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81 Cards in this Set

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What are the 3 layers of the heart from inner to outer?
- endocardium
- myocardium
- pericardium
What is the purpose of the pericardial fluid normally found in the pericardial space?
prevents friction between surfaces as the heart contracts
The heart is divided vertically by what?
the septum
Which is thicker, atrial or ventricular myocardium? why?
ventricular b/c of the force needed to move blood forward
Which is thicker, the right or left ventricle? why?
left b/c it must move blood into systemic circulation which requires more muscular effort
The right atrium receives blood from what 3 structures?
- inferior and superior venae cavae
- coronary sinus
Blood passes through what structure when leaving the right atrium to enter the right ventricle?
tricuspid valve
The right ventricle pumps blood where?
through the pulmonary artery to the lungs
Blood flows from the lungs to the left ventricle through what structures?
pulmonary veins
Blood passes through what structure when exiting the left atrium to enter the left ventricle?
bicuspid (mitral) valve
What is the function of the 4 valves (mitral, tricuspid, pulmonic, aortic) in the heart?
to prevent blood from backflowing (to keep blood moving forward)
What arteries supply blood to the myocardium?
the coronary arteries
In most people, the AV node and bundle of HIS receive blood from where?
the right coronary artery
An action potential generated and transported by the SA node of the heat stimulates what?
depolarization of muscle fibers in the heart
What occurs once the muscle fibers in the heart are depolarized?
contraction
Depolarization triggers what?
mechanical activity, also known as systole
Relaxation of the myocardium is known as what?
diastole
What is the functional purpose of diastole?
it allows the ventricles to fill with blood
What is cardiac output?
the amount of blood pumped by each ventricle in one minute
How is cardiac output calculated?
by multiplying stroke volume by heart rate
What is normal cardiac output?
4-8 L per minute
Heart rate is regulated primarily by what system?
autonomic nervous system
(def)

the volume of blood in the ventricles at the end of diastole
preload
(def)

the peripheral resistance against which the left ventricle must pump
afterload
Contractility can be increased by what 2 sympathetic nervous system hormones?
- epinephrine
- norepinephrine
What does Starling's Law state?
the more the myocardial fibers are stretched, the greater the force of contraction
(def)

the percentage of total ventricular filling volume that is ejected during each ventricular contraction
ejection fraction
What is the hallmark of systolic function?
ejection fraction
What is a normal ejection fraction?
greater than 55%
How does hyperkalemia affect the heart? (3)
- decreases heart rate
- decreases the force of cardiac contraction
- may dilate the heart
Extreme large increases in K+ can have what affect on the heart?
- may block the conduction through the atrioventricular bundle
How does hypokalemia effect the heart?
- decrease in heart rate
- increases the force of cardiac contraction
What is calcium primarily involved in regarding the heart?
- contractile process of the myocardium
Hypercalcemia has what effect on the heart?
overcontraction
Hypocalcemia has what effect on the heart?
cardiac flaccidity
IV ________ is generally given to protect the heart from hyperkalemic effects.
calcium
True/False:

Sodium imbalances are usually manifested in some of the other systems before cardiac problems arise
true
What happens to the heart if sodium levels are increased?
depressed cardiac function
Why are sodium levels a concern in CHF?
b/c of the edema that can exacerbate CHF
High magnesium can have what effects on the cardiovascular system?
- affects heart rate, cardiac conduction, and blood pressure

- This includes hypotension, vasodilation, bradycardia, heart block, and cardiac arrest
Low magnesium levels may have what effect on the heart?
cardiac arrhythmias
Attempting to replace potassium is difficult if a deficiency in what other 2 electrolytes is present?
Magnesium and/or calcium
While CVD can refer to any disease that affects the cardiovascular system, it is usually used to refer to which ones?
those related to atherosclerosis
Atherosclerosis is characterized by what?
deposit of cholesterol and lipids, primarily w/i the intimal wall of the artery
What occurs within the artery that is central to the development of atherosclerosis?
inflammation and endothelial injury
Atheromas, or fatty deposits, have a preference for which arteries?
Coronary Arteries
What is the leading cause of death globally?
cardiovascular disease
Origens of CVD are found around what age?
30ish
New studies reveal that atherosclerotic changes begin when?
Early childhood
What is the leading cause of all cardiovascular disease deaths (and deaths in general)?
heart attacks
List the nonmodifiable risk factors for CAD? (5)
- age
- gender
- ethnicity
- family history
- genetic inheritence
List the modifiable risk factors for CAD? (9)
- elevated serum lipids
- hypertension
- tobacco use
- physical inactivity
- obesity
- diabetes
- metabolic syndrome
- psychologic states
- homocysteine level
What group has the highest incidence of CAD?
White, middle-aged men
Are African American or white women more at risk for CAD?
African american women- higher risk, earlier onset, and more severe CAD
Do men or women have an earlier onset of CAD?
men
Are men or women less ill with CVD presentation?
men
Do men or women have more typical angina symptoms associated with CVD?
men
Describe the pain men typically feel with CVD.
substernal/crushing
Is screening for cardiovascular problems more predictive in men or women?
men
Women with CVD have ________ (typical, atypical) symptoms.
atypical
Women may have pain (with CVD) in what areas of the body?
back, jaws, arms, epigastric
What type of symptoms might a women with CVD display?
- fatigue, diaphoresis, palpitations, nausea, vomiting
Are diagnostic tests for CVD more predictive in men or women?
men
Why are stress tests not reliable for CVD diagnoses in women?
b/c or hormones
What is the most effective test for CVD in women?
dobutamine stress test
Why is nuclear imaging less reliable in women?
b/c of breast tissue
Kyphosis might be present in an elderly adult. What effect might this have on a cardiovascular assessment?
- altered chest landmarks
- distant heart sounds
Myocardial hypertrophy (increased collagen and scarring, decreased elastin) might be seen in the elderly. What affect does this have on their cardiovascular system?
- decreased cardiac reserve
- heart failure
The heart might be displaced downward in the elderly. What effect might this have on your assessment findings?
difficulty in isolating the apical pulse
Valvular rigidity occurs in the elderly. How might this effect your cardiovascular assessment findings?
- a systolic murmur is possible without being an indication of cardiovascular pathology
Blood vessels in the elderly experience stiffening due to what? (3)
- loss of elastin in arterial walls
- thickening of intima of the arteries
- progressive fibrosis of the media
What effect does arterial stiffening (as seen in the elderly) have on assessment findings?
- increase in systolic BP
- increase/decrease in diastolic BP
- widened pulse pressure
- pedal pulses diminished
- increase in intermittent claudication
What effect does the increase in venous tortousity as seen in the elderly have on assessment findings?
- inflamed, painful, or cordlike varicosities.
When assessing/identifying a high-risk person, what information should the nurse address?
- health history
- all medications
- presence of any cardiovascular symptoms
- environmental patterns, such as diet/exercise
- values & beliefs re: health and illness
When addressing CAD, nutritional therapy is included. What has been shown to reduce the risks associated with CAD when consumed regularly?
omega-3-fatty acids
When advising a patient on what type of foods include omega-3-fatty acids, the nurse should include what 2 examples?
salmon and tuna
What are 2 examples of drugs that restrict lipoprotein productions?
- statins
- niacin
What is an example of a drug that increases lipoprotein removal?
bile-acid sequestrant
What is an example of a drug that decreases cholesterol absorption?
- Ezetimibide (Zetia)
What are common problems associated with aspirin therapy?
GI upset and bleeding
If a person is intolerant to aspirin, what type of medication may be considered?
Plavix (clopidogrel)