Chapter 36 Assessment Of Cardiovascular

Front 1

Describe the Aortic Valve?

Back 1

Valve from the leftf ventricle to the aorta

Front 2

Describe the Atria?

Back 2

Upper heart chamber

Front 3

Describe the Chordae tendineae?

Back 3

Filaments that secure the AV valve leaflets

Front 4

Describe the Coronary arteries?

Back 4

Vessels that supply the heart with oxygenated blood

Front 5

Describe the Mitral valve?

Back 5

Valve between left atrium and ventricle, bicuspid valve

Front 6

Describe the Pulmonic valve?

Back 6

Valve between right ventricle and pulmonary artery

Front 7

Describe the Septum?

Back 7

Muscular wall dividing the heart into halves

Front 8

Describe the Tricuspid valve?

Back 8

Valve between right atrium and ventricle

Front 9

Describe the Ventricle?

Back 9

Lower heart chamber

Front 10

What are the three pacemaker sites in the heart?

Back 10

SA node
AV node
Purkinje fibers

Front 11

What are the pacer rate for each site? (3 pacemaker sites)

Back 11

SA node 60 to 100 beats/min
AV node 40 to 60 beats/min
Purkinje 20 to 40 beats/min

Front 12

Increasing the intracellular concentration of which ion causes a chemical interaction within the actin and myosin filaments in the myocardial muscle fibers?

Back 12

Calcium

Front 13

Which of the following statements about the cardiac cycle is correct?

Back 13

S1 results from tricuspid and mitral valve closure

Front 14

Identify the two main properties that determine the function of the cardiovascular system?

Back 14

Electrical
Mechanical

Front 15

Describe the Heart rate?

Back 15

Number of times ventricles contract per minute

Front 16

Describe Preload?

Back 16

Degree of myocardial fiber stretch at end of diastole and just before heart contracts

Front 17

Describe Afterload?

Back 17

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

Front 18

Describe Impedance?

Back 18

Pressure that ventricle must overcome to open aortic valve

Front 19

Describe Contractility?

Back 19

Force of contraction independent of preload

Front 20

How is blood flow from the heart into the systemic arterial circulation measured clinically?

Back 20

By Cardiac output

Front 21

Define cardiac output (CO)?

Back 21

Is the amount of blood pumped in liters, from the left ventricle each minute

Front 22

CO is the product of what two variables?

Back 22

CO = heart rate (HR) . stroke volume (SV)

Front 23

Define SV and give the variables that impact it and CO?

Back 23

Is the amount of blood ejected by the left ventricle during each systole. Variables include preload, afterload, heart rate, and contractility

Front 24

Define preload?

Back 24

Refers to the degree of myocardial fiber stretch at the end of diastole and just before contraction of the heart.

Front 25

What is preload determined by?

Back 25

Left ventricular end-diastole (LVED) volume

Front 26

What is Starling's law of the heart?

Back 26

The more the heart is filled during diastole (within limits), the more forcefully it contracts

Front 27

What happens with excessive filling of the ventricles?

Back 27

Excessive filing of the ventricles results in excessive LVED volume and pressure and a decreased CO

Front 28

Briefly discuss afterload?

Back 28

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

Front 29

What factors affect it?

Back 29

The amount of resistance directly relates to arterial blood pressure. Aortic compliance and total systemic vascular resistance affect afterload

Front 30

The ability of all cardiac cells to initiate an impulse spontaneously and repetitively is?

Back 30

Automaticity

Front 31

Cardiac cells are unable to respond to a stimulus until they have recovered, or repolarized, because of this property?

Back 31

Refractoriness

Front 32

The trasmitting of electrical impulses from cardiac cell to cardiac cell is

Back 32

Conductivity

Front 33

The ability of a cell to respond to a stimulus by initiating an impulse (depolarization) is

Back 33

Excitability

Front 34

Describe the relationship of the left ventricle to maintaining the B/P and adequate CO?

Back 34

Does the most work of the heart because it pumps oxygenated blood into the systemic arterial circulation. Proper functioning ensures adequate CO, and ultimately adequate systolic and diastolic B/P.
B/P= CO X Peripheral vascular resistance

Front 35

Briefly explain the three systems/mechanisms and external factors that regulate B/P?

Back 35

The nervous, renal, and endocrine systems. External factors that affect systolic pressure include CO and arterial distention; diastolic pressure is affected by peripheral vascular resistance. SEE TEXT

Front 36

Name the three types of sensory receptors in the body that affect the autonomic nervous system in regulating B/P?

Back 36

Baroreceptors
Chemoreceptors
Stretch receptors

Front 37

________ blood pressure is the lowest pressure during the relaxation phase of the cardiac cycle

Back 37

Diastolic

Front 38

________blood pressure is the highest pressure during contraction of the ventricles

Back 38

Systolic

Front 39

Diastolic B/P is primarily determined by the amount of __________.

Back 39

Peripheral vasoconstriction

Front 40

_____________ is the difference between the systolic and diastolic pressures.

Back 40

Pulse pressure

Front 41

______ moves from the vascular system into the interstitial spaces when the capillary endothelium is impaired.

Back 41

Fluid

Front 42

The chamber of the heart that can generate the greatest amount of B/P is?

Back 42

The Left ventricle

Front 43

In the older adult, a common assessment finding is which of the following?

Back 43

S4 heart sound

Front 44

The description of S1 and S2 refers to?

Back 44

First and second heart sounds

Front 45

An S3 or S4 that is heard on auscultation of the heart refers to?

Back 45

Gallop

Front 46

Which finding in an assesment is abnormal?

Back 46

Jugular vein distention to level of the mandible

Front 47

An abnormal heart sound in a 54 year old is?

Back 47

S3

Front 48

Why does clubbing of the fingers and toes occur?

Back 48

Due from chronic oxygen deprivation in the tissue beds.

Front 49

Clubbing is a characteristic in clients with advanced? (3)

Back 49

Chronic pulmonary disease
Congenital heart defects
Cor pulmonale

Front 50

How is clubbing identified?

Back 50

By assessing th angle of the nail bed. A normal nail bed is 160 degrees, with clubbing it increases to greater than 180 degrees, and nail becomes spongy

Front 51

4 true statements about symptoms of heart disease in women.

Back 51

-Symptoms are subtle or atypical.
-Woman may not respond to rest or medication.
-Antacids, rather than nitroglycerin, may relieve pain.
-Other symptoms, such as back pain, indigestion, nausea, vomiting, and anorexia are common.

Front 52

What are the 3 sources of chest pain that have a sudden onset?

Back 52

Angina
Myocardial infarction
Pericarditis

Front 53

What assessment finding is Moderate ache, worse on inspiration?

Back 53

Pleuroplumonary

Front 54

What assessment finding is Substernal, may spread to shoulders or abdomen?

Back 54

Esophageal-gastric

Front 55

What assessment finding is
Intermittent, relieved with sitting upright?

Back 55

Pericarditis

Front 56

Angina is described as? (2)

Back 56

-Substernal, may spread across the chest,back,arms.
-Usually lasts less than 15 minutes

Front 57

Pleuroplumonary is also described as?

Back 57

Continuous until underlying condition is treated

Front 58

MI is described as? (2)

Back 58

-Intense stabbing, vice-like pain.
-Sudden onset, often in early morning

Front 59

Anxiety is described as? (2)

Back 59

-Dull ache to sharp stabbing, may have numbness of fingers.
-Usually on left side of chest without radiation.

Front 60

Pericarditis is also described as?

Back 60

Sharp stabbing, moderate to severe pain

Front 61

Esophageal-gastric is also described as?

Back 61

Squeezing,heartburn,variable in severity

Front 62

What test is done to determine if a pt is having an MI?

Back 62

CK-MB

Front 63

What lab tests are used to predict a client's risk for coronary artery disease? (3)

Back 63

Cholesterol level
Triglyceride level
Low-density lipoprotein level

Front 64

What test is done to determine the location and extent of coronary artery disease?

Back 64

Cardiac catheterization

Front 65

One of the most modifiable,controllable risk factors for cardiovascular disease is?

Back 65

Obesity

Front 66

A finding of pallor is indicative of?

Back 66

Anemia

Front 67

An ankle-brachial index of 0.7 is an indication of?

Back 67

Moderate arterial disease of the lower extremities

Front 68

______ can occur with both cardiac disease and pulmonary disease

Back 68

Dyspnea

Front 69

When does paroxysmal nocturnal dyspnea occurs?

Back 69

When the client has been lying down for several hours

Front 70

What might be the only sign of early heart failure in women?

Back 70

Dyspnea on exertion

Front 71

A pericardium assessment begins with?

Back 71

Inspection

Front 72

Heaves and lifts are associated with ________ and with valve disease

Back 72

Palpation

Front 73

When palpating, turn the client to the _____ side to bring the heart closer to the surface of the chest

Back 73

Left

Front 74

Which of the following procedures requires informed consent?

Back 74

Stress Test
Cardiac catheterization
Electrophysiologic study

Front 75

What should you report immediately on a client who has had a cardiac catheterization?

Back 75

Catheterized extremity dusky with decreased peripheral pulses

Front 76

What is the normal lab value for Cholesterol?

Back 76

122 to 200 mg/dL
Older adults is 144 to 280 mg/dL

Front 77

What is the normal lab value for Triglycerides?

Back 77

Females 35 to 135;
Males 40 to 160;
and older adults is 55 to 260 mg/dL

Front 78

What is the normal lab value for Plasmal high-density lipoproteins (HDLs)?

Back 78

Females 55 to 60;
Males 45 to 50; range increases with age

Front 79

What is the normal lab value for Plasma low-density lipoproteins (LDLs)?

Back 79

60 to 180 mg/dL;
Older than 6 years of age is 92 to 221 mg/dL

Front 80

What is the normal lab value for HDL;LDL ratio?

Back 80

3:1

Front 81

What lipid test is considered to protect against CAD when the values are elevated?

Back 81

HDL's

Front 82

Define Right atrial pressure?

Back 82

Pressure within the right atrium, ranges from 1 to 8 mm Hg

Front 83

Define Pulmonary artery pressure (PAP)?

Back 83

Pressure within the pulmonary artery, ranges from 15 to 26 mm Hg systolic/5 to 15 mm Hg diastolic (a mean of 15)

Front 84

Define Pulmonary artery occlusion pressure (PAOP)?

Back 84

Pulmonary artery occlusion pressure (PAOP)

Front 85

A right atrial pressure (RAP) reading less than 3 cm H2O indicates?

Back 85

Hypovolemia