Cardiovascular Disorders/peripheral Vascular Disorder

Front 1

What are modifiable risks factors for heart disease?

Back 1

-Smoking-the nicotine content of cigarettes causes vaoconstriction and teh prduction of carbon monoxide, which place a greater demand on the heart and interfere with o2 supply
-Hyperlipidemia-elevated contrations of any or all lipids in the plasma. Ratio of high-density lipoproteins(HDL) to LDL is the best predictor for the development of cardiovascular disease.Low levels of HDL increase the person's risk for CAD.
-Hypertension-b/p <140/90mm Hg
-Diabetes-blood glucose levels cause damage to the arterial intima and contribute to atherosclerosis
-obesity-excess body weight increases the workload of the heart
-sedentary lifestyle
-stress-releases catecholamines that increase the heart rate
-Oral contraceptives
-Psychosocial factors-Coronary-prone(type A personallity)-agressiveness, competitiveness, perfectionism, compulsiveness, urgent sense of time

Front 2

What are non-modifiable risks factors for heart disease?

Back 2

-family hx:parent or sibling who has a cardiovascular problem before 50yrs of age
-age:approx. 50% of all myocardial infarctions occur in people over the age of 65
-sex:Men @greater risk. Women affected following menopause because of the decrease in estrogen
-culturalðnic consideration:African-American males have a higer incidence of hypertension than do whites

Front 3

What are the four heart malformations in Tetrology of Fallor?

Back 3

-pulmonary stenosis
-VSD
-Right ventricular hypertrophy
-over-riding aorta

Front 4

Coarctation of the aorta has a classic symptom of?

Back 4

causes marked elevated B/P in upper extremities with decreased perfusion in lower extremities

Front 5

Definition of Congential Heart Disease vs. Acquired Heart Disease?

Back 5

Acquired: after birth
Congential: before birth

Front 6

A Heart Block is?

Back 6

An arrhythmia. The electrical current is slowed between the atria and ventricles. In more severe cases, conduction is blocked completely and the atria and ventricles beat independently.

Front 7

What does Normal Sinus Rhythm mean?

Back 7

rate of 60-100 bpm and rhythm regular from SA node

Front 8

Left sided Heart Failure signs and symptoms

Back 8

-Dyspnea
-Paroxysmal nocturnal dyspnea (PND)
-Cough
-Frothy, blood tinged sputum
-Orthopnea
-Pulmonary crackls
-Evidence of pulmonary vascular congestion with pleural effusion, as seen on chest radiograph

Front 9

Right side Heart Failure signs and symptoms

Back 9

-distended jugular veins
-anorexia, nausea, and abdominal distention
-liver enlargement with right upper quadrant pain
-ascites
-edema in feet, ankles, sacrum; may progress up the legs into thighs, external genitalia, and lower trunk

Front 10

What is the most important assessment item when assessing pain?

Back 10

Severity

Front 11

What does the NYHA classification of IV indicate?

Back 11

SEVERE.
-pt unable to perform any physical activity without discomfort
-angina or symptoms of cardiac inefficency may develop at rest. Physical activity increases discomfort

Front 12

What does complete bed rest mean?

Back 12

can't get up for anything. use bedpan

Front 13

What are NSAIDs?

Back 13

Nonsteroidal antiinflammatory drugs-aspirin, ibuprofen (Advil, Nurofen etc), mefanamic acid (Ponstan), naproxen sodium (Aleve, Naprosyn, or in Naprogesic in combination with dextropropoxyphene),

Front 14

Classic sign/symptom of angina pectoris?

Back 14

Pain described as heaviness or tightness of the chest

Front 15

Other than mediations what is the best way to treat lower extremity edema?

Back 15

elevate feet, TED hose

Front 16

What most commonly linked with Buerger's syndrome?

Back 16

TOBBACO USE!

Front 17

What is an anerurysm?

Back 17

An enlarged, dilated portion of an artery. May be the result of arteriosclerosis, trauma, or a congential defect. Starts with a weakened arterial wall that become dilated from blood flow and pressure in the area
-large pulsating mass-identifiable factor

Front 18

How does the Nurse monitor an aneurysm for changes?

Back 18

Monitor for signs of rupture-paleness, weakness, tachycardia, hypotension, abdominal pain, back pain, or groin pain

Front 19

What are the hallmark signs of infective endocarditis?

Back 19

as the organism embeds int othe tissue, a VEGETATIVE growth perforates the chambers or valve leaflets. Fibrin and calciferous growths of the vegetation may ulcerate and scar the valves or may break away, causing emboli, infection or abscess in organs where they may lodge. The loss of portions of vegetative lesions into the cirulation results in embolization.

Front 20

What does the Nurse reinforce in dicharge teaching about medications?

Back 20

Take all meds at the same time every day. Finish all meds.

Front 21

PATCHES stands for?

Back 21

Pulses, Apperance, Capillary refill, hardness, Edema, Sensation

Front 22

Valsalva's maneuver should be avoided after an MI because?

Back 22

may cause severe changes in B/P and heart rate, which may trigger ischemia, dysrhymias, or cardiac rest

Front 23

What is Valsalva's maneuver?

Back 23

pt holds breath and bears down as if straining during bowel movement

Front 24

Hypertension definition

Back 24

B/P higher than 140/90

Front 25

Nursing discussion when planning for discharge of pt with cardiac disease includes?

Back 25

Prevention

Front 26

How to help a pt who is non-compliant with medications?

Back 26

-Social services...cost could be an issue.
**Take the time to Find out why???either you find out or contact social services.

Front 27

How to take NTG?

Back 27

1 tab sublingual every 5 minutes, up to 3, must be sitting or lying down

Front 28

Signs of cardioshock?

Back 28

decreased LOC, skin cool, clamy, B/P decreased, pulse increases, respirations increase, urine output decreased

Front 29

How to avoid thrombophelebitis?

Back 29

avoid proglonged sitting/standing, reduce weight, do dorsiflexion/extension of feet and legs. Do not cross legs and knees. elevate legs when sitting

Front 30

What is a Healthy Lifestyle for a cardiac client?

Back 30

Exercise, reduce stress healthy diet, healthy weight, low sodium, rest

Front 31

The cardiovascular system is composed of?

Back 31

-the heart, blood vessels, and lymphatic structures

Front 32

The functions of the cardiovascular system are?

Back 32

to deliver oxygen and nutrients to the cells and to remove carbon dioxide and waste products from the cells

Front 33

The heart is?

Back 33

a large pump (the sized of a human fist) that propels blood through the circulatory system

Front 34

How many coronary arteries are there and what do they do?

Back 34

2; they supply the heart with nutrition and oxygen

Front 35

The electrical pattern of impulse starts with?

Back 35

the sinoatrial (SA) node, which is the pacemaker of the heart; it initiates the heartbeat. This impulse travels to the atrioventricular (AV) node. From here the impulse travels to a bundle of fibers called the bundle of His and divides into right and left bundle branches and finally to the Purkinje fibers

Front 36

What are the 3 kinds of blood vessels organized for carrying blood to and from the heart?

Back 36

the arteries, veins, and capillaries

Front 37

Risk factors for developing coronary artery disease (CAD)

Back 37

are classified as nonodifiable and modifiable

Front 38

Nonmodifiable risk factors for CAD include?

Back 38

-advanced age
-being of the male gender
-Africian American
-positive family Hx of CAD

Front 39

Modifiable risk factors include?

Back 39

-smoking
-hyperlipidemia
-stress
-obesity
-sendentary lifestyle
-hypertension
-diet in cholesterol and saturated fats contributes to risk factors

Front 40

An important aspect of caring for a pt with a cardiovascular disorder is?

Back 40

understanding the risk factors and incorporating them into pt teaching

Front 41

Major dx tests to evaluate cardiovascular function may include:

Back 41

-chest radiograph
-arteriography
-cardiac catherization
-electrocardiography (ECG)
-echocardiogram
-telemetry
-stress test
-positron emission tomography (PET)
-thallium scanning

Front 42

Common lab exams to evaulate cardiovascular function are?

Back 42

-blood cultures
-CBC
-prothrombin time (PT)
-International Normalized Ratio (INR)
-partial thromboplastin time (PTT)
-ESR
-serum electrolytes, lipids (VLDL), LDL, HDL), triglycerides,
-ABGs
-B-type natriuretic peptide (BNP), and serum cardiac markers
-Troponin I is a myocardial muscle protein released into circulation after myocardial injury and is useful in diagnosing a myocardial infarction

Front 43

Coronary artery disease (CAD) is the term used to describe?

Back 43

a variety of conditions that Obstruct blood flow in the coronary arteries

Front 44

When the myocardial oxygen demand execess the myocardial oxygen supply..

Back 44

ischemia of the heart muscle occurs, resulting in chest pain or angina

Front 45

Pt teaching to minimize the pain of angina pectoris will include?

Back 45

-Nitroglycerin before exertion
-sm frequent feddings rather than 2 large meals
-exercise periods with rest periods
-avoiding exposure to extreme weather conditions
-ceasing to smoke
-seeking a calm environment

Front 46

The subjective data of an MI may include:

Back 46

-heavy pressure or squeezing pressure in the chest
-retrosternal pain radiating to left arm and jaw
-anxiety
-nausea
-dyspea

Front 47

Major objective data for the pt with MI include:

Back 47

-pallor
-hypertension
-cardiac rhythm changes
-vomiting
-fever
-diaphoresis

Front 48

Possible Nx for the pt with MI may include:

Back 48

-pain (acute), tissue perfussion (ineffective), activity intolerance, decreased cardiac output, anxiety, and constipation

Front 49

Cardiac rehabilitation services are designed to?

Back 49

help patients with heart disease recover faster and return to full and productive lives. Cariac rehabilitation improves patient compliance.

Front 50

Heart Failure (HF) leads to?

Back 50

the congested state of the heart, lungs, and systemic circulation as a result of the heart's inability to act as an effective pump. The most recent definition is that heart failure should be viewed as a neurophormonal problem in which heart failure progresses as a result of chronic release in the body of substances such as catecholamines (epinephrine and norpinephrine). These substances are capable of toxic effects on the heart.

Front 51

It is important for the nurse to realize that...

Back 51

1 L of fluid equals 1 kg (2.2lbs); a weight gain of 2.2lbs will signify a gain of 1 L of body fluid

Front 52

Signs and Symptoms of HF with left ventricular failure?

Back 52

-dyspnea
-cough
-frothy, blood-tinged sputum
-pulmonary crackles
-evidence of pulmonary vasular congestion with pleural effusion

Front 53

Signs and Symptoms of HF with right ventricular failure?

Back 53

-edema in the feet, ankes, and sacrum, which may progress into the thight and external genitals
-liver congestion
-ascites
-and distended jugular veins

Front 54

Medical management of HF includes:

Back 54

-increasing cardiac efficiency with digitalis, vasodilators, and ACE inhibitors
-oxygen requirements through bed rest
-providing oxygen to the tissues through oxygen therapy if the pt is hypoxic
-treating edema and pulmonary congestion with a diuretic and a sodium-restricted diet
-weighing daily to monitor fluid retention

Front 55

Nursing interventions for the pt with VALVULAR heart disease include:

Back 55

-administering the prescribed meds (diuretics, digoxin, and antidysrhythmics)
-monitoring I&O and daily weight; auscultating breath sounds and heart sounds
-taking B/P
-assessing capillary perfusion, pedal pulses and presence of edema

Front 56

Pt teaching for the pt with VALVULAR heart disease includes:

Back 56

-dietary management
-activity limitations
-importance of antibiotic prophylaxis before invasive procedure

Front 57

Most patients with cardiomyopathey have?

Back 57

A severe progressively deteriorating course, and the majority older than 55yrs die within 2 years of the onset of signs and symptoms

Front 58

Peripheral vasucular diseases is?

Back 58

any abnormal condition that affects the blood vessels outside the heart and the lymphatic vessels

Front 59

Arteriosclerosis is?

Back 59

the underlying problem associated with peripheral vascular disorders

Front 60

Hypertension-

Back 60

occurs when there is a sustained elevatged systolic b/p greater than 140 mm Hg and/or sustained elevated diastolic b/p of less than 90 mm Hg on two or more such reading

Front 61

The main focus of nursing interventions for the pt with hypertension is?

Back 61

to maintain b/p management throught pt teaching, risk factor recognition, and drug therapy as well as dietary management, exercise, and stress-reduction techniques

Front 62

An aneurysm is?

Back 62

an enlarged, dilated portion of an artery and may be the result of arteriosclerosis, trauma, or a congenital defect

Front 63

The hazards of cigarette smoking and its relations to?

Back 63

thromboangitis obliterans (Buergers disease) are the primary focuses of pt teaching.

Front 64

2 major venous disorders are?

Back 64

-thrombophlebitis
-varicose veins

Front 65

Thombophelbitis results in?

Back 65

calf pain upon dorsiflexion of the foot, which is referred to as a positive Homan's sign

Front 66

Pt teaching to avoid thrombophlebitis includes:

Back 66

-avoid prolonged sitting or standing
-reduce weight if obese
-do dorsiflexion-extension exercises of feet and legs, do not cross legs at the kness, and elevate legs while sitting

Front 67

The blood that is pumped out of the left ventricle contains:

Back 67

a full supply of oxygen

Front 68

The heart contracts in the following patterns?

Back 68

both atria, then both ventricles

Front 69

The interior lining of the hear, the valves, and the large vessels of the heart are together called the:

Back 69

ENDOCARDIUM

Front 70

Valve flaps prevent the backflow of blood from the pumonary artery into the:

Back 70

RIGHT VENTRICLE

Front 71

The normal period in the heart cycle during which the muscles fibers lengthen, the heart dilates and the cavities fill with blood, roughly the period of relaxation, is called:

Back 71

diastole