Heart Function and Cardiac Output
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Questions and Answers

Which of the following is NOT a key benefit of early intervention in acute myocardial infarction (MI)?

  • Reducing the extent of myocardial damage
  • Improving patient comfort (correct)
  • Maintaining cardiovascular stability
  • Decreasing cardiac workload

    • What is the recommended timeframe for initiating percutaneous coronary intervention (PCI) after medical contact in a patient with suspected acute coronary syndrome (ACS)?

  • Within 120 minutes
  • Within 30 minutes
  • Within 60 minutes (correct)
  • Within 10 minutes

    • Which of the following laboratory markers is MOST specific for myocardial damage and is typically elevated within 2-4 hours of an acute myocardial infarction (MI)?

  • Troponin I (correct)
  • Blood glucose
  • CK-MB
  • C-reactive protein

    • Which of the following medications is NOT typically used in the initial management of acute coronary syndrome (ACS)?

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

    Which of the following BEST describes the underlying pathophysiology of heart failure (HF)?

    <p>All of the above.</p> Signup and view all the answers

    Which of the following nursing interventions is MOST appropriate for a patient with heart failure (HF) who is experiencing shortness of breath and fatigue?

    <p>Administer oxygen as prescribed.</p> Signup and view all the answers

    Which type of myocardial infarction is characterized by ST-segment elevation on an EKG?

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

    What is a common symptom of a myocardial infarction in women that differs from the typical presentation in men?

    <p>Dizziness and fatigue</p> Signup and view all the answers

    Which of the following is NOT a manifestation of myocardial infarction?

    <p>Severe headache</p> Signup and view all the answers

    What immediate treatment goal is essential for a patient diagnosed with myocardial infarction?

    <p>Administer antiplatelet medication</p> Signup and view all the answers

    Which risk factor is commonly associated with the development of acute coronary syndrome?

    <p>Increased age</p> Signup and view all the answers

    Which of the following heart failure types is characterized by a reduced ejection fraction?

    <p>Systolic heart failure</p> Signup and view all the answers

    Which of the following is NOT a common cause of heart failure?

    <p>Diabetes mellitus</p> Signup and view all the answers

    What is the significance of an ejection fraction (EF) of 50% in left-sided heart failure?

    <p>Mild heart failure</p> Signup and view all the answers

    Which diagnostic test is primarily used to assess the severity of heart failure?

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

    Which pharmacological agent is classified as a positive inotropic agent?

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

    In right-sided heart failure, which manifestation is typically observed?

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

    What does an increase in jugular venous pressure (JVP) indicate in heart failure?

    <p>Fluid overload</p> Signup and view all the answers

    Which type of heart failure is characterized by increased pressure in the pulmonary circulation?

    <p>Left-sided heart failure</p> Signup and view all the answers

    What nursing intervention is most appropriate for a patient exhibiting signs of heart failure?

    <p>Monitor daily weight</p> Signup and view all the answers

    Which of the following is a common symptom of acute coronary syndrome (ACS) that may present differently in women compared to men?

    <p>Back pain</p> Signup and view all the answers

    Which of the following is a characteristic of a non-ST-segment elevation myocardial infarction (NSTEMI)?

    <p>Absence of ST-segment elevation on an EKG</p> Signup and view all the answers

    Which type of heart failure is characterized by a reduced ejection fraction (EF)?

    <p>Systolic heart failure</p> Signup and view all the answers

    Which of the following is a modifiable risk factor for acute coronary syndrome (ACS)?

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

    What nursing intervention is most appropriate for a patient with heart failure experiencing shortness of breath?

    <p>Administering oxygen therapy</p> Signup and view all the answers

    Which of the following is a common cause of right-sided heart failure?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What is a primary goal of administering fibrinolytics in patients with myocardial infarction?

    <p>Reduction of myocardial damage</p> Signup and view all the answers

    Which laboratory marker is significant for indicating myocardial damage and typically lasts up to 10-14 days after elevation?

    <p>Troponin T</p> Signup and view all the answers

    Which statement best describes the definition of heart failure?

    <p>The heart's inability to pump sufficient blood to meet the body's needs.</p> Signup and view all the answers

    What is the recommended approach for patients with acute myocardial infarction to maintain cardiovascular stability?

    <p>Reduce cardiac workload and relieve chest pain</p> Signup and view all the answers

    Which of the following is a common risk factor associated with acute coronary syndrome?

    <p>Chronic smoking</p> Signup and view all the answers

    Which nursing intervention is most appropriate for a patient with heart failure who presents with dyspnea?

    <p>Provide supplemental oxygen</p> Signup and view all the answers

    What is a common risk factor for developing heart failure?

    <p>Hypermetabolic states</p> Signup and view all the answers

    Which manifestation is typically associated with left-sided heart failure?

    <p>Dyspnea and cough</p> Signup and view all the answers

    In terms of diagnostic testing for heart failure, what does a BNP level over 900 indicate?

    <p>Severe heart failure</p> Signup and view all the answers

    Which of the following best describes two common types of heart failure?

    <p>Diastolic and systolic heart failure</p> Signup and view all the answers

    Which nursing intervention is most effective for a patient with right-sided heart failure exhibiting peripheral edema?

    <p>Administer diuretics as prescribed</p> Signup and view all the answers

    What is the main purpose of using angiotensin-converting enzyme (ACE) inhibitors in heart failure treatment?

    <p>Lower blood pressure and reduce workload on the heart</p> Signup and view all the answers

    Which of the following is NOT a common complication contributing to heart failure?

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

    Which type of heart failure is characterized by a preserved ejection fraction?

    <p>Diastolic heart failure</p> Signup and view all the answers

    Study Notes

    Heart Function and Cardiac Output

    • Cardiac output (CO) formula: CO = Heart Rate (HR) x Stroke Volume (SV)
    • Normal CO ranges from 4-8 L/min, with some sources citing 5-6 L/min.

    Causes of Heart Failure

    • Myocardial Infarction (MI) and coronary artery disease (CAD) leading causes.
    • Hypertension, including pulmonary hypertension, contributes to heart strain.
    • Conditions causing fluid overload, abnormal heart rhythms (A-fib), and valvular insufficiencies are significant.
    • Infection, substance use disorders, congenital issues, and hypermetabolic states also play roles in heart failure.

    Heart Failure Types and Symptoms

    Right-Sided Heart Failure

    • Causes systemic symptoms, including peripheral edema and jugular venous pressure (JVP) increase.
    • Patients may experience weight gain (2 lbs/day or 5 lbs/week), hepatomegaly, lethargy, and nocturia.

    Left-Sided Heart Failure

    • Leads to pulmonary edema and diminished ejection fraction (EF<50%).
    • Symptoms include crackles, orthopnea, paroxysmal nocturnal dyspnea (PND), dyspnea on exertion, and weight gain.

    Heart Failure Diagnostic Testing

    • B-type natriuretic peptide (BNP) levels: >300 (mild), >600 (moderate), >900 (severe).
    • Imaging and cardiac tests: Chest X-ray (CXR), ECG, echocardiogram.
    • Assessments of serum electrolytes, liver function tests (LFTs), urinalysis, blood urea nitrogen (BUN), serum creatinine, and arterial blood gas (ABG).

    Pharmacological Treatments

    • Angiotensin-Converting Enzyme (ACE) inhibitors like Perindopril.
    • Angiotensin II-Receptor Blockers (ARBs) such as Atacand (Candesartan).
    • Beta-blockers, diuretics, vasodilators, antiarrhythmics, and positive inotropic agents like digoxin.

    Myocardial Infarction (MI)

    • Occurs due to prolonged ischemia, resulting in irreversible myocardial cell death.
    • Classic symptoms include chest pain (radiating to neck, jaw, and arms), tachycardia, dyspnea, nausea, anxiety, diaphoresis, and potential altered mental status.

    EKG Findings in MI

    • STEMI indicates ST-segment elevation, while Non-STEMI does not show this elevation.

    Immediate Treatment Goals for MI

    • Obtain EKG within 10 minutes of patient presentation.
    • Alleviate chest pain and ensure cardiovascular stability.
    • Minimize myocardial damage and prevent complications; “time is muscle” emphasizes rapid intervention.

    Essential Labs and Monitoring in MI

    • Troponin I: elevated 2-4 hours post-event, peaks at 24-36 hours, persists for 7-10 days.
    • Troponin T: similar timelines as Troponin I but lasts longer (10-14 days).
    • Creatine Kinase-MB (CK-MB): elevated at 4-8 hours, peaks in 18-24 hours, lasts 72 hours.
    • Monitor inflammatory markers like C-reactive protein, complete blood count (CBC), and vital signs.

    Angina and Additional Treatment Considerations

    • Fibrinolytics (TNK, Streptokinase) are critical; ensure to rule out contraindications.
    • Morphine may be utilized alongside oxygen and nitroglycerin for symptom relief.
    • Antiplatelet and anticoagulant medications, such as ASA and heparin, are commonly prescribed.

    Heart Function and Cardiac Output

    • Cardiac output (CO) formula: CO = Heart Rate (HR) x Stroke Volume (SV)
    • Normal CO ranges from 4-8 L/min, with some sources citing 5-6 L/min.

    Causes of Heart Failure

    • Myocardial Infarction (MI) and coronary artery disease (CAD) leading causes.
    • Hypertension, including pulmonary hypertension, contributes to heart strain.
    • Conditions causing fluid overload, abnormal heart rhythms (A-fib), and valvular insufficiencies are significant.
    • Infection, substance use disorders, congenital issues, and hypermetabolic states also play roles in heart failure.

    Heart Failure Types and Symptoms

    Right-Sided Heart Failure

    • Causes systemic symptoms, including peripheral edema and jugular venous pressure (JVP) increase.
    • Patients may experience weight gain (2 lbs/day or 5 lbs/week), hepatomegaly, lethargy, and nocturia.

    Left-Sided Heart Failure

    • Leads to pulmonary edema and diminished ejection fraction (EF<50%).
    • Symptoms include crackles, orthopnea, paroxysmal nocturnal dyspnea (PND), dyspnea on exertion, and weight gain.

    Heart Failure Diagnostic Testing

    • B-type natriuretic peptide (BNP) levels: >300 (mild), >600 (moderate), >900 (severe).
    • Imaging and cardiac tests: Chest X-ray (CXR), ECG, echocardiogram.
    • Assessments of serum electrolytes, liver function tests (LFTs), urinalysis, blood urea nitrogen (BUN), serum creatinine, and arterial blood gas (ABG).

    Pharmacological Treatments

    • Angiotensin-Converting Enzyme (ACE) inhibitors like Perindopril.
    • Angiotensin II-Receptor Blockers (ARBs) such as Atacand (Candesartan).
    • Beta-blockers, diuretics, vasodilators, antiarrhythmics, and positive inotropic agents like digoxin.

    Myocardial Infarction (MI)

    • Occurs due to prolonged ischemia, resulting in irreversible myocardial cell death.
    • Classic symptoms include chest pain (radiating to neck, jaw, and arms), tachycardia, dyspnea, nausea, anxiety, diaphoresis, and potential altered mental status.

    EKG Findings in MI

    • STEMI indicates ST-segment elevation, while Non-STEMI does not show this elevation.

    Immediate Treatment Goals for MI

    • Obtain EKG within 10 minutes of patient presentation.
    • Alleviate chest pain and ensure cardiovascular stability.
    • Minimize myocardial damage and prevent complications; “time is muscle” emphasizes rapid intervention.

    Essential Labs and Monitoring in MI

    • Troponin I: elevated 2-4 hours post-event, peaks at 24-36 hours, persists for 7-10 days.
    • Troponin T: similar timelines as Troponin I but lasts longer (10-14 days).
    • Creatine Kinase-MB (CK-MB): elevated at 4-8 hours, peaks in 18-24 hours, lasts 72 hours.
    • Monitor inflammatory markers like C-reactive protein, complete blood count (CBC), and vital signs.

    Angina and Additional Treatment Considerations

    • Fibrinolytics (TNK, Streptokinase) are critical; ensure to rule out contraindications.
    • Morphine may be utilized alongside oxygen and nitroglycerin for symptom relief.
    • Antiplatelet and anticoagulant medications, such as ASA and heparin, are commonly prescribed.

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    Learn about cardiac output formula, normal ranges, and causes of heart failure including myocardial infarction, hypertension, and more.

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