Cardiac/Circulatory Assessment

Question 1

Apex of Heart

Answer 1

“Point of maximal impulse”

-pulsation caused by contraction can be felt

Question 2

Where is the apex of the heart located?

Answer 2

Midclavicular line of chest wall at 5th intercostal space

Question 3

What is the primary pacemaker of the heart?

Answer 3

Sinoatrial node

Question 4

Depolarization

Answer 4

“Atrial Kick”

Contraction of the stimulated myocardium

Question 5

Diastole

Answer 5

the period in which the atria and ventricles are in a relaxed state; allowing ventricles to fill w/ blood

Question 6

Systole

Answer 6

period of myocardial contraction

Question 7

Is pressure in the ventricles increased or decreased during Diastole?

Answer 7

Decreased

Question 8

Decreased pressure in the ventricles during Diastole causes what?

Answer 8

the AV Valves (tricuspid in right/mitral in left) to open and let blood flow into ventricles

Question 9

Is pressure increased or decreased during Ventricular Systole?

Answer 9

Increased

Question 10

Increased pressure in the ventricles during Ventricular Systole causes what?

Answer 10

Closes AV valves and forces pulmonic valve on right and aortic valve on left to open

Question 11

What is Cardiac Output?

Answer 11

refers to the amount of blood pumped by each ventricle in liters per minute

Question 12

What is the average Cardiac Output for an adult?

Answer 12

4-6 L/min

Question 13

What is the stroke volume?

Answer 13

amount of blood ejected w/ each heartbeat

Question 14

What is the average stroke volume?

Answer 14

70 mL

Question 15

What may cause a decrease in stroke volume?

Answer 15

• dehydration
• diuretics
• nitrates

Question 16

How would you increase a patients stroke volume?

Answer 16

Giving fluids-Normal Saline

Question 17

If the patients heart rate is decreased what does that mean for the cardiac output?

Answer 17

It is decreased

Question 18

What is the preload?

Answer 18

• Amount of volume coming to the heart

- pressure generated in the ventricles at the end of diastole

Question 19

If the preload increases what happens to the stroke volume?

Answer 19

Increases

Question 20

How do you want to treat preload in a patient w/ HF?

Answer 20

Decrease w/ fluid restriction, diuretics, nitrates

Question 21

How to tell if a patient has a Pericardial Friction Rub

Answer 21

• ask them to hold their breath and if the noise is still heard it is positive
• count the rate; should be 70 or more/min

Question 22

Pericardial Friction Rub

Answer 22

Fluid in the pericardial space

Question 23

How to tell if patient has a Pleural Friction Rub

Answer 23

• should not be able to hear noise when they hold their breath
• rate 14-18 per/min

Question 24

Common CVD S/S

Answer 24

• chest pain/discomfort
• dizziness/syncope/change in LOC
• palpations/tachycardia
• peripheral edema
• SOB/dyspnea
• fatigue

Question 25

Where is the Aortic Area/Valve found?

Answer 25

second intercostal space to the right of the sternum

Question 26

Where is the Pulmonic Area/Valve found?

Answer 26

second intercostal space left sternal border

Question 27

Where is the Tricuspid Area/Valve found?

Answer 27

fourth ad fifth intercostal space LSB

Question 28

Where is the Mitral Area/Valve Found?

Answer 28

Left fifth intercostal space at midclavicular line

Question 29

The first heart sound is created from what?

Answer 29

The closing of the Tricuspid and mitral valve

Question 30

When is the second heart sound created?

Answer 30

Closing of the pulmonic and aortic valves

Question 31

What types of drugs are used to treat CVD?

Answer 31

- positive inotrope - negative inotrope - positive chronotrope - negative chronotrope

Question 32

Positive Inotrope

Answer 32

increases myocardial contractility

Question 33

Negative Inotrope

Answer 33

decreases myocardial contractility

Question 34

Positive Chronotrope

Answer 34

increases heart rate

Question 35

Negative Chronotrope

Answer 35

decreases heart rate

Question 36

How does the blood flow during Diastole?

Answer 36

Flows from left & right atrium to ventricle through mitral and tricuspid valve -SA node stimulates atrium; causes P wave

Question 37

What happens during P Wave?

Answer 37

atrium is depolarized and contracts forcing rest of blood into ventricles

Question 38

When does diastole end?

Answer 38

all the blood is in the ventricles and pressure increases in ventricles causing Mitral and Tricuspid Valve to close -systole begins

Question 39

How does Systole and blood flow work?

Answer 39

"QRS" wave - aortic and pulmonic valves open; blood flows out and pressure in ventricles decrease - valves close and diastole begins again

Question 40

How can preload be increased?

Answer 40

controlling the loss of blood or body fluids and replacing fluids