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81 Cards in this Set
- Front
- Back
What are the 3 layers of the heart from inner to outer?
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- endocardium
- myocardium - pericardium |
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What is the purpose of the pericardial fluid normally found in the pericardial space?
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prevents friction between surfaces as the heart contracts
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The heart is divided vertically by what?
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the septum
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Which is thicker, atrial or ventricular myocardium? why?
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ventricular b/c of the force needed to move blood forward
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Which is thicker, the right or left ventricle? why?
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left b/c it must move blood into systemic circulation which requires more muscular effort
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The right atrium receives blood from what 3 structures?
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- inferior and superior venae cavae
- coronary sinus |
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Blood passes through what structure when leaving the right atrium to enter the right ventricle?
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tricuspid valve
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The right ventricle pumps blood where?
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through the pulmonary artery to the lungs
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Blood flows from the lungs to the left ventricle through what structures?
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pulmonary veins
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Blood passes through what structure when exiting the left atrium to enter the left ventricle?
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bicuspid (mitral) valve
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What is the function of the 4 valves (mitral, tricuspid, pulmonic, aortic) in the heart?
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to prevent blood from backflowing (to keep blood moving forward)
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What arteries supply blood to the myocardium?
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the coronary arteries
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In most people, the AV node and bundle of HIS receive blood from where?
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the right coronary artery
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An action potential generated and transported by the SA node of the heat stimulates what?
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depolarization of muscle fibers in the heart
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What occurs once the muscle fibers in the heart are depolarized?
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contraction
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Depolarization triggers what?
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mechanical activity, also known as systole
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Relaxation of the myocardium is known as what?
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diastole
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What is the functional purpose of diastole?
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it allows the ventricles to fill with blood
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What is cardiac output?
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the amount of blood pumped by each ventricle in one minute
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How is cardiac output calculated?
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by multiplying stroke volume by heart rate
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What is normal cardiac output?
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4-8 L per minute
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Heart rate is regulated primarily by what system?
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autonomic nervous system
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(def)
the volume of blood in the ventricles at the end of diastole |
preload
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(def)
the peripheral resistance against which the left ventricle must pump |
afterload
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Contractility can be increased by what 2 sympathetic nervous system hormones?
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- epinephrine
- norepinephrine |
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What does Starling's Law state?
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the more the myocardial fibers are stretched, the greater the force of contraction
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(def)
the percentage of total ventricular filling volume that is ejected during each ventricular contraction |
ejection fraction
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What is the hallmark of systolic function?
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ejection fraction
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What is a normal ejection fraction?
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greater than 55%
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How does hyperkalemia affect the heart? (3)
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- decreases heart rate
- decreases the force of cardiac contraction - may dilate the heart |
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Extreme large increases in K+ can have what affect on the heart?
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- may block the conduction through the atrioventricular bundle
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How does hypokalemia effect the heart?
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- decrease in heart rate
- increases the force of cardiac contraction |
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What is calcium primarily involved in regarding the heart?
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- contractile process of the myocardium
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Hypercalcemia has what effect on the heart?
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overcontraction
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Hypocalcemia has what effect on the heart?
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cardiac flaccidity
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IV ________ is generally given to protect the heart from hyperkalemic effects.
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calcium
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True/False:
Sodium imbalances are usually manifested in some of the other systems before cardiac problems arise |
true
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What happens to the heart if sodium levels are increased?
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depressed cardiac function
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Why are sodium levels a concern in CHF?
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b/c of the edema that can exacerbate CHF
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High magnesium can have what effects on the cardiovascular system?
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- affects heart rate, cardiac conduction, and blood pressure
- This includes hypotension, vasodilation, bradycardia, heart block, and cardiac arrest |
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Low magnesium levels may have what effect on the heart?
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cardiac arrhythmias
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Attempting to replace potassium is difficult if a deficiency in what other 2 electrolytes is present?
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Magnesium and/or calcium
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While CVD can refer to any disease that affects the cardiovascular system, it is usually used to refer to which ones?
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those related to atherosclerosis
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Atherosclerosis is characterized by what?
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deposit of cholesterol and lipids, primarily w/i the intimal wall of the artery
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What occurs within the artery that is central to the development of atherosclerosis?
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inflammation and endothelial injury
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Atheromas, or fatty deposits, have a preference for which arteries?
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Coronary Arteries
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What is the leading cause of death globally?
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cardiovascular disease
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Origens of CVD are found around what age?
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30ish
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New studies reveal that atherosclerotic changes begin when?
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Early childhood
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What is the leading cause of all cardiovascular disease deaths (and deaths in general)?
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heart attacks
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List the nonmodifiable risk factors for CAD? (5)
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- age
- gender - ethnicity - family history - genetic inheritence |
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List the modifiable risk factors for CAD? (9)
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- elevated serum lipids
- hypertension - tobacco use - physical inactivity - obesity - diabetes - metabolic syndrome - psychologic states - homocysteine level |
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What group has the highest incidence of CAD?
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White, middle-aged men
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Are African American or white women more at risk for CAD?
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African american women- higher risk, earlier onset, and more severe CAD
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Do men or women have an earlier onset of CAD?
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men
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Are men or women less ill with CVD presentation?
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men
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Do men or women have more typical angina symptoms associated with CVD?
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men
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Describe the pain men typically feel with CVD.
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substernal/crushing
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Is screening for cardiovascular problems more predictive in men or women?
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men
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Women with CVD have ________ (typical, atypical) symptoms.
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atypical
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Women may have pain (with CVD) in what areas of the body?
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back, jaws, arms, epigastric
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What type of symptoms might a women with CVD display?
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- fatigue, diaphoresis, palpitations, nausea, vomiting
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Are diagnostic tests for CVD more predictive in men or women?
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men
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Why are stress tests not reliable for CVD diagnoses in women?
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b/c or hormones
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What is the most effective test for CVD in women?
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dobutamine stress test
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Why is nuclear imaging less reliable in women?
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b/c of breast tissue
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Kyphosis might be present in an elderly adult. What effect might this have on a cardiovascular assessment?
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- altered chest landmarks
- distant heart sounds |
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Myocardial hypertrophy (increased collagen and scarring, decreased elastin) might be seen in the elderly. What affect does this have on their cardiovascular system?
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- decreased cardiac reserve
- heart failure |
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The heart might be displaced downward in the elderly. What effect might this have on your assessment findings?
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difficulty in isolating the apical pulse
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Valvular rigidity occurs in the elderly. How might this effect your cardiovascular assessment findings?
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- a systolic murmur is possible without being an indication of cardiovascular pathology
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Blood vessels in the elderly experience stiffening due to what? (3)
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- loss of elastin in arterial walls
- thickening of intima of the arteries - progressive fibrosis of the media |
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What effect does arterial stiffening (as seen in the elderly) have on assessment findings?
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- increase in systolic BP
- increase/decrease in diastolic BP - widened pulse pressure - pedal pulses diminished - increase in intermittent claudication |
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What effect does the increase in venous tortousity as seen in the elderly have on assessment findings?
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- inflamed, painful, or cordlike varicosities.
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When assessing/identifying a high-risk person, what information should the nurse address?
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- health history
- all medications - presence of any cardiovascular symptoms - environmental patterns, such as diet/exercise - values & beliefs re: health and illness |
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When addressing CAD, nutritional therapy is included. What has been shown to reduce the risks associated with CAD when consumed regularly?
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omega-3-fatty acids
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When advising a patient on what type of foods include omega-3-fatty acids, the nurse should include what 2 examples?
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salmon and tuna
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What are 2 examples of drugs that restrict lipoprotein productions?
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- statins
- niacin |
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What is an example of a drug that increases lipoprotein removal?
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bile-acid sequestrant
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What is an example of a drug that decreases cholesterol absorption?
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- Ezetimibide (Zetia)
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What are common problems associated with aspirin therapy?
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GI upset and bleeding
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If a person is intolerant to aspirin, what type of medication may be considered?
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Plavix (clopidogrel)
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