Cardiac Health and Sinus Bradycardia

Questions and Answers

What is a potential management step for a patient exhibiting sinus bradycardia symptoms?

May need atropine (correct)

Immediate surgery

Administer aspirin

Increase fluid intake

In what situation should synchronized cardioversion be considered in sinus tachycardia?

Patient is experiencing chest pain (correct)

Patient has a stable heart rate over 100 bpm

Patient has a resting heart rate below 60 bpm

Patient is asymptomatic

Which characteristic is true for premature ventricular complexes (PVC)?

Always associated with a visible P wave

Always indicates heart failure

QRS duration of less than 0.12 seconds

Irregular rhythm due to early QRS (correct)

What sound is associated with S3 heart sound and when does it occur?

It occurs during rapid ventricular filling Signup and view all the answers

What might indicate the presence of a fourth heart sound (S4)?

Noncompliant ventricle during atrial contraction Signup and view all the answers

How can a friction rub sound be best characterized?

A harsh, grating sound caused by pericarditis Signup and view all the answers

Which of the following is NOT a common cause of murmurs?

Normal valve opening Signup and view all the answers

What is the appropriate ratio of compressions to rescue breaths in CPR?

30 compressions to 2 breaths Signup and view all the answers

Which of the following conditions represents an unresponsive patient needing immediate action?

Patient has no pulse or breathing Signup and view all the answers

What percentage of Americans are likely to have primary hypertension?

90-95% Signup and view all the answers

Which of the following is NOT considered a complication of hypertension?

Asthma Signup and view all the answers

What is the primary purpose of thiazide diuretics in the treatment of hypertension?

Decrease blood pressure Signup and view all the answers

In a hypertensive emergency, what should the mean arterial pressure be reduced by during the first hour?

20-25% Signup and view all the answers

Which medication is associated with the side effect of a dry cough?

ACE inhibitors Signup and view all the answers

Which risk factor is associated with a higher prevalence of hypertensive disorders?

Being African American Signup and view all the answers

Which characteristic symptom is primarily associated with peripheral artery disease (PAD) in the lower extremities?

Intermittent claudication Signup and view all the answers

What is the recommended daily foot care routine for a patient with PAD?

Washing between toes with mild soap and lukewarm water Signup and view all the answers

Which condition can indicate a serious complication such as compartment syndrome in a patient with PAD?

Decreased sensation of toes Signup and view all the answers

Which treatment modality is classified as a pharmacologic intervention for managing PAD?

Cilostazol Signup and view all the answers

What pathophysiological change occurs as a result of chronic venous insufficiency?

Obstruction of venous valves Signup and view all the answers

During which time of day do patients typically experience fewer symptoms of chronic venous insufficiency?

In the morning Signup and view all the answers

Which of the following is NOT a recommended patient education point for managing foot health in PAD?

Use heating pads on the feet regularly Signup and view all the answers

What term describes the indication of fluid imbalances that includes urine output changes and altered mental status in PAD-related complications?

Hemodynamic instability Signup and view all the answers

In the management of PAD, what does the acronym '5 P's' stand for?

Pain, Pale, Paresthesia, Pulseless, Paralysis Signup and view all the answers

Which of the following is a surgical treatment option for addressing PAD?

Bypass grafting Signup and view all the answers

What is the primary trigger for stable angina?

Excessive physical exertion Signup and view all the answers

Which laboratory value should be monitored for a patient receiving Heparin drip?

aPPT Signup and view all the answers

Which clinical manifestation is primarily associated with right-sided heart failure?

Distended neck veins Signup and view all the answers

What happens as a result of Angiotensin II stimulation in the RAAS system?

Increased sodium and water retention Signup and view all the answers

Which of the following medications is commonly used to prevent platelet aggregation in patients at risk for myocardial infarction?

Aspirin Signup and view all the answers

What is the goal of using diuretics in patients with pulmonary edema?

To remove excess fluid from the body Signup and view all the answers

What is a potential consequence of the compensatory mechanisms activated during heart failure?

Fluid overload Signup and view all the answers

Which risk factor for atherosclerosis is considered modifiable?

Sedentary lifestyle Signup and view all the answers

Which symptom is most indicative of left-sided heart failure?

Pink frothy sputum Signup and view all the answers

What is the purpose of a Left Ventricular Assist Device (LVAD)?

To improve cardiac output temporarily Signup and view all the answers

What is indicated by the presence of ECG changes in two contiguous leads during a myocardial infarction?

The patient is experiencing STEMI Signup and view all the answers

Which of the following is a contraindication for administering Nitroglycerin?

Concurrent use of Viagra Signup and view all the answers

Which modifiable risk factor is associated with coronary artery disease (CAD)?

Hyperlipidemia Signup and view all the answers

What should be monitored post-cardiac catheterization to assess potential complications?

Puncture site for hematoma or bleeding Signup and view all the answers

In the assessment of a myocardial infarction, elevated Troponin levels indicate what?

Damage to the myocardium Signup and view all the answers

What is the first intervention recommended for treating a myocardial infarction?

Oxygen therapy Signup and view all the answers

Which lifestyle modification is vital for patients at risk for coronary artery disease?

Starting smoking cessation programs Signup and view all the answers

What is the primary nursing intervention to be performed during an acute myocardial infarction?

Monitoring vital signs and connecting to an ECG Signup and view all the answers

Which of the following best describes a NSTEMI?

Patient has elevated cardiac biomarkers without clear ECG changes Signup and view all the answers

What specific cardiac condition does preeclampsia increase the risk for later in life?

Coronary artery disease Signup and view all the answers

Study Notes

Cardiac Rhythms and Management

An increase of 10 bpm or more in resting heart rate is linked to a higher risk of sudden cardiac death, atrial fibrillation, heart failure, coronary artery disease (CAD), stroke, and cardiovascular disease.

Sinus Bradycardia

Characterized by a heart rate of less than 60 bpm, normal P wave positioned before QRS, PR interval between 0.12 and 0.20 seconds.
1:1 ratio of P waves to QRS complexes.
Management based on symptoms: symptomatic patients may require atropine, transcutaneous pacing, or catecholamines.
Nurse actions include patient assessment for symptoms like fatigue and light-headedness. For asymptomatic cases, monitor ECG and vital signs.

Sinus Tachycardia

Defined by a heart rate greater than 100 bpm with a regular rhythm and normal P waves (which may be obscured in T waves).
Management involves treating underlying causes, with symptomatic patients potentially requiring synchronized cardioversion or adenosine administration.
Important nursing actions include assessing patient status and checking for factors such as fever or dehydration.

Ventricular Dysrhythmias

Premature Ventricular Complex (PVC): Early impulse from the ventricle with abnormal QRS morphology, visible P waves depend on PVC timing, PR interval less than 0.12 seconds.
Ventricular Tachycardia (VTACH), Ventricular Fibrillation (VFIB), PEA, and Asystole are critical pulseless rhythms that necessitate immediate CPR.

Heart Sounds and Clinical Assessment

Third Heart Sound (S3) is indicative of heart failure, heard during rapid ventricular filling.
Fourth Heart Sound (S4) relates to hypertensive heart disease, occurring during atrial contraction.
Other sounds include opening snaps (associated with AV valve malfunction) and systolic clicks (from stenosis of semilunar valves).
Murmurs caused by turbulent blood flow can result from narrowed or malfunctioning valves.
A friction rub is a harsh sound linked to pericarditis and can mimic murmurs.

Cardiopulmonary Resuscitation (CPR)

Effective CPR consists of a compression to breath ratio of 30:2.
The process prioritizes assessing the patient's responsiveness and circulation, followed by calling for assistance.
Essential to provide blood flow to vital organs until circulation is restored.

Myocardial Infarction

Acute Coronary Syndrome leads to myocardial death due to ischemia.
STEMI shows characteristic ECG changes; NSTEMI presents elevated cardiac biomarkers without notable ECG changes.
Treatment begins with oxygen, followed by nitroglycerin, morphine, and aspirin (with contraindications for low blood pressure and viagra use).
Patient education includes lifestyle modifications and monitoring for cardiac symptoms.

Coronary Artery Disease (CAD) Risk Factors

Modifiable: hyperlipidemia, tobacco use, hypertension, diabetes, and obesity.
Nonmodifiable: family history, age, gender, race.
Post-Operative Care after CABG focuses on ensuring adequate heart function and monitoring for complications.

Heart Failure

Key diagnostic test: B-type natriuretic peptide (BNP).
Right heart failure presents with edema and distended neck veins; left heart failure affects lung function, causing dyspnea.
Risk factors include myocardial infarction, aging, and valve abnormalities.
Education emphasizes a low-sodium diet and daily weight monitoring.

Atherosclerosis and Peripheral Vascular Disease (PAD)

Atherosclerosis involves plaque build-up influenced by both modifiable (smoking, diabetes) and nonmodifiable (age, genetics) risk factors.
PAD often presents as intermittent claudication and is characterized by reduced blood flow to limbs.
Patient education on foot hygiene is crucial; complications include ulcers and gangrene.

Hypertension

New definitions categorize hypertension over 130/80 mmHg; complication risks include heart attack and kidney disease.
Primary hypertension has no identifiable cause; secondary hypertension stems from specific conditions.
Evidence suggests lifestyle changes and dietary modifications are essential for management.
Medications include thiazide diuretics, ACE inhibitors, and calcium channel blockers; patient education is crucial for adherence and monitoring.

Hypertensive Crisis

Defined by severe elevations in blood pressure (>180/100 mmHg).
Emergency treatment requires immediate intervention to decrease mean arterial pressure by 20-25% with IV vasodilators.
Urgency requires careful monitoring without evidence of immediate organ damage.

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Description

This quiz focuses on the implications of heart rate changes and the characteristics of sinus bradycardia. Understand how variations in resting heart rate can influence health risks. Explore management strategies for symptomatic sinus bradycardia.