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Applied Patho > Week 11 > Flashcards

Week 11 Flashcards

Perfusion: HF & Shock

1
Q

The relaxation of the ventricles during the cardiac cycle

A

Diastole

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2
Q

The mechanism describing how the ventricle can adjust its pumping force to accommodate various levels of preload and afterload

A

Frank Starling Law

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3
Q

Describes how the cardiac muscle force of contraction is affected

A

Inotropic Function= contraction

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4
Q

The volume of blood in the heart at the end of diastole, also known as ventricular end diastolic volume

A

Preload> precardiac cycle

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5
Q

The amount of blood the heart pumps out of the ventricle each minute

A

Cardiac Output

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6
Q

Describes how the heart rate is affected?

A

Chronotropic= HR

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7
Q

The volume of blood pumped out of the ventricle with each contraction

A

Stroke Volume

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8
Q

The amount of resistance the ventricle must overcome in order to pump blood out of the heart

A

Afterload= resistance

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9
Q

The contraction of the ventricles during the cardiac cycle

A

Systole

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10
Q

Weak distended left ventricle cannot pump blood forward:
- Systolic/ diastolic dysfunction?

A

Systolic dysfunction

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11
Q

Stiff non-elastic left ventricle with less filling of blood:
- Systolic/ diastolic dysfunction?

A

Diastolic dysfunction

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12
Q

Can occur in traumatic injuries blocking venous return to heart:
- High/low output failure?

A

Low output failure
-don’t have enough output

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13
Q

Can be caused by systemic conditions with high metabolic demand:
- high/ low output failure?

A

High-output failure
- High demand= high output

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14
Q

Symptoms include jugular venous distention and ascites:
-L/R ventricle failure?

A

Right ventricular failure

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15
Q

Symptoms include paroxysmal nocturnal dyspnea and crackles:
L/R ventricle failure?

A

Left ventricular failure

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16
Q

The most common cause of heart failure is _____

A

Ischemic heart failure
- damages muscles and causes them to not work

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17
Q

In Cor Pulmonale, _______ stimulates vasoconstriction of the pulmonary arterial circulation, creating high pressures or pulmonary hypertension

A

Chronic Hypoxia
- tries to conserve O2 w/ vasoconstriction

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18
Q

The term, ______ is commonly used to describe a disease that targets the heart muscle itself. It can described as restrictive or __________.

A
  • Cardiomyopathy
  • Hypertrophy(muscle is too big)
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19
Q

Cardiogenic shock can be caused by _______, which occurs when there is an increased amount of fluid in the pericardial sac that surround the heart

A

Cardiac Tamponade

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20
Q

The underlying cause of ____ is widespread vasodilation that reduces venous return to the heart and unopposed action of the parasympathetic nervous system

A

Neurogenic
- spinal cord injury
- parasympathetic nervous system and heart don’t balance each other

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21
Q

In the _________ stage of shock, wide spread cellular hypoxia and lactic acid build up occurs

A
  • irreversible
  • when lactic acid build up occurs and irreversible damage occurs
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22
Q

Cardiac Contractility

A

The myocardium’s ability to stretch and contract in response to the filling of the heart wih blood.
- Afterload can negatively affect contractility by increasing the heart’s workload
- Also influenced by the ANS, acid-base, and electrolytes

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23
Q

Starling capillary forces

A

the two opposing pressure forces present at every capillary bed-hydrostatic pressure and oncontic/osmotic pressure…. normally they balance eachother out

24
Q

Hydrostatic fluid

A

forcing fluid out of the vessel and into the intracellular and interstitial spaces

25
Q

Oncotic pressure

A

force attempts to pull fluid from the intracellular spaces back to the vessel

26
Q

What is hemodynamic monitoring

A

measuring pressure within the chambers and vessels of the right and left sides of the heart

27
Q

How to measure the right heart pressure

A

using central venous pressure

28
Q

Pressure measurement within the IVC at that locations is referred to as

A

Central Venous Pressure

29
Q

When the L ventricle is not working and pressure is high what happens?

A

Backflow of the blood occurs

30
Q

How to measure the left heart pressure

A

catheter inserted into femoral or radial artery, advanced into aorta, then further advanced into left ventricle

31
Q

What percentage is concerning of LVEF and indicated heart failure

A

any percentage lower than 40%

32
Q

In heart failure can you differentiate between right and left-sided failure? T or F

A

TRUE

33
Q

Regulatory and compensatory mechanisms include

A
  • RAAS
  • ANS (barorecptors)
  • Posterior pituitary(ADH released)
    -Natriuretic peptide (BNP & ANP)
34
Q

The inability of the heart and lungs to satisfy the metabolic and oxygen requirements of the peripheral tissues

A

SHOCK

35
Q

Angiotensin II is a potent _____

A

vasodilator

36
Q

Aldosterone does what

A
  • raises bp
  • raises blood volume
37
Q

When ADH hormones go wrong they can act like a _____

A

vasoconstrictor

38
Q

ANP is secreted by

A

The hearts atria

39
Q

BNP is secreted by

A

The hearts ventricles

40
Q

T or F:
High Blood volume stimulates releases of ANP and BNP, which stimulates the process of natriuresis

A

TRUE, increased excretion of sodium and water by nephron

41
Q

Is lower or elevated BNP an indicator in heart failure

A

Elevated

42
Q

Nitric oxide is a _________

A

vasodilator, produced by vascular endothelial cells

43
Q

TNF means

A

tumor numeric factor, elevated levels present with heart failure

44
Q

Endothelium stimulates ______

A

vasoconstriction

45
Q

What other organ is involved with maintaining blood pressure?

A

The kidney

46
Q

When the heart is filled with more blood, the heart is able to eject more blood describes

A

Preload

47
Q

A pt has a fluid overload due to CHF. what compensations will the body attempt to address the fluid volume overload

A

Increased natriuretic peptide

48
Q

Which type of hemodynamic pressure helps evaluate right ventricular failure?

A

Central Venous Pressure

49
Q

Which type of hemodynamic pressure helps evaluate left ventricular failure?

A

Pulmonary Capillary Wedge Pressure

50
Q

LVEF lower than ___% is indicative of heart failure

A

40%

51
Q

A patient with left ventricular failure is completing a cardiac assessment. Which of the following results would be concerning to a clinician?
A. Left ventricular ejection fraction (LVEF) of 35%
B. Resting cardiac output of 5.2 liters per minute
C. Low to normal central venous pressure
D. Blood pressure of 130/82

A

A, LVEF of 35%

52
Q

A patient is given an angiotensin receptor blocker. As the nurse with the discharge instructions, which of the following would you tell the patient is the effect of the medication?
A. The medication increases heart rate
B. The medication decreases pulmonary congestion
C. The medication decreases the constriction and resistance of your blood vessels
D. The medication increases urine output

A

C. medication decreases the constriction and resistance of your blood vessels
- goes along with the RAAS

53
Q

A patient is displaying increased pulmonary capillary wedge pressure due to coronary issues. What else may the nurse expect to see?
A. Increased jugular vein distension
B. Paroxysmal nocturnal dyspnea (PND)
C. Decreased left ventricular size
D. Hepatomegaly

A

B. Paroxysmal nocturnal dyspnea (PND)
- greater pressure in the lungs

54
Q

What is Cardiac Tamponade

A
  • Increased amount of fluid in the pericardial sac that surrounds the heart
  • the heart becomes restricted
55
Q

A patient’s blood pressure is failing due to hemorrhage. Which of the following are appropriate compensations by the body? Select all that apply:
a. Decreased heart rate
b. Increased antidiuretic hormone (ADH)
c. Increased aldosterone
d. Decreased peripheral vasoconstriction
e. Increased fluid retention

A

b, c, e

56
Q

The lungs, kidneys, gut, pancreas and liver begin to suffer decreased perfusion while all available blood is conserved for the heart and brain in which stage of shock?
a. Initial
b. Progressive
c. Irreversible

A

b. heart and brain are still conserved with bloodflow

57
Q

A patient in Hawaii presented to the ED with extremely low BP, bradycardia, mild confusion and inability to feel their legs. The recent history included ocean swimming in high surf, and difficulty exiting the water after being pushed ashore (per witness). Which type of shock is this patient most likely experiencing?
Anaphylactic
Cardiogenic
Neurogenic
Hypovolemic
Septic

A

Neurogenic!
- spinal cord injury

Applied Patho (11 decks)

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