Circulation:Overview

Question 1

Each beat of the heart pumps about __mL of blood, or _L/min

Answer 1

60mL, 5L/min

Question 2

pressure of blood in the aorta of a young adult averages about _____

Answer 2

100-120 mm Hg

Question 3

pressure of blood in the RA averages about _ to _ mm Hg.

Answer 3

0 to 5 mmHg

Question 4

to maintain adequate blood flow through the coronary arteries, MAP must be at least ___ mmHg.

Answer 4

60 - 70 mmHg

Question 5

the period of time when the heart refills (relaxing) with blood after systole (contraction)

Answer 5

diastole

Question 6

a term describing the contraction and emptying of the atria and ventricles

Answer 6

systole

Question 7

Myocardial contraction results from the release of large numbers of _______ ions

Answer 7

calcium

Question 8

average CO of an adult

Answer 8

4-7L/min

Question 9

can be determined by dividing the CO by the body surface area

Answer 9

cardiac index (normal range 2.7-3.2 L/min/m²)

Question 10

the HR is extrensically controlled by the _______________, which adjusts rapidly when necessary to regulate cardiac output.

Answer 10

autonomic nervous system (ANS)

Question 11

slows the heart rate

Answer 11

parasympathetic (vagus nerve) system

Question 12

increases the heart rate

Answer 12

sympathetic stimulation

Question 13

the amount of blood ejected by the left vetricle during each contraction

Answer 13

Stroke Volume (SV)

Question 14

refers to the degree of myocardial fiber stretch at the end of diastole and just before contraction

Answer 14

preload

Question 15

the pressure or resistance that the ventricles must overcome to eject blood through the semilunar valves and into the peripheral blood vessels

Answer 15

afterload

Question 16

the peripheral component of afterload, the pressure that the heart must overcome to open the aortic valve

Answer 16

impedance

Question 17

the force of cardiac contraction independent of preload

Answer 17

myocardial contractility

Question 18

factors that increase myocardial contractility:

Answer 18

• sympathetic stimulation
• calcium release
• positive inotropic drugs

Question 19

factors that decrease myocardial contractility:

Answer 19

hypoxia and acidemia

Question 20

the force of blood exerted against the vessel walls

Answer 20

blood pressure

Question 21

Blood Pressure

Answer 21

Cardiac Output x Peripheral vascular resistance

Question 22

the amount of pressure/force generated by the left ventricle to distribute blood into the aorta with each contraction of the heart. it is a measure of how effectively the heart pumps and is an indicator of vascular tone

Answer 22

systolic BP

Question 23

the amount of pressure/force against the arterial walls during the relaxation phase of the heart

Answer 23

diastolic BP

Question 24

supplies blood to portions of the left ventricle, ventricular septum, chordae tendonae, papillary muscle, and sometimes RV

Answer 24

Left anterior descending (LAD) branch

Question 25

supplies blood to left atrium, lateral and posterior surgaces of LV, and sometimes interventricular septum

Answer 25

left circumflex (LCX) branch

Question 26

supplies blood to RA, RV, inferior portion of the LV. SA & AV nodes.

Answer 26

Right coronary artery (RCA)

Question 27

Serum markers of Myocardial damage:

Answer 27

* troponin * creatine kinase - MB * myoglobin

Question 28

an invasive diagnostic procedure that involves fluoroscopy and the use of contrast media. performed when an arterial obstruction, narrowing, or aneurysm is suspected.

Answer 28

angiography (arteriography)

Question 29

Complications of Cardiac Cath:

Answer 29

* MI * Stroke * Arterial bleeding * Thromboemolism * Lethal dysrhythmias * Arterial dissection * Death

Question 30

What can be given pre and post cardiac cath to help eliminate or minimize contrast-induced renal toxicity?

Answer 30

acetylcysteine

Question 31

an alternative to injecting a medium into the coronary arteries, which introduces a flexible catheter with a miniature transducer at the distal tip to view the coronary arteries

Answer 31

intravasacular ultrasonography (IVUS); more reliable than angiography in indicating plaque distribution and composition, arterial dissection, and degree of stenosis of the occluded artery

Question 32

How often do you monitor patients vital signs in Follow up care of a cardiac cath?

Answer 32

VS every 15min for 1hr, then every 30min for 2hr or until VS are stable

Question 33

assesses cardiovascular abnormalities, necrotic or ischemic tissue does not absorb the radioisotope and appears as "cold spots" on the scan. Assess myocardial scarring and perfusion, to detect the location and extent of an acute or chronic MI, graft patency after bypass, evaluate antianginal therapy, thrombolytic therapies, or balloon angioplasty

Answer 33

Thalium imaging of the heart (myocardial nuclear perfusion imaging (MNPI)

Question 34

assess cardopvascular response to an increased workload. Helps determine the functional capacity of the heart and screens for asymptomatic coronary artery disease. Detects dysrhythmias and effectiveness of antidysrhythmia drugs.

Answer 34

Stress test, exercise electrocardiography, exercise tolerance test

Question 35

an invasive system used in critical care areas to provide quantitative information about vascular capacity, blood volume, pump effectiveness, and tissue perfusion. DIRECTLY measures pressures in the heart and great vessels

Answer 35

hemodynamic monitoring

Question 36

how is the patency of a hemodynamic monitor maintained?

Answer 36

slow continuous infusion of NS, usually infused at 3-4mL/hr to prevent backup of blood and occlusion of the catheter

Question 37

What information is provided by monitoring the pulmonary artery wedge pressure (PAWP)?

Answer 37

tip of the catheter can sense pressures transmitted from the left atrium, which reflect left ventricular end diastolic pressure (**LVEDP**)

Question 38

increased PAWP; (trend)

Answer 38

Left ventricular failure, hypervolemia, mitral regurgitation, intracardiac shunt

Question 39

decreased PAWP; (trend)

Answer 39

hypovolemia or afterload reduction

Question 40

normal RA pressure

Answer 40

1-8mmHg

Question 41

normal pulmonay artery pressure (PAP)

Answer 41

15-30/8-15 mmHg

Question 42

normal pulmonary artery wedge pressure (PAWP)

Answer 42

4-12 mmHg

Question 43

Increased RA pressures may occur with:

Answer 43

right ventricular failure

Question 44

low RA pressures usually indicate:

Answer 44

hypovolemia

Question 45

What are two very important nursing interventions to remember when performing hemodynamic monitoring? (location, balloon)

Answer 45

* transducer be level of the phlebostatic axis * if balloon remains in wedge position after reading call Dr IMMEDIATELY

Question 46

Direct measurements of BP are usually __ to __ mmHg greater than indirect (cuff) measurements.

Answer 46

10-15mmHg