Cardiac System (Final)

Front 1

The heart is a hollow, cone shaped organ approximately the size of ______ and weighs less than ____.

Back 1

adult fist; 1 lbs

Front 2

The pericardium has 2 layers: the ________ is the outermost layer and the _________ (also called the ______) adheres to teh heart surface.

Back 2

parietal paricardium; visceral pericardium (epicardium)

Front 3

The right atrium receives ______ blood.

Back 3

deoxygenated

Front 4

The left atrium receives ___________ _____ blood.

Back 4

freshly oxygenated

Front 5

The heartbeat is controlled by specialized cells within the myocardium know as the _____ ______.

Back 5

conduction system

Front 6

The sinoatrial (SA) node acts as the _______ of the heart, usually generating an impulse ________ times per minute.

Back 6

pacemaker; 60 to 100 bpm

Front 7

The AV node beats ______ bpm. The ventricles can beat a maximum of ______ bpm by theirself.

Back 7

AV = 40-60
Ventricles = 20-40

Front 8

DEFINE: the force exerted by blood against the walls of the arteries.

Back 8

Blood pressure

Front 9

The _______ pressure is the force exerted as teh heart contracts

Back 9

systolic

Front 10

The ______ pressure reflects the force exerted when the heart is filling.

Back 10

diastolic

Front 11

When booking a female client of childbearing age for an Electron beam computed tomography (EBCT) you should ask the about ______.

Back 11

the possiblity of pregnancy.

Front 12

With radionuclear scans increased fluid intake is encouraged after the scan to _______.

Back 12

speed elimination of the substance from the body

Front 13

Coronary heart disease (CHD) or Coronary artery disease (CAD) is the ____________ for both men and women in the United States.

Back 13

leading cause of death

Front 14

Metabolic syndrome is a _________ occurring in the same person.

Back 14

group of related risk factors

Front 15

The Pritkin program reqires ___________ daily.

Back 15

45 minutes of walking

Front 16

Clients with CAD should limit their _____ intake.

Back 16

fat

Front 17

Liver function tests and muscle enzymes are monitored during therapy to assess for possible toxic effects. This is known as ________.

Back 17

statin therapy

Front 18

Angina pertoris often occurs in a pattern: _______ brings on the pain & _____ relives the pain.

Back 18

exercise brings on; rest relieves it

Front 19

During periods of myocardial ischemia the ST segment is _______, and the T wave may ___________.

Back 19

depressed; flatten or invert

Front 20

Beta blockers such as metoprolol (Lopressor) ______ _____________ by blocking sympathetic nervous system stimulation

Back 20

decrease cardiac workload

Front 21

You should closely monitor the client after a PTCA procedure for c/o _____ or _________ pain.

Back 21

chest or extremity

Front 22

Which of the following is NOT a manifestation of MI?
1. chest pain
2.SOB, dyspnea
3. diaphoreses (profuse perspiration)
4.relief from resting

Back 22

4. relief from resting

Front 23

What is the classic manifestation of an Acute Myocardial Infarction

Back 23

pain

Front 24

What type of infarction affects all layers of the heart?

Back 24

transmural

Front 25

If the client is experiencing chest pain that is not relieved by rest or NTG (nytroglycerin) and last more than 15 to 20 minutes it more than likely NOT an ________.

Back 25

MI

Front 26

Women and older adults may experience _______ in particular along with n/v & back/jaw pain.

Back 26

SOB

Front 27

Women and older adults may experience _______ in particular along with n/v & back/jaw pain.

Back 27

SOB

Front 28

remember treat the ____ not the ______.

Back 28

Client NOT the machine

Front 29

Many women having an AMI experience epigastric pain and nausea, causing them to believe their pain is due to ______.

Back 29

heartburn

Front 30

Sinus tachycardia (heart rate greater than _____ bpm) and is common.

Back 30

>100bpm

Front 31

What is the most sensitive indicator of AMI?

Back 31

CK-MB isoenzyme

Front 32

Characteristic changes in the ECG with an acute MI include:
inversion of the ____ wave; depression or elevation of the ___ segment; formation of a ____ wave.

Back 32

T wave - inversion
ST seg - depression/elevation
Q wave - formation

Front 33

Pain relief is ______ in treating the client with an Acute MI.

Back 33

vital

Front 34

The drug of choice for pain and sedation with AMI is _____?

Back 34

morphine sulfate

Front 35

Give an example of a beta blocker used with AMI?

Back 35

atenolol (tenormin)

Front 36

____ _____ is a planned program of activity and exercises.

Back 36

Cardiac rehabilitation

Front 37

The normal heart rhythm is _________. Impulses originate in the ________ and the rate is between _______ bpm.

Back 37

normal sinus rhythm; SA node; 60 to 100bpm

Front 38

Impulses may develop more rapidly or more slowly than normal, or may orginate outside the SA node. These are called _______ _____.

Back 38

ectopic beats

Front 39

Sinus bradycardia is a heart beat of less than _____.

Back 39

60 bpm

Front 40

_________ is used to treat rhythms that affect cardiac output and the client's welfare.

Back 40

Cardioversion (or defibrillation)

Front 41

You have a client that just had a permanent pacemaker implanted. As the nurse you should _______ for 24 hours.

Back 41

restrict movement of affected arem and shoulder

Front 42

Discharge teaching should include not only information about the pacemaker & its function, but also for the patient to how to ________.

Back 42

take and record the pulse rate.

Hint 42

This should be done daily.

Front 43

DEFINE: removal of a part or pathway

Back 43

surgical ablation

Front 44

________ is defined as death occuring within 1 hour of the onset of cardiac symptoms.

Back 44

sudden cardias death

Front 45

The risk of sudden cardiac death is highest in the _________ following an acute myocardial infarction (AMI) or other major cardiac events.

Back 45

first 6 to 18 months

Front 46

The risk of sudden cardiac death is highest in the _________ following an acute myocardial infarction (AMI) or other major cardiac events.

Back 46

first 6 to 18 months

Front 47

What sound do you hear in Heart failure?

Back 47

Gallops

Front 48

Name a Class 1B drug that is prmarily used to treat ventricular dysrhythmias, including PVCs and v-tach.

Back 48

Lidocaine

Front 49

Name the Class IV: Calcium Channel Blockers used to manage supraventricular tachycardias.

Back 49

Diltiazem (Cardizem)

Front 50

DEFINE: accumulation of fluid in the interstitial spaces and alveoli of the lungs.

Back 50

acute pulmonary edema

Front 51

Which side (left or right) & what effects (forward or backward) of Heart Failure do the following manifestations show? (Note it can be both)
1. abdomen distention, ascites = R back
2. activity intolerance = both
3. anorexia, nausea =R back
4. cough = L back
5. crackels in lungs = L back
6. dizziness & syncope = L forward
7. dyspnea = L back
8. fatigue = both
9. jugular vein distention = R back
10. liver,spleen enlargement/ tenderness = R back
11. orthopnea = L back
12. tachycardia = L back
13. peripheral edema = R back
14. weakness = L forward

Back 51

1. abdomen distention, ascites = R back
2. activity intolerance = both
3. anorexia, nausea =R back
4. cough = L back
5. crackels in lungs = L back
6. dizziness & syncope = L forward
7. dyspnea = L back
8. fatigue = both
9. jugular vein distention = R back
10. liver,spleen enlargement/ tenderness = R back
11. orthopnea = L back
12. tachycardia = L back
13. peripheral edema = R back
14. weakness = L forward

Front 52

To simplify the previous question L-Sided Heart Failure is _____ breakdown and R-Side Heart Failure?

Back 52

L = Lung/Resp breakdown
R = Systemic breakdown

Front 53

MATCHING:
A. ACE Inhibitors
B. Phosphodiesterase Inhibitors
C. Positive Inotropic Agents
D. Potassium-sparing diuretics

1. Amrinone (Inocor)
2. Digoxin (Lanoxin)
3. Lisinopril (Prinivil)
4. Spironolactone (Aldactone)

Back 53

A1. ACE Inhibitors = Amrinone (Inocor)
B3. Phosphodiesterase Inhibitors = Lisinopril (Prinivil)
C2. Positive Inotropic Agents = Digoxin (Lanoxin)
D4. Potassium-sparing diuretics = Spironolactone (Aldactone)

Front 54

LAB VALUES MATCHING:

A) 0.5-2 ng/mL
B) 3.5-5.0 mEq
C) 8.5-10 mg/dL
D) 135-145 mEq/L
E) 5,000-10,000/mm3

1) Calcium (Ca2+)
2) Digoxin
3) Potassium (K+)
4) Sodium (Na)
5) WBC count

Back 54

A2) Digoxin = 0.5-2 ng/mL
B3) Potassium (K+) = 3.5-5.0 mEq
C1) Calcium (Ca2+) = 8.5-10 mg/dL
D4) Sodium (Na) = 135-145 mEq/L
E5) WBC count = 5,000-10,000/mm3

Front 55

The dried fruit of hawthorn may benefit the client with heart failure by acting like an ___________.

Back 55

ACE inhibitor

Front 56

Digitalis has a positive inotropic effect on the heart, ________ the strength of myocardial contraction.

Back 56

increasing

Front 57

Always take ________ before administering any digitalis drug. Hold med if __________ or if has manifestations of digitailis toxicity. What addition action should you take after holding the drug?

Back 57

apical pulse; >60bpm; notify the charge nurse or MD

Front 58

Rheumatic Fever can damage the heart valves and often leads to _______ & ________ valve disorders.

Back 58

mitral and aortic valves

Front 59

_______ ______ _____ is slowly progressive valve deformity.

Back 59

Rheumatic heart disease (RHD)

Front 60

Murmurs are charicteristic of _______ problems

Back 60

bowel

Front 61

Complications of infective endocarditis include heart failure and infarctions of other organs (lungs, brain, kidneys, or bowel) from _____________ that can break off, traveling through the bloodstream to other organs.

Back 61

embolization of vegetative fragments

Front 62

Instruct clients with previous history of Rheumatic heart disease to notify MD and obtain antibiotic prophylaxis to prevent endocarditis before what procedures?

Back 62

ANY dental procedures including cleaning

Front 63

What drug may be ordered to manager heart failure?

Back 63

digoxin

Front 64

What heart sound may you hear with pericarditis?

Back 64

friction rub

Front 65

Muffled heart sounds, dyspnea tachypnea, tachycardia and a narrowed pulse pressure are all manifestations of _______ _______, which is a medical emergeny.

Back 65

cardiac tamponade (compression of the heart by a rapid buildup of pericardial fluid)

Front 66

Rheumatic heart disease is the most common underlying cause of _________

Back 66

valvular disease

Front 67

DEFINE: back flow of blood through the incompletely closed valve in to the area it just left

Back 67

regurgitation

Front 68

The result of regurgitation is a ________, one of the characteristic manifestation of valvular disease.

Back 68

murmur

Front 69

DEFINE: the narrowing of the mitral valve that obstructs blood flow from the left atrium into the left ventricle during diastole.

Back 69

mitral stenosis

Front 70

Mitral stenosis is usually caused by __________.

Back 70

rheumatic heart disease

Front 71

What is typically the earliest manifestation of mitral stenosis?

Back 71

dyspnea on exertion (DOE)

Front 72

regurgitaion from the left ventricle into the left atrium

Back 72

mitral insufficiency

Front 73

The murmur of mitral regurgitation has a musical quality and is heard best where?

Back 73

the apex of the heart.

Front 74

DEFINE: a form of mital insufficiency that occurs when the posterior cusp of the mitral valve flops back into the left atrium during systole.

Back 74

Mitral Valve Prolapse (MVP)

Front 75

Advise clients on heparin (or any anticoagulant therapy to wear ___________.

Back 75

medic-alert bracelet

Front 76

What type of therapy may be ordered to reduce the risk of clotting with valve disorders or an artificial valve?

Back 76

Anticoagulant therapy

Front 77

When S3 & S4 heard on ausculation this indicates a _________.

Back 77

murmur

Front 78

Hypertrophic cardiomyopathy is characterized by herpertrophy and decreased compliance of the _________ (portion of the heart)

Back 78

Left Ventricle

Front 79

One major teaching for the client being discharged for cardiomyopathy is to restrict ____________.

Back 79

strenuous physical exertion

Front 80

__________ is the "silent killer"

Back 80

Hypertension

Front 81

Instruct older clients to change positions slowly, especially when rising from bed or chair to avoid ________ _________.

Back 81

orthostatic hypotension

Front 82

Alcohol intake is limited to no more than ______ of ethanol per day which equals ___ of beer, ____ of wine, ____ of whiskey.

Back 82

1 ounce alcohol:
24 oz of beer
10 oz of wine
2 oz of whiskey.

Front 83

MATCHING
A. ACE inhibitors
B. Beta-Andrenergic Blockers
C. Calcium Channel Blockers

1. Atenolol (Tenormin)
2. Diltiazem (Cardizem)
3. Lisinopril (Zestril)

Back 83

A3. ACE Inhibitors= Lisinopril (Zestril)
B1. Beta-Andrenergic Blockers= Atenolol (Tenormin)
C2. Calcium Channel Blockers= Diltiazem (Cardizem)

Front 84

This drug reduces heart rate and cardiac output. Assess b/p and apical pulse before giving; notify charge nurse if they are not within established limits.

Back 84

Atenolol (Tenormin)

Front 85

When a client is d/c on the drug Tenormin they should be instructed to do what at home?

Back 85

Take their pulse and b/p daily.

Front 86

The calcium channel blocker cardizem relaxes arterial ______________ causing vasodilations. Client should be instructed to _________.

Back 86

smooth muscles; Take b/p and pulse daily

Front 87

What drug is used with deep vein thrombophlebitis?

Back 87

Heparin sodium

Front 88

When a client asked the nurse what the purpose of Heparin therapy is the nurse should tell him that Heparin interfers with normal clotting by ________________.

Back 88

preventing the formation of new clots and the extension of existing clots.

Front 89

In normal hearts, the _____ _____ allows the heart to adjust its output to meet the metabolic needs of the body.

Back 89

cardiac reserve