Intro To Cardiovascular Disease (Nac 1)

Front 1

What are the 3 layers of the heart from inner to outer?

Back 1

- endocardium
- myocardium
- pericardium

Front 2

What is the purpose of the pericardial fluid normally found in the pericardial space?

Back 2

prevents friction between surfaces as the heart contracts

Front 3

The heart is divided vertically by what?

Back 3

the septum

Front 4

Which is thicker, atrial or ventricular myocardium? why?

Back 4

ventricular b/c of the force needed to move blood forward

Front 5

Which is thicker, the right or left ventricle? why?

Back 5

left b/c it must move blood into systemic circulation which requires more muscular effort

Front 6

The right atrium receives blood from what 3 structures?

Back 6

- inferior and superior venae cavae
- coronary sinus

Front 7

Blood passes through what structure when leaving the right atrium to enter the right ventricle?

Back 7

tricuspid valve

Front 8

The right ventricle pumps blood where?

Back 8

through the pulmonary artery to the lungs

Front 9

Blood flows from the lungs to the left ventricle through what structures?

Back 9

pulmonary veins

Front 10

Blood passes through what structure when exiting the left atrium to enter the left ventricle?

Back 10

bicuspid (mitral) valve

Front 11

What is the function of the 4 valves (mitral, tricuspid, pulmonic, aortic) in the heart?

Back 11

to prevent blood from backflowing (to keep blood moving forward)

Front 12

What arteries supply blood to the myocardium?

Back 12

the coronary arteries

Front 13

In most people, the AV node and bundle of HIS receive blood from where?

Back 13

the right coronary artery

Front 14

An action potential generated and transported by the SA node of the heat stimulates what?

Back 14

depolarization of muscle fibers in the heart

Front 15

What occurs once the muscle fibers in the heart are depolarized?

Back 15

contraction

Front 16

Depolarization triggers what?

Back 16

mechanical activity, also known as systole

Front 17

Relaxation of the myocardium is known as what?

Back 17

diastole

Front 18

What is the functional purpose of diastole?

Back 18

it allows the ventricles to fill with blood

Front 19

What is cardiac output?

Back 19

the amount of blood pumped by each ventricle in one minute

Front 20

How is cardiac output calculated?

Back 20

by multiplying stroke volume by heart rate

Front 21

What is normal cardiac output?

Back 21

4-8 L per minute

Front 22

Heart rate is regulated primarily by what system?

Back 22

autonomic nervous system

Front 23

(def)

the volume of blood in the ventricles at the end of diastole

Back 23

preload

Front 24

(def)

the peripheral resistance against which the left ventricle must pump

Back 24

afterload

Front 25

Contractility can be increased by what 2 sympathetic nervous system hormones?

Back 25

- epinephrine
- norepinephrine

Front 26

What does Starling's Law state?

Back 26

the more the myocardial fibers are stretched, the greater the force of contraction

Front 27

(def)

the percentage of total ventricular filling volume that is ejected during each ventricular contraction

Back 27

ejection fraction

Front 28

What is the hallmark of systolic function?

Back 28

ejection fraction

Front 29

What is a normal ejection fraction?

Back 29

greater than 55%

Front 30

How does hyperkalemia affect the heart? (3)

Back 30

- decreases heart rate
- decreases the force of cardiac contraction
- may dilate the heart

Front 31

Extreme large increases in K+ can have what affect on the heart?

Back 31

- may block the conduction through the atrioventricular bundle

Front 32

How does hypokalemia effect the heart?

Back 32

- decrease in heart rate
- increases the force of cardiac contraction

Front 33

What is calcium primarily involved in regarding the heart?

Back 33

- contractile process of the myocardium

Front 34

Hypercalcemia has what effect on the heart?

Back 34

overcontraction

Front 35

Hypocalcemia has what effect on the heart?

Back 35

cardiac flaccidity

Front 36

IV ________ is generally given to protect the heart from hyperkalemic effects.

Back 36

calcium

Front 37

True/False:

Sodium imbalances are usually manifested in some of the other systems before cardiac problems arise

Back 37

true

Front 38

What happens to the heart if sodium levels are increased?

Back 38

depressed cardiac function

Front 39

Why are sodium levels a concern in CHF?

Back 39

b/c of the edema that can exacerbate CHF

Front 40

High magnesium can have what effects on the cardiovascular system?

Back 40

- affects heart rate, cardiac conduction, and blood pressure

- This includes hypotension, vasodilation, bradycardia, heart block, and cardiac arrest

Front 41

Low magnesium levels may have what effect on the heart?

Back 41

cardiac arrhythmias

Front 42

Attempting to replace potassium is difficult if a deficiency in what other 2 electrolytes is present?

Back 42

Magnesium and/or calcium

Front 43

While CVD can refer to any disease that affects the cardiovascular system, it is usually used to refer to which ones?

Back 43

those related to atherosclerosis

Front 44

Atherosclerosis is characterized by what?

Back 44

deposit of cholesterol and lipids, primarily w/i the intimal wall of the artery

Front 45

What occurs within the artery that is central to the development of atherosclerosis?

Back 45

inflammation and endothelial injury

Front 46

Atheromas, or fatty deposits, have a preference for which arteries?

Back 46

Coronary Arteries

Front 47

What is the leading cause of death globally?

Back 47

cardiovascular disease

Front 48

Origens of CVD are found around what age?

Back 48

30ish

Front 49

New studies reveal that atherosclerotic changes begin when?

Back 49

Early childhood

Front 50

What is the leading cause of all cardiovascular disease deaths (and deaths in general)?

Back 50

heart attacks

Front 51

List the nonmodifiable risk factors for CAD? (5)

Back 51

- age
- gender
- ethnicity
- family history
- genetic inheritence

Front 52

List the modifiable risk factors for CAD? (9)

Back 52

- elevated serum lipids
- hypertension
- tobacco use
- physical inactivity
- obesity
- diabetes
- metabolic syndrome
- psychologic states
- homocysteine level

Front 53

What group has the highest incidence of CAD?

Back 53

White, middle-aged men

Front 54

Are African American or white women more at risk for CAD?

Back 54

African american women- higher risk, earlier onset, and more severe CAD

Front 55

Do men or women have an earlier onset of CAD?

Back 55

men

Front 56

Are men or women less ill with CVD presentation?

Back 56

men

Front 57

Do men or women have more typical angina symptoms associated with CVD?

Back 57

men

Front 58

Describe the pain men typically feel with CVD.

Back 58

substernal/crushing

Front 59

Is screening for cardiovascular problems more predictive in men or women?

Back 59

men

Front 60

Women with CVD have ________ (typical, atypical) symptoms.

Back 60

atypical

Front 61

Women may have pain (with CVD) in what areas of the body?

Back 61

back, jaws, arms, epigastric

Front 62

What type of symptoms might a women with CVD display?

Back 62

- fatigue, diaphoresis, palpitations, nausea, vomiting

Front 63

Are diagnostic tests for CVD more predictive in men or women?

Back 63

men

Front 64

Why are stress tests not reliable for CVD diagnoses in women?

Back 64

b/c or hormones

Front 65

What is the most effective test for CVD in women?

Back 65

dobutamine stress test

Front 66

Why is nuclear imaging less reliable in women?

Back 66

b/c of breast tissue

Front 67

Kyphosis might be present in an elderly adult. What effect might this have on a cardiovascular assessment?

Back 67

- altered chest landmarks
- distant heart sounds

Front 68

Myocardial hypertrophy (increased collagen and scarring, decreased elastin) might be seen in the elderly. What affect does this have on their cardiovascular system?

Back 68

- decreased cardiac reserve
- heart failure

Front 69

The heart might be displaced downward in the elderly. What effect might this have on your assessment findings?

Back 69

difficulty in isolating the apical pulse

Front 70

Valvular rigidity occurs in the elderly. How might this effect your cardiovascular assessment findings?

Back 70

- a systolic murmur is possible without being an indication of cardiovascular pathology

Front 71

Blood vessels in the elderly experience stiffening due to what? (3)

Back 71

- loss of elastin in arterial walls
- thickening of intima of the arteries
- progressive fibrosis of the media

Front 72

What effect does arterial stiffening (as seen in the elderly) have on assessment findings?

Back 72

- increase in systolic BP
- increase/decrease in diastolic BP
- widened pulse pressure
- pedal pulses diminished
- increase in intermittent claudication

Front 73

What effect does the increase in venous tortousity as seen in the elderly have on assessment findings?

Back 73

- inflamed, painful, or cordlike varicosities.

Front 74

When assessing/identifying a high-risk person, what information should the nurse address?

Back 74

- health history
- all medications
- presence of any cardiovascular symptoms
- environmental patterns, such as diet/exercise
- values & beliefs re: health and illness

Front 75

When addressing CAD, nutritional therapy is included. What has been shown to reduce the risks associated with CAD when consumed regularly?

Back 75

omega-3-fatty acids

Front 76

When advising a patient on what type of foods include omega-3-fatty acids, the nurse should include what 2 examples?

Back 76

salmon and tuna

Front 77

What are 2 examples of drugs that restrict lipoprotein productions?

Back 77

- statins
- niacin

Front 78

What is an example of a drug that increases lipoprotein removal?

Back 78

bile-acid sequestrant

Front 79

What is an example of a drug that decreases cholesterol absorption?

Back 79

- Ezetimibide (Zetia)

Front 80

What are common problems associated with aspirin therapy?

Back 80

GI upset and bleeding

Front 81

If a person is intolerant to aspirin, what type of medication may be considered?

Back 81

Plavix (clopidogrel)