Cardiovascular Nursing Care Quiz Medium
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Which of the following is NOT a characteristic of aging and its effect on the cardiovascular system?

  • Valves thicken and calcify
  • Decreased blood flow to organs
  • Dysrhythmias are common
  • Heart rate and maximum cardiac output increase (correct)

    • What is the term used for the amount of blood pumped by the left ventricle in one minute?

  • Afterload
  • Cardiac output (correct)
  • Ejection fraction
  • Venous return

    • What is the primary focus of the nursing care for patients with cardiovascular disorders?

  • Managing symptoms and improving quality of life (correct)
  • Preventing future complications and promoting recovery
  • Relieving pain and promoting comfort
  • Educating patients about their condition and treatment options

    • Which of the following is NOT a component that affects cardiac output?

    <p>Blood pressure (C)</p> Signup and view all the answers

    What is the normal range for ejection fraction?

    <p>55-70% (A)</p> Signup and view all the answers

    Which of the following is NOT a common symptom of cardiovascular disorders?

    <p>Headache (C)</p> Signup and view all the answers

    What are some of the indications for invasive cardiac catheterization?

    <p>To determine the extent of occlusions (A), To open occluded arteries (B), To measure pressure in chambers of the heart (C)</p> Signup and view all the answers

    What is the term for the force the left ventricle must overcome to eject blood?

    <p>Afterload (D)</p> Signup and view all the answers

    What is the term for the condition where the heart is unable to pump blood effectively?

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

    What is one of the important pre-procedure nursing interventions for a patient undergoing cardiac catheterization?

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

    Which nursing intervention is MOST important for preventing complications in patients with cardiovascular disorders?

    <p>Monitoring vital signs frequently (D)</p> Signup and view all the answers

    Which of the following is NOT considered an antiembolism device?

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

    Which of the following is a subjective data that can be collected to assess cardiovascular health?

    <p>Chest pain (D)</p> Signup and view all the answers

    What is the purpose of a Holter monitor?

    <p>To monitor heart rhythm over a 24-hour period (A)</p> Signup and view all the answers

    What is the normal range for a resting heart rate?

    <p>60-100 beats per minute (B)</p> Signup and view all the answers

    What is the primary reason for encouraging fluids after a cardiac catheterization procedure?

    <p>To help flush out the contrast dye (B)</p> Signup and view all the answers

    What is the term used for the forcefulness with which the heart contracts?

    <p>Contractility (C)</p> Signup and view all the answers

    A patient with cardiovascular disease is experiencing dyspnea on exertion (DOE). What is the BEST nursing intervention in this situation?

    <p>Encourage the patient to rest (B)</p> Signup and view all the answers

    What is one common instruction to give to a patient after a cardiac catheterization procedure if the groin site was used?

    <p>Avoid flexing the leg for a prescribed time (C)</p> Signup and view all the answers

    What is a key health teaching point regarding oxygen safety?

    <p>No smoking (B)</p> Signup and view all the answers

    Which of the following is NOT a modifiable risk factor for cardiovascular disease?

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

    Which of the following findings is most indicative of pulmonary edema in a patient with heart failure?

    <p>Pink, frothy sputum (C)</p> Signup and view all the answers

    Which of the following tests is used to evaluate the heart's ability to respond to increased oxygen demands?

    <p>Exercise stress test (A)</p> Signup and view all the answers

    What is the name of the surgical procedure that bypasses blocked coronary arteries?

    <p>Coronary artery bypass graft (CABG) (A)</p> Signup and view all the answers

    Which of the following is NOT a typical nursing responsibility in the care of patients with cardiovascular disorders?

    <p>Performing surgical procedures (D)</p> Signup and view all the answers

    A patient undergoing a cardiac catheterization procedure is experiencing a warm, flushed feeling. What is the MOST likely explanation for this?

    <p>The patient is experiencing a normal reaction to the contrast dye injection. (B)</p> Signup and view all the answers

    Which of the following medications would NOT be classified as part of the Cardiovascular System Medications category?

    <p>Antibiotics (D)</p> Signup and view all the answers

    What is the PRIMARY purpose of a Holter monitor?

    <p>To monitor the patient for irregular heart rhythms. (D)</p> Signup and view all the answers

    A patient with cardiovascular disease is taking medication that is metabolized by an enzyme that is inhibited by grapefruit juice. What nursing intervention would be MOST important for this patient?

    <p>Educate the patient about the potential for drug interactions and advise them to avoid grapefruit juice. (D)</p> Signup and view all the answers

    What is the MAIN purpose of using antiembolism stockings?

    <p>To prevent deep vein thrombosis (DVT). (A)</p> Signup and view all the answers

    A patient who has undergone a cardiac catheterization procedure with the groin site used is placed on bedrest. What is the PRIMARY reason for this?

    <p>To prevent bleeding or hematoma formation at the insertion site. (A)</p> Signup and view all the answers

    Which condition significantly impacts the compliance of the cardiovascular system in older adults?

    <p>Increased vascular stiffness (A)</p> Signup and view all the answers

    What contributes to the increased risk of cardiovascular disorders in patients with diabetes?

    <p>Heightened inflammatory response (D)</p> Signup and view all the answers

    Which nursing intervention is crucial for patients at high risk of thrombosis?

    <p>Providing antiplatelet therapy (D)</p> Signup and view all the answers

    Which factor is least likely to contribute to the development of heart failure?

    <p>Regular aerobic exercise (C)</p> Signup and view all the answers

    What is likely the first indication of declining cardiac function in older adults?

    <p>Progressive fatigue during daily activities (D)</p> Signup and view all the answers

    What mechanical dysfunction is primarily associated with rheumatic heart disease?

    <p>Mitral valve stenosis (D)</p> Signup and view all the answers

    What is a common consequence of untreated hypertension over time?

    <p>Heart chamber enlargement (B)</p> Signup and view all the answers

    In patients with heart failure, which laboratory value is most critical to monitor?

    <p>B-type natriuretic peptide (BNP) (B)</p> Signup and view all the answers

    Which lifestyle modification is recommended to improve cardiovascular health?

    <p>Weight reduction through diet (D)</p> Signup and view all the answers

    What change occurs in the heart muscle efficiency as a person ages?

    <p>Decreased heart rate and maximum cardiac output (B)</p> Signup and view all the answers

    Which of the following correctly describes jugular venous distention?

    <p>Indicates right-sided heart failure or volume overload (B)</p> Signup and view all the answers

    What is the primary purpose of measuring blood pressure in both arms?

    <p>To establish differences for future measurements (C)</p> Signup and view all the answers

    Which condition indicates an increased risk of clot formation due to atherosclerosis?

    <p>Thickening of arterial walls (B)</p> Signup and view all the answers

    What signifies a change in ejection fraction concerning cardiac function?

    <p>Decreased percentage of blood ejected with each heartbeat (A)</p> Signup and view all the answers

    Which symptom is commonly associated with orthostatic blood pressure changes?

    <p>Light-headedness or syncope (D)</p> Signup and view all the answers

    What does a capillary refill time of more than 2 seconds indicate?

    <p>Potential hypoxia or poor vascular supply (D)</p> Signup and view all the answers

    How does the presence of a third heart sound (S3) typically present in patients?

    <p>Indicative of heart failure or volume overload (D)</p> Signup and view all the answers

    What does the Doppler study primarily assess?

    <p>Patterns of blood flow through vessels (A)</p> Signup and view all the answers

    What benefit does echocardiography provide in cardiovascular assessment?

    <p>Records heart structure and blood flow dynamics (A)</p> Signup and view all the answers

    Study Notes

    Cardiovascular Nursing Care

    • Cardiac Function and Pathophysiology:
      • The heart has three layers and four chambers, with four valves.
      • The right side of the heart carries deoxygenated blood.
      • The left side of the heart carries oxygenated blood from the lungs.
      • Valves include tricuspid (between right atrium and ventricle), pulmonic (between right ventricle and pulmonary artery), mitral (between left atrium and ventricle), and aortic (between left ventricle and aorta).

    Cardiac Output

    • The amount of blood pumped by the left ventricle in one minute is cardiac output.
    • Cardiac output is determined by stroke volume multiplied by heart rate.
    • Factors affecting cardiac output include preload, afterload, and contractility.
    • Ejection fraction measures the percentage of blood ejected from the left ventricle with each heartbeat (normally between 55-70%).
    • Venous return (preload) equals the amount of blood returning to the right atrium.
    • Contractility is the force of heart contraction, influenced by hormones and venous return

    Pathophysiology – Aging and the Cardiovascular System

    • Atherosclerosis narrows arterial lumens, increasing afterload and blood pressure.
    • Rough arterial surfaces increase clot risk.
    • Decreased blood flow occurs to vital organs.
    • Heart muscles become less efficient.
    • Cardiac output decreases.
    • Atypical symptoms may mask myocardial infarction.
    • Conduction cells become less efficient.
    • Dysrhythmias become common.
    • Valves thicken and calcify.
    • Murmurs may be present.

    Health Data Collection

    • Patient health history, physical examination, and subjective data are gathered.
    • Specific tables (21.1, 21.2) are likely referenced in the full text.

    Measuring Blood Pressure

    • Normal blood pressure is 120/80.
    • Measure blood pressure in both arms for baseline comparison.
    • If readings differ, use the higher-pressure arm for future measurements.

    Orthostatic Blood Pressure

    • Orthostatic blood pressure is assessed when the patient moves from lying to sitting to standing positions.
    • A decrease of more than 15 mm Hg in systolic pressure and an increase of more than 20 beats per minute in pulse rate indicates orthostatic hypotension.
    • Common associated symptoms include lightheadedness and syncope.
    • Common causes are fluid volume deficit, diuretics use, and pain.

    Pulses

    • Count the apical pulse for a full minute.
    • Normal apical pulse rate is 60-100 beats per minute.
    • Compare apical and radial pulse rates and qualities.
    • Peripheral pulse quality can range from 0 (non-palpable) to 3+ (bounding).

    Respirations

    • Respiratory rate and work of breathing are assessed.
    • Pink, frothy sputum indicates pulmonary edema (acute heart failure).
    • A dry cough may signal heart failure.

    Inspection

    • Observe skin color, mucous membranes, and peripheral extremities.
    • Pale or ashen coloration can signal decreased arterial blood flow.
    • Findings such as cyanosis, grayish skin, or discolored extremities signal potential hypoxia or other circulatory issues.
    • Observe for dependent rubor (reddish purple discoloration in dependent areas) and pallor as clues to arterial or venous disorders; this would be seen when comparing lower extremities when elevated to when the patient is standing or sitting upright.
    • Inspect for varicose veins, stasis ulcers, scars, and swelling (potentially venous thrombosis-related).
    • Inspect for presence of jugular venous distention suggesting potential volume overload or right-sided heart failure.
    • Look for clubbing (associated with congenital heart disease or chronic lung disease).

    Palpation

    • Assess the point of maximum impulse (PMI).
    • Measure body temperature.
    • Assess for edema.

    Auscultation

    • Auscultate heart sounds (S1, S2 are normal; S3, S4 abnormal).
    • Listen for murmurs (turbulent blood flow through one or more valves that may indicate valve disorders).
    • Listen for pericardial friction rubs.

    Blood Tests-Cardiac Biomarkers

    • Troponin and CK-MB measure proteins and enzymes released by damaged cardiac cells.
    • These biomarkers are used to diagnose myocardial infarctions.
    • Troponin elevations are detected 2-6 hours after an event and can remain elevated for 5-7 days.
    • CK-MB elevation is apparent 4-6 hours after an event; it typically remains elevated for 24–36 hours.

    Blood Tests-Lipids

    • Lipid tests (e.g., cholesterol) assess risk for coronary artery disease (CAD).
    • Patients usually fast for 6-12 hours to allow for accurate reading; avoid alcohol for 24 hours before.
    • Water consumption before the test is okay.
    • High levels of low-density lipoproteins (LDL) and triglycerides are risk factors for CAD.

    Electrocardiogram(ECG)

    • Records the electrical activity of the heart to assess for dysrhythmias, enlarged heart chambers, myocardial ischemia/infarction, electrolyte imbalances, and pericarditis.
    • Includes ambulatory ECG monitoring and Holter monitoring, and specific lead placement locations are detailed in the provided diagrams.

    Echocardiogram

    • This is an ultrasound-based visual test that aids in determining structural heart problems.
    • The method includes trans-esophageal ultrasound (requires throat anesthesia) and regular ultrasound and should be preceded by a 6-hour NPO period.
    • The echocardiogram helps to assess heart structures (valves, size, shape), blood flow through the heart.

    Exercise Stress Test

    • Evaluates the heart's ability to respond to increased oxygen demands.
    • Evaluates peripheral vascular disease
    • A physical exerciser like a treadmill, stairs or stationary bicycle may be used
    • A non-exercise stress test using drugs (dipyridamole, or adenosine) to stress the heart may be used for patients unable to exercise.
    • The non-pharmacological test is stopped if intermittent claudication develops.

    Doppler Studies

    • Ultrasound images are used for assessing blood vessels for occlusions and clots.
    • Arterial and venous issues are assessed.
    • This is a non-invasive test.

    Invasive Studies-Cardiac Catheterization

    • This involves inserting a flexible tube into arteries or veins and guiding it to the heart to examine for obstructions, open occluded arteries, and measure pressure, oxygen saturations, and cardiac output.
    • It can involve insertion in the wrist, groin, forearm, or neck.

    Angiography and Cardiac Catheterization

    • Pre-procedural considerations include assessing the patient for prior contrast dye reactions.
    • Patients are given an NPO (nothing by mouth, except water which may be allowed) status 8 hours before the procedure.
    • The procedure requires hydration and is performed under local anesthesia and sedation, potentially supplemented with IV fluids.
    • Vital signs and ECG monitoring are continuously performed pre and post-procedure.

    Post-Cardiac Catheterization

    • Pressure is applied to insertion sites (likely groin) to prevent hematoma or retroperitoneal bleeding.
    • Vital signs and pulses are closely monitored.
    • Patients need bedrest and avoid leg flexion if a groin insertion site was used, for a prescribed time.
    • Fluid intake is encouraged to flush dye.

    Medications for the Cardiovascular System

    • Common medication classes addressed are antihypertensives, antianginals, anticoagulants, cardiac glycosides, thrombolytics, and vasodilators.
    • Grapefruit and some citrus fruits can interact with some medications, potentially increasing toxicity risk.

    Evidence-based Therapeutic Measures

    • Various devices and procedures for preventing blood clots and supporting the cardiovascular system and peripheral blood flow are mentioned.
    • These include antiembolism devices, stockings, non-medical support hosiery, and intermittent pneumatic compression.
    • Oxygen and medication treatment may be used as well as cardiac surgery as needed.

    Health Teaching

    • Patients benefit from education to manage cardiac conditions effectively.
    • This includes advice on a healthy diet (e.g., limiting saturated fats, sodium) and healthy lifestyle choices, such as consuming more fruits, vegetables, and fish.
    • Smoking cessation, oxygen safety (no smoking or open flames) , and proper application of antiembolism stockings are essential aspects of patient education.

    Cardiovascular Disease in the U.S.

    • Cardiovascular disease is a very significant problem and leading cause of death in the US, affecting millions.
    • Lifestyle factors and access to high-quality care play vital roles.

    Review

    • The review includes key topics such as cardiac anatomy, physiology, health history, diagnostic tests, medications, evidence-based practice and health teaching specific to cardiovascular health in the United states.

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    Description

    Test your knowledge on cardiovascular nursing care focusing on cardiac function and pathophysiology. This quiz covers the anatomy of the heart, cardiac output, and factors affecting it, including preload, afterload, and contractility. Perfect for nursing students and healthcare professionals.

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