Q

relief from restless leg syndrome comes from..

A

Relief comes only from moving the legs, which prevents relaxation and subsequent sleep.

81
Q

what are the 8 categories of major sleep disorders

A

-sleep-related breathing disorders
-hypersomnias
-circadian rhythm sleep disorders
- parasomnias
-sleep and wake distrubances
-sleep-related movement disorders
-“other” sleep disorders

82
Q

hypersomnia

A

excessive daytime sleepiness

83
Q

circadian rhythm sleep disorder

A

caused by a misalignment between the timing of sleep and individual desires or the societal norm

84
Q

parasomnia

A

are sleep problems that are more common in children (sleep walking, night terrors, bedwetting, etc)

85
Q

polysomnogram

A

involves the use of EEG, EMG, and EOG to monitor stages of sleep and wakefulness during nighttime sleep.

86
Q

Insomnia

A

the most common sleep disorder, is a symptom patients experience when they chronically have difficulty falling asleep.

87
Q

Sleep apnea

A

characterized by lack of airflow through the nose and mouth for periods of 10 seconds or longer during sleep.

88
Q

Obstructive sleep apnea (OSA)

A

occurs when muscles or structures of the oral cavity or throat relax during sleep. The upper airway becomes partially or completely blocked, diminishing nasal airflow (hypopnea) or stopping it (apnea) for as long as 30 seconds.

89
Q

what are major risk factors for OSA

A

obesity and hypertension.

90
Q

Central Sleep Apnea (CSA)

A

involves dysfunction in the respiratory control center of the brain.
-The impulse to breathe fails temporarily, and nasal airflow and chest wall movement cease.

91
Q

what are major risk factors for CSA

A

patients with brainstem injury, muscular dystrophy, and encephalitis.

92
Q

narcolepsy

A

a dysfunction of mechanisms that regulate the sleep and waking states.

93
Q

Cataplexy

A

sudden muscle weakness/loss of muscle control during intense emotions such as anger, sadness, or laughter, occurs at any time during the day.

94
Q

sleep paralysis

A

the experience of waking up unable to move

95
Q

sleep deprivation causes

A

fever, difficulty breathing, pain, emotional stress, medications, and disturbances in the health care setting.

96
Q

somnambulism

A

sleepwalking

97
Q

night terrors

A

a sleep disorder characterized by high arousal and an appearance of being terrified; unlike nightmares, night terrors occur during Stage 4 sleep, within two or three hours of falling asleep, and are seldom remembered

98
Q

night mares

A

bad dreams occurring during REM sleep

99
Q

nocturnal enuresis

A

bed wetting

100
Q

body rocking

A

moving back and forth in a slow, rhythmic fashion

101
Q

bruxism

A

grinding teeth

102
Q

young adults should get ____ hours of sleep

A

6-8.5

103
Q

factors influencing sleep: drugs and substances

A

Hypnotics, antidepressants and stimulants, alcohol, caffeine, diuretics, beta-adrenergic blockers, benzos, nicotine, narcotics, anticonvulsants

104
Q

factors influencing sleep: exercise and fatigue

A

Moderate exercise and fatigue cause a restful sleep

105
Q

factors influencing sleep: food and calorie intake

A

Time of day, caffeine, nicotine, alcohol

106
Q

sleep is a ____ experience

A

subjective

107
Q

who are the sources for a sleep assessment

A

patient and the family

108
Q

tools for sleep assessment

A

Epworth Sleepiness Scale - evaluates severity of EDS
Pittsburg Sleep Quality Index - evaluates sleep quality & patterns
Visal Analog Scale
Numeric Scale

109
Q

environmental controls and sleep

A

All patients require a sleeping environment with a comfortable room temperature and proper ventilation, minimal sources of noise, a comfortable bed, and proper lighting. Eliminate distracting noise so the bedroom is as quiet as possible

110
Q

promoting bedtime routines

A

-It is always important for persons to go to sleep when they feel fatigued or sleepy.
-A bedtime routine (e.g., same hour for bedtime, snack, or quiet activity) used consistently helps young children avoid delaying sleep.
-Adults need to avoid excessive mental stimulation just before bedtime.

111
Q

any patient prone to confusion or falls, safety is critical

A

· Night light
· Beds set lower to the floor
· Remove clutter

112
Q

when someone is sleep walking…

A

they are are unaware of their surroundings and are slow to react, increasing the risk of falls.
-Do not startle sleepwalkers but instead gently awaken them and lead them back to bed.

113
Q

infants’ bed

A

-reduce the chance of suffocation
-do not place pillows, stuffed toys, or the ends of loose blankets in cribs
-Loose-fitting plastic mattress covers are dangerous
-Parents need to place an infant on his or her back to prevent suffocation.

114
Q

what foods promote sleep

A

A dairy product such as warm milk or cocoa that contains L-tryptophan is often helpful

115
Q

what is the recommended dose of melatonin

A

0.3 to 1 mg taken 2 hours before bedtime.

116
Q

Recommend lifestyle changes to patients with OSA:

A

include sleep hygiene, alcohol moderation, smoking cessation, and a weight-loss program.

117
Q

continuous positive airway pressure (CPAP)

A

device used to treat sleep apnea; includes a mask that fits over the sleeper’s nose and mouth, which is connected to a pump that pumps air into the person’s airways, forcing them to remain open
-A mask delivers room air at a high pressure.

118
Q

hypnotics

A

medications that induce sleep

119
Q

Sedatives

A

medications that produce a calming or soothing effect

NSG 300 7-9 EXAM 11/9 (10 decks)

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