Assessment Of Cardiovascular Function

Front 1

What does the right main coronary artery supply?

Back 1

right side of heart + anterior left ventricle

Front 2

What does the posterior descending artery (which branches off the right main coronary artery) supply?

Back 2

posterior right side

Front 3

What does the left anterior descending artery supply?

Back 3

anterior surface of the left side of the heart

Front 4

What does the left circumflex artery supply?

Back 4

the lateral portion of the left side of the heart and a portion of the left posterior

Front 5

3 physiologic characteristics of the cardiac conduction cells are

Back 5

1. Automaticity: the ability to initiate an electrical impulse
2. Excitability: the ability to respond to an electrical impulse
3. Conductivity: the ability to transmit an electrical impulse from one cell to another

Front 6

The 4 main landmarks of the cardiac conduction system are:

Back 6

1. SA node
2. AV node or AV junction
3. Bundle of HIS
4. Purkinje fibers

Front 7

The SA Node (primary pacemaker of the heart)

Back 7

* fires 60 - 100 impulses per minute
* located in the right atrium
* impulse causes contraction of the atria
* conducts impulses along the internodal pathway

Front 8

The AV node

Back 8

* located in the right atrium near the tricuspid valve
* transmits impulse after slight delay (for filling) to the ventricles
* has its own intrinsic beat of 40 - 60 impulses per minute

Front 9

The Bundle of HIS

Back 9

* located in the septum separating the ventricles, bifurcating into a left bundle branch and a right bundle branch
* impulse transmitted to the Purkinje fibers

Front 10

The Purkinje fibers

Back 10

* the point at which the myocardial cells are stimulated into ventricular contraction
* the ventricles also have an intrinsic beat of 30 - 40 impulses per minute

Front 11

What does it mean that cardiac cells are polarized in the resting state?

Back 11

Means that the cell is negatively charged inside and positively charged outside

Front 12

What is depolarization?

Back 12

* when an impulse is initiated, the cell membrane permeability changes and Na enters cell

* the end result is that the cell becomes + charged
* muscle contraction follows as the cells transmit the impulse to one another

Front 13

What is repolarization?

Back 13

* repolarization is the return of the cell to its resting state
* corresponds to the relaxation of the cardiac muscle
* after the rapid influx of Na into the cell during depolarization, the permeability of the cell membrane to Ca is changed
* The increase in intracellular Ca is slower

Front 14

What is the refractory period?

Back 14

prolonged period during which the heart cannot be stimulated (protecting the heart from sustained contraction or tetany, which would result in cardiac death)

Front 15

What is the ABSOLUTE refractory period

Back 15

The heart cannot be stimulated to contract regardless of strength of stimulus
* corresponds to depolarization and early part of repolarization periods

Front 16

What is the RELATIVE refractory period?

Back 16

*The heart can be stimulated to contract during this period if the stimulus is strong enough.
* corresponds to the late part of repolarization

Front 17

What are the 2 major components to the cardiac cycle?

Back 17

1. systole
2. diastole

Front 18

Describe systole

Back 18

When the rising pressure in the L and R ventricles leads to the forceful ejection of blood from the ventricles

Front 19

Describe diastole

Back 19

A filling period when the ventricles relax, the valves open

Front 20

Describe cardiac output
* formula
* ave adult cardiac output

Back 20

* the amount of blood pumped by the ventricle in a given period
* CO = Stroke volume * Heart rate
* average adult cardiac output is 5L per minute

Front 21

Describe stroke volume
* ave stroke volume
* ave heart rate

Back 21

* The amount of blood ejected per heartbeat
* The average resting stroke volume is about 70 mL
* The average heart rate is 60 - 80 bpm

Front 22

What effects the heart rate?

Back 22

1) autonomic nervous system (parasympathetic and sympathetic nervous system responses)
2) increase in circulating catecholamines
3) excess thyroid hormone
4) CNS/baroreceptors which responds to changes in blood pressure
5) certain medications
6) acidotic / alkalotic state

Front 23

What are catecholamines?

Back 23

*hormones released by the adrenal glands in situations of stress or low blood sugar
*catecholamines have the effect of increasing heart rate, blood pressure and blood sugar levels as well as activating a "fight or flight" response
* epinephrine and norepinephrine are examples

Front 24

What is the effect of thyroid hormone

Back 24

Increases cardiac output
Increases heart rate
Increases ventilation rate
Increases effect of catecholamines

Front 25

How do beta-blockers effect heart rate?

Back 25

Beta blockers block the beta adrenergic impulses and lower heart rate and decrease cardiac output
* When the beta adrenergic receptors are stimulated, heart rate increases, the force of contraction increases and conduction is enhanced

Front 26

What is a chronotropic effect?

Back 26

the term chronotropic effect has to do with how a stimulus effects the heart rate (eg beta adrenergics have a + chronotropic effect, digoxin has a - chronotropic effect)

Front 27

What is an inotropic effect?

Back 27

describes how a stimulus effects the force of a muscle contraction

Front 28

What is a dromotropic effect?

Back 28

*Describes how a stimulus effects the velocity of the impulse through the AV node
* This can work both ways, if the velocity is too fast, the muscle cannot respond quickly enough (refractory period)

Front 29

Three major variables that determine stroke volume

Back 29

1. Contractility
2. Preload
3. Afterload

Front 30

What is Contractility?

Back 30

* Contractility is the degree of force with which the the heart is able to contract.
* Increased contractility results in increased stroke volume

Front 31

What effects the heart's contractility?

Back 31

* Contractility is depressed by hypoxemia, acidosis (lactic acid means that the metabolism is anaerobic), and certain meds (beta adrenergic blocking meds such as atenolol
* Contractility is enhanced by circulating catecholamines, sympathetic neuronal activity and certain meds (dopamine, dobutamine, digoxin)

Front 32

What is Preload?

Back 32

the degree of stretch of the cardiac muscle fibers at the end of diastole (think rubber band)

Front 33

What is Starlings Law

Back 33

As the volume of blood returning to the heart increases, muscle fiber stretch increases, resulting in stronger contraction and greater stroke volume

Front 34

What is Afterload?

Back 34

The force (resistance) at which the ventricle pumps against; When the afterload increases, the stroke volume decreases

Front 35

What effects afterload?

Back 35

Hypertension increases afterload; ACE inhibitors or other meds that decrease blood pressure, decrease afterload; peripheral vasodilation decreases afterload

Front 36

What is the ejection fraction?

Back 36

* the percentage of the end diastolic volume that is ejected with each stroke
* ejection fraction = (stroke volume / end diastolic volume) * 100
* Normally, about 42 - 50% or more of the end-diastolic volume is ejected by the normal heart
* can be used as a measure of contractility: the ejection fraction decreases if contractility is depressed

Front 37

Cardiac Assessment (PQRST - R)

Back 37

P What PROVOKED this pain or discomfort
Q What is the QUALITY of the pain
R Where does it radiate to?
S What is the strength (0-10) fo thepain
T TIME How long have you had this pain
R What RELIEVED your pain in the past

Front 38

Changes in the aging heart--adequate cardiac output in normal circumstances but limited ability to respond to stress

Back 38

1. Decreased elasticity and widening of the aorta (decr. contractility)
2. Thickening and rigidity of the cardiac valves (increased ejection time)
3. Increased connective tissue in the AV and SA nodes (delayed conduction)

Front 39

Warning signs of MI / heart disease in women

Back 39

1. upper back pain, fatigue
2. prodromal period of 2 weeks with shortness of breath, sleep changes and fatigue

Front 40

Anatomical differences in women

Back 40

1) smaller heart and vessel size mean more chance for occlusion, more difficulty with cardiac catherization and angioplasty
2) protective effect of estrogen on premenopausal women (estrogen regulates vasomotor tone and response to vascular injury)

Front 41

4 Non-modifiable risk factors for heart disease

Back 41

1. + family history for premature coronary artery disease
2. increasing age
3. gender (men and postmenopausal women)
4. race (higher incidence in african americans than in caucasians)

Front 42

8 modifiable risks of heart disease

Back 42

1. hypertension
2. hyperlipidemia
3. smoking
4. elevated glucose level
5. obesity
6. physical activity level
7. use of oral contraceptives
8. type A personality

Front 43

6 Typical signs/symptoms of people with cardiac disorders

Back 43

1. chest pain or discomfort
2. shortness of breath or dyspnea
3. edema or weight gain
4. palpitations
5. fatigue
6. dizziness, syncope, loss of consciousness

Front 44

4 important points to remember about assessing cardiac symptoms

Back 44

1. women often have atypical symptoms
2. little correlation between the severity of the symptom and the gravity of the cause
3. poor correlation between the location of the pain and the source
4. patient may have more than one clinical condition occurring simultaneously

Front 45

What is the character/location of pain of ANGINA?

Back 45

1) substernal or retrosternal pain
2) may radiate to inside of arm, neck or jaw

Front 46

What is the duration of pain/discomfort with ANGINA?

Back 46

5 - 15 minutes

Front 47

What are the common precipitating events to ANGINA?

Back 47

4 Es:
1. exercise
2. exposure to cold
3. excitement
4. eating

Front 48

What are the relieving measures for ANGINA?

Back 48

1. Rest
2. Nitroglycerin
3. Oxygen

Front 49

What is the character and location of pain/discomfort with Myocardial Infarction?

Back 49

1) substernal pain that spreads throughout the whole chest
2) pain in shoulders/hands may be present
3) nausea, dizziness, diaphoresis, feeling of doom

Front 50

What is the duration of pain/discomfort with MYOCARDIAL INFARCTION

Back 50

GREATER THAN 15 MINUTES

Front 51

What is a common precipitating event for MI?

Back 51

occurs spontaneously, but may follow unstable ANGINA

Front 52

What are relieving measures for MYOCARDIAL INFARCTION?

Back 52

1) morphine sulfate
2) successful reperfusion of blocked coronary artery

Front 53

What is the duration of pain/discomfort for PERICARDITIS (inflammation of the pericardium)

Back 53

Intermittant

Front 54

What is the character/location of pain and discomfort in PERICARDITIS?

Back 54

1) Sharp substernal pain
2) Pain to left sternum
3) Pain may be referred to epigastrum, neck, arms & back

Front 55

What is the typical duration of pain/discomfort for PERICARDITIS?

Back 55

intermittant pain

Front 56

What is the precipitating event/s for PERICARDITIS?

Back 56

1) aggravated by movement
2) pain increases with inspiration, coughing, swallowing or rotation of the trunk

Front 57

What are the relieving measures for PERICARDITIS?

Back 57

1) sitting upright
2) analgesia
3) anti-inflammatory medication

Front 58

What is the character and location for PLEURITIC PAIN (arises from the inferior portion of the pleura)?

Back 58

1) sharp substernal pain
2) pain to left of sternum
3) may be referred to the costal margins or upper abdomen--pt may be able to localize pain

Front 59

What is the typical duration for PLEURITIC PAIN?

Back 59

30+ minutes

Front 60

What are precipitating factors for PLEURITIC PAIN?

Back 60

occurs spontaneously, but pain may increase with inspiration

Front 61

What relieves PLEURITIC PAIN?

Back 61

1)rest, time
2) treatment of underlying cause (broncho dilators)

Front 62

What is the character/location of GI-esophageal pain?

Back 62

1) substernal pain; maybe projected around chest and shoulders
2) reflux--hiatal hernia; ingestion

Front 63

What is the typical duration of GI-esophageal pain?

Back 63

5 - 60 min.

Front 64

What are the precipitating factors for GI esophageal pain?

Back 64

recumbancy, cold liquids, exercise

Front 65

What are relieving measures for GI-Esophageal pain?

Back 65

food, antacid, nitroglycerin relieves spasms

Front 66

What is the character and location of pain for ANXIETY ATTACKS?

Back 66

pain all over the chest; hyperventilating, numbness, tingling

Front 67

What are the precipating factors for ANXIETY ATTACKS>?

Back 67

stress, emotional stress, tachypnea

Front 68

What is the typical duration for an ANXIETY ATTACK?

Back 68

2 - 3 min

Front 69

What are the relieving measures for ANXIETY ATTACKS?

Back 69

removal of stimulus, relaxation

Front 70

Cardiac Physical Assessment always includes:

Back 70

1) evaluation of effectiveness of heart as a pump (reduced pulse pressure, cardiac enlargement, murmurs or gallop rhythms)
2)filling volumes and pressures (est by jugular vein distention, lung congestion, peripheral edema)
3) cardiac output (hr, pulse pressure, color skin, urine output)
4) compensatory mechanisms (ie. increasing hr)

Front 71

Why do cardiac patients have to avoid straining?

Back 71

Val Salva triggers a vagal response causing the heart to slow down which may cause syncope in some patients

Front 72

What are cardiac patients on anticoagulants screened for?

Back 72

bloody stools and urine

Front 73

What is pulse pressure

Back 73

the difference between the systolic and diastolic pressures (normally 30 - 40 mm/hg)

Front 74

What increases pulse pressure?

Back 74

Things that increase systolic pressure or decrease diatolic pressure
1. conditions that elevate the stroke volume (anxiety, exercise, bradycardia)
2. conditions that decrease vascular resistance (fever)
3. conditions that reduce artery distension (atherosclerosis, aging, hypertension)

Front 75

What conditions decrease pulse pressure

Back 75

Things that decrease systole or increase diastole are:
1. reduced stroke volume
2. reduced ejection velocity (shock, HF, hypovolemia, mitral regurgitation)
3. obstruction to blood flow during systole (mitral or atrial stenosis)

Front 76

What (8) skin conditions might one observe on a cardiac physical assessment?

Back 76

1. pallor
2. peripheral cyanosis
3. central cyanosis
4. xanthelasma (the little yellow cholesterol pimples)
5. reduced skin turgor (dehydration)
6. cool extremities (with cardiogenic shock) and diaphoresis
7. ecchymosis (from those receiving anticoagulant therapy)
8. scars and tissue surrounding implanted devices

Front 77

What is an arrhythmia/dysrhythmia??

Back 77

Uncoordinated atrial/ventricular contractions

Front 78

What is fibrillation?

Back 78

rapid and irregular or out of phase contractions in which control of the heart rhthym is taken away from the SA node by rapid activity in other heart rhythms (like a squirming bag of worms)

Front 79

What is heart block

Back 79

damage to the av node interferes with the ventricles ability to receive impulses

Front 80

What are mumurs?

Back 80

Abnormal heart sounds which may indicate valve problems:
1. imcompetant valve: backflow
2. stenotic valve: opening is narrowed

Front 81

What is orthostatic (or postural) hypotension?

Back 81

When BP drops significantly after the patient assumes an upright posture (usually accompanied by syncopy, dizziness, light headedness)

Front 82

What are the 3 most common causes of orthostatic hypotension in cardiac patients

Back 82

1. reduced volume of fluid in the circulatory system (intravascular volume depletion or dehydration)
2. Inadequate vasoconstrictor mechanisms
3. insufficient autonomic effect on vascular constriction

Front 83

How to assess for postural changes

Back 83

1. start lying down for 10 min before first bp and hr
2. wait for 1-3 min after each postural change
3. sitting, then standing

Front 84

What normal postural responses should you see?

Back 84

1. heart rate increase of 5 - 20 bpm (to offset reduced stroke volume)
2. an unchanged or slightly decreased (of up to 10mm)systolic pressure
3. a slightly increased pressure of 5 mm in diastolic pressure

Front 85

6 Lung Assessment findings exhibited by cardiac pts

Back 85

1. tachypnea
2. Cheyne Stokes (fast shallow w apnea)
3. Hemoptysis (pink frothy sputum)
4. dry cough (pulmonary congestion)
5. crackles (heart failure or atelectasis)
6. wheezes (compression sm airways/pulmonary edema)

Front 86

5 reasons to do Laboratory Tests on cardiac patients

Back 86

1. diagnose acute MI
2. Assess degree of inflammation
3. Screen for coronary artery disease risk factors
4. determine baseline values and monitor med response
5. Indentify other abnormalities that may effect treatment

Front 87

5 steps to heart auscultation

Back 87

1. patient in supine position
2. start in the apical area
3. progress up the left sternal border to the pulmonic and aortic areas
4. S1 evaluated for intensity and splitting
5. S2 evaluated for intensity and splitting

Front 88

5 things to document about extra heart sounds

Back 88

1. location
2. timing
3. intensity (1=very faint 6= so loud you don't need stethoscope)
4. Pitch (high, medium, low)
5. Quality of sound (blowing, harsh, musical)

Front 89

Describe extra heart sound: snaps and clicks

Back 89

* Usually heard in diastole in the Left Sternal border
* sounds like a high pitched pressure sound then an opening snap of mitral valve
* most often associated with stenosis of the mitral valve from rheumatic heart disease

Front 90

What differences in heart sounds would you expect to hear in the elderly?

Back 90

1. 90% of elderly have an S4 sound
2. 60% have a slight systolic ejection murmur (S2 splitting) resulting from sclertoic changes in aortic leaflets

Front 91

What are the 3 roles of nurses in interpreting heart sounds?

Back 91

Depends on level of expertise
1. recognizing a sound that is not normal
2. recognizing patterns and reporting to physician
3. differentiate among dysrhythmias and respond accordingly

Front 92

What is pericarditis?

Back 92

An inflammation of the pericardium that hinders the production of serous fluid causing sternum pain and creaking noise

Front 93

What is a complication of pericarditis

Back 93

*Over time, the adhesions formed s/t pericarditis cause inflammation and a great deal of inflammatory fluid in the cavity.
* This fluid compresses the heart "cardiac tamponade" (heart plug) and must be drained

Front 94

How to auscultate a friction rub sound

Back 94

Friction rub (most often from pericarditis) is heard best in the lower left sternal border when the patient is sitting up/leaning forward
* it is a harsh grating sound during both systole and diastole

Front 95

Describe normal postural blood pressure and heart rate changes

Back 95

1. slight decrease in systolic pressure (10 mm)
2. slight increase in diastolic pressure (5 mm)
3. heart rate increase (5-20 bpm)

Front 96

Name the 3 most common causes of orthostatic hypotension in cardiac patients

Back 96

1. reduced volume of fluid in the circulatory system
2. inadequate vasoconstriction
3. insufficient autonomic effects on vascular constriction

Front 97

What part of the heart does heart percussion identify

Back 97

left border of the heart

Front 98

Describe s1

Back 98

1. Closure of the mitral and tricuspid valves
2. The time between s1 and s2= systole
3. best heard at the apex of the heart

Front 99

Describe s2

Back 99

1. Closure of the aortic and pulmonic valves (pulmonic may lag slightly and you may hear a 2nd s2 accentuated at inspiration b/c more blood is ejected at inspiration)
3. Best heard at the base of the heart

Front 100

What are gallop sounds

Back 100

A third sound heard that makes the heart beat almost sound like a gallop (s3 and s4)

Front 101

Describe s3

Back 101

* rapid ventricular filling
* normal finding in young children & elderly
* in adults: indicates heart failure--ventricles fail to eject all of the blood during systole
* best heard with patient lying on left side

Front 102

Describe s4

Back 102

* heard during atrial contraction
* enlarged or hypertrophied heart resistant to filling

Front 103

What might indicate a left ventricular enlargement

Back 103

apical pulse below 5th ics

Front 104

What is a thrill?

Back 104

a purring senstation that indicates abnormal turbulent blood flow

Front 105

What is the hepatojugular reflex--

Back 105

*liver engorgement occurs b/c decr venous return
* pt lies supine, 30-60s note rise of jugular venous distention (inability for the right side of the heart to accom. incr. volume)

Front 106

Why do you assess bladder distention in a cardiac assessment?

Back 106

to rule out a mechanical reason (distended bladder) for low urine output

Front 107

6 observations of extremities in cardiac physical assessment

Back 107

1. decreased cap refill time (hypotension/hf)
2. quality and equality of pulse
3. discomfort, pain, parasthesia
4. decr temp and color of extremities
5. peripheral edema
6. wounds, hair distribution

Front 108

What do BUN and creatinine levels in a cardiac patient indicate

Back 108

1.High BUN, High Creatinine = decreased renal perfusion s/t cardiac output
2. High BUN, Normal Creatinine=fluid volume deficit (diuretic therapy or dehydration)

Front 109

Why do you have to monitor glucose so closely in diabetic cardiac patients?

Back 109

1. incr phys stress incr epinephrine secretion which increases glucose levels
2. monitor glycosylated hemoglobin aka Hemoglobin A1c(normal 4-6%) which reflects blood glucose levels over 2-3 months (important for cvd prevention)

Front 110

What information does cardiac enzyme analysis provide?

Back 110

*enzymes are released when there is cell damage
*certain specific myocardial isoenzymes move into blood at various times in relation to the timing of the MI

Front 111

What information does troponin provide?

Back 111

* Gold statndard for MI diagnosis--isomers I & T are specific to cardiac muscle
* troponin is a protein that regulates the contractile process
* Increases 2-4 hours after MI
* Peaks 12 hours after MI
* Returns to normal 4-10 days after MI

Front 112

What information does myoglobin provide?

Back 112

* heme protein that transports o2 found in cardiac & skeletal muscle
* starts to increase 2-4 hours after MI (can't diagnose MI but can rule out)
* Peaks 12 hours after MI
* Returns to normal 24 hours after MI

Front 113

5 effects of the sympathetic nervous system?

Back 113

*inc rate of SA node pacing
*inc rate of conduction
*inc force of contraction
*inc irritability of foci
* constricts arteries (inc bp and blood flow)

Front 114

What are 5 effects of the parasympathetic nervous system?

Back 114

* decr rate of SA node pacing
* decr rate of conduction
* decr force of contraction
* decr irritability of atrial and junctional foci
* dilates arteries (decr bp and blood flow)

Front 115

How does the sympathetic nervous system work?

Back 115

release of norepinephrine (adrenaline like) that activates adrenergic receptors (B1) which produces cardiac excitatory effects

Front 116

How does the parasympathetic nervous system work?

Back 116

secretes acetylCHOLine which activates CHOLINergic receptors to produce cardiac inhibitory effects (note vagus nerve is the main pathway-vasovagal stimulation = inhibitory)
**note GI tract is stimulated by the parasympathetic innervation

Front 117

How does epinephrine work?

Back 117

Norepinephrine's "brother" epinephrine is secreted into the blood stream by the adrenal glands for a more potent stimulatory effect

Front 118

What are vagal maneuvers

Back 118

an induced parasympathetic response may be used to: 1) therapeutically depress an irritable focus in the atria or AV junction (supraventricular tachycardia converts to sinus rhythm)
2)to slow AV node conduction to make AV node more refractory to depolarization
3) induced gagging & carotid sinus massage

Front 119

What do the small and big boxes on a EKG strip represent?

Back 119

sm box = 0.04 seconds,
big box= 0.2 seconds

Front 120

How do you calculate HR on an EKG?

Back 120

Count how many R waves in 6 seconds and multiply by 10

Front 121

What does a depressed ST segment indicate?

Back 121

ST segment should be flat and horizontal, most importantly, even with the base line== myocardial ischemia

Front 122

What does an elevated ST segment indicate?

Back 122

ST segment should be flat and horizontal, most importantly, even with the base line== evidence of an evolving MI

Front 123

What tests measure the intrinsic pathway for coagulation?

Back 123

*Partial thromboplastin time (PTT) and activated ptt (aPTT)measure the effects of HEPARIN (intrinsic pathway)

Front 124

What PTT values should be observed in heparin therapy

Back 124

Patients receiving heparin should have their values @ 1.5 - 2.5 times their baseline values (ref range 25-38s)

Front 125

What tests measure the extrinsic pathway for coagulation?

Back 125

Prothrombin Time (PT) and the International Normalized Ratio (INR) measure the extrinsic pathway and are used to measure the effects of coumadin

Front 126

What INR would you expect in patients wih heart valve replacement

Back 126

2.5-3.5

Front 127

What is the difference between creatine kinase (CK) and CK MB?

Back 127

Creatinine Kinase is released in all muscle damage, CKMB is exclusively found in muscle tissue

Front 128

Name 2 major sources of cholesterol

Back 128

1. diet
2. liver (where cholesterol is synthesized)

Front 129

What is Fluoroscopy and what is it used for?

Back 129

1. "Xray" of hear with cardiac and vascular pulsations
2. Used for positioning intravenous pacing electrodes and for guiding cardiac catheterization

Front 130

What is Chest xray used for

Back 130

Used to: 1) determine the size, position, location and contour of heart, 2) reveals calcifications and 3) confvirms placement of catheters, pacemakers, & catheters

Front 131

What are the normal levels of cholesterol, triglycertides, LDL and HDL?

Back 131

Total Cholesterol: < 200
Triglycerides: 40 -150 mg/Dl
HDL: 35 - 85 women (35-65 men)--the goal would be 60 or more
LDL: less than 130 (the goal would be 100 or less)

Front 132

What are low density lipoproteins?

Back 132

primary transporters of cholesterol and triglycerides to the cells

Front 133

What are high density lipoproteins

Back 133

primary transporters of cholesterol and triglycerides away from the cells

Front 134

What is the purpose of measuring cholesterol, triglycerides and lipoproteins?

Back 134

To evaluate a person's risk for developing atheroslerotic disease

Front 135

What is the significance of calcium in the blood labs for cardiac evaluation?

Back 135

* hypo/hyper calcemia cause dysrhythmias
* calcium is necessary for clotting and neuromusc activity

Front 136

What is the significance of potassium in the blood labs for cardiac evaluation?

Back 136

* hypokalemia causes cardiac irritability and predisposes pt. to digitalis toxicity
* hyperkalemia = myocardial deptression and ventricular irritability
* many diuretics cause K depletion

Front 137

8 Factors that contribute to cholesterol levels

Back 137

1.age
2.gender
3.diet
4.exercise
5. genetics
6.menopause
7.tobacco use
8.stress

Front 138

What is the significance of magnesium in the blood labs for cardiac evaluation?

Back 138

hypo mag lengthens QRS and predisposes patient to life threatening dysrhythmias

Front 139

What is sinus arrhythmia?

Back 139

when the pulse (heart) rate increases during inhalation and slows during exhalation