Unit 3 exam

Question 1

4 determinants of cardiac output

Answer 1

• Heart rate
• Preload
• Afterload
• Contractibility

Question 2

The number of cardiac contractions per minute. Can be affected by many variables depending on pressure.

Answer 2

Heart rate

Question 3

increases HR by releasing norepinephrine

Answer 3

Positive chronotropic effect

Question 4

decreases HR by releasing acetylcholine

Answer 4

Negative chronotropi effect

Question 5

• Directly related to stroke volume.
• The amount of blood in the ventricles at the end of diastole.
• Also refers to the amount of stretch of the muscle tissue at the end of filling.

Answer 5

Preload

Question 6

• Inversely correlated to stroke volume.
• The resistance to flow the ventricle must overcome to open the semilunar vlalves and eject its contents.
• This is related to bp, vessel lumen diameter and or vessel compliance.

Answer 6

Afterload

Question 7

A increased after load causes what?

Answer 7

Decreased stroke volume and decreased cardiac output

Question 8

A decreased afterload causes what?

Answer 8

Increased stroke volume and increased cardiac output

Question 9

• The force of the mechanical contraction.
• Contractile force can be increased with sympathetic stimulation or calcium release.
• It can be decreased in the face of hypoxia or acidosis

Answer 9

Contractability

Question 10

What can cause a decrease in contractability

Answer 10

Hypoxia or acidosis

Question 11

Formula for calculating cardiac output

Answer 11

Heart rate X Stroke volume = Cardiac output

Question 12

Normal cardiac output in a healthy adult

Answer 12

4-7 L/min

Question 13

How does exercise or activity affect cardiac output?

Answer 13

Increases it

Question 14

How does rest/sleep affect cardiac output

Answer 14

Decreases it

Question 15

Labs associated with CV disease

Answer 15

• Lipid panel
• CPK
• Troponin
• Myoglobin
• BNP

Question 16

Age related cardiovascular changes

Answer 16

• Atrophy of left ventricle
• Decreased elasticity of aorta
• Valce rigidity
• Stenosis of heart valances
• Stiffening vessels
• Increase fibrotic changes
• Atheroscopic plaques
• Narrowing vessel walls

Question 17

1 cause of death in older adults

Answer 17

Heart disease

Question 18

Altherosclerotic plaques cause what? Which increases the risk for what?

Answer 18

• Narrowing of vessel walls
• Increased risk for clots and CVA

Question 19

Increased fibrotic changes cause what?

Answer 19

HTN

Question 20

List things that cause alterations in perfusion

Answer 20

• Early menopause
• Clotting disorders
• Congenital cardiac defects
• CAD
• MI
• Dysrhythmias
• Heart failure

Question 21

• This causes alterations in perfusion.
• This condition causes the circulation of blood to be slowed d/t shifting hormones

Answer 21

Early menopause

Question 22

• This condition causes alterations in perfusion
• Perfusion is interuppted when it encounters clots or active bleeding

Answer 22

Clotting disorders

Question 23

• This condition causes alterations in perfusion
• Causes abnormal blood flow through the heart or obstructs blood in the heart or vessels

Answer 23

confenital cardiac deffects

Question 24

• This condition causes alterations in perfusion
• plaque builds up causing restricted blood flow

Answer 24

CAD

Question 25

* This condition causes alterations in perfusion * A clot or severely obstructed blood flow occurs. * Tissue becomes ischemic

Answer 25

MI

Question 26

* This can cause an alteration in perfusion. * Can be associated with myocardial automaticity, conductivity, or contractability which effects cardiac output.

Answer 26

Dysrhythmias

Question 27

* This causes alterations in perfusion * The pumping function of the heart is not working causing a back up of blood in the heart which causes fluid build up in the lungs and legs

Answer 27

Heart failure

Question 28

Diagnostic tests for CV disease

Answer 28

* CHXR * ECHOcardiography (ECHO) * Cardiac stress test * Cardiac catheterization * Ejection Fraction * Coronary angiography * EKG

Question 29

# Name this type of cardiac testing * Assess electrical conduction system * Graphic recording of the hearts electrical activity * ID’s dysrhythmias, old or new heart damage, electrolyte abnormalities, cardiac hypertrophy

Answer 29

EKG

Question 30

# What type of cardiac testing is this? Left sided cardiac catheterization with purpose of inspecting the coronary arteries for blockage and determining the necessity of revascularization procedures such as Coronary bypass surgery or percutaneous coronary intervention.

Answer 30

Coronary angoigraphy

Question 31

* Measurement of how much blood your heart is pumping out with each contraction * Indicator of heart function * Described as a percentage * Healthy level 55-65%

Answer 31

Ejection fraction (EJF)

Question 32

Normal ejection fraction

Answer 32

55-65%

Question 33

# What type of cardiac testing is this? * Invasive X-ray procedure * Evaluates cardiac filling pressure, CO, and valve functions * Studies can be done on both sides of the heart

Answer 33

Cardiac catheterization

Question 34

# What type of heart cath is this? * cath can be done through femoral , brachial or subclavian vein * Catheter advanced to the right heart via the inferior or superior vena cava

Answer 34

Right heart cath

Question 35

# What type of cardiac cath is this? * cath can be done through femoral , brachial , or radial artery * Catheter advanced up through the aorta into the left heart.

Answer 35

Left heart cath

Question 36

# What type of cardiac testing is this? * done to evaluate heart functioning during times of increased workload. * To evaluate the functional ability of the heart. * Can also be used as a screening tool for symptoms of CV disease that are only apperent when heart is stressed.

Answer 36

Cardiac stress test

Question 37

# What type of cardiac stress test is this? on tread mill or bike

Answer 37

Regular stress test

Question 38

# What type of stress test is this? chemical stress test is done if patient is unable to exercise d/t physical limitations

Answer 38

Isotope (nuclear) stress test

Question 39

# What type of cardiac testing is this? Uses ultrasound to provide information on the size and pumping function of the heart, blood-volume status, and valve function and integrity. The ultrasound waves are converted to a picture, which can be evaluated

Answer 39

ECHOcardiography or ECHO

Question 40

# What kind of ECHO is this? Performed by placing a transducer on the patients chest

Answer 40

Transthoracic ECHOcardiography or TTE

Question 41

# What type of ECHO is this? Performed by placing a transducer in the patients esophagus

Answer 41

Transesophogeal ECHOcardiography or TEE

Question 42

# What type of cardiac testing is this? * Provides info about (size , shape and position of heart) * Cannot diagnose heart disease * Highlight complications such as cardiac enlargement or pulmonary congestion

Answer 42

Chest X-ray

Question 43

When body tissues do not receive enough blood and oxygen

Answer 43

ischemia

Question 44

When cells begin to die when they do not receive enough blood and oxygen to maintain cellular functions

Answer 44

Necrosis/infarct

Question 45

Possible revascularization procedures

Answer 45

* Percutaneous coronary intervantion * Coronary Artery Bypass Graft (CABG)

Question 46

How long should a patient remain on flat bedrest post cardiac cath? and why?

Answer 46

2-6 hrs to prevent stress on insertion site that can cause bleeding.

Question 47

Post-cardiac cath, what are you observing the insertion site for?

Answer 47

Bleeding or hematoma formation

Question 48

Post cardiac cath, what should you monitor peripheral pulses for?

Answer 48

Color and temp in affected extremity

Question 49

The contrast dye used in cardiac catheterization affects the kidneys so what needs to be monitored?

Answer 49

Urine output

Question 50

The contrast dye used in cardiac catherization affacts the kidneys, so what needs to be done to prevent kidney damage post cardiac cath?

Answer 50

Maintain sufficient oral and/or IV fluid intake to ensure renal clearance of the dye and to maintain adequate hydration status

Question 51

Pre-procedure teaching for patients undergoing a cardiac cath

Answer 51

* Fasting 6 to 8 hours prior to procedure * Expected duration of procedure * Expect IV insertion and sedation * Tell them to expect “hot flash” as the dye is injected or palpitations if dysrhythmias occur * Maintaining adequate fluid intake after the procedure * Avoiding strenuous activity until your provider gives the OK to resume normal activities * Monitoring cannula insertion site for bleeding

Question 52

Pre procedure care for a patient undergoing a cardiac cath

Answer 52

* Establish baseline vital signs * Review blood work focusing on renal studies * Complete pre-procedure checklist that includes obtaining height and weight and ensuring patient has been NPO * Administer pre-procedure hydration * Check glucose levels while NPO * Anticipate holding diabetic medications

Question 53

Intraprocedure nursing interventions for a cardiac cath patient

Answer 53

o Psychological support of the patient during the procedure to help ease fears o Vigilant cardiac monitoring during the procedure to observe for dysrhythmias o Readiness and ability to respond with advanced cardiac life-support interventions should a lethal dysrhythmia occur

Question 54

If a patient who just had a cardiac cath dispays weakness, confusion, or slurred speech what could this indicate?

Answer 54

a stroke

Question 55

* chest pain triggered by some type of exertion i.e. stress, exercise, etc. * Predictable (each time you work out super hard, you get some chest pain) * Lasts a short time, 5 min or less * Resolves itself

Answer 55

Stable angina | sometimes called predictable angina

Question 56

* Chest pain that may not have a trigger * Medical emergency * Unpredictable * Occurs at rest * Continues despite resting

Answer 56

Unstable angina

Question 57

Unstable angina can preced what?

Answer 57

MI

Question 58

Life's simple 7 strategies

Answer 58

1. No smoking of cigarettes or other tobacco products 2. Maintain a normal body weight 3. Exercise for at least 150 minutes with moderate-intensity activity, or 75 minutes of vigorous-intensity activity, or a combination of each per week 4. Eat a healthy diet that follows the current American Heart Association recommendations. 5. Maintain total cholesterol level less than 200 mg/dL 6. Keep BP less than 120/79 mm Hg 7. Keep fasting blood glucose less than 100 mg/dL

Question 59

Primary risk factor for dysrhythmias

Answer 59

AGE