Questions and Answers
What is the first intervention in treating a patient experiencing a myocardial infarction?
Which of the following is NOT a modifiable risk factor for Coronary Artery Disease (CAD)?
Which cardiac biomarker is indicative of heart damage during a myocardial infarction?
What should be assessed post-cardiac catheterization?
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Which of the following symptoms is commonly associated with acute coronary syndrome?
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What is a contraindication for administering Nitroglycerin?
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What is a recommended lifestyle modification for patients to manage CAD risk factors?
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Which of the following is an essential clinical intervention during the immediate care of a patient with unresponsiveness?
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What is preload primarily influenced by?
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Which condition is associated with an increase in afterload?
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How is cardiac output calculated?
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What does central venous pressure (CVP) indicate?
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What may the purpose of a stress test include?
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Which of the following represents a normal heart rate?
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What does the P wave on an ECG represent?
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How can the heart conduction pathway be traced?
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What is considered a hallmark manifestation of peripheral artery disease?
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What should patients with peripheral vascular disease do to maintain foot hygiene?
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Which of the following is a potential complication of leg crossing in patients with peripheral vascular disease?
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What does the acronym 'PAD' in patient education refer to in managing peripheral artery disease?
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Which medication is classified as a phosphodiesterase III inhibitor and is used in treatment?
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What is a common clinical manifestation of chronic venous insufficiency?
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What is an important patient education point for those with chronic venous insufficiency?
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Which of the following describes a sign of compartment syndrome?
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What heart rate defines Sinus Bradycardia?
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Which medication may be used for a symptomatic patient with Sinus Bradycardia?
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What is the ratio of P waves to QRS complexes in Sinus Tachycardia?
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What is a key characteristic of Premature Ventricular Complexes (PVCs)?
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What should be the first action if a patient is found unresponsive?
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Which condition is associated with a resting heart rate increase of 10 bpm or more?
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How does the PR interval in Sinus Bradycardia typically present?
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In managing Sinus Tachycardia, which is NOT a typical treatment option?
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What is the main difference between venous and arterial ulcers?
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What is a recommended nursing action for managing a patient with abdominal aortic aneurysm?
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Which factor is NOT a common risk factor for developing hypertension?
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What is the primary treatment for Raynaud's disease?
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What is a common side effect of thiazide diuretics?
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Which of the following teaches patients about lifestyle changes important for managing hypertension?
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What is one method to provide post-operative care for a patient who has undergone a femoral popliteal bypass?
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What is the normal blood pressure classification for hypertension according to recent guidelines?
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Which of these is a clinical manifestation of Raynaud's disease?
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What should be avoided to help manage Raynaud's disease symptoms?
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Study Notes
Cardiac Conditions and Management
- An increase of 10 bpm or more in resting heart rate correlates with higher risks for sudden cardiac death, atrial fibrillation, heart failure, coronary artery disease (CAD), stroke, and overall cardiovascular disease.
Sinus Bradycardia
- Defined as a heart rate of less than 60 bpm.
- Characteristic includes a normal, consistent P wave preceding the QRS complex, with a PR interval of 0.12-0.20 seconds.
- Management depends on patient symptoms; symptomatic patients may receive atropine or require transcutaneous pacing.
- Nurses should assess the patient for bradycardia symptoms like fatigue and light-headedness, and monitor ECG and vital signs for asymptomatic patients.
Sinus Tachycardia
- A heart rate exceeding 100 bpm, with a regular rhythm and normal P waves, which may be obscured in the T wave.
- Management is based on symptoms; potential treatments include synchronized cardioversion, adenosine, or AV blocking medications.
- Nurses need to assess for underlying causes and ensure accurate readings, monitoring for signs like fever or dehydration.
Ventricular Dysrhythmias: Premature Ventricular Complex (PVC)
- PVC is an impulse originating in the ventricle, appearing before the subsequent normal sinus rhythm (NSR) complex.
- This irregular rhythm features an early QRS that lasts 0.12 seconds or longer, with abnormal shape and a PR interval of less than 0.12 seconds.
Hemodynamics
- Preload: Indicates the degree of ventricular muscle fiber stretch at the end of diastole, influenced by blood volume and heart failure.
- Afterload: Refers to resistance against ventricular ejection, affected by hypertension and vasoconstriction; increased afterload results in greater cardiac workload.
- Cardiac Output (CO): Product of stroke volume and heart rate, reflecting total blood ejected by one ventricle per minute.
- Central Venous Pressure (CVP): Measures blood pressure in the vena cava near the right atrium, indicating blood return volume and heart pump efficiency.
- Stroke Volume (SV): Amount of blood ejected from one ventricle per heartbeat.
Stress Test
- Conducted to identify heart conditions by inducing stress on the heart to analyze symptoms like shortness of breath and chest pain along with ECG changes.
- Nurses monitor vital signs and ECG for abnormalities during the test.
Heart Conduction System
- The conduction pathway includes the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers, with a normal rate of 60-100 bpm.
- The SA node acts as the natural pacemaker.
ECG Analysis
- ECG strips help determine heart rate and rhythm; a one-minute strip contains 300 large and 1500 small boxes.
- To calculate heart rate, count large boxes between QRS complexes and divide by 300.
Myocardial Infarction (Heart Attack)
- Acute Coronary Syndrome involves sudden ischemia leading to myocardial death.
- Diagnosis includes a 12-lead ECG, cardiac biomarkers (elevated Troponin), and cardiac catheterization.
- Initial treatments involve oxygen, nitroglycerin, morphine, and aspirin; contraindications for nitroglycerin include recent use of Viagra and low blood pressure.
- Patient education covers lifestyle modifications and knowledge of cardiac medications.
Coronary Artery Disease (CAD)
- Modifiable risk factors: Hyperlipidemia, tobacco use, hypertension, diabetes, obesity, and inactivity.
- Nonmodifiable risk factors: Family history, age, gender, and race.
- Focus on behavior changes: smoking cessation and healthy diet.
Post-Operative Care
- After CABG surgery, monitor heart function through urine output and blood pressure.
- Complications may include bleeding, thrombosis, and compartment syndrome.
- Peripheral manifestations include claudication and skin changes; patient education on foot hygiene and circulation is crucial.
Chronic Venous Insufficiency (CVI)
- Results from valve obstruction or blood reflux, leading to venous hypertension.
- Symptoms include edema, altered pigmentation, and stasis dermatitis, with more noticeable signs at night.
- Nursing care emphasizes leg elevation, skin care, and compression stocking use, along with patient education on leg positioning.
Raynaud's Disease
- Characterized by intermittent vascular constriction leading to coldness, pain, and color changes in fingers.
- Management strategies include calcium channel blockers and avoidance of cold and smoking.
Ulcer Distinction
- Venous ulcers: Shallow with irregular borders, common over the leg/ankle.
- Arterial ulcers: Typically located on the feet, characterized by severe pain and distinct "whole punch" appearance.
Hypertension
- New thresholds: 130/80 mmHg for diagnosis; categorized into stages.
- Major complications include increased risk of TIA/stroke, left ventricular hypertrophy, and chronic kidney disease.
- Education including lifestyle changes and medications is essential for management, with thiazide diuretics as a first-line treatment.
Nursing Considerations
- Regular monitoring, patient education, and lifestyle modification support are key roles in managing various cardiac and vascular conditions.
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Description
This quiz focuses on cardiac rhythms, specifically sinus bradycardia, and the implications of resting heart rate on health. It addresses conditions associated with abnormal heart rates and highlights management strategies. Test your knowledge on the relationship between heart rate and cardiovascular diseases.
