Podcast
Questions and Answers
What is a common symptom of paroxysmal nocturnal dyspnea?
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.
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?
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 ______.
Common symptoms of heart failure include fatigue, edema, and ______.
Match the symptoms with their corresponding questions about chest pain.
Match the symptoms with their corresponding questions about chest pain.
What type of pain feature is considered a major finding in heart-related symptoms?
What type of pain feature is considered a major finding in heart-related symptoms?
Cough is a symptom that should be asked about when evaluating chest pain.
Cough is a symptom that should be asked about when evaluating chest pain.
Identify one initiating factor that can lead to chest pain.
Identify one initiating factor that can lead to chest pain.
What is the primary purpose of cardiac catheterization?
What is the primary purpose of cardiac catheterization?
Local anesthesia is not applied to the throat during TEE procedures.
Local anesthesia is not applied to the throat during TEE procedures.
What should be monitored throughout the TEE procedure?
What should be monitored throughout the TEE procedure?
Heart failure is a disease in which _____ and/or _____ is impaired.
Heart failure is a disease in which _____ and/or _____ is impaired.
Match the following techniques with their purposes:
Match the following techniques with their purposes:
Which of the following is a common cardiac risk factor related to age?
Which of the following is a common cardiac risk factor related to age?
Men have the same risk of myocardial infarction (MI) as post-menopausal women.
Men have the same risk of myocardial infarction (MI) as post-menopausal women.
What can a 12-lead ECG help identify?
What can a 12-lead ECG help identify?
What is the term for the increase in heart rate that can occur with advanced age?
What is the term for the increase in heart rate that can occur with advanced age?
Patients should keep their mouths closed for at least 4 hours after the TEE procedure.
Patients should keep their mouths closed for at least 4 hours after the TEE procedure.
What is the main cause of heart failure?
What is the main cause of heart failure?
The condition known as ______ occurs when there is a buildup of fluid in the body's tissues.
The condition known as ______ occurs when there is a buildup of fluid in the body's tissues.
Match the following cardiac symptoms with their definitions:
Match the following cardiac symptoms with their definitions:
Which of the following conditions can be affected by smoking?
Which of the following conditions can be affected by smoking?
Angina is often associated with coronary arteriosclerosis.
Angina is often associated with coronary arteriosclerosis.
What does the term 'arrhythmia' refer to in cardiac evaluation?
What does the term 'arrhythmia' refer to in cardiac evaluation?
Which of the following statements about atrioventricular valves is correct?
Which of the following statements about atrioventricular valves is correct?
The sinoatrial node produces 40-60 impulses per minute.
The sinoatrial node produces 40-60 impulses per minute.
What is the role of the pulmonary artery in the circulatory system?
What is the role of the pulmonary artery in the circulatory system?
The impulse from the AV node is transmitted to the ventricles through the __________.
The impulse from the AV node is transmitted to the ventricles through the __________.
Match the parts of the conduction system with their functions:
Match the parts of the conduction system with their functions:
How long does one complete heart cycle last?
How long does one complete heart cycle last?
The heart pumps approximately 750 liters of blood per day.
The heart pumps approximately 750 liters of blood per day.
What is the primary purpose of autoregulation in heart muscle function?
What is the primary purpose of autoregulation in heart muscle function?
Which type of heart failure is characterized by impaired left-ventricular function?
Which type of heart failure is characterized by impaired left-ventricular function?
The prevalence of heart failure among individuals aged 70-80 is 10%.
The prevalence of heart failure among individuals aged 70-80 is 10%.
List two signs and symptoms of heart failure.
List two signs and symptoms of heart failure.
The prevalence of hypertension, CAD, diabetes, and obesity in Turkey is above the average of __________ countries.
The prevalence of hypertension, CAD, diabetes, and obesity in Turkey is above the average of __________ countries.
Match the following clinical features with their corresponding symptoms:
Match the following clinical features with their corresponding symptoms:
Which of the following factors can lead to acute heart failure? (Select all that apply)
Which of the following factors can lead to acute heart failure? (Select all that apply)
Heart failure accounts for approximately 1-2% of a country's budget.
Heart failure accounts for approximately 1-2% of a country's budget.
What percentage of patients admitted to the hospital acutely suffer from heart failure?
What percentage of patients admitted to the hospital acutely suffer from heart failure?
What is the primary role of serum electrolytes such as sodium and potassium?
What is the primary role of serum electrolytes such as sodium and potassium?
Hypomagnesemia can prolong the QT interval on an ECG.
Hypomagnesemia can prolong the QT interval on an ECG.
What are the first symptoms of hypermagnesemia?
What are the first symptoms of hypermagnesemia?
An increase in the LDL/HDL ratio indicates a higher risk of __________.
An increase in the LDL/HDL ratio indicates a higher risk of __________.
Match the following conditions with their effects on the ECG:
Match the following conditions with their effects on the ECG:
Which of the following electrolytes is necessary for coagulability and neuromuscular activity?
Which of the following electrolytes is necessary for coagulability and neuromuscular activity?
Fluid excess is indicated by hypernatremia.
Fluid excess is indicated by hypernatremia.
What diagnostic tests are routinely performed before invasive procedures?
What diagnostic tests are routinely performed before invasive procedures?
Flashcards
Tricuspid Valve
Tricuspid Valve
Valve between the right atrium and right ventricle.
Mitral Valve
Mitral Valve
Valve between the left atrium and left ventricle.
Pulmonary Valve
Pulmonary Valve
Valve between the right ventricle and the pulmonary artery.
Aortic Valve
Aortic Valve
Valve between the left ventricle and the aorta.
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Sinoatrial Node (SA Node)
Sinoatrial Node (SA Node)
The natural pacemaker of the heart, located in the right atrium.
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Atrioventricular Node (AV Node)
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 His
Bundle of specialized fibers that transmit the electrical signal from the AV node to the ventricles.
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Starling's Law
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)
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
Palpitation
The feeling of having a fast and irregular heartbeat.
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Tiredness
Tiredness
Feeling tired or lacking energy, often experienced as a constant fatigue.
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Edema
Edema
Swelling, usually in the legs or ankles, caused by fluid buildup.
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Chest Pain
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
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
Cough
A forceful expulsion of air from the lungs, often accompanied by a sound.
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Arrhythmia
Arrhythmia
A condition where the heart beats irregularly, too fast, too slow, or with an abnormal rhythm.
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Claudication
Claudication
Pain or discomfort in the legs that occurs during exercise and is relieved by rest.
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Heart Sounds
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
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
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
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)
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
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?
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)?
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?
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)
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?
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
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
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
Left heart failure
Heart failure where the left ventricle is unable to pump blood effectively.
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Right heart failure
Right heart failure
Heart failure where the right ventricle is unable to pump blood effectively.
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Systolic heart failure
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
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
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
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
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
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
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 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
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
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
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
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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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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