Cardio/valves

Question 1

What does the coronary system require?

Answer 1

Oxygenated blood

Question 2

Left side of heart

Answer 2

• High pressure

- Oxygen rich blood pumped propelled through body

Question 3

Right side of heart

Answer 3

• Low pressure

- Oxygen poor blood through pulmonary system

Question 4

Cycle

Answer 4

One complete heart beat

Question 5

Cardiac output

Answer 5

• amount of blood ejected in 1 minute

- HR X stroke volume

Question 6

Stroke volume

Answer 6

• Amount of blood ejected with each contraction

- Effected by preload, after load, and contractility

Question 7

Preload

Answer 7

-Degree of stretch before contraction

Question 8

Afterload

Answer 8

-Amount of tension the ventricle must develop to open valves

Question 9

Major determinant of afterload

Answer 9

Arterial B/P

Question 10

Contractility

Answer 10

Intensity of cardiac muscle contraction

Question 11

What is the #1 cause of death in the US?

Answer 11

Coronary Artery Disease (CAD)

Question 12

Coronary Artery Disease (CAD) begins with…

Answer 12

atherosclerosis
>Asymptomatic
>stable angina
>unstable angina
>MI

Question 13

Risk factors for CAD

Answer 13

• family and genetics

* If dad/brother had heart attack before 55, or mom/sister before 65.

Question 14

CAD complications

Answer 14

• Angina
• MI
• HF
• Arrhythmias

Question 15

How many valves does the heart have?

Answer 15

2 atrioventricular valves

2 semilunar valves

Question 16

What are the atrioventricular valves?

Answer 16

Mitral (bicuspid)

Tricuspid

Question 17

What are the semilunar valves?

Answer 17

Aortic

Pulmonic

Question 18

What is stenosis?

Answer 18

Constriction/narrowing

Question 19

What is regurgitation?

Answer 19

Backflow of blood due to incomplete closure of valves

Question 20

What is contracture?

Answer 20

Stiffening

Question 21

What is mitral valve stenosis?

Answer 21

decreased blood flow from left atrium to left ventricle

Question 22

What does mitral valve stenosis increase?

Answer 22

Increases left atrial pressure and volume

Increases pressure in pulmonary vasculature

Question 23

What does mitral valve stenosis cause?

Answer 23

Back pressure to lungs

Question 24

S/S mitral valve stenosis

Answer 24

Exertional dyspnea
Loud S1
Murmur
Fatigue
Palpitations
Chest pain, seizures/stroke
Coughing up blood

Question 25

Acute mitral valve regurgitation-S/S

Answer 25

Pulmonary edema - thready peripheral pulses - cool, clammy extremities

Question 26

Chronic mitral valve regurgitation

Answer 26

Left atrial enlargement | Ventricular hypertrophy

Question 27

S/S of chronic mitral valve regurgitation

Answer 27

Asymptomatic for years until some degree of left ventricular failure - weakness - fatigue - palpitations - progressive dyspnea - peripheral edeam - S3 - murmur

Question 28

What is mitral valve prolapse?

Answer 28

Mitral valve prolapse backs into left atrium during systole

Question 29

S/S mitral valve prolapse

Answer 29

Most patients asymptomatic for life. - murmur - dysrhythmias-palpitations, light-headedness, dizziness - infective endocarditis - chest pain

Question 30

Patient teaching for mitral valve prolapse

Answer 30

``` Antibiotic prophylaxis Take meds as prescribed Healthy diet Avoid caffeine Avoid OTC stimulants Exercise When to call Dr. ```

Question 31

What is aortic valve stenosis?

Answer 31

Obstruction of flow from left ventricle to aorta

Question 32

S/S aortic valve stenosis

Answer 32

``` Angina Syncope Exertional dyspnea Normal to soft S1 Diminished or absent S2 Systolic murmur Prominent S4 ```

Question 33

Aortic valve stenosis: is prognosis good or poor if patient is symptomatic and not corrected?

Answer 33

Poor

Question 34

What is aortic valve regurgitation?

Answer 34

Backward blood flow from ascending aorta into left ventricle

Question 35

Acute aortic valve regurgitation

Answer 35

Infective endocarditis Trauma Aortic dissection *Life-threatening emergency

Question 36

S/S of acute aortic valve regurgitation

Answer 36

- Severe dyspnea - Chest pain - Hypotension - Cardiogenic shock

Question 37

S/S of chronic aortic valve regurgitation

Answer 37

May be asymptomatic for years - exertional dyspnea, orthopnea, paroxysmal dyspnea - angina - Water-hammer pulse is severe**** - Soft or absent S1 - S3 or S4 - Murmur

Question 38

What happens with tricuspid valve stenosis?

Answer 38

Right atrial enlargement and increased systemic venous pressure

Question 39

Who is at risk of getting tricuspid valve stenosis?

Answer 39

Patients with rheumatic fever and IV drug abuse

Question 40

Clinical manifestations of tricuspid valve stenosis

Answer 40

- peripheral edema - ascites - hepatomegaly - murmur

Question 41

What does pulmonic valve stenosis cause?

Answer 41

Right ventricular hypertension and hypertrophy

Question 42

Clinical manifestations of pulmonic valve stenosis

Answer 42

Fatigue | Loud murmur

Question 43

Diagnostics of valvular heart disease

Answer 43

- history/exam - CT - Echo - Chest x-ray - EKG - Cardiac cath

Question 44

A 19 year old with rheumatic heart disease is admitted to the hospital with a recurrence of rheumatic fever. In planning care for the patient, which nursing diagnosis should the nurse include? a. Ineffective coping related to refusal to carry out health promotion activities b. Risk for infection related to recent exposure to group A B-hemolytic streprococci c. Impaired adjustment related to unsuccessful lifestyle modifications, goal setting, and problem solving. d. Ineffective self-health management related to lack of knowledge about long-term prophylactic antibiotic therapy

Answer 44

d. Ineffective self-health management related to lack of knowledge about long-term prophylactic antibiotic therapy

Question 45

The nurse is caring for a patient with aortic stenosis. For what should the nurse assess the patient? a. systolic murmur b. pericardial friction rub c. diminished or absent S4 d. low-pitched diastolic murmur

Answer 45

a. systolic murmur