p.2
Cardiovascular System Anatomy and Physiology
What is the relationship described in this chapter regarding the cardiovascular system?
The relationship between anatomic structures and physiologic function.
p.2
Risk Factors for Coronary Artery Disease
What should be incorporated into the health history of a patient with cardiovascular disease?
Assessment of cardiac risk factors.
p.2
Nursing Interventions for Cardiovascular Disorders
What is the goal of assessing cardiac findings?
To determine between normal and abnormal assessment findings.
p.2
Myocardial Ischemia and Its Consequences
What major aspect should be recognized and evaluated in cardiovascular dysfunction?
Major manifestations of cardiovascular dysfunction.
p.3
Coronary Artery Disease Pathophysiology
What do the left and right coronary arteries supply?
Nutrient-rich, oxygenated blood to the heart.
p.3
Coronary Artery Disease Pathophysiology
What is the role of coronary veins?
To take nutrient-poor deoxygenated blood away from the myocardium to the right atrium.
p.8
Myocardial Ischemia and Its Consequences
What is the primary function of the coronary arteries?
To supply blood flow sufficient to meet the demands of the myocardium.
p.17
Coronary Artery Disease Pathophysiology
What causes acute coronary syndromes?
Sudden coronary obstruction caused by thrombus formation over a ruptured or ulcerated atherosclerotic plaque.
p.44
Heart Failure: Types and Pathophysiology
What are the two categories of left heart failure?
Heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).
p.40
Dysrhythmias and Their Management
What is the most common cardiac rhythm disorder?
Atrial fibrillation (AF).
p.14
Myocardial Ischemia and Its Consequences
What does a normal ECG reading during rest indicate?
It suggests no immediate cardiac issues, but changes like ST depression or T-wave inversion during pain may indicate ischemia.
p.36
Dysrhythmias and Their Management
What should be ensured regarding the environment when delivering countershock?
No one should be touching the bed or the client.
p.31
Dysrhythmias and Their Management
What are disorders of impulse conduction?
Conditions that affect the electrical signals in the heart, leading to abnormal heart rhythms.
p.35
Dysrhythmias and Their Management
What is cardioversion?
A synchronized countershock to convert an undesirable rhythm to a stable rhythm.
p.48
Heart Failure: Types and Pathophysiology
What is a consequence of ventricular remodeling?
Deposition of collagen between myocytes, disrupting muscle integrity and decreasing contractility.
p.4
Coronary Artery Disease Pathophysiology
What is coronary artery disease?
A condition with inadequate supply of blood and oxygen to the myocardium.
p.20
Myocardial Infarction: Diagnosis and Management
What occurs when a thrombus occludes a vessel for a prolonged period?
Myocardial ischemia progresses to myocyte necrosis and death.
What should the client do before carotid sinus massage?
Turn the head away from the side to be massaged.
p.29
Dysrhythmias and Their Management
How can disorders of impulse formation be diagnosed?
Through electrocardiograms (ECGs) and clinical evaluation.
p.8
Myocardial Ischemia and Its Consequences
What leads to the development of myocardial ischemia?
When the supply of coronary blood cannot meet the demand of the myocardium for oxygen and nutrients.
p.40
Dysrhythmias and Their Management
What is the heart rate during atrial fibrillation?
350 to 600 times per minute.
p.44
Heart Failure: Types and Pathophysiology
What is left heart failure also known as?
Congestive heart failure.
p.36
Myocardial Infarction: Diagnosis and Management
What diagnostic procedure should be performed to rule out clots in the atria before an elective procedure?
Transesophageal echocardiogram (TEE).
p.48
Heart Failure: Types and Pathophysiology
What condition is characterized by weakness of cardiac muscle due to hypertension-induced hypertrophy?
Hypertensive hypertrophic cardiomyopathy.
p.26
Nursing Interventions for Cardiovascular Disorders
What should be allowed for the client to void after an acute episode?
Standing to void or using a bedside commode if prescribed.
p.14
Myocardial Ischemia and Its Consequences
What might chest pain or changes in the electrogram during a stress test indicate?
They may indicate ischemia.
p.32
Dysrhythmias and Their Management
How are disorders of impulse conduction diagnosed?
Diagnosis is typically made using an electrocardiogram (ECG).
p.5
Risk Factors for Coronary Artery Disease
Which gender has a higher risk for coronary artery disease until menopause?
Males have a higher risk than females until menopause, after which the risk is equal.
p.45
Heart Failure: Types and Pathophysiology
What factors influence stroke volume?
Contractility, preload, and afterload.
p.14
Coronary Artery Disease Pathophysiology
What is the purpose of a coronary angiogram or cardiac catheterization?
To provide definitive diagnosis by assessing the patency of the coronary arteries.
p.29
Dysrhythmias and Their Management
What are disorders of impulse formation?
Conditions that affect the generation of electrical impulses in the heart.
p.26
Nursing Interventions for Cardiovascular Disorders
What is the initial intervention following an acute episode?
Maintain bed rest as prescribed.
p.4
Coronary Artery Disease Pathophysiology
What causes the demand-supply mismatch of oxygen in coronary artery disease?
Occlusion of the coronary arteries.
p.20
Myocardial Infarction: Diagnosis and Management
What determines the size and character of a myocardial infarction?
The duration of ischemia.
p.43
Heart Failure: Types and Pathophysiology
What was heart failure (HF) previously referred to as?
Congestive heart failure (CHF).
p.4
Coronary Artery Disease Pathophysiology
What typically forms in the lumen of coronary arteries in coronary artery disease?
Plaques that impede blood flow.
p.19
Coronary Artery Disease Pathophysiology
What is the most common cause of myocardial infarction?
Underlying coronary artery disease.
p.40
Dysrhythmias and Their Management
What happens to the atria during atrial fibrillation?
They quiver, which can lead to thrombi formation.
p.32
Dysrhythmias and Their Management
What are potential treatments for disorders of impulse conduction?
Treatments may include medications, lifestyle changes, or procedures like pacemaker implantation.
p.35
Dysrhythmias and Their Management
What should be monitored after cardioversion?
Indications of successful response, such as conversion to sinus rhythm, strong peripheral pulses, adequate BP, and adequate urine output.
p.7
Coronary Artery Disease Pathophysiology
What initiates the inflammatory response in coronary atherosclerosis?
Injury to the vascular endothelium.
p.47
Heart Failure: Types and Pathophysiology
What is the effect of increased PVR on the left ventricle?
It creates resistance to ventricular emptying and increases workload, leading to hypertrophy of the myocardium.
p.15
Myocardial Ischemia and Its Consequences
What is the purpose of administering nitroglycerin?
To dilate the coronary arteries, reduce the oxygen requirements of the myocardium, and relieve chest pain.
p.52
Heart Failure: Types and Pathophysiology
How does insulin resistance affect heart failure?
It contributes to and complicates heart failure by causing abnormal myocyte fatty acid metabolism and ATP generation.
p.19
Myocardial Infarction: Diagnosis and Management
What characterizes a transmural infarction?
Ischemic necrosis that extends through the full thickness of the myocardial wall.
p.48
Heart Failure: Types and Pathophysiology
What state develops due to energy starvation in myocytes?
An energy-starved state that contributes to changes in the myocytes and ventricular remodeling.
p.12
Angina Pectoris: Types and Symptoms
What is another name for variant angina?
Prinzmetal’s angina or vasospastic angina.
p.44
Heart Failure: Types and Pathophysiology
What does HFrEF stand for?
Heart failure with reduced ejection fraction (systolic heart failure).
p.28
Dysrhythmias and Their Management
What are dysrhythmias?
Disturbances of heart rhythm.
p.44
Heart Failure: Types and Pathophysiology
What does HFpEF stand for?
Heart failure with preserved ejection fraction (diastolic heart failure).
p.12
Angina Pectoris: Types and Symptoms
When does variant angina typically occur?
Almost exclusively at rest.
p.5
Risk Factors for Coronary Artery Disease
What are nonmodifiable risk factors for coronary artery disease?
Hereditary factors, gender, ethnic background, and age.
p.44
Heart Failure: Types and Pathophysiology
Can HFrEF and HFpEF occur together?
Yes, they can occur together in one individual or singly.
p.15
Nursing Interventions for Cardiovascular Disorders
What is the first step in the immediate management of chest pain?
Assess pain and institute pain relief measures.
p.52
Heart Failure: Types and Pathophysiology
Why is calcium transport critical in myocytes?
It is essential for normal contractile function.
p.38
Myocardial Infarction: Diagnosis and Management
What is the first step in using an AED?
Place the client on a firm, dry surface.
p.51
Heart Failure: Types and Pathophysiology
What is a key characteristic of systolic congestive heart failure?
A complex constellation of neurohumoral, inflammatory, and metabolic processes.
p.37
Myocardial Infarction: Diagnosis and Management
What is defibrillation used for?
To terminate pulseless VT or VF.
p.20
Myocardial Infarction: Diagnosis and Management
What happens if the thrombus lodges permanently in the vessel?
The infarction extends through the myocardium from endocardium to epicardium, resulting in severe cardiac dysfunction.
p.28
Dysrhythmias and Their Management
What role do conduction pathways play in dysrhythmias?
Dysrhythmias can arise from abnormal conduction of impulses through the heart's conduction system.
p.35
Dysrhythmias and Their Management
How does the energy used in cardioversion compare to defibrillation?
A lower amount of energy is used in cardioversion than in defibrillation.
p.31
Dysrhythmias and Their Management
What are potential symptoms of impulse conduction disorders?
Symptoms may include palpitations, dizziness, and syncope.
p.38
Myocardial Infarction: Diagnosis and Management
Where should the electrode patches be placed?
In the correct position on the client’s chest.
p.58
Heart Failure: Types and Pathophysiology
What are common causes of high-output failure?
Anemia, septicemia, hyperthyroidism, and beriberi.
p.6
Coronary Artery Disease Pathophysiology
What triggers the inflammatory response in atherosclerosis?
Injury to the artery wall.
p.39
Dysrhythmias and Their Management
What does a spike on the monitor or ECG strip indicate?
It indicates that a pacing stimulus has been delivered to the heart.
p.51
Heart Failure: Types and Pathophysiology
What is tolvaptan used for?
Treatment of heart failure that is resistant to conventional diuretics.
p.29
Dysrhythmias and Their Management
What can cause disorders of impulse formation?
Ischemia, electrolyte imbalances, and structural heart changes.
p.29
Dysrhythmias and Their Management
What is the effect of disorders of impulse formation on heart rhythm?
They can lead to arrhythmias or irregular heartbeats.
p.8
Myocardial Ischemia and Its Consequences
What happens when a major coronary artery is narrowed by more than 50%?
It impairs blood flow sufficiently to hamper cellular metabolism under increased myocardial demand.
p.17
Coronary Artery Disease Pathophysiology
What leads to plaque disruption in acute coronary syndromes?
Shear forces and inflammation with the release of multiple inflammatory mediators.
What is the purpose of carotid sinus massage?
To determine whether a change in cardiac rhythm occurs.
p.48
Heart Failure: Types and Pathophysiology
What does the activation of the RAAS lead to?
Increased peripheral vascular resistance (PVR) and plasma volume, raising afterload and preload.
p.45
Heart Failure: Types and Pathophysiology
What is Heart Failure with Reduced Ejection Fraction (HFrEF) defined as?
An ejection fraction of <40% and an inability of the heart to generate adequate cardiac output.
p.35
Dysrhythmias and Their Management
When can cardioversion be performed?
As an elective procedure for stable tachydysrhythmias resistant to medical therapies or as an emergent procedure for hemodynamically unstable tachydysrhythmias.
p.36
Myocardial Infarction: Diagnosis and Management
What is the priority postprocedural assessment for a client after an atrial fibrillation procedure?
Ability to maintain airway and breathing.
p.39
Dysrhythmias and Their Management
What is the purpose of a pacemaker?
To provide electrical stimulation and maintain heart rate when the intrinsic pacemaker fails.
p.28
Dysrhythmias and Their Management
How can dysrhythmias occur in relation to the SA node?
From an abnormal rate of impulse generation by the SA node or other pacemaker.
p.52
Heart Failure: Types and Pathophysiology
What changes in calcium transport mechanisms can lead to heart failure?
Alterations in calcium ion channels, intracellular transport in the sarcoplasmic reticulum, and calcium cycling.
p.19
Myocardial Infarction: Diagnosis and Management
What are the two major types of myocardial infarction?
Subendocardial infarction and transmural infarction.
p.43
Heart Failure: Types and Pathophysiology
What does the term 'heart failure' indicate?
Myocardial disease with impaired contraction (systolic dysfunction) or filling (diastolic dysfunction) of the heart.
p.58
Heart Failure: Types and Pathophysiology
What is high-output heart failure?
The inability of the heart to adequately supply the body with blood-borne nutrients, despite adequate blood volume and normal or elevated myocardial contractility.
p.4
Coronary Artery Disease Pathophysiology
What could thrombosis in coronary artery disease lead to?
Subtotal or total occlusion of the lumen, resulting in acute coronary syndrome (ACS).
p.45
Heart Failure: Types and Pathophysiology
What is ventricular remodeling?
Changes in left ventricular geometry, mass, and volume in response to myocardial injury or alterations in load.
p.49
Heart Failure: Types and Pathophysiology
What is the effect of the vicious cycle on left heart failure?
It causes progressive worsening of left heart failure.
p.52
Heart Failure: Types and Pathophysiology
What role does the sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS) play in heart failure?
They are activated by heart failure and contribute to insulin resistance.
p.20
Myocardial Infarction: Diagnosis and Management
What ECG changes are typically seen in a STEMI?
Marked elevations in the ST segments.
p.8
Myocardial Ischemia and Its Consequences
How do healthy coronary arteries respond to increased myocardial oxygen needs?
They dilate to increase the flow of oxygenated blood.
p.30
Dysrhythmias and Their Management
What are disorders of impulse formation?
Conditions that affect the generation of electrical impulses in the heart.
p.32
Dysrhythmias and Their Management
What can cause disorders of impulse conduction?
Causes can include ischemia, electrolyte imbalances, and structural heart changes.
p.40
Dysrhythmias and Their Management
What causes atrial fibrillation?
Disorganized electrical impulses in the heart.
p.52
Heart Failure: Types and Pathophysiology
What is a key characteristic of systolic congestive heart failure?
A complex constellation of neurohumoral, inflammatory, and metabolic processes.
p.31
Dysrhythmias and Their Management
What can cause disorders of impulse conduction?
Causes may include ischemia, electrolyte imbalances, and structural heart disease.
p.10
Angina Pectoris: Types and Symptoms
What causes angina pectoris?
Myocardial ischemia due to inadequate blood and oxygen supply or an imbalance between supply and demand.
p.26
Nursing Interventions for Cardiovascular Disorders
What is the purpose of dangling legs at the side of the bed?
To progress mobility as prescribed.
p.31
Dysrhythmias and Their Management
What is one common type of impulse conduction disorder?
Atrioventricular (AV) block.
p.15
Nursing Interventions for Cardiovascular Disorders
What should be administered to a patient experiencing chest pain?
Oxygen by nasal cannula as prescribed.
p.17
Coronary Artery Disease Pathophysiology
What are the types of acute coronary syndromes?
Unstable angina and myocardial infarction.
p.49
Heart Failure: Types and Pathophysiology
What response is stimulated by baroreceptors when they detect decreased perfusion?
Stimulation of the SNS to cause vasoconstriction and the hypothalamus to produce antidiuretic hormone.
What equipment should be available during carotid sinus massage?
A defibrillator and resuscitative equipment.
p.20
Myocardial Infarction: Diagnosis and Management
What is a transmural myocardial infarction?
An infarction that extends through the entire myocardium, resulting in severe cardiac dysfunction.
p.41
Dysrhythmias and Their Management
How does the SA node affect the ventricles during AF?
The response of the ventricles can also be rapid and irregular, depending on the filtering effect of the SA node.
p.24
Myocardial Infarction: Diagnosis and Management
What are the three zones associated with myocardial infarction?
The zones are the necrotic zone, the zone of injury, and the zone of ischemia.
p.54
Heart Failure: Types and Pathophysiology
What are the major causes of HFpEF?
Hypertension-induced myocardial hypertrophy and myocardial ischemia.
p.41
Dysrhythmias and Their Management
What is the fundamental cause of Atrial Fibrillation?
Atrial remodeling that generates ectopic foci or 'triggers' for electrical impulses.
p.5
Risk Factors for Coronary Artery Disease
What is the role of HDL in relation to cholesterol?
HDL helps remove cholesterol from tissues.
p.11
Angina Pectoris: Types and Symptoms
How is stable angina relieved?
With rest and nitroglycerin.
p.39
Dysrhythmias and Their Management
What does a spike preceding the QRS complex indicate?
That the ventricle is being paced.
p.24
Myocardial Infarction: Diagnosis and Management
What is the zone of injury in myocardial infarction?
It is the area surrounding the necrotic zone that is still alive but at risk of dying.
p.30
Dysrhythmias and Their Management
What can cause disorders of impulse formation?
Ischemia, electrolyte imbalances, and structural heart changes.
p.32
Dysrhythmias and Their Management
What are common symptoms of impulse conduction disorders?
Symptoms may include palpitations, dizziness, syncope, and shortness of breath.
p.20
Myocardial Infarction: Diagnosis and Management
What is a subendocardial myocardial infarction?
An infarction that involves only the myocardium directly beneath the endocardium.
p.28
Dysrhythmias and Their Management
What can cause dysrhythmias?
Ischemia, hypoxia, ANS imbalances, lactic acidosis, electrolyte abnormalities, conduction defects, drug toxicity, or hemodynamic abnormalities.
p.9
Myocardial Ischemia and Its Consequences
What are common causes of increased myocardial demand for blood?
Tachycardia, exercise, hypertension (hypertrophy), and valvular disease.
p.46
Heart Failure: Types and Pathophysiology
What does an increase in preload (LVEDV) indicate?
Decreased contractility or excess plasma volume.
p.38
Myocardial Infarction: Diagnosis and Management
What should you do after turning on the AED?
Follow the voice prompts.
p.6
Coronary Artery Disease Pathophysiology
What is atherosclerosis?
A progressive disease characterized by the accumulation of lipids and fibrous elements in arterial walls, reducing blood flow to the myocardium.
p.9
Myocardial Ischemia and Its Consequences
What happens to heart cells after several minutes of ischemia?
They lose the ability to contract, leading to decreased cardiac output.
p.43
Heart Failure: Types and Pathophysiology
What results from structural or functional cardiac disorders in heart failure?
Impaired ability of the ventricles to fill or eject blood.
p.19
Myocardial Infarction: Diagnosis and Management
How is myocardial infarction clinically categorized?
STEMI (ST Elevation MI) and non-STEMI (non-ST Elevation MI).
p.46
Heart Failure: Types and Pathophysiology
Which law describes the relationship between preload and cardiac output?
The Frank-Starling law of the heart.
p.58
Heart Failure: Types and Pathophysiology
How does anemia affect the body in high-output failure?
It decreases the oxygen-carrying capacity of the blood, leading to metabolic acidosis as cells switch to anaerobic metabolism.
p.57
Heart Failure: Types and Pathophysiology
What is the primary focus of treatment for left ventricular dysfunction?
Management of the left ventricular dysfunction.
p.53
Heart Failure: Types and Pathophysiology
What is the primary goal in managing chronic left heart failure?
Increasing contractility and reducing preload and afterload.
p.35
Dysrhythmias and Their Management
What medication should be held prior to an elective cardioversion?
Digoxin should be held for 48 hours preprocedural to prevent post-cardioversion ventricular irritability.
p.62
Nursing Interventions for Cardiovascular Disorders
What type of diet should be prescribed to clients following an acute episode?
A low-sodium, low-fat, and low-cholesterol diet.
p.49
Heart Failure: Types and Pathophysiology
What does LVEDV stand for?
Left ventricular end-diastolic volume.
p.54
Heart Failure: Types and Pathophysiology
What role does diabetes play in HFpEF?
It increases the risk for diastolic dysfunction.
p.62
Nursing Interventions for Cardiovascular Disorders
Why should clients be provided with a list of potassium-rich foods?
Because diuretics can cause hypokalemia (except for potassium-retaining diuretics).
p.24
Myocardial Infarction: Diagnosis and Management
What occurs in the zone of ischemia during myocardial infarction?
This zone has reduced blood flow and may show changes on an electrocardiogram (ECG).
p.7
Coronary Artery Disease Pathophysiology
What is an atheroma?
A plaque formed by lipid and inflammatory deposits in the arterial wall.
p.55
Heart Failure: Types and Pathophysiology
What is systolic heart failure?
A condition where the heart cannot pump effectively due to decreased contractility.
p.17
Coronary Artery Disease Pathophysiology
What happens when the plaque substrate is exposed?
It activates platelet activation and adherence, resulting in fast thrombus formation.
p.14
Myocardial Ischemia and Its Consequences
What are the findings of cardiac enzyme and troponin levels in angina?
They are typically normal.
p.43
Heart Failure: Types and Pathophysiology
What characterizes heart failure as a clinical syndrome?
Signs and symptoms of fluid overload or inadequate tissue perfusion.
p.30
Dysrhythmias and Their Management
How do disorders of impulse formation affect heart function?
They can lead to irregular heartbeats and impaired cardiac output.
p.47
Heart Failure: Types and Pathophysiology
What is the most common cause of increased afterload?
Increased peripheral vascular resistance (PVR), such as that seen with hypertension.
p.10
Angina Pectoris: Types and Symptoms
How is angina pectoris described?
As transient substernal chest discomfort, ranging from heaviness or pressure to moderately severe pain.
What should be documented during carotid sinus massage?
An electrocardiographic rhythm strip before, during, and after the procedure.
p.31
Dysrhythmias and Their Management
How can disorders of impulse conduction be diagnosed?
Through electrocardiograms (ECGs) and clinical evaluation.
p.46
Heart Failure: Types and Pathophysiology
How can increases in LVEDV affect cardiac output?
They can improve cardiac output up to a certain point.
p.7
Coronary Artery Disease Pathophysiology
What happens to the endothelium during the progression of atherosclerosis?
It stops producing normal antithrombotic and vasodilating agents.
p.39
Dysrhythmias and Their Management
When is an asynchronous (fixed rate) pacemaker used?
When the client is asystolic or profoundly bradycardic.
p.51
Heart Failure: Types and Pathophysiology
What effects does arginine vasopressin have in heart failure?
Causes peripheral vasoconstriction and renal fluid retention, exacerbating hyponatremia and edema.
p.45
Heart Failure: Types and Pathophysiology
What happens to the myocardium during ventricular remodeling?
Disruption of the normal myocardial extracellular structure, resulting in dilation and progressive myocyte contractile dysfunction.
p.16
Myocardial Ischemia and Its Consequences
What are the indications for calcium channel blockers such as Verapamil and Amlodipine?
Anginal prophylaxis, negative inotropic effects, and treatment for vasospasms.
p.11
Angina Pectoris: Types and Symptoms
What typically triggers stable angina?
Activities involving exertion or emotional stress.
p.45
Heart Failure: Types and Pathophysiology
What occurs when contractility decreases?
Stroke volume falls and left ventricular end-diastolic volume (LVEDV) increases, causing heart dilation and increased preload.
p.49
Heart Failure: Types and Pathophysiology
What role do increased preload and afterload play in heart failure?
They contribute to the progression of left heart failure.
p.6
Coronary Artery Disease Pathophysiology
What are unstable plaques in coronary artery disease?
Plaques that are prone to ulceration or rupture, potentially leading to thrombus formation.
p.41
Dysrhythmias and Their Management
What role do ectopic foci play in AF?
They serve as additional sources of electrical impulses that disrupt normal conduction.
p.21
Myocardial Ischemia and Its Consequences
What happens to cardiac cells if blood flow returns within 20 minutes?
They can remain viable even if metabolically altered and nonfunctional.
p.22
Risk Factors for Coronary Artery Disease
What is a major risk factor for myocardial infarction related to blood vessel health?
Coronary Artery Disease (CAD).
p.33
Dysrhythmias and Their Management
What should be recorded before, during, and after the Vagal Maneuvers?
An electrocardiographic rhythm strip.
p.37
Myocardial Infarction: Diagnosis and Management
What occurs in the second phase of a biphasic shock?
The current reverses direction and runs from the second electrode back to the first via the heart.
p.57
Heart Failure: Types and Pathophysiology
What are some causes of right heart failure?
Right ventricular myocardial infarction (MI), cardiomyopathies, and pulmonic valvular disease.
p.23
Myocardial Infarction: Diagnosis and Management
How long does it take for CK-MB isoenzyme to return to normal?
It returns to normal 48-72 hours later.
p.55
Heart Failure: Types and Pathophysiology
What characterizes diastolic heart failure?
The heart has difficulty filling with blood due to stiff or thickened heart muscles.
p.12
Angina Pectoris: Types and Symptoms
What ECG finding is associated with variant angina?
ST-segment elevation, indicating possible total blockage or myocardial infarction.
p.46
Heart Failure: Types and Pathophysiology
What neurohormones are released during ventricular remodeling?
Angiotensin II, aldosterone, catecholamines, and cytokines.
What monitoring is required during carotid sinus massage?
The client must be on a cardiac monitor.
p.20
Myocardial Infarction: Diagnosis and Management
What ECG changes are associated with a non-STEMI?
ST depression and T-wave inversion.
p.43
Heart Failure: Types and Pathophysiology
What causes the symptoms associated with heart failure?
The heart cannot generate sufficient cardiac output to meet the body's demands for oxygen and nutrients.
p.54
Heart Failure: Types and Pathophysiology
What is Heart Failure with Preserved Ejection Fraction (HFpEF)?
A type of heart failure characterized by pulmonary congestion despite normal stroke volume and cardiac output.
p.8
Myocardial Ischemia and Its Consequences
What is the consequence of inefficient oxygen extraction from coronary arteries?
It can lead to myocardial ischemia if not compensated by increased blood flow.
p.10
Angina Pectoris: Types and Symptoms
What causes the pain in angina pectoris?
Buildup of lactic acid or abnormal stretching of the ischemic myocardium irritating nerve fibers.
p.47
Heart Failure: Types and Pathophysiology
What characterizes pathologic hypertrophy?
Myocyte death, fibrosis, inflammation, and alterations in cardiac energetics.
p.16
Myocardial Ischemia and Its Consequences
How do beta blockers like Propranolol and Metoprolol help in anginal prophylaxis?
By blocking beta-adrenergic stimulation of the heart, reducing myocardial oxygen demand.
p.31
Dysrhythmias and Their Management
What is the treatment for severe impulse conduction disorders?
Treatment may include medications, pacemaker implantation, or catheter ablation.
p.33
Dysrhythmias and Their Management
Describe the Valsalva Maneuver.
While lying on your back, take a deep breath and act like you’re exhaling with your nose and mouth closed for 10 to 30 seconds.
p.7
Coronary Artery Disease Pathophysiology
What are foam cells?
Macrophages that ingest lipids.
p.33
Dysrhythmias and Their Management
What is a modified version of the Valsalva Maneuver?
Sitting up, taking a deep breath, and then having the PHCP lower the bed while bringing the knees to the chest or legs in the air for 30 to 45 seconds.
p.60
Heart Failure: Types and Pathophysiology
What are the two types of heart failure mentioned?
Right-sided and left-sided heart failure.
p.59
Myocardial Ischemia and Its Consequences
What happens to the heart's output in overwhelming septicemia?
It may not be able to raise its output enough to compensate for vasodilation, leading to septic shock.
p.41
Dysrhythmias and Their Management
Why is coordinated activity of the atria and ventricles important?
It is essential for efficient pumping of blood by the heart.
p.58
Heart Failure: Types and Pathophysiology
What occurs in septicemia that affects cardiac output?
Disturbed metabolism, bacterial toxins, and the inflammatory process cause systemic vasodilation and fever, leading to increased cardiac output to maintain blood pressure.
p.33
Dysrhythmias and Their Management
What precaution should be taken if the gag reflex is stimulated during the procedure?
Provide an emesis basin and initiate precautions to prevent aspiration.
p.56
Heart Failure: Types and Pathophysiology
What is the most common cause of Right Heart Failure?
Severe left heart failure.
p.42
Nursing Interventions for Cardiovascular Disorders
What should be administered to control the ventricular rhythm?
Cardiac medications as prescribed.
p.54
Heart Failure: Types and Pathophysiology
What is the main goal of management in HFpEF?
To improve ventricular relaxation and prolong diastolic filling times to reduce diastolic pressure.
p.4
Coronary Artery Disease Pathophysiology
What can happen when some plaques rupture in coronary artery disease?
Exposure of tissue factor, leading to thrombosis.
p.39
Dysrhythmias and Their Management
What is a synchronous (demand) pacemaker?
A device that senses the client's rhythm and paces only if the intrinsic rate falls below the set rate.
p.14
Coronary Artery Disease Pathophysiology
What are some common assessment findings in patients with coronary artery disease?
Angina, dyspnea, pallor, sweating, palpitations, tachycardia, dizziness, syncope, hypertension, and digestive disturbances.
p.33
Dysrhythmias and Their Management
What are Vagal Maneuvers used for?
To induce vagal stimulation of the cardiac conduction system and terminate supraventricular tachydysrhythmias.
p.35
Dysrhythmias and Their Management
What is required if the cardioversion is an elective procedure?
Informed consent must be obtained.
p.57
Heart Failure: Types and Pathophysiology
What happens to systemic venous circulation when pressure rises in right heart failure?
It results in jugular venous distention, peripheral edema, and hepatosplenomegaly.
p.47
Heart Failure: Types and Pathophysiology
Which factors mediate pathologic hypertrophy?
Angiotensin II, catecholamines, and changes in intracellular signaling within the myocytes.
p.5
Risk Factors for Coronary Artery Disease
What factors are included in modifiable risk factors for coronary artery disease?
Hyperlipidemia, obesity, physical inactivity, smoking, stress, hypertension, and diabetes.
p.37
Myocardial Infarction: Diagnosis and Management
What should be done immediately after delivering a countershock?
Resume CPR for 5 cycles or about 2 minutes.
p.38
Myocardial Infarction: Diagnosis and Management
When are shocks recommended with an AED?
For pulseless VT or VF only.
p.24
Myocardial Infarction: Diagnosis and Management
What characterizes the necrotic zone in myocardial infarction?
It is the area where myocardial cells have died due to lack of blood supply.
p.7
Coronary Artery Disease Pathophysiology
What do fatty streaks in the arterial wall consist of?
Dead foam cells at the site of endothelial damage.
p.51
Heart Failure: Types and Pathophysiology
What role does TNF-α play in heart failure?
Elevated levels contribute to myocardial hypertrophy, remodeling, and down-regulation of nitric oxide synthesis.
p.23
Myocardial Infarction: Diagnosis and Management
When does the total creatinine kinase level rise after chest pain onset?
It rises within 6 hours after the onset of chest pain and peaks within 18 hours.
p.15
Risk Factors for Coronary Artery Disease
What dietary advice should be given to patients following an acute episode?
Dietary changes must be maintained for life.
p.6
Coronary Artery Disease Pathophysiology
How do stable plaques affect coronary blood flow?
They limit coronary flow and can cause ischemia, especially during exercise.
p.60
Heart Failure: Types and Pathophysiology
What vital sign changes might indicate acute pulmonary edema?
Tachycardia and tachypnea.
p.24
Myocardial Infarction: Diagnosis and Management
How can electrocardiographic alterations indicate myocardial infarction?
Changes such as ST elevation or depression and T wave inversions can be observed.
p.11
Angina Pectoris: Types and Symptoms
How does unstable angina differ from stable angina?
It occurs with an unpredictable degree of exertion or emotion and worsens over time.
p.53
Heart Failure: Types and Pathophysiology
How do ACE inhibitors affect mortality in chronic left heart failure?
They significantly reduce mortality.
p.7
Coronary Artery Disease Pathophysiology
What occurs during plaque rupture?
The fibrous cap covering the plaque breaks open.
p.55
Heart Failure: Types and Pathophysiology
How does systolic heart failure affect ejection fraction?
It typically results in a reduced ejection fraction (less than 40%).
p.59
Myocardial Ischemia and Its Consequences
What condition can result from high blood levels of thyroxine?
An abnormally elevated cardiac output may be inadequate.
p.23
Myocardial Infarction: Diagnosis and Management
What diagnostic tests may be performed following the acute stage of a myocardial infarction?
Exercise tolerance test, thallium scan, multigated cardiac blood pool imaging, and cardiac catheterization.
p.30
Dysrhythmias and Their Management
What is the significance of recognizing disorders of impulse formation?
Early identification can prevent complications such as stroke or heart failure.
p.12
Angina Pectoris: Types and Symptoms
What characterizes intractable angina?
Severe, incapacitating chest pain.
p.16
Myocardial Ischemia and Its Consequences
What is the primary use of nitrates like Nitroglycerin and Isosorbide dinitrate?
Anginal prophylaxis and reduction of myocardial oxygen consumption through vasodilation.
p.26
Nursing Interventions for Cardiovascular Disorders
What medications should be administered as prescribed?
ACE inhibitors, ARBs, calcium channel blockers, aspirin, thienopyridines, and lipid-lowering agents.
p.40
Dysrhythmias and Their Management
What can be observed instead of a P wave in atrial fibrillation?
Fibrillatory waves before each QRS complex.
p.41
Dysrhythmias and Their Management
What characterizes the electrical activity in Atrial Fibrillation (AF)?
It is rapid and irregular, leading to no coordinated atrial contraction.
p.5
Risk Factors for Coronary Artery Disease
What type of cholesterol is increased in coronary artery disease risk?
Low-density lipoproteins (LDL).
What vital signs should be monitored after the procedure?
Vital signs, cardiac rhythm, and level of consciousness.
p.9
Myocardial Ischemia and Its Consequences
What abnormalities can ischemia cause in the heart?
Conduction abnormalities that lead to dysrhythmias.
p.49
Heart Failure: Types and Pathophysiology
What are the initial insults that can lead to left heart failure?
Decreased contractility (e.g., myocardial infarction), increased preload (e.g., renal failure), or increased afterload (e.g., hypertension).
p.52
Heart Failure: Types and Pathophysiology
How does diabetes contribute to heart failure?
Through disturbed calcium metabolism, oxidative stress, changes in fatty acid and glucose metabolism, and mitochondrial dysfunction.
p.9
Myocardial Ischemia and Its Consequences
How long can cardiac cells remain viable under ischemic conditions?
Approximately 20 minutes.
p.16
Myocardial Ischemia and Its Consequences
What is the purpose of antiplatelet medications like Aspirin and Clopidogrel?
Prevention of platelet aggregation.
p.37
Myocardial Infarction: Diagnosis and Management
How does a monophasic waveform deliver electrical shocks?
In a single direction from one electrode to another.
p.47
Heart Failure: Types and Pathophysiology
What happens when energy demand exceeds ATP supply in the myocardium?
Contractility of the myocardium is compromised.
p.15
Angina Pectoris: Types and Symptoms
What should patients do if chest pain occurs after an acute episode?
Stop activity, rest, and take nitroglycerin as prescribed.
p.11
Angina Pectoris: Types and Symptoms
What characterizes the pattern of stable angina?
Stable onset, duration, severity, and relieving factors.
p.54
Myocardial Ischemia and Its Consequences
What diagnostic tools are used for HFpEF?
Electrocardiography and echocardiography.
p.23
Myocardial Infarction: Diagnosis and Management
What is the peak elevation time for CK-MB isoenzyme after chest pain onset?
Peak elevation occurs 18 hours after the onset of chest pain.
p.15
Risk Factors for Coronary Artery Disease
What should patients be assisted with after an acute episode?
Identifying angina-precipitating events and setting lifestyle change goals.
p.62
Nursing Interventions for Cardiovascular Disorders
What should clients balance after an acute episode?
Periods of activity and rest.
p.59
Heart Failure: Types and Pathophysiology
What are the two forms of hyperthyroidism?
Chronic (thyrotoxicosis) and acute (thyroid storm).
p.11
Angina Pectoris: Types and Symptoms
How does unstable angina relate to myocardial infarction (MI)?
It is characterized by chest pain that occurs days to weeks before an MI.
p.61
Nursing Interventions for Cardiovascular Disorders
What medications should be prepared for administration in a client with pulmonary edema?
Diuretic and morphine sulfate.
p.60
Heart Failure: Types and Pathophysiology
What psychological symptoms may accompany acute pulmonary edema?
Acute anxiety, apprehension, and restlessness.
p.56
Heart Failure: Types and Pathophysiology
What are the consequences of the right ventricle's increased workload over time?
Progressive diastolic and systolic deterioration, leading to dilation and failure.
p.46
Heart Failure: Types and Pathophysiology
What happens when preload continues to rise beyond a certain point?
It causes stretching of the myocardium, leading to dysfunction of the sarcomeres and decreased contractility.
p.26
Nursing Interventions for Cardiovascular Disorders
What should be encouraged regarding the client's feelings after a myocardial infarction?
Encourage the client to verbalize feelings regarding the MI.
p.38
Myocardial Infarction: Diagnosis and Management
What must be ensured during rhythm analysis?
No one is touching the client to avoid motion artifact.
p.26
Nursing Interventions for Cardiovascular Disorders
What should be monitored for during the recovery process?
Monitor for complications.
p.6
Coronary Artery Disease Pathophysiology
What are stable plaques in coronary artery disease?
Plaques that gradually increase in size and may partially occlude the vessel lumina, limiting coronary flow and causing ischemia, especially during exercise.
p.39
Dysrhythmias and Their Management
What does a spike preceding a P wave indicate?
That the atrium is being paced.
p.58
Heart Failure: Types and Pathophysiology
What physiological response occurs due to metabolic acidosis in high-output failure?
Heart rate and stroke volume increase to circulate blood faster.
p.23
Myocardial Infarction: Diagnosis and Management
What happens to troponin levels after a myocardial infarction?
Troponin levels rise within 3 hours and remain elevated for up to 7-10 days.
p.33
Dysrhythmias and Their Management
What should be monitored during Vagal Maneuvers?
Heart rate, rhythm, and blood pressure.
p.37
Myocardial Infarction: Diagnosis and Management
What happens during the first phase of a biphasic shock?
The current runs from the first electrode to the second electrode via the patient’s heart.
p.21
Myocardial Ischemia and Its Consequences
What occurs after 8 to 10 seconds of decreased blood flow to the myocardium?
The affected myocardium becomes cyanotic and cooler.
p.41
Dysrhythmias and Their Management
Where do electrical impulses begin in the heart?
In the sinoatrial (SA) node.
p.51
Heart Failure: Types and Pathophysiology
What is the role of IL-6 in heart failure?
Elevated in severe heart failure and cardiogenic shock, contributing to immune activation.
p.50
Heart Failure: Types and Pathophysiology
What characterizes systolic congestive heart failure?
A complex constellation of neurohumoral, inflammatory, and metabolic processes.
p.21
Myocardial Ischemia and Its Consequences
What metabolic changes occur as glycogen stores decrease during ischemia?
Anaerobic metabolism begins, leading to the accumulation of hydrogen ions and lactic acid.
p.22
Risk Factors for Coronary Artery Disease
How does physical inactivity contribute to the risk of myocardial infarction?
It increases the likelihood of other risk factors such as obesity and hypertension.
p.53
Heart Failure: Types and Pathophysiology
What are neprilysin (NEP) inhibitors and how do they benefit heart failure patients?
A new class of medications that, when combined with ARBs, can improve heart failure outcomes.
p.60
Heart Failure: Types and Pathophysiology
What are some signs of sympathetic nervous system activation in acute pulmonary edema?
Profuse sweating and cold, clammy skin.
p.27
Myocardial Infarction: Diagnosis and Management
What complication involves leakage of blood from the mitral valve after a myocardial infarction?
Mitral valve insufficiency.
p.55
Heart Failure: Types and Pathophysiology
What are common causes of diastolic heart failure?
Hypertension, aging, and conditions that cause stiffening of the heart muscle.
p.60
Heart Failure: Types and Pathophysiology
Where are signs of right ventricular failure evident?
In the systemic circulation.
p.10
Angina Pectoris: Types and Symptoms
What accounts for the variety of locations and radiation patterns of anginal pain?
The entry of nerve fibers into the spinal cord from levels C3 to T4.
p.47
Heart Failure: Types and Pathophysiology
What is the consequence of increased muscle mass in the heart?
An increase in oxygen and energy demand.
p.51
Heart Failure: Types and Pathophysiology
What is endothelin and its significance in heart failure?
A potent vasoconstrictor associated with poor prognosis in heart failure.
p.57
Heart Failure: Types and Pathophysiology
What is the most common cause of right heart failure in the absence of left heart failure?
Pulmonary hypertension resulting from diffuse hypoxic pulmonary disease.
p.53
Heart Failure: Types and Pathophysiology
Which medications are indicated for all patients with reduced ejection fraction in chronic left heart failure?
ACE inhibitors and beta-blockers.
p.58
Heart Failure: Types and Pathophysiology
What happens if anemia is severe in high-output failure?
Even maximum cardiac output does not supply enough oxygen for cellular metabolism.
p.57
Heart Failure: Types and Pathophysiology
Which diseases are associated with pulmonary hypertension leading to right heart failure?
Chronic obstructive pulmonary disease (COPD) and cystic fibrosis.
p.59
Myocardial Ischemia and Its Consequences
What are the signs of inadequate blood supply in septic shock?
Body tissues show signs of inadequate blood supply despite a very high cardiac output.
p.62
Nursing Interventions for Cardiovascular Disorders
What fluid management advice should be given to clients if fluid restriction is prescribed?
Spread the fluid intake throughout the day and suck on hard candy to reduce thirst.
p.58
Heart Failure: Types and Pathophysiology
What is the body's response to lowered systemic vascular resistance (SVR) in septicemia?
Cardiac output increases to maintain blood pressure and prevent metabolic acidosis.
p.33
Dysrhythmias and Their Management
What equipment should be available during Vagal Maneuvers?
A defibrillator and resuscitative equipment.
p.50
Heart Failure: Types and Pathophysiology
How does sympathetic nervous system activation initially compensate for decreased cardiac output?
By increasing heart rate and peripheral vascular resistance.
p.53
Heart Failure: Types and Pathophysiology
When should ARBs be used in heart failure management?
Only in individuals who do not tolerate ACE inhibitors.
p.56
Heart Failure: Types and Pathophysiology
What is the response of the right ventricle to increased workload in Right Heart Failure?
The right ventricle hypertrophies.
p.42
Diagnostic Procedures
What laboratory test is used to check for infections and anemia?
Complete blood count (CBC).
p.50
Heart Failure: Types and Pathophysiology
What are the consequences of Ang II-mediated remodeling?
Sarcomere death, loss of the normal collagen matrix, interstitial fibrosis, decreased contractility, changes in myocardial compliance, and ventricular dilation.
p.59
Heart Failure: Types and Pathophysiology
How does thiamine deficiency affect the myocardium?
It impairs cellular metabolism in all tissues, including the myocardium.
p.42
Diagnostic Procedures
What do cardiac biomarkers and B-type natriuretic peptide (BNP) assess?
Underlying heart disease.
p.61
Nursing Interventions for Cardiovascular Disorders
What should a client with pulmonary edema avoid?
Over-the-counter medications.
p.62
Nursing Interventions for Cardiovascular Disorders
What should clients avoid after an acute episode?
Large amounts of caffeine found in coffee, tea, cocoa, chocolate, and some carbonated beverages.
p.54
Heart Failure: Types and Pathophysiology
How does hypertension affect myocytes in HFpEF?
It decreases their ability to actively pump calcium, resulting in impaired relaxation.
p.9
Myocardial Infarction: Diagnosis and Management
What occurs if coronary artery occlusion persists beyond 20 minutes?
Myocardial infarction (MI) occurs.
p.5
Risk Factors for Coronary Artery Disease
What lifestyle factors contribute to the risk of coronary artery disease?
Obesity, metabolic syndrome, physical inactivity, cigarette smoking, and substance abuse.
p.6
Coronary Artery Disease Pathophysiology
What happens when unstable plaques rupture?
Underlying tissues of the vessel wall are exposed, resulting in platelet adhesion and thrombus formation.
p.39
Dysrhythmias and Their Management
What is referred to as 'capture' in pacing?
An atrial spike followed by a P wave or a ventricular spike followed by a QRS complex.
p.51
Heart Failure: Types and Pathophysiology
How does TNF-α affect myocytes?
Induces myocyte apoptosis and may contribute to cardiac cachexia.
p.42
Nursing Interventions for Cardiovascular Disorders
What is one of the nursing interventions for a patient at risk of emboli?
Administer anticoagulants as prescribed.
p.53
Heart Failure: Types and Pathophysiology
What role do loop diuretics and aldosterone-blockers play in chronic left heart failure management?
They are effective in reducing preload and improving outcomes.
p.59
Heart Failure: Types and Pathophysiology
How does hyperthyroidism affect cellular metabolism?
It accelerates cellular metabolism through elevated levels of thyroxine from the thyroid gland.
p.60
Heart Failure: Types and Pathophysiology
What physical signs may indicate respiratory distress in acute pulmonary edema?
Nasal flaring and use of accessory breathing muscles.
p.56
Heart Failure: Types and Pathophysiology
How does severe left heart failure affect the right heart?
Increased left ventricular filling pressure is reflected back into the pulmonary circulation, raising pressure in the pulmonary circulation.
p.56
Heart Failure: Types and Pathophysiology
What happens to the resistance faced by the right ventricle during Right Heart Failure?
Resistance to right ventricular emptying increases as pressure in the pulmonary circulation rises.
p.55
Heart Failure: Types and Pathophysiology
What is the ejection fraction in diastolic heart failure?
It is usually preserved (greater than 50%).
p.23
Myocardial Infarction: Diagnosis and Management
What is the significance of an elevated WBC count in myocardial infarction?
An elevated count can reach up to 20,000 cells/mm³.
p.21
Myocardial Ischemia and Its Consequences
What causes irreversible hypoxic injury and cellular death after myocardial ischemia?
About 20 minutes of ischemia.
p.42
Diagnostic Procedures
What does a Basic Metabolic Panel (BMP) assess?
Electrolyte abnormalities.
p.55
Heart Failure: Types and Pathophysiology
What are common causes of systolic heart failure?
Coronary artery disease, myocardial infarction, and cardiomyopathy.
p.22
Myocardial Ischemia and Its Consequences
What emotional responses may accompany a myocardial infarction?
Feelings of fear and anxiety.
p.7
Coronary Artery Disease Pathophysiology
What forms the fibrous cap in atherosclerosis?
Proliferation of smooth muscle cells filled with lipid and inflammatory deposits.
p.38
Myocardial Infarction: Diagnosis and Management
What is the procedure if the initial shocks are unsuccessful?
Continue CPR for 1 minute and then deliver another series of shocks.
p.56
Heart Failure: Types and Pathophysiology
What is Right Heart Failure?
The inability of the right ventricle to provide adequate blood flow into the pulmonary circulation at a normal central venous pressure.
p.7
Coronary Artery Disease Pathophysiology
How do plaques affect blood flow in arteries?
They protrude into the lumen, narrowing it and obstructing blood flow.
p.41
Dysrhythmias and Their Management
What is the function of the atrioventricular (AV) node?
It delays the transit of electrical impulses before they enter the ventricles.
p.11
Angina Pectoris: Types and Symptoms
What is a key symptom of unstable angina?
Chest pain lasting longer than 15 minutes.
p.42
Nursing Interventions for Cardiovascular Disorders
What preparation should be made for a client undergoing cardioversion?
Prepare the client for cardioversion as prescribed.
p.53
Heart Failure: Types and Pathophysiology
What is the role of beta-blockers in chronic left heart failure?
They improve symptoms and increase survival.
p.59
Heart Failure: Types and Pathophysiology
What type of heart failure does beriberi cause?
A mixed type of heart failure.
p.53
Heart Failure: Types and Pathophysiology
When might anticoagulants and antithrombotics be indicated in heart failure patients?
In selected individuals, particularly those with intracardiac thrombi or atrial fibrillation.
p.42
Diagnostic Procedures
What is the purpose of thyroid function tests?
To check for hyperthyroidism.
p.54
Heart Failure: Types and Pathophysiology
What does echocardiography reveal in HFpEF?
Poor ventricular filling, abnormal relaxation, hypertrophy, and/or left atrial enlargement with normal ejection fractions.
p.57
Heart Failure: Types and Pathophysiology
What does the management of right heart failure rely on?
Treating the underlying condition, managing intravascular volume, and assisting right ventricular contractility.
p.23
Myocardial Infarction: Diagnosis and Management
When does myoglobin rise after cell death?
Myoglobin rises within 2 hours after cell death, with a rapid decline after 7 hours.
p.61
Nursing Interventions for Cardiovascular Disorders
What is essential to ensure for a client with pulmonary edema?
An intravenous (IV) access device is in place.
p.60
Heart Failure: Types and Pathophysiology
What type of sputum may be expectorated in acute pulmonary edema?
Large amounts of blood-tinged, frothy sputum.
p.11
Angina Pectoris: Types and Symptoms
What symptoms indicate worsening cardiac ischemia in unstable angina?
Symptoms that are not relieved with nitroglycerin.
p.55
Heart Failure: Types and Pathophysiology
What are common symptoms of systolic heart failure?
Fatigue, shortness of breath, and fluid retention.
p.50
Heart Failure: Types and Pathophysiology
What effects does aldosterone have in systolic congestive heart failure?
Causes salt and water retention, contributes to myocardial fibrosis, autonomic dysfunction, dysrhythmias, endothelial dysfunction, and prothrombotic effects.
p.61
Nursing Interventions for Cardiovascular Disorders
What medication regimen should a client with pulmonary edema be instructed on?
Digoxin, a diuretic, ACE inhibitors, low-dose beta blockers, and vasodilators.
p.41
Dysrhythmias and Their Management
What causes sequential contraction of cardiomyocytes?
The propagation of electrical impulses through the atria and ventricles.
p.50
Heart Failure: Types and Pathophysiology
What are some deleterious effects of catecholamines on the myocardium?
Direct toxicity to myocytes, induction of myocyte apoptosis, myocardial remodeling, downregulation of adrenergic receptors, facilitation of dysrhythmias, and potentiation of autoimmune effects.
p.21
Heart Failure: Types and Pathophysiology
What happens to the heart's pumping ability due to oxygen deprivation?
It diminishes due to electrolyte disturbances and loss of contractility, potentially leading to heart failure.
p.21
Myocardial Infarction: Diagnosis and Management
What is released into interstitial spaces due to necrosis of myocardial tissue?
Intracellular enzymes, such as troponin.
p.60
Heart Failure: Types and Pathophysiology
What abnormal lung sounds may be heard during auscultation in acute pulmonary edema?
Wheezing and crackles; gurgling respirations.
p.59
Myocardial Ischemia and Its Consequences
What does the body's increased demand for oxygen during hyperthyroidism lead to?
An increase in cardiac output.
p.50
Heart Failure: Types and Pathophysiology
What role does Angiotensin II (Ang II) play in heart failure?
It increases preload and afterload and causes direct toxicity to the myocardium, mediating remodeling of the ventricular wall.
p.55
Heart Failure: Types and Pathophysiology
What symptoms are associated with diastolic heart failure?
Similar symptoms like shortness of breath and fluid retention, but may also include exercise intolerance.
p.61
Nursing Interventions for Cardiovascular Disorders
What should be assisted in identifying after an acute episode of pulmonary edema?
Precipitating risk factors of heart failure.
p.22
Myocardial Ischemia and Its Consequences
What physical signs may indicate a myocardial infarction?
Pallor, cyanosis, and coolness of extremities.
p.25
Myocardial Infarction: Diagnosis and Management
What should be assessed to identify poor cardiac output?
Distal peripheral pulses and skin temperature.
p.61
Nursing Interventions for Cardiovascular Disorders
What should be prepared for if required in a client with pulmonary edema?
Intubation and ventilator support.
p.61
Nursing Interventions for Cardiovascular Disorders
What should be documented after managing a client with pulmonary edema?
The event, actions taken, and the client’s response.
p.42
Diagnostic Procedures
What does the D-dimer test assess?
The breakdown of fibrin in the presence of blood clots.
p.25
Myocardial Infarction: Diagnosis and Management
What should be done if systolic blood pressure drops below 100 mm Hg after medication administration?
Lower the head of the bed and notify the PHCP.
p.25
Myocardial Infarction: Diagnosis and Management
What should be done to assess the patient's cardiovascular status?
Obtain vital signs and maintain cardiac monitoring.
p.32
Dysrhythmias and Their Management
What are disorders of impulse conduction?
Conditions that affect the electrical signals in the heart, leading to abnormal heart rhythms.
p.3
Coronary Artery Disease Pathophysiology
What happens to arterial branches during systole?
They are compressed, preventing perfusion.
p.48
Heart Failure: Types and Pathophysiology
What happens to renal perfusion as cardiac output falls?
Renal perfusion diminishes, activating the RAAS.
p.26
Nursing Interventions for Cardiovascular Disorders
What type of exercises should be provided to prevent thrombus formation?
Range-of-motion exercises.
p.38
Myocardial Infarction: Diagnosis and Management
What is the purpose of an Automated External Defibrillator (AED)?
To be used by laypersons and emergency medical technicians for prehospital cardiac arrest.
p.8
Myocardial Ischemia and Its Consequences
What can cause imbalances between myocardial demand and coronary blood supply?
A number of conditions that affect blood flow and oxygen delivery.
p.12
Angina Pectoris: Types and Symptoms
What is silent ischemia?
Objective evidence of ischemia without reported pain by the patient.
p.16
Myocardial Ischemia and Its Consequences
What are the two main objectives of medical management for myocardial oxygen supply?
Decrease the oxygen demand of the myocardium and increase its oxygen supply.
