Cardiology

Question 1

Chambers

Question 2

Vessels

Question 3

Depolarization

Answer 3

Heart is contracting

Question 4

Repolarization

Answer 4

Heart is relaxing

Question 5

Refractory Periods

Question 6

Cardiac Cycle

Question 7

Pathway of Deoxygenated Blood

Question 8

The Only Artery That Carries Deoxygenated Blood

Answer 8

Pulmonary artery

Question 9

The Only Vein That Carries Oxygenated Blood

Answer 9

Pulmonary vein

Question 10

Ejection Fraction

Question 11

Test for Ejection Fraction

Question 12

Ranges of Ejection Fraction

Question 13

Cardiac Output

Answer 13

Stroke volume x heart rate

Question 14

Stroke Volume

Question 15

Preload

Answer 15

Amount of stretch during diastole
A lot of preload = heart is working hard

Question 16

Afterload

Answer 16

Pressure that needs to be overcome to pump

Question 17

Contractility

Answer 17

Ability of heart muscle to shorten in response to electrical impulse
High contractility = lower HR

Question 18

Influencing Factors

Answer 18

HR: Autonomic nervous system, baroreceptors
?Stroke volume:

Question 19

Primary Pacemaker

Answer 19

SA node
Bradycardia occurs if not working

Question 20

Secondary Pacemaker

Question 21

Assessment of CV System

Answer 21

Health history
Common sx: chest pain (women may have pain in the jaw instead, elderly may not have chest pain due to diminished baroreceptors), SOB, peripheral edema,

Question 22

Physical Assessment of CV System

Answer 22

Pallor (pale)
Peripheral cyanosis
Central cyanosis
Increased skin turgor
Zensomethingsomething???
Scars (past surgeries)
Ecchymosis (bruises could indicate blood outside the vessels)
Skin + extremities
Pulse pressure/blood pressure? (difference between systolic and diastolic)
Baseline vitals
Mean Arterial Pressure (MAP)

Question 23

True MAP

Answer 23

Can only be acquired with an invasive procedure

Question 24

Murmurs

Answer 24

Scale of I to VI
Grade I = barely audible
Grade II = audible but quiet and soft
Grade III = moderately loud
Grade IV = loud with a thrill
Grade V = very loud with palpable thrill
Grade VI =

Question 25

Edema

Answer 25

Scale of 0 to 4 0 = None +1 = Minimal (less than 2 mm) +2 = Depression 2 to 4 mm +3 = Depression 5 to 8 mm +4 = Depression greater than 8 mm You could also weigh your patient to measure edema but you must be consistent (same instrument, time, clothes, factors)

Question 26

Heart Sound Sites

Answer 26

APTM Aortic -> pulmonary -> tricuspid -> mitral

Question 27

EKG

Answer 27

Diagnostic tool EKG can be normal during heart attack

Question 28

Cardiac Stress Testing

Answer 28

Can be physical or pharmacological

Question 29

Electro-physiologic Testing (EPS)

Answer 29

Invasive Used to diagnose and manage serious dysrhythmias Used for: syncope, palpitations,

Question 30

Cardiac Catheterization

Answer 30

Invasive Determine how much plaque Diagnose structural and fnctional dx of heart and great vessels

Question 31

Right Heart Cath

Answer 31

Obtains pulmonary artery pressure and oxygen saturation Obtains biopsy of myocardial tissue

Question 32

Left Heart Cath

Answer 32

Involves use of contrast agent Get dye out of system as fast as possible to avoid kidney failure (pt needs fluids ahead of operation, contrast always needs to be removed quickly)

Question 33

Nursing Interventions - Cardiac Cath

Answer 33

Observe cath site for bleeding, hematoma Assess peripheral arteries (looking for perfusion/blood flow) Evaluate temp, color, and cap refill of affected extremity Screen for dysrhythmias Bed rest for 2 to 6 hours (rolling and bed pan will be used) Instruct pt that chest pain, bleeding, or neuropathy must be reported Ensure pt safety May need a stent

Question 34

Hemodynamic Monitoring

Answer 34

Invasive (minimally) Central venous pressure (CVP) = 0 to 8 mm Pulmonary artery pressure (PAP) = 25/9 mm or mean pressure of 15 mm? Intra-arterial B/P monitoring Minimally invasive cardiac output monitoring devices Typically used in ICU Know normal values, complications, how its done, interventions, how to read/monitor values

Question 35

Central Venous Pressure (CVP)

Answer 35

Indirect measure of preload Increase in CVP caused by hypervolemia (administer diuretics) Increase in CVP caused by hypovolemia (give fluids)

Question 36

Pulmonary Artery Pressure (PAP)

Answer 36

Evaluate pt reaction to medication

Question 37

Intra-arterial B/P Monitoring

Answer 37

Used to monitor

Question 38

Genetic & Cardiovascular Disorders

Answer 38

Assess all pts with cardiovascular sxs for CAD Assess for family hx of Sudden Cardiac Death Ask about family history of biochemical or neuromuscular conditions Assess whether

Question 39

Aging & The Cardiac System

Answer 39

Atrium in elderly is increased in size, irregular rhythm,

Question 40

Female Heart

Answer 40

Smaller, weighs less, smaller coronary arteries More easily occluded by arthrosclerosis Procedures like cardiac cath and angiograms are more difficult leading to more complications Resting rate, stroke volume, and ejection fraction are higher than a man's Conduction of electrical impulses from the AV node to Purkinji fibers are briefer

Question 41

Coronary Atherosclerosis

Question 42

Risk Factors for Coronary Artery Disease (CAD)