what does it mean for a patient to have a decrease
identify disorders that may cause a decrease in
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NRSG 421 Cardiac Output
NRSG 421 Cardiac Output
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NRSG 421 Cardiac Output Exam Questions And
Correct Answers
What does it mean for a patient to have a decreased cardiac output? - ANS Inadequate
blood pumped by the heart to meet metabolic demands of the body
Identify disorders that may cause a decrease in cardiac output. - ANS MI, HTN, valvular
heart disease, congenital heart disease, arrhythmias, drug effects, fluid overload,
decreased fluid volume and electrolyte imbalances
What is a major cause of CAD, patho? - ANS Atherosclerosis
What is atherosclerosis? - ANS - The hardening of the arteries by accumulation of fatty
deposits (421)
- Soft deposits of fat that harden with age (226)
Fatty deposits (atheromas) have a predilection for _____________ arteries? - ANS ___
coronary___
What are the basic stages of atheroma development? - ANS 1) Fatty streak in artery
(lipid-filled smooth muscle cells)
2) Elevated fibrous plaque (LDLs and platelets stimulate smooth muscle proliferation
and thickening, transport cholesterol into intama, collagen covers the fatty streak and
forms fibrous plaque)
3) Complicated lesion (platelets accumulate to form thrombus, instability of fibrous
lesion may result in instability, ulceration and rupture)
True or false.
A complicated lesion only partially occludes the affected artery - ANSWER False
,May partially or totally occlude artery
Describe the pathophysiology coronary artery disease? - ANS - Increased serum LDL
and cholesterol levels and migration of monocytes
- Monocytes accumulate lipids and become foam cells this causes fatty streaks within
the blood vessel
- Endothelium breaks and accumulates platelets
- Vasoconstriction leads to hypertrophy of vessel walls
- Nitric oxide is inhibited by increased insulin levels, nicotine and HTN
- Decreased ability of blood vessel to vasodilate
- Narrowed hardened arteries
- CAD or coronary artery disease
What is(are) some of the non-modifiable risk factors of CAD? (this is a 226 question) -
ANSWER - Increasing age
- Sex-more common in men until women reach age 65
- Ethnicity-more common in caucasian people
- Genetic predisposition and family history
What do you consider to be some major modifiable risk factors of CAD? (this is a 226
question) - ANSWER - High, LDL cholesterol and triglycerides and reduced HDL serum
lipid levels
- HTN
- Tobacco use
- Physical inactivity
- Obesity
What do you consider to be some contributing modifiable risk factors for CAD? (this is a
, 226 question) - ANSWER - Diabetes
- Metabolic syndrome
- Psychological states (stress, anxiety, etc)
- Increased homocysteine levels
- Substance use
True or false.
High levels of LDL are associated with increased risk of CAD while high levels of HDL
are associated with decreased risk of CAD ANSWER True
How do high levels of HDL decrease risk for CAD? ANSWER Reverses cholesterol
transport by taking excess cholesterol from the tissues back to the liver for metabolism
What might increase HDL levels in the body? ANSWER - Exercise and weight loss
- Fish oil
- Decreased intake of alcohol
- Drugs like niacin, fibrates and statins
What is nitric oxide? -answer- Potent vasodilator which normally inhibits platelet
aggregation and monocyte adherence (421)
- A kind of endothelium derived relaxing factor that helps in maintaining low arterial tone
at rest, inhibits growth of smooth muscle layer & inhibits platelet aggregation
what is angina? -ANSWER- Angina is tightness, squeezing, pressure, or pain in the
chest. It occurs when heart muscle receives less oxygen than usual (421)
-demand for myocardial oxygen exceeds the ability of coronary arteries to supply the
heart with oxygen. AKA myocardial ischemia. Anaerobic metabolism may begin causing
lactic acid build up which is irritating to myocardial nerve fibers (226)
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