36 cardio system

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carolyn
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36 cardio system
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2011-11-03 12:46:47
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  1. True or False

    Men are more likely to have lung cancer over
    women
    true
  2. Hemorrhage of the nares or nostrils
    epistaxis
  3. Where is the heart located?
    In the lower anterior area of the mediastinum
  4. ____ carry oxygenated blood away from the left side of the heart to the body tissues.
    arteries
  5. ____ carry deoxygenated blood back to the right side of the heart
    veins
  6. What is the function of the cardiovascular system?
    To provide oxygen, nutrients, and hormones to cells and remove carbon dioxide and waste products from the body cells
  7. The protective sac that encapsulates the heart is called ___
    pericardium
  8. What are the three layers of the pericardium?
    • 1. endocardium
    • 2. myocardium
    • 3. epicardium
  9. The layer that lines the inside of the heart that is made up of epithelium cells
    endocardium
  10. Layer that is made up of striated muscles and varies in thickness depending on the hearts chamber
    myocardium
  11. The thickest chamber of the heart that pumps blood to the body is ___
    left ventricle
  12. Layer that surrounds the outside of the heart
    epicardium
  13. The layer that is also called the epicardium that surrounds the heart and lines the great vessels
    Visceral layer
  14. The emptying of blood with each contraction
    depolarization
  15. The cardiac recovery phase
    repolarization
  16. The upper chambers of the heart are called ___
    atria
  17. The lower chambers of the heart are called
    ventricles
  18. Left ventricle pumps blood into the ____
    Aorta and out to the body
  19. Right ventricle pumps blood into the ____
    Pulmonary arteries and on to the lungs
  20. What are the 4 heart valves
    • 1. tricuspid
    • 2. bicuspid
    • 3. pulmonic
    • 4. aortic
  21. Fibrous cords attached to the cusps of the tricuspid and mitral valves is called __
    Chordae tendineae
  22. ___ keeps the valves from inverting when the ventricles contract thus preventing blood from flowing back into the atrium
    Chordae tendineae
  23. ____ and ____ valves prevent blood from flowing back into the ventricles from the pulmonary artery and aorta during repolarization
    Pulmonic and aortic
  24. The volume of blood ejected from the left ventricle with each contraction or systole is known as ____?
    stroke volume
  25. The amount of blood ejected in 1 minute
    Cardiac output
  26. ____ Supply nutrients and oxygen to the heart
    Coronary arteries
  27. The conduction system that controls the heartbeat consists of
    • 1. sinotria node (SA node)
    • 2. atrioventricular node (AV node)
    • 3. bundle of His
    • 4. bundle branches
    • 5. purkinje fibers
  28. Called the pacemaker of the heart that initiates electrical impulses and is Located in the right atrium
    SA node
  29. Located in the lower right atrium
    AV node
  30. Group of specialized conduction fibers located in the interventricular septum
    Bundle of His
  31. Fibersthat separate into right and left bundle branches and divides into smaller branches
    Purkinje fibers
  32. _____ is completed when an impulse has completely gone through the conduction system of the heart and the ventricles have contracted
    Cardiac cycle
  33. Factors that influence stroke volume
    Preload, afterload, contractility and HR
  34. Amount of pressure within the ventricle
    preload
  35. The force that resists ejection of blood from the ventricles
    afterload
  36. The strength of cardiac contraction
    contractility
  37. Sound of the mitral and tricuspid valves closing simultaneously
    Lubb (s1)
  38. Sound heard on the right intercostal space. Simultaneous closing of the pulmonic and aortic valves.
    Dubb (s2)
  39. Low pitched sound that sounds like a gallop
    S3
  40. Three layers of arteries
    • Tunica intima
    • Tunica media
    • Tunica adventitia
  41. Single layer of smooth endothelial cells
    Tunica intima
  42. Middle layer composed of smooth muscle cells
    Tunica media
  43. Outer layer that consists of connective tissue sheaths and collagen fibers that hold the vessel in place
    Tunica adventitia
  44. Thin vessels that connect the smallest arterioles with the smallest venules
    capillaries
  45. Excess fluid in the abdomen
    ascites
  46. Capillary refill should be less than ____ in fingers and toes
    3 seconds
  47. The leg will be ____if there is an arterial circulatory problem
    cool
  48. The leg will be ____ if there is a venous circulatory problem
    warm
  49. Inflammation of the skin caused by decreased circulation
    Stasis dermatitis
  50. A positive ____ is present in some cases of DVT and if there is pain in the calf or behind the knee it may indicate a venous clot.
    Homan's sign
  51. The firing of the SA node and the electrical impulse spreading across the atria yields a ___ wave in the ECG
    P wave
  52. Purkinje fibers transmit an electrical impulse to the _____ cells resulting in depolarization or contraction of ventricles
    myocardial
  53. Waves that represent repolarization of the ventricles and are repeated after each heart beat
    T wave
  54. The wave that is not always present on an ECG strip
    Q wave
  55. complex that represents the electrical impulse from beginning to end
    QRS complex
  56. The pause after qrs complex that represents the period between contraction and repolarization or recovery
    ST segment
  57. Irregularity in the rate, rhythm or conduction of the electrical system of the heart
    dysrythmia
  58. Irregular beats
    ectopic beats
  59. Most common causes of dysrythmias
    • 1. myocardial infarction
    • 2. coronary artery disease
    • 3. CHF
    • 4. electrolyte imbalance
    • 5. drug toxicity
  60. Administration of atropine is a treatment for ____?
    bradycardia
  61. Device that senses the dysrhythmia and automatically sends an electrical shock directly to the heart to defibrillate it.
    Implanted cardiovascular defibrillator (ICD)
  62. Occurs when the valves do not open and close properly
    Valvular heart disease
  63. When the valve does not close and leaks blood back into the chamber which it came from is called
    regurgitation
  64. True or False

    The aortic valve is not repaired only replaced
    True
  65. Narrowing and hardening of arteries
    arteriosclerosis
  66. Fatty deposits on the inner lining of vessel walls also known as plaque
    atherosclerosis
  67. Chest pain that is a tempoarary inadequate blood and oxygen supply to the myocardial tissues is also called
    Angina pectoris
  68. Ischemic attacks that do not experience angina
    Silent Myocardial infarction
  69. Final stage of heart conditions
    heart failure
  70. HF usually begins on which side
    left
  71. _____ failure is caused by left ventricular myocardial infarction, aortic valve stenosis, prolapsed valve complications and hypertension
    Left sided heart failure
  72. when blood becomes congested in the inferior vena cava, causing edema first in the extremeties and then in the trunk of the body this is a liklyhood of ______.
    right sided heart failure
  73. enlargement of the liver
    hepatomegaly
  74. edema, hepatomegaly, and neck vein distention are all signs and symptoms of ________.
    right sided heart failure
  75. a localized dilation occuring in a weakened section of an artery's medial layer is called a(n):
    aneurysm
  76. an example of congenital congestion would be:
    Marfan's syndrome
  77. known as high blood pressure
    hypertension
  78. a BP of 140/90 indicates
    hypertension
  79. african american race, male gender, aging, post menopausal women, and family history are all_______ risk factors
    unalterable
  80. smoking, lack of exercise, obesity, stress, low socioeconomic status, diet high in fat and sodium, alcohol intake, and oral contraceptives are all examples of ______ risk factors
    modifiable
  81. cause of hypertension is unknown is called:
    primary hypertension
  82. when the cause of hypertension is another condition in the body such as renal artery stenosis, chronic renal disease, sleep apnea etc is also known as:
    secondary hypertension
  83. which step in the stepped care approach involves adding a diuretic or beta blocker to the clients care regimen
    second step
  84. this step in the stepped care approach is to increase the drugs, try another drug, or add a secondary hypertensive
    third step
  85. this step in the stepped care approach invilves encouraging the client to try some lifestyle changes such as diet adn exercise.
    first step
  86. inflammation in the wall of a vein without clot formation
    phlebitis
  87. formation of a clot in a vessel
    thrombosis
  88. clot that remains in the site where it formed
    thrombus
  89. a clot (thromubus) that moves becomes an
    embolus
  90. pooling of blood, vessel trauma, and coagulation problems are all known as:
    virchow's triad
  91. true or false

    is there are clinical signs of a thrombus homan's sign should not be assessed because the clot may be dislodged adn become an embolus
    true
  92. when a clot is surgically removed is called:
    thrombectomy
  93. value at a particular time taht serves as a reference point for future value levels
    baseline level
  94. destruction of red blood cells
    hemolysis
  95. involves injecting a chemicalinto the vein causing the vein to become hardened so blood no longer flows through it
    sclerotherapy
  96. involves introducing a wire into a vein is called:
    vein stripping
  97. visibly prominant, dilated, and twisted veins usually in the lower extremeties
    varicose veins
  98. varicose veins in the esophagus is also known as
    esophageal varices
  99. varicose veins in the anus is also known as:
    hemorrhoids
  100. tieing off an involved section of the vein with a suture is called
    vein ligation
  101. an intermitten spasm of the digital arteries and arterioles resulting in decreased circulation in the fingers and toes is called
    raynaud's disease
  102. dysrhythmia that occurs from electrical conduction disturbances in the atria. Not usually life threatening.

    common causes: MI, CHF, electrolyte imbalance, stress, medication
    atrial dysrhythmia
  103. dysrythmia that is more life threatening and originates from the ventricles
    ventriclar dysrhythmia
  104. dysrhtymia when client has no BP, pulse or respiration
    V-Fib
  105. dysrythmia when client is unconscious, no pulse or resps
    V-asystole
  106. electrical conduction interrupted to some degree between atria and ventricles at AV node
    AV block
  107. inflammation or infection of inside lining of heart
    infective endocarditis
  108. what does the cardio system consist of
    the heart and its vasculature and the peripheral vascular system
  109. in a lifetime how much blood will the heart pump
    80 million gallons
  110. peripheral vascular system consists of:
    • arteries
    • arterioles
    • capillaries
    • venules
    • veins
  111. how much blood volume do veins and venules contain
    60-70%
  112. 3 goals when obtaining health history
    1. identify present and potential health problems

    2. identify possible familial and lifestyle risk factors

    3. involve client in planning long term health care
  113. major risk factors associated with cardiovascular diseases
    • stress
    • age
    • gender
    • heredity
    • smoking
    • dyslipidemia
    • high BP
    • physical inactivity
    • obesity
    • DM
  114. unalterable risk factors
    • age
    • male gender
    • diabetes
    • heredity
    • family Hx of chest pain
    • MI
  115. 3 objectives in assisting client toward healthier lifestyle
    1. educate about risk factors

    2. determine risk factors client wants to modify
  116. typical concers expressed by a client with cardiac disorder
    • chest pain
    • dyspnea
    • edema
    • fainting
    • palpitations
    • disphoresis
    • fatigue
  117. a woman with cardiac disorder is most likely to experience:
    • SOB
    • back or jaw pain
    • indigestion
    • nausea
    • vomiting
  118. why do caridac cleints faint
    bc of decreased CO causing decrease blood flow to brain
  119. how to alleviate fatigue in cardiac clients
    frequent rest periods
  120. distended internal and external neck veins with HOB at 45 degrees can indicate:
    right sided HF
  121. if a heartbeat is heard but not felt through radial pulse this can mean?
    Decreased CO to extremeties
  122. Bradycardia:

    –Heart rate of:

    –Treatment?
    Heart rate of 60 beats per minute or less

    Treatment: Atropine or pacemaker
  123. Tachycardia

    –Heart rate of:

    –Treatment:
    Heart rate of 100 to 150 beats per minute

    Treatment depends on cause
  124. dysrythmia Symptoms vary from:
    • none to cardiacarrest:
    • Fainting, seizures, fatigue,decreased energy level, exertional dyspnea, chest pain, andpalpitations
  125. most important thing a nurse should consider if tachycardic is
    what was pt doing
  126. Occur from electrical conduction
    disturbances in atria resulting in

    Premature atrial contractions
    Atrial tachycardia
    Atrial flutter
    Atrial fibrillation
    Atrial Dysrhythmias
  127. paroxysmal supraventricular tachycardia occurs suddenly, what could the MD perform to help stop this dysrythmia
    vagal stimulation/valsalva maneuver
  128. rapid contraction ofthe atria yielding a HR of 250-350 bpm, sawtooth pattern requiring immediate intervention
    atrial flutter
  129. erratic electrical activity of the atria of 350-600 bpm. atria quivers bc of mitral valve disease, HF, CAD, MI, hyperthyroidism, hypertensive HD.
    a-fib
  130. lifethreatning dysrythmia bc of the blood supply to lungs and body
    ventricular dysrythmia
  131. if PVC occurs without any other cardiac contractions what Tx should be done
    remove cause such as stress or caffeine
  132. dysrhythmia that can lead to pulmonary congestion and can result in low BP, weak body, and unconsciousness. rate may go as high as 140-240 bpm
    ventricular tachycardia
  133. cardioversion is delivered on ___ wave. why?
    R

    bc if given during ventricular depolarization it may cause ventricles to fibrillate
  134. types of ventricular dysrythmia Treatment:
    Oxygen, amiodarone (Cordarone), magnesium sulfate, lidocaine, cardioversion or defibrillation, CPR, andadvanced cardiac life support (ACLS) protocol
  135. delivery of a synchorized electrical shock to change rythm circulate blood and oxygenate tissues
    cardioversion
  136. delivery of an unsynchornized, high energy electrical shock given in emergency situation. everyone stands clear of bed to prevent shock.
    defibrillation
  137. most common cause of ventricular fibrillation is _____
    CAD
  138. disorganized, chaotic, jagged unidentifiable waves with client having no BP, pulse, or respiratrion.
    ventricular fibrillation
  139. during ventricular fibrillation measures are to
    initiate CPR and defibrillate immediately
  140. electrical conduction is interrupted to some degree between atria and ventricles at the AV node
    atrioventricular blcok
  141. AV block degree with impulse that reaches ventricles but is delayed. requires no Tx bc it has no s/s
    first degree
  142. Tx for 2nd and 3rd degree AV block
    pacemaker
  143. nursing mgt for dysrythmia
    • monitor vitals = apical
    • provide rest
  144. Tx for atria dysythmia
    • amiodarone
    • cardizem
    • digoxin
  145. Tx for ventricular dysrythmia
    • amiodarone
    • lidocaine
    • mag
  146. what do crackles indicate
    lung is filling with fluid
  147. A Complication of rheumatic fever with s/s such as polyarthritis, chorea, rash, carditis

    Linked to group A streptococcus following
    upper respiratory infection

    occurs 2-3 weeks after inadequetly treated pharyngitis
    rheumatic fever
  148. main goal for rheumatic fever
    •Treat inflammation, prevent cardiac complications, and prevent recurrence
  149. what should be done for people with rheumatic heart disease before surgery or dental work
    put on prophylactic antibiotic
  150. rheumatic heart disease can be treated with
    • antibiotic
    • antiinflammatory
    • corticoseroids
    • bed rest
  151. Inflammation or infection of inside
    lining of heart Including valves

    Clients may develop murmurs, dyspnea,
    peripheral edema, or pulmonary congestion

    •Acute symptoms: Tachycardia, pallor, diaphoresis,
    and symptoms of infection
    infective endocarditis
  152. infective carditis is caused by
    • bacteria
    • fungi
    • virus
  153. Tx for infective endocarditis
    Surgery and antibiotics (penicillin, vancomcin, garamycin)
  154. •Inflammation of myocardium

    •Symptoms: Flu-like symptoms of fever,
    pharyngitis, myalgias, GI complications, chest pain, and pericardial friction rub

    Treatment: Digoxin, antibiotics, anti-inflammatories, oxygen, and bed rest to prevent congestive heart failure

    can lead to CHF

    usually caused by virus

    prevelant in aids Pt
    myocarditis
  155. activity to prevent myocarditis
    bed rest
  156. •Inflammation of membranous sac surrounding heart

    •Symptoms: Severe chest pain and pericardial
    friction rub

    •Complication: Cardiac tamponade
    pericarditis
  157. •Caused by myocardial ischemia

    •Squeezing pain under sternum radiating to left or right shoulder, jaw, or ear

    •Pain may be mild or immobilizing

    •Treat to increase blood supply to affected area via medication or surgical procedures E.g., percutaneous transluminal coronary angioplasty (PTCA), stent, coronary artery bypass graft (CABG)
    angina pectoris
  158. vasodilator tx for angina
    nitro then morphine
  159. mona for angina
    • morphine
    • oxygen
    • nitro
    • asprin
  160. •Obstruction in coronary artery resulting
    in necrosis to tissues supplied by artery

    •Symptoms: Chest heaviness, lower sternal pain, dyspnea, diaphoresis, nausea, anxiety, vomiting, change in pulse and blood pressure, pallor, and cyanosis

    •Women may have different symptoms

    atherosclerosis common cause

    left ventricle most affected
    MI
  161. MI s/s for men
    chest heaviness tightness griping pain in sternal area

    pain in arm, neck, back, epigastric area
  162. •Treat to reduce oxygen demands, increase oxygen supply, relieve pain, improve tissue perfusion, and prevent complications and further tissue damage

    •Treatment: Medications, surgery, diet, and bed rest
    MI
  163. •Develops when heart no longer capable of
    meeting body’s oxygen needs

    •Causes: Untreated left ventricular failure, right ventricular myocardial infarction, chronic obstructive coronary disease, cor pulmonale, and pulmonic valve stenosis
    right side hf
  164. Treatment of Heart Failure
    • •Treat to improve circulation to coronary
    • arteries and decrease workload of left ventricle

    •Treatment: Medication, diet changes, fluid restriction, oxygen, and surgery E.g., ventricular assist device (VAD), intra-aortic balloon pump
  165. •Heart affected because of lung condition
    that interferes with exchange of carbon dioxide and oxygen in alveoli

    •Symptoms and medical and nursing care
    same as right-sided heart failure
    cor pulmonale
  166. •Done for cardiomyopathy, end-stage coronary artery disease, and valvular disease

    •Recipient must remain on immunosuppressant medication for remainder of life
    Cardiac Transplantation
  167. •Localized dilation occurring in weakened
    section of artery

    •Symptoms depend on location:Hypotension, tachycardia, pallor, cool and clammy skin, and abdominal or back pain

    •Treatment: Medications, surgery, and periodic
    monitoring

    abdominal aorta common
    aneurysm
  168. •Inflammatory disease of small and medium
    arteries and veins leading to vascular obstruction

    •Symptoms: Numbness, burning, pain at rest,
    and decreased sensation in hands and feet
    Buerger’s Disease (Thromboangiitis Obliterans)
  169. •Intermittent spasm of digital arteries and arterioles

    –Results in decreased circulation to fingers and toes

    •Symptoms: Fingers pale, cyanotic, red as
    circulation returns, and with tingling or throbbing pain
    Raynaud’s Disease/Phenomenon

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