Heart's Electrical System and Coronary Arteries
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Questions and Answers

Which of the following is a consequence of decreased contractility?

  • Increased stroke volume
  • Increased sympathetic stimulation
  • Higher levels of ejection fraction
  • Reduced contractile strength in ischemic tissue (correct)

    • What type of medication is known to decrease contractility?

  • Negative inotropes (correct)
  • Vasodilators
  • Sympathomimetics
  • Positive inotropes

    • Which factor is associated with increased contractility?

  • Sympathetic stimulation (correct)
  • Decreased heart rate
  • Electrolyte imbalance
  • Negative inotropes

    • What is a primary compensatory mechanism that kicks in when pump failure occurs?

    <p>Myocardial hypertrophy</p> Signup and view all the answers

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

    <p>Iron deficiency</p> Signup and view all the answers

    What role does epinephrine play during the compensatory response to pump failure?

    <p>Increases contractility</p> Signup and view all the answers

    Which outcome results from peripheral vasoconstriction during heart failure?

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

    How does the body interpret decreased renal perfusion during heart failure?

    <p>As hypovolemia</p> Signup and view all the answers

    What is the primary purpose of an electrocardiogram (EKG)?

    <p>To assess the electrical activity of the heart</p> Signup and view all the answers

    Which test involves injecting a radioactive isotope into a vein?

    <p>Radionuclide imaging</p> Signup and view all the answers

    What condition can a treadmill exercise test help diagnose?

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

    Which symptom is commonly associated with chronic heart conditions?

    <p>Heavy and uncontrollable coughing</p> Signup and view all the answers

    What is the focus of electrophysiology testing?

    <p>To record heart's electrical activity and pathways</p> Signup and view all the answers

    What is a common non-pharmacologic therapy for managing heart failure?

    <p>Dietary sodium and fluid restriction</p> Signup and view all the answers

    Which symptom might indicate heart rhythm problems?

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

    What do blood tests look for in patients suspected of right-sided heart failure?

    <p>Specific substances indicating heart failure</p> Signup and view all the answers

    What is the main function of a transducer in hemodynamic monitoring?

    <p>To convert pressure into an electrical signal</p> Signup and view all the answers

    What does a pressure bag accomplish in a hemodynamic monitoring system?

    <p>It maintains the flush solution at high pressure.</p> Signup and view all the answers

    Why is it important for the transducer stopcock to be positioned at the level of the atrium?

    <p>To measure the pressure accurately.</p> Signup and view all the answers

    Which of the following components is NOT part of the pressure monitoring system?

    <p>Patient transport cart</p> Signup and view all the answers

    What is the purpose of the flush device in the pressure monitoring system?

    <p>To deliver flush solution continuously</p> Signup and view all the answers

    Which of the following should nurses ensure when setting up the monitoring system?

    <p>The system is free of air bubbles</p> Signup and view all the answers

    What additional component may be included in the disposable flush system to prevent clotting?

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

    Which patient population typically requires hemodynamic monitoring?

    <p>Patients in progressive care units</p> Signup and view all the answers

    What is the primary pacemaker of the heart responsible for initiating electrical impulses?

    <p>Sinoatrial (SA) node</p> Signup and view all the answers

    Which artery supplies the right side of the heart?

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

    What allows the atria to contract before the electrical impulse is relayed to the ventricles?

    <p>AV node delay</p> Signup and view all the answers

    What is the purpose of using a stent in fluid balance procedures?

    <p>To open up narrowed blood vessels due to plaque buildup</p> Signup and view all the answers

    What is the process called when the heart's muscle cells return to their resting state after depolarization?

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

    How can a nurse help prevent pressure sores in patients with edematous skin?

    <p>By changing the patient's position at frequent intervals</p> Signup and view all the answers

    What are the specialized tracts that conduct electrical impulses along the myocardial cells of the atria called?

    <p>Internodal pathways</p> Signup and view all the answers

    What is the inherent firing rate of a normal resting adult heart initiated by the SA node?

    <p>60 to 100 impulses per minute</p> Signup and view all the answers

    What dietary recommendations are suggested for patients in the acute phase of heart failure?

    <p>Low-calorie, bland, low-residue meals with vitamin supplements</p> Signup and view all the answers

    What nursing intervention should be prioritized for a patient with ineffective tissue perfusion?

    <p>Monitor vital signs, especially blood pressure and pulse rate</p> Signup and view all the answers

    Which part of the heart receives its blood supply from the posterior descending artery?

    <p>Posterior wall</p> Signup and view all the answers

    What term describes the continuous cycle of depolarization and repolarization in the heart?

    <p>Cardiac action potential</p> Signup and view all the answers

    Why is it important to provide oxygen and monitor oxygen saturation in patients with decreased cardiac output?

    <p>To maintain adequate tissue oxygenation</p> Signup and view all the answers

    Which of the following is not a recommended intervention for promoting fluid balance?

    <p>Dry phlebotomy</p> Signup and view all the answers

    In patients with right-sided heart failure, which of the following symptoms is commonly observed?

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

    Which measurement is essential for evaluating the effectiveness of diuretics in managing heart failure?

    <p>Urine output</p> Signup and view all the answers

    Study Notes

    Heart's Electrical System

    • Conductivity refers to the heart's ability to transmit electrical impulses between cells
    • Sinoatrial (SA) Node: Primary pacemaker of the heart, located at the junction of the superior vena cava and right atrium, with a normal firing rate of 60 to 100 impulses per minute
    • Atrioventricular (AV) Node: Secondary pacemaker, coordinates electrical impulses from the atria and, after a slight delay, relays them to the ventricles
    • Electrocardiogram (EKG): Measures electrical activity of the heart, revealing information about heart enlargement or damage.

    Coronary Arteries

    • Left anterior descending artery: Courses down the anterior wall of the heart
    • Circumflex artery: Circles around to the lateral left wall of the heart
    • Right coronary artery: Supplies the right side of the heart
    • Posterior descending artery: Supplies blood to the posterior wall of the heart, originating as a branch of the Right coronary artery

    Hemodynamic Monitoring

    • A sophisticated technique used in critical care units for monitoring the heart's performance
    • Utilizes a catheter inserted into a blood vessel or heart chamber, connected to a pressure monitoring system
    • The system includes components such as a flush system, a pressure bag, an amplifier, and a monitor
    • Nurses play a crucial role in setting up and maintaining this system
    • Essential guidelines for safe and effective use include ensuring system integrity, correctly positioning the transducer, and maintaining proper calibration.

    Right Sided Heart Failure

    • Diagnostic Procedures:
      • Stress testing during exercise to assess heart rate response
      • Blood tests to evaluate for specific substances associated with right-sided heart failure, and to screen other organs for abnormalities.
    • Medical Management:
      • Non-pharmacologic therapies:
        • Dietary sodium and fluid restriction
        • Control of sodium intake
      • Pharmacologic therapies:
        • Administering diuretics and digitalis as prescribed
    • Nursing Interventions:
      • Fluid Balance: Monitor intake and output, weight, and vital signs (especially blood pressure and pulse)
      • Skin Care: Provide care for edematous skin to prevent pressure sores, change position at frequent intervals, assess the sacral area regularly, and use protective devices.
      • Nutrition: Provide bland, low-calorie, low-residue meals with vitamin supplements during the acute phase, offering frequent small feedings to minimize exertion and reduce gastrointestinal blood demands.

    Left Sided Heart Failure

    • Nursing Diagnoses:
      • Ineffective tissue perfusion: Monitor vital signs, elevate the head of the bed, and provide oxygen as ordered.

    Contractility

    • Contractility decreased with: Infarcted tissue, ischemic tissue, electrolyte/acid-base imbalance, negative inotropes
    • Contractility increased with: Sympathetic stimulation, positive inotropes.

    Pathophysiology of CHF

    • Pump failure leads to a decrease in stroke volume and cardiac output.
    • Compensatory mechanisms such as sympathetic nervous system stimulation, myocardial hypertrophy, and hormonal response try to increase cardiac output.

    Etiology of CHF

    • Can be caused by any condition that interferes with normal cardiac output regulation.
    • Common causes include: hypertension, myocardial infarction, dysrhythmias, valvular disorders.

    Risk Factors for Coronary Artery Disease

    • Age
    • Hypertension
    • Obesity
    • Cigarette Smoking
    • Diabetes Mellitus
    • High Cholesterol
    • African Descent

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    Description

    Test your knowledge about the heart's electrical system and the coronary arteries. This quiz covers essential elements like the SA node, AV node, and how electrical impulses are transmitted. Additionally, learn about the anatomy and function of major coronary arteries that supply blood to the heart.

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