Cardiovascular Health Quiz

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Questions and Answers

What is a common symptom of paroxysmal nocturnal dyspnea?

  • Cough
  • Air hunger (correct)
  • Fever
  • Nausea

In paroxysmal nocturnal dyspnea, the person typically experiences relief by remaining in bed.

False (B)

What factors can increase respiratory distress during daily activities in heart failure?

Increased intrathoracic blood volume

Common symptoms of heart failure include fatigue, edema, and ______.

<p>palpitation</p> Signup and view all the answers

Match the symptoms with their corresponding questions about chest pain.

<p>When did it start? = Timing of symptoms Where is the pain located? = Location of pain Does the pain radiate? = Pain characteristics Have you had this type of pain before? = Past medical history</p> Signup and view all the answers

What type of pain feature is considered a major finding in heart-related symptoms?

<p>All of the above (D)</p> Signup and view all the answers

Cough is a symptom that should be asked about when evaluating chest pain.

<p>True (A)</p> Signup and view all the answers

Identify one initiating factor that can lead to chest pain.

<p>Exercise</p> Signup and view all the answers

What is the primary purpose of cardiac catheterization?

<p>To assess oxygen saturation and evaluate coronary anatomy (A)</p> Signup and view all the answers

Local anesthesia is not applied to the throat during TEE procedures.

<p>False (B)</p> Signup and view all the answers

What should be monitored throughout the TEE procedure?

<p>ECG and vital signs</p> Signup and view all the answers

Heart failure is a disease in which _____ and/or _____ is impaired.

<p>filling, emptying</p> Signup and view all the answers

Match the following techniques with their purposes:

<p>Angiocardiography = Examine coronary arteries Electrophysiological examination = Assess electrical activity of the heart Coronary ultrasonography = Evaluate structural changes in arteries Biopsy = Obtain tissue samples</p> Signup and view all the answers

Which of the following is a common cardiac risk factor related to age?

<p>Hypertension (A)</p> Signup and view all the answers

Men have the same risk of myocardial infarction (MI) as post-menopausal women.

<p>False (B)</p> Signup and view all the answers

What can a 12-lead ECG help identify?

<p>Dysrhythmias and cardiac ischemia (B)</p> Signup and view all the answers

What is the term for the increase in heart rate that can occur with advanced age?

<p>bradycardia</p> Signup and view all the answers

Patients should keep their mouths closed for at least 4 hours after the TEE procedure.

<p>True (A)</p> Signup and view all the answers

What is the main cause of heart failure?

<p>Structural or functional disorder</p> Signup and view all the answers

The condition known as ______ occurs when there is a buildup of fluid in the body's tissues.

<p>edema</p> Signup and view all the answers

Match the following cardiac symptoms with their definitions:

<p>Chest Pain = Discomfort or pain in the chest area Palpitation = A feeling of having a fast-beating or pounding heart Arrhythmia = An irregular heartbeat Claudication = Pain caused by too little blood flow during exercise</p> Signup and view all the answers

Which of the following conditions can be affected by smoking?

<p>Hypertension (A)</p> Signup and view all the answers

Angina is often associated with coronary arteriosclerosis.

<p>True (A)</p> Signup and view all the answers

What does the term 'arrhythmia' refer to in cardiac evaluation?

<p>An irregular heartbeat</p> Signup and view all the answers

Which of the following statements about atrioventricular valves is correct?

<p>They are responsible for preventing backflow of blood into the atria. (B), They consist of the tricuspid and mitral valves. (C)</p> Signup and view all the answers

The sinoatrial node produces 40-60 impulses per minute.

<p>False (B)</p> Signup and view all the answers

What is the role of the pulmonary artery in the circulatory system?

<p>To carry blood from the right ventricle to the lungs.</p> Signup and view all the answers

The impulse from the AV node is transmitted to the ventricles through the __________.

<p>bundle of His</p> Signup and view all the answers

Match the parts of the conduction system with their functions:

<p>Sinoatrial node = Produces primary electrical impulses AV node = Delays impulse before ventricles Bundle of His = Transmits impulses to myocardium Purkinje fibers = Distributes impulses throughout the ventricles</p> Signup and view all the answers

How long does one complete heart cycle last?

<p>0.8 seconds (B)</p> Signup and view all the answers

The heart pumps approximately 750 liters of blood per day.

<p>False (B)</p> Signup and view all the answers

What is the primary purpose of autoregulation in heart muscle function?

<p>To increase contraction strength as the heart muscle is stretched.</p> Signup and view all the answers

Which type of heart failure is characterized by impaired left-ventricular function?

<p>Systolic heart failure (A), Diastolic heart failure (B)</p> Signup and view all the answers

The prevalence of heart failure among individuals aged 70-80 is 10%.

<p>False (B)</p> Signup and view all the answers

List two signs and symptoms of heart failure.

<p>Dyspnea, fluid retention</p> Signup and view all the answers

The prevalence of hypertension, CAD, diabetes, and obesity in Turkey is above the average of __________ countries.

<p>industrialized</p> Signup and view all the answers

Match the following clinical features with their corresponding symptoms:

<p>Peripheral edema = Ascites Fatigue, weakness = Decreased exercise tolerance Severe dyspnea at rest = Fluid retention Confusion = Inadequate peripheral perfusion</p> Signup and view all the answers

Which of the following factors can lead to acute heart failure? (Select all that apply)

<p>Acute myocardial infarction (B), Uncontrolled hypertension (C), Excessive fluid intake (D)</p> Signup and view all the answers

Heart failure accounts for approximately 1-2% of a country's budget.

<p>True (A)</p> Signup and view all the answers

What percentage of patients admitted to the hospital acutely suffer from heart failure?

<p>5%</p> Signup and view all the answers

What is the primary role of serum electrolytes such as sodium and potassium?

<p>Cell depolarization and repolarization (B)</p> Signup and view all the answers

Hypomagnesemia can prolong the QT interval on an ECG.

<p>True (A)</p> Signup and view all the answers

What are the first symptoms of hypermagnesemia?

<p>Lethargy and decreased neuromuscular activity</p> Signup and view all the answers

An increase in the LDL/HDL ratio indicates a higher risk of __________.

<p>coronary artery disease</p> Signup and view all the answers

Match the following conditions with their effects on the ECG:

<p>Hypokalemia = Ventricular fibrillation Hyperkalemia = Prolonged QT interval Hypomagnesemia = Life-threatening arrhythmias Hypermagnesemia = Decreased neuromuscular activity</p> Signup and view all the answers

Which of the following electrolytes is necessary for coagulability and neuromuscular activity?

<p>Calcium (A)</p> Signup and view all the answers

Fluid excess is indicated by hypernatremia.

<p>False (B)</p> Signup and view all the answers

What diagnostic tests are routinely performed before invasive procedures?

<p>Coagulation tests</p> Signup and view all the answers

Flashcards

Tricuspid Valve

Valve between the right atrium and right ventricle.

Mitral Valve

Valve between the left atrium and left ventricle.

Pulmonary Valve

Valve between the right ventricle and the pulmonary artery.

Aortic Valve

Valve between the left ventricle and the aorta.

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Sinoatrial Node (SA Node)

The natural pacemaker of the heart, located in the right atrium.

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Atrioventricular Node (AV Node)

Tissue at the base of the right atrium, responsible for delaying the electrical signal before it reaches the ventricles.

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Bundle of His

Bundle of specialized fibers that transmit the electrical signal from the AV node to the ventricles.

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Starling's Law

The force of contraction is proportional to the degree of stretch of the heart muscle.

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Paroxysmal Nocturnal Dyspnea (PND)

A condition where a person wakes up suddenly during the night, often gasping for air, due to shortness of breath.

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Palpitation

The feeling of having a fast and irregular heartbeat.

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Tiredness

Feeling tired or lacking energy, often experienced as a constant fatigue.

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Edema

Swelling, usually in the legs or ankles, caused by fluid buildup.

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Chest Pain

Discomfort or pain in the chest, which can be caused by heart problems, lung issues, digestive issues, or other medical conditions.

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Angina

A specific type of chest pain that occurs due to a lack of oxygen to the heart muscle. It usually feels like a pressure or tightness in the chest and can radiate to other areas, such as the jaw, neck, or arms.

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Cough

A forceful expulsion of air from the lungs, often accompanied by a sound.

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Arrhythmia

A condition where the heart beats irregularly, too fast, too slow, or with an abnormal rhythm.

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Claudication

Pain or discomfort in the legs that occurs during exercise and is relieved by rest.

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Heart Sounds

Sounds made by the heart as the valves open and close, which can be heard with a stethoscope.

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Cardiac Risk Factors

Factors that increase the risk of developing heart disease, such as high blood pressure, high cholesterol, smoking, diabetes, and family history of heart disease.

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Evaluation Of Cardiac Functions

A medical evaluation to assess how well the heart is functioning. This can include taking a medical history, performing a physical exam, and ordering tests to assess the heart's rhythm, structure, and function.

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Cardiac Catheterization

A procedure where a thin, flexible tube (catheter) is inserted into a blood vessel and guided to the heart to diagnose and treat cardiovascular conditions.

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Electrocardiography (ECG)

It is a technique using electrodes placed on the body to record the electrical activity of the heart.

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Heart Failure

A condition where the heart is unable to pump blood effectively to meet the body's needs, leading to fatigue, shortness of breath, and swelling.

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What information can be obtained during Cardiac Catheterization?

The oxygen saturation of the blood is determined, anatomy of the heart and coronary arteries are visualized, and structural changes in the coronary arteries are evaluated.

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What is recorded during Electrocardiography (ECG)?

The heart's electrical activity is recorded using multiple electrodes placed on the body.

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What are some things that can be identified with a standard 12-lead ECG?

Dysrhythmias, conduction arrhythmias, heart wall expansion, cardiac ischemia or infarction, high or low calcium and potassium levels, and some treatment effects can be identified.

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Transesophageal Echocardiogram (TEE)

A procedure that involves applying local anesthesia to the throat, monitoring vitals, and keeping the mouth closed for 4 hours after the procedure.

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What is the core problem in Heart Failure?

The heart is unable to adequately fill and/or empty due to structural or functional problems, leading to insufficient blood pumping.

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Acute heart failure

Heart failure caused by a sudden, acute event like a heart attack, irregular heartbeat, or severe infection.

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Chronic heart failure

Heart failure that develops gradually over time, often due to long-standing conditions like high blood pressure or coronary artery disease.

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Left heart failure

Heart failure where the left ventricle is unable to pump blood effectively.

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Right heart failure

Heart failure where the right ventricle is unable to pump blood effectively.

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Systolic heart failure

Heart failure caused by a weakened heart muscle, making it difficult to pump blood out of the heart.

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Diastolic heart failure

Heart failure caused by the heart's inability to relax and fill properly between beats.

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Heart failure symptoms

A group of symptoms associated with heart failure, including shortness of breath, fatigue, and swelling in the extremities.

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Prevalence of heart failure

The prevalence of heart failure is high, affecting 2-3% of the population, and increasing with age.

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Size and symmetry of extremities

Assessing the size and symmetry of extremities helps determine any swelling, asymmetry, or variations in limb size, which could indicate circulatory issues.

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Skin color of extremities

Examining the skin color of the extremities reveals potential circulatory issues like pallor (pale), cyanosis (blue), erythema (redness), or jaundice (yellow).

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Nail bed examination

Nail bed examination helps assess capillary refill time, indicating peripheral blood flow. Bleached nailbeds refill slowly with reduced circulation.

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Capillary refill test

Capillary refill time is the time it takes for blanched nailbeds to return to their normal color after pressure is released. A prolonged refill time suggests poor circulation.

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Extremity temperature

Measuring and comparing temperature of extremities can reveal differences in circulation. Cold extremities suggest poor blood flow.

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Edema examination

Examining for edema (swelling) in the extremities can indicate fluid buildup, often associated with poor venous return or heart failure.

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Cardiac Enzymes

Cardiac enzymes like troponin are released into the bloodstream after myocardial injury (heart attack). Elevated levels indicate damage to the heart muscle.

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Serum Electrolytes

Electrolytes play vital roles in heart function. Sodium, potassium, calcium, and magnesium are crucial for cell depolarization and repolarization, impacting heart rhythm and function.

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Study Notes

Internal Medicine Nursing Week 4

  • This document covers Internal Medicine Nursing for Week 4 of the course.
  • The focus is on Cardiovascular Diseases and Nursing Care.
  • Subtopics include Heart Anatomy and Physiology, Layers of the Heart, Functional Cavities of the Heart, Heart Valves, Vascular Structure of the Heart, Conduction System of the Heart, Heart Cycle, Evaluation of Cardiac Functions, Blood Pressure, Pulse Pressure, and Common Symptoms.

Heart Anatomy and Physiology

  • The heart is located slightly to the left of the chest's midline, with the sternum in the front and spine in the back providing protective anatomy.
  • It is approximately 350 grams in weight.

Layers of the Heart

  • Endocardium: The inner layer covering the heart's cavities and internal structures (epithelial tissue).
  • Myocardium: The middle layer consisting of thin muscles enabling involuntary contraction of the heart (cardiac muscle has striated structure).
  • Pericardium: A two-layered membrane surrounding the heart. The parietal pericardium is the outer layer, acting as a barrier against infections. The visceral pericardium is the inner layer, closely attached to the heart. The pericardial space between these layers contains 10-12 ml of pericardial fluid.

Functional Cavities of the Heart

  • Right atrium: The first part of the heart where blood is pumped from the body via superior vena cava, inferior vena cava, anterior cardiac veins, coronary sinus, and marginal vein.
  • Right ventricle: Receives blood from the vena cava, pumps it into the pulmonary artery.
  • Left atrium: Receives oxygenated blood from the lungs via four pulmonary veins.
  • Left ventricle: The thickest-walled cavity, pumps blood into the aorta.

Heart Valves

  • Atrioventricular valves (tricuspid and mitral)
  • Semilunar valves (pulmonary and aortic)

Vascular Structure of the Heart

  • The superior vena cava carries venous blood from the upper body (head, neck, and upper extremities) to the right atrium.
  • The inferior vena cava carries venous blood from the lower body (lower extremities) to the right atrium.
  • Pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs.
  • Pulmonary veins carry oxygenated blood from the lungs to the left atrium.
  • The aorta carries oxygenated blood from the left ventricle to the rest of the body.

Conduction System of the Heart

  • Sinoatrial (SA) node: The primary pacemaker, initiating 60-100 impulses per minute in the right atrium.
  • Atrioventricular (AV) node: It receives the impulses from the SA node, delays it, and then transmits it to the ventricles (40-60 impulses per minute).
  • Bundle of His: The impulse is then transmitted to the right and left bundle branches and ultimately to the Purkinje fibers, stimulating the ventricles to contract.

Heart Cycle

  • One heart cycle comprises systole (contraction) and diastole (relaxation) and lasts for about 0.8 seconds.
  • Diastole is 0.5 seconds, Systole is 0.3 seconds
  • The heart pumps approximately 7500 liters of blood per day.
  • Control of heart function is through autoregulation (starling's law) and neurohormonal control.

Evaluation of Cardiac Functions

  • Includes nursing history (health perceptions, nutrition, elimination, exercise, sleep, role perception, stress, religion, and culture).
  • Requires detailed medical history (heart disease, hypertension, surgical interventions, chest pain, palpitations, arrhythmias, heart sounds, edema, claudication, and test results).
  • Assessment of age and gender (risk factors for heart attack, incidence of heart disease in men vs. women).
  • Physical examination includes checking skin appearance, general view, and blood pressure.
  • Blood pressure normal value around 100/60-140/90 mmHg in adults.

Additional Topics (Blood Pressure, Pulse Pressure, Common Symptoms)

  • Detailed descriptions of blood pressure, pulse pressure, and a range of common symptoms (dyspnea, palpitation, chest pain, cough).
  • Specific questions to ask during assessment related to each symptom

Diagnostic Tests

  • Details of plasma cardiac enzyme/isoenzymes, serum electrolytes (sodium, potassium, calcium, and magnesium importance in heart functions).
  • lipid and lipoprotein tests, hematological studies, chest X-ray, long term ambulatory ECG recording, echocardiography, and cardiac catheterization.
  • Importance of each test and relevant pre-procedure guidelines.

Cardiovascular System Diseases

  • Information about heart failure, including different classifications (acute vs. chronic, high vs. low flow, left-right heart failure, systolic vs. diastolic), epidemiology, etiology, signs and symptoms.
  • Framingham criteria detailed.
  • Treatment and nursing care related to each of these conditions

Peripheral Vascular Diseases

  • Categories of arteriosclerosis (ASO/Arteriosclerosis Obliterans, etiology, signs and symptoms)
  • Details of Buerger's disease (Thromboangiitis Obliterans/Pruning Disease), etiology, signs and symptoms, diagnostic methods, treatment, and nursing care.
  • Varicose veins (anatomy, etiology, signs and symptoms, diagnostic methods, treatment, and nursing care).
  • Thrombophlebitis (etiology, signs and symptoms), diagnostic methods, treatment, and nursing care.

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