Cardiovascular

Question 1

What is preload?

Answer 1

Volume of blood in ventricles at the end of diastole

Question 2

What can increase preload?

Answer 2

hypervolemia
regurgitation of valves
Heart failure

Question 3

What is Afterload?

Answer 3

resistance the left ventricle must overcome to circulate blood

Question 4

What can increase afterload?

Answer 4

hypertension
vasoconstriction

Question 5

An increased afterload can increase…?

Answer 5

cardiac workload

Question 6

What are chemoreceptors?

Answer 6

receptors that are sensitive to changes in partial pressure

Question 7

What are baroreceptors?

Answer 7

receptors that are sensitive to stretch and pressure

Question 8

What 3 things affect stroke volume?

Answer 8

preload
afterload
contractility

Question 9

What is cardiac output?

Answer 9

volume of blood ejected from the heart per minute

Question 10

CO =

Answer 10

heart rate x Stroke volume

Question 11

What is the range of Cardiac output?

Answer 11

4-8 L/min

Question 12

What is ejection fraction?

Answer 12

fraction of blood ejected with each beat

Question 13

What is the normal EF?

Answer 13

60-70%

Question 14

What is cardiac index?

Answer 14

an assessment based on body size

Question 15

Cardiac index parameters?

Answer 15

2.8-4.2 L/min

Question 16

How is Cardiac index calculated?

Answer 16

Cardiac output / body surface area

Question 17

What is contractility?

Answer 17

the force of ventricular contraction

Question 18

What is systemic vascular resistance?

Answer 18

the resistance the blood flow has to overcome in the blood vessels
higher SVR = more constriction

Question 19

How is arterial BP calculated?

Answer 19

Cardiac output x systemic vascular resistance

Question 20

What are some cardiac considerations when it comes to older adults?

Answer 20

more sensitive to meds
monitor effectiveness
reinforce teaching
circulation decreases with aging
increase monitoring post procedures

Question 21

Nursing assessment for patients with an A-line?

Answer 21

neuro vascular
assess q hour: pulse, pallor, cap refill, no bleeding or hematoma

Question 22

What are some A-line complications?

Answer 22

thrombosis
embolism
hemorrhage
infection

Question 23

What is Angina?

Answer 23

chest pain/ squeezing associated with myocardial ischemia
can be a precursor to a heart attack

Question 24

What is stable angina? ECG presentation?

Answer 24

chronic and occurs with exertion
relieved by rest

May see T-wave inversion

Question 25

What is unstable (crescendo) angina? ECG presentation?

Answer 25

more often and more severe not easily relieved by rest May see ST elevation

Question 26

Symptoms of angina

Answer 26

left pectoral, epigastric, or retrosternal pain can radiate pain associated with dyspnea, diaphoresis, or lightheadedness lasts 1-5 minutes

Question 27

What is the dosage for sublingual nitroglycerin?

Answer 27

0.4 mg q 5 minutes for up to 3 doses

Question 28

What is acute coronary syndrome?

Answer 28

an imbalance between myocardial oxygen supply and demand result of decreased coronary artery perfusion

Question 29

Atherosclerosis vs arteriosclerosis

Answer 29

Arteriosclerosis is a general term for thickening of blood vessels atherosclerosis is a specific type of arteriosclerosis involves fatty deposits in the arteries, i.e. clogged arteries

Question 30

causes of ACS?

Answer 30

atherosclerosis emboli blunt trauma spasm

Question 31

what are the atypical symptoms women have with ACS?

Answer 31

N&V dyspnea diaphoresis syncope fatigue palpitations

Question 32

Assessment for someone with ACS?

Answer 32

crushing, tight, squeezing feeling precordial, substernal or back radiate to arms, neck, or jaw clammy, cool, pale, diaphoretic elevated Troponin

Question 33

What should you inspect for on the ECG for an AMI?

Answer 33

ST elevation ST depression new onset of left bundle branch block

Question 34

What are some labs to assess for AMI?

Answer 34

Troponin T and I Myoglobin CKMB Serum lipids

Question 35

What are some complications of AMI?

Answer 35

cardiac dysrhythmias HF thromboembolism

Question 36

What is percutaneous transluminal coronary angioplasty?

Answer 36

procedure to compress plaque to increase blood flow to the myocardium

Question 37

What is the criteria for PTCA?

Answer 37

uncompromised collateral flow noncalcified lesions lesions not on bifurcations of vessels

Question 38

What is RAP/CVP? Normal value?

Answer 38

direct measurement of pressure in right atrium 2-6 mm Hg

Question 39

Assessment for a RAP/CVP?

Answer 39

Zero/balance waveform analysis PEEP Positioning monitor for complications

Question 40

Complications of a RAP/CVP

Answer 40

infection pneumothorax/hemothorax carotid puncture heart perforation dysrhythmias

Question 41

What is variant (Prinzmetal's)? Treatment?

Answer 41

Vasospasms MAY see ST elevation Calcium channel blocker

Question 42

What are modifiable factors for CAD?

Answer 42

Smoking obesity cholesterol diabetes hypertension

Question 43

What is the number 1 intervention for a patient that comes in with chest pain?

Answer 43

12-lead EKG

Question 44

What medication must you have if you have a stent?

Answer 44

Anticoagulation therapy

Question 45

What is the post cath care?

Answer 45

bed rest bed no higher than 30 degrees monitor site antiplatelet drugs after procedure

Question 46

What is the medical management for hyperlipidemia?

Answer 46

low cholesterol, low salt stop smoking exercise aerobic weight loss lipid-lowering agents management HTN and diabetes

Question 47

What is a CABG?

Answer 47

Coronary artery bypass graft ischemia areas of the myocardium are revascularized

Question 48

What are some complications of cardiac surgery?

Answer 48

low cardiac output renal impairment G.I. dysfunction mediastinal bleeding infection hypovolemia atrial dysrhythmias

Question 49

Complications of a CABG?

Answer 49

resp insufficiency shock death AMI emobli stroke pain

Question 50

What is Pericarditis?

Answer 50

inflammation of the pericardium can be from an MI

Question 51

What is the assessment for pericarditis?

Answer 51

friction rub pulses paradoxus ST elevation Precordial pain

Question 52

What is endocarditis?

Answer 52

inflammation of the endocardium typically infective

Question 53

s/s of right sided heart failure

Answer 53

fatigue ascites N/V JVD edema increased CVP

Question 54

s/s of left sided heart failure

Answer 54

paroxysmal nocturnal dyspnea cough crackles wheezes blood-tinged sputum tachypnea restlessness exertional dyspnea cyanosis

Question 55

What are some diagnostics used to diagnose HF?

Answer 55

Echo (for EF) ABG's Serum electrolytes BUN/creatinine CBC BNP ECG

Question 56

Heart failure treatment/goals

Answer 56

improve pump action reduce cardiac workload optimize gas exchange

Question 57

What are some heart failure complications?

Answer 57

pulmonary edema cardiogenic shock

Question 58

What is an aneurysm?

Answer 58

dilation or thinning of the wall

Question 59

Aortic dissection

Answer 59

tear of intimal layer of the vessel sudden sharp shifting pain life threatening

Question 60

what are some abnormal physical findings for endocarditis?

Answer 60

Janeway lesions Osler nodes Splinter hemorrhages Roth spots