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Questions and Answers
Which of the following accurately describes the sequence of blood flow through the heart?
Which of the following accurately describes the sequence of blood flow through the heart?
- Left atrium → mitral valve → left ventricle → aortic valve → pulmonary arteries → lungs → pulmonary veins → right atrium → tricuspid valve → right ventricle → pulmonary valve → aorta
- Left atrium → tricuspid valve → left ventricle → pulmonary valve → pulmonary arteries → lungs → pulmonary veins → right atrium → mitral valve → right ventricle → aortic valve → aorta
- Right atrium → mitral valve → right ventricle → aortic valve → pulmonary arteries → lungs → pulmonary veins → left atrium → tricuspid valve → left ventricle → pulmonary valve → aorta
- Right atrium → tricuspid valve → right ventricle → pulmonary valve → pulmonary arteries → lungs → pulmonary veins → left atrium → mitral valve → left ventricle → aortic valve → aorta (correct)
The myocardium is primarily responsible for which function within the heart?
The myocardium is primarily responsible for which function within the heart?
- Facilitating the exchange of oxygen and carbon dioxide.
- Contracting to pump blood through the heart. (correct)
- Generating the electrical impulses for heart rhythm.
- Providing a protective outer layer for the heart.
What is the primary role of the pericardial space in the heart?
What is the primary role of the pericardial space in the heart?
- To regulate blood flow through the heart.
- To reduce friction during heart contractions. (correct)
- To provide structural support for the myocardium.
- To facilitate electrical impulse transmission.
Which of the listed arteries is NOT part of the left coronary artery system?
Which of the listed arteries is NOT part of the left coronary artery system?
If the sinoatrial (SA) node fails, what is the typical heart rate generated by the atrioventricular (AV) node?
If the sinoatrial (SA) node fails, what is the typical heart rate generated by the atrioventricular (AV) node?
What is the primary function of the Purkinje fibers within the heart's conduction system?
What is the primary function of the Purkinje fibers within the heart's conduction system?
The delay in conduction between the SA and AV nodes is most critical for which process to occur efficiently?
The delay in conduction between the SA and AV nodes is most critical for which process to occur efficiently?
A patient presents with jugular venous distention (JVD) while their head of bed (HOB) is elevated. What does this finding most directly indicate?
A patient presents with jugular venous distention (JVD) while their head of bed (HOB) is elevated. What does this finding most directly indicate?
A patient with heart failure is prescribed an Angiotensin Receptor-Neprilysin Inhibitor (ARNI). Which of the following is a characteristic of this medication?
A patient with heart failure is prescribed an Angiotensin Receptor-Neprilysin Inhibitor (ARNI). Which of the following is a characteristic of this medication?
A patient exhibiting signs of digoxin toxicity, including confusion and visual disturbances, is likely to also have which of the following?
A patient exhibiting signs of digoxin toxicity, including confusion and visual disturbances, is likely to also have which of the following?
During the monitoring of a patient in the ICU with an arterial line, which of these statements about mean arterial pressure (MAP) is most accurate?
During the monitoring of a patient in the ICU with an arterial line, which of these statements about mean arterial pressure (MAP) is most accurate?
On a standard electrocardiogram (ECG), what does the ST segment represent?
On a standard electrocardiogram (ECG), what does the ST segment represent?
A client with angina is being discharged. Which behavior should the nurse emphasize as the most important to report?
A client with angina is being discharged. Which behavior should the nurse emphasize as the most important to report?
When instructing an outpatient about the purpose of a cardiac stress test, which explanation is most accurate?
When instructing an outpatient about the purpose of a cardiac stress test, which explanation is most accurate?
During an exercise stress test, which finding would be most concerning and require immediate attention?
During an exercise stress test, which finding would be most concerning and require immediate attention?
A client is unable to achieve their target heart rate during an exercise stress test. What alternative testing method would most likely be used?
A client is unable to achieve their target heart rate during an exercise stress test. What alternative testing method would most likely be used?
Which of the following symptoms experienced during an exercise stress test would be considered abnormal?
Which of the following symptoms experienced during an exercise stress test would be considered abnormal?
A client with known stable angina is preparing for discharge. The nurse should emphasize that which scenario requires immediate reporting to their healthcare provider?
A client with known stable angina is preparing for discharge. The nurse should emphasize that which scenario requires immediate reporting to their healthcare provider?
Which of these is a characteristic of unstable angina?
Which of these is a characteristic of unstable angina?
What is the fundamental cause of a myocardial infarction?
What is the fundamental cause of a myocardial infarction?
During an exercise stress test, which of these assessments is the nurse least likely to perform?
During an exercise stress test, which of these assessments is the nurse least likely to perform?
A client is undergoing an exercise stress test. At what point should the test be immediately discontinued?
A client is undergoing an exercise stress test. At what point should the test be immediately discontinued?
A patient's lab results indicate elevated levels of homocysteine. Which of the following is the most likely contributing factor to this finding?
A patient's lab results indicate elevated levels of homocysteine. Which of the following is the most likely contributing factor to this finding?
A patient with a history of cardiovascular disease is being assessed for a potential myocardial infarction. Which of the following laboratory values would be most indicative of cardiac muscle damage?
A patient with a history of cardiovascular disease is being assessed for a potential myocardial infarction. Which of the following laboratory values would be most indicative of cardiac muscle damage?
A patient's lipid profile reveals elevated total cholesterol and LDL levels, alongside low HDL levels. Which dietary recommendation is most appropriate?
A patient's lipid profile reveals elevated total cholesterol and LDL levels, alongside low HDL levels. Which dietary recommendation is most appropriate?
A patient is experiencing chest pain that is relieved with rest and nitroglycerin. Based on this information, which type of angina is the patient most likely experiencing?
A patient is experiencing chest pain that is relieved with rest and nitroglycerin. Based on this information, which type of angina is the patient most likely experiencing?
Which of the following best describes the mechanism by which atherosclerosis contributes to acute coronary syndrome (ACS)?
Which of the following best describes the mechanism by which atherosclerosis contributes to acute coronary syndrome (ACS)?
A patient has an increased risk of cardiovascular disease, specifically related to a hormonal imbalance. Which hormonal change is most likely contributing to this increased risk?
A patient has an increased risk of cardiovascular disease, specifically related to a hormonal imbalance. Which hormonal change is most likely contributing to this increased risk?
A patient is admitted with heart rhythm abnormalities. Which of the following electrolyte imbalances is most likely contributing to this condition?
A patient is admitted with heart rhythm abnormalities. Which of the following electrolyte imbalances is most likely contributing to this condition?
A patient has just been diagnosed with a STEMI. What diagnostic test was most likely used to arrive at this diagnosis?
A patient has just been diagnosed with a STEMI. What diagnostic test was most likely used to arrive at this diagnosis?
Which of the following scenarios would most strongly suggest a patient has coronary artery disease?
Which of the following scenarios would most strongly suggest a patient has coronary artery disease?
Which of the following best describes afterload?
Which of the following best describes afterload?
A patient has a mean arterial pressure (MAP) of 55. Which of the following is the most accurate assessment?
A patient has a mean arterial pressure (MAP) of 55. Which of the following is the most accurate assessment?
What formula accurately represents how to calculate stroke volume?
What formula accurately represents how to calculate stroke volume?
What does preload primarily reflect?
What does preload primarily reflect?
A patient's echocardiogram shows the following: End-diastolic volume (EDV) of 120 mL and end-systolic volume (ESV) of 50 mL. What is the patient's ejection fraction?
A patient's echocardiogram shows the following: End-diastolic volume (EDV) of 120 mL and end-systolic volume (ESV) of 50 mL. What is the patient's ejection fraction?
A patient's ejection fraction is calculated at 30%. Which of the following best describes this finding?
A patient's ejection fraction is calculated at 30%. Which of the following best describes this finding?
Which of the following is a typical cause of diastolic heart failure?
Which of the following is a typical cause of diastolic heart failure?
What is the most common cause of right-sided heart failure?
What is the most common cause of right-sided heart failure?
Which of the following indicates a potential complication related to left-sided heart failure?
Which of the following indicates a potential complication related to left-sided heart failure?
What is a unique characteristic of cor pulmonale, in differentiating it from right sided heart failure caused by left sided heart failure?
What is a unique characteristic of cor pulmonale, in differentiating it from right sided heart failure caused by left sided heart failure?
Flashcards
Epicardium
Epicardium
The external layer of the heart.
Myocardium
Myocardium
The muscular layer of the heart responsible for contraction.
Endocardium
Endocardium
The inner lining of the heart, including the valves, composed of epithelial tissue.
Interventricular Septum
Interventricular Septum
A thick wall separating the right and left ventricles.
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Pericardium
Pericardium
The sac surrounding the heart, consisting of two layers: visceral and parietal.
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Pericardial Space
Pericardial Space
The space between the visceral and parietal layers of the pericardium, containing about 20 ml of fluid to prevent friction.
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SA Node
SA Node
The natural pacemaker of the heart, located in the right atrium, responsible for the rhythm.
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Atherosclerosis
Atherosclerosis
The buildup of plaque within the coronary artery that can worsen over time, potentially blocking the vessel or causing a blood clot.
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Lipid Profile
Lipid Profile
A series of tests to assess a person's cardiovascular health, including levels of LDL, HDL, total cholesterol, and triglycerides.
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C-reactive Protein
C-reactive Protein
A marker of inflammation in the body, particularly associated with atherosclerosis in blood vessels.
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Brain Natriuretic peptide (BNP)
Brain Natriuretic peptide (BNP)
A hormone released primarily by the heart in response to stretching of the heart chambers, commonly used to assess heart failure.
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Troponin
Troponin
The enzyme released by damaged heart muscle cells, used as a marker for heart attack.
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Homocysteine
Homocysteine
An amino acid that can contribute to inflammation and damage to the endothelial layer of blood vessels, increasing the risk of atherosclerosis.
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High LDL Cholesterol
High LDL Cholesterol
A critical risk factor for coronary artery disease. It is associated with low levels of HDL cholesterol and high total cholesterol levels.
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Hypertension
Hypertension
A critical risk factor for coronary artery disease, characterized by persistently elevated blood pressure.
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Diabetes
Diabetes
A condition where the body cannot effectively regulate blood sugar levels leading to increased risk of CVD.
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Stable Angina
Stable Angina
Chest pain that occurs during exercise and resolves with rest or nitroglycerin.
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Unstable Angina
Unstable Angina
Chest pain that occurs unexpectedly, even at rest, often caused by narrowed coronary arteries (atherosclerosis).
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Myocardial Infarction (MI)
Myocardial Infarction (MI)
A blockage in a coronary artery leading to death of heart tissue.
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Cardiac Stress Test
Cardiac Stress Test
A test to assess the heart's ability to tolerate a workload, often used to diagnose angina and other cardiovascular conditions.
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Exercise Stress Test
Exercise Stress Test
A type of cardiac stress test that involves walking or running on a treadmill or stationary bike.
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Pharmacologic Stress Test
Pharmacologic Stress Test
A type of cardiac stress test that uses medication to simulate exercise, used for people who cannot exercise sufficiently.
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Pain Following Sexual Activity
Pain Following Sexual Activity
Pain that occurs following sexual activity.
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Pain After Large Meal
Pain After Large Meal
Pain that occurs after eating a large meal.
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Change in Character of Pain
Change in Character of Pain
A change in the character of chest pain.
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Headache After Nitroglycerin
Headache After Nitroglycerin
A headache after taking nitroglycerin.
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Hemodynamics
Hemodynamics
The study of how blood circulates through the body's vessels.
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Cardiac Output
Cardiac Output
The amount of blood ejected by the ventricles each minute, calculated as stroke volume (SV) multiplied by heart rate (HR).
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Afterload
Afterload
The pressure the heart must overcome during systole to pump blood out of the ventricles. It's influenced by blood pressure and vessel constriction.
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End-diastolic Volume (EDV)
End-diastolic Volume (EDV)
The amount of blood in the ventricles at the end of diastole (the 'full' state).
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Stroke Volume (SV)
Stroke Volume (SV)
The amount of blood ejected with each heartbeat. Calculated as end-diastolic volume minus end-systolic volume.
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Ejection Fraction
Ejection Fraction
The percentage of blood ejected from the heart with each contraction.
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Preload
Preload
The stretch of the myocardium at the end of diastole (the 'full' state). It's influenced by blood volume.
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Echocardiogram
Echocardiogram
An ultrasound imaging technique used to visualize the heart and vessels.
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Heart Failure
Heart Failure
A clinical syndrome where the heart cannot pump enough blood to meet the body's needs.
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Systolic Heart Failure
Systolic Heart Failure
Type of heart failure where the ejection fraction is reduced (less than 40%) due to decreased contractility or increased afterload.
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Mean Arterial Pressure (MAP)
Mean Arterial Pressure (MAP)
A measurement of the pressure in the arteries during a heartbeat cycle, reflecting the workload on the heart.
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ACE-I or ARBs
ACE-I or ARBs
A group of medications addressing the renin-angiotensin-aldosterone system (RAAS) to manage high blood pressure and improve heart health.
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Central Venous Pressure (CVP)
Central Venous Pressure (CVP)
The pressure in the right atrium that reflects the preload (blood volume) in the heart.
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Cardio A - Blood Flow and Anatomy
- Blood enters the right atrium via the superior and inferior vena cava.
- It flows through the tricuspid valve to the right ventricle.
- Then, it passes through the pulmonary valve into the pulmonary arteries.
- These arteries carry deoxygenated blood to the lungs.
- In the lungs, CO2 is exchanged for O2.
- Oxygenated blood returns to the left atrium via the pulmonary veins.
- Next, it passes through the mitral valve to the left ventricle.
- The blood then flows through the aortic valve into the aorta.
- The aorta distributes blood to the body.
Cardiac Layers
- Epicardium: The outermost layer of the heart.
- Myocardium: The muscular layer that pumps/contracts the heart.
- Endocardium: The inner lining layer of the heart and valves.
- Pericardium: The external sac surrounding the heart, made of two layers (visceral against epicardium, parietal surrounding visceral).
Coronary Circulation
- Aortic sinuses lead to coronary arteries supplying blood to the heart's tissues.
- The right coronary artery supplies the right ventricle, right atrium, SA node, and AV node.
- It also extends to the right posterior descending artery.
- The left coronary artery supplies the left ventricle, left atrium, and the anterior left side of the heart, extending to the left anterior descending and circumflex arteries.
Conduction System
- The SA node (pacemaker) initiates the heartbeat at 60-100 bpm.
- The internodal pathway carries the signal to depolarize the atria.
- The AV node introduces a delay, allowing the atria to contract completely before ventricular contraction.
- This impulse then travels through the bundle of His, left and right bundle branches, and Purkinje fibers.
- Finally, the ventricles contract.
- The AV node fires at 40-60 bpm if the SA node fails.
Cardiac Enzymes and Electrolytes
- Cardiac enzymes (CK, CK-MB, myoglobin, troponin) aid in diagnosing myocardial damage.
- Electrolyte imbalances (K+, Mg2+, Ca2+) can impact heart function and rhythms.
- Lipid profiles are usually checked to assess risk of atherosclerosis and/or CVD (high LDL, total cholesterol, triglycerides, a low HDL is considered unhealthy)
- Other labs related to CVD include C-reactive protein, Homocysteine and NT-proBNP.
Cardiac Stress Testing
- Stress tests evaluate the heart's response to physical or pharmacological exertion.
- Exercise or medication stress the heart to assess for ischemia and blood flow issues.
- A variety of tests are performed to measure blood pressure, heart rate, ECG, skin temperature, physical appearance and/or perceived exertion.
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