Examen
Med Surge 2 (Nurs 2207 Exam 2) – Cardiac: Qs & As
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Med Surge 2 (Nurs 2207 Exam 2) – Cardiac: Qs & As
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Med Surge 2 (Nurs 2207 Exam 2) – Cardiac: Qs & AsCardiac Output: Right Ans - Stroke Volume x Heart Rate
Stroke Volume: Right Ans - The amount of blood ejected from the heart in
one contraction. You take the ESV and subtract it by EDV to get stroke volume
What are the 2 factors that help us determine Stroke Volume: Right Ans - 1.
End Diastole Volume
2. End Systole Volume
End Diastole Volume: Right Ans - PRELOAD!
- Common when the heart is relaxing and refilling
- Normal amount is 130 mL in the heart at this point
End Systole Volume: Right Ans - AFTERLOAD!
- When the heart is sending out blood to the rest of the body
- Normal amount is 60 mL left inside the heart after this
What do you do once you multiple SV and HR: Right Ans - move the
decimal point three places to the left to get liters
What are some things that affect Cardiac Output: Right Ans - 1. Exercise
2. Stress
3. Electrolytes
4. Narrowed vessels
What does exercise have to do with Cardiac Output: Right Ans - exercising
increases the heart rate, leading to an increased cardiac output
What does stress have to do with Cardiac Output: Right Ans - stress
increases the heart rate, leading to an increased cardiac output
What does electrolytes have to do with Cardiac Output: Right Ans - having
too much or not enough electrolyte can lead to changes in heart rate and
cardiac out put
- MOST COMMON: POTASSIUM (K+)
,What does narrowed arteries have to do with Cardiac Output: Right Ans -
the heart is working hard to get blood either away from the heart or back
towards the heart. Diseases like PAD or PVD can make this hard. This in turn
raises the blood pressure, heart rate, and cardiac output.
Blood flow through the heart: Right Ans - 1-Superior & Inferior Vena Cava,
2-Rt Atrium
3-Tricuspid Valve
4- Rt Ventricle
5-Pulmonary Valve
6-Pulmonary Artery
7- Lungs-pick up oxygen, 8-Pulmonary Veins
9- Lt Atrium
10- Mitral Valve (Bicuspid)
11-Lt Ventricle
12- Aortic Valve
13-Aorta
14- Body
Veins throughout the body: Right Ans - bring blood BACK to the heart like a
VACCUM. They have special valves inside to help since almost 65% of blood is
found within these vessels.
Arteries throughout the body: Right Ans - sends blood AWAY from the
heart. No need for valves since not as much blood is present in these vessels
compared to Veins.
PAD: Right Ans - peripheral artery disease
PVD: Right Ans - peripheral vascular disease
Atherosclerosis: Right Ans - condition in which fatty deposits called plaque
build up on the inner walls of the arteries
What common disease processes stem from Atherosclerosis: Right Ans - 1.
Hypertension (High Blood Pressure)
2. Angina (Stable & Unstable)
3. Acute Coronary Syndrome
4. Coronary Artery Disease
,Angina: Right Ans - a decrease in supply of oxygen to the heart muscle from
narrowed vessels due to atherosclerosis. Can be seen as either increase O2
demand or decrease O2 supply.
What are the types of Angina: Right Ans - 1. Silent
2. Nocturnal
3. Prinzmental or Variant
4. Chronic Stable
5. Unstable
Silent Angina: Right Ans - COMMONLY SEEN WITH: Diabetes
- Sugar damages arteries and veins leading to heart ischemia
- No chest pain is present
- Prodromal Signs: nausea, fatigue, or just don't feel right
- Dx: Stress test or ECG can show this
Nocturnal Angina: Right Ans - chest pain that is heard of at night but not as
common as the other types of angina
Prinzmetal or Variant Angina: Right Ans - COMMON SIGN: ST elevation or
PQ wave changes
- 90% starts as stable angina (poor O2 getting through and increasing cardiac
output)
- Vasospasms can be present or not
- Caused by Raynaud's Syndrome
- Caused by Migraines
Vasospasms: Right Ans - a sudden and brief tightening or constricting of a
blood vessel
Why does Raynaud's Syndrome lead to Priznmetal or Variant Angina: Right
Ans - this is due to Coronary Artery Vasospasm in the hands or feet this can
lead to increase vitals and cardiac output. This can even cause lots of pain to
the patient in the long run.
Why does Migraines cause Priznmetal or Variant Angina: Right Ans -
abnormal vasospasm and endothelial dysfunction, that affect both the
cerebral and coronary arterie
, What is a good medication to use for Prinzmetal or Variant Angina: Right
Ans - Calcium Channel Blockers
Chronic Stable Angina: Right Ans - These patients will know their limits.
Intermittent form, can sense pattern changes.
What is a medication Chronic Stable Angina patients should carry around with
them? Right Ans - Nitroglycerin
Unstable Angina: Right Ans - chest pain that is constant and doesn't stop
with rest. We must fix this one or it could turn into an MI or other
complications
When a patient comes in with Angina what types of Questions or Details will
be looking for: Right Ans - - OLD CARTS = Pain Tool
- What have you been doing at home about this?
- What medications are you currently taking?
- When was your last dose of your common medications?
- What is your history?
- What were you doing before the chest pain started?
What are some common Precipitating Factors for Angina: Right Ans - 1.
Physical Exertion
2. Temperature Extremes
3. Strong Emotions
4. Eating a Heavy Meal
5. Tobacco use or Smoking
6. Sexual Activity
7. Stimulants (caffeine)
Why is it important to stop Smoking or using Tobacco if you have cardiac
complications: Right Ans - Smoking or any type of Tobacco products leads
to further vasoconstriction of the arteries and vessels. Leading to increased
vitals, work load of the heart and cardiac output.
Where are some common pain areas for someone experiencing Angina:
Right Ans - 1. Upper Chest
2. Neck
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