Podcast
Questions and Answers
Which of the following is a consequence of decreased contractility?
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?
What type of medication is known to decrease contractility?
- Negative inotropes (correct)
- Vasodilators
- Sympathomimetics
- Positive inotropes
Which factor is associated with increased contractility?
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?
What is a primary compensatory mechanism that kicks in when pump failure occurs?
Which of the following is NOT a common cause of heart failure?
Which of the following is NOT a common cause of heart failure?
What role does epinephrine play during the compensatory response to pump failure?
What role does epinephrine play during the compensatory response to pump failure?
Which outcome results from peripheral vasoconstriction during heart failure?
Which outcome results from peripheral vasoconstriction during heart failure?
How does the body interpret decreased renal perfusion during heart failure?
How does the body interpret decreased renal perfusion during heart failure?
What is the primary purpose of an electrocardiogram (EKG)?
What is the primary purpose of an electrocardiogram (EKG)?
Which test involves injecting a radioactive isotope into a vein?
Which test involves injecting a radioactive isotope into a vein?
What condition can a treadmill exercise test help diagnose?
What condition can a treadmill exercise test help diagnose?
Which symptom is commonly associated with chronic heart conditions?
Which symptom is commonly associated with chronic heart conditions?
What is the focus of electrophysiology testing?
What is the focus of electrophysiology testing?
What is a common non-pharmacologic therapy for managing heart failure?
What is a common non-pharmacologic therapy for managing heart failure?
Which symptom might indicate heart rhythm problems?
Which symptom might indicate heart rhythm problems?
What do blood tests look for in patients suspected of right-sided heart failure?
What do blood tests look for in patients suspected of right-sided heart failure?
What is the main function of a transducer in hemodynamic monitoring?
What is the main function of a transducer in hemodynamic monitoring?
What does a pressure bag accomplish in a hemodynamic monitoring system?
What does a pressure bag accomplish in a hemodynamic monitoring system?
Why is it important for the transducer stopcock to be positioned at the level of the atrium?
Why is it important for the transducer stopcock to be positioned at the level of the atrium?
Which of the following components is NOT part of the pressure monitoring system?
Which of the following components is NOT part of the pressure monitoring system?
What is the purpose of the flush device in the pressure monitoring system?
What is the purpose of the flush device in the pressure monitoring system?
Which of the following should nurses ensure when setting up the monitoring system?
Which of the following should nurses ensure when setting up the monitoring system?
What additional component may be included in the disposable flush system to prevent clotting?
What additional component may be included in the disposable flush system to prevent clotting?
Which patient population typically requires hemodynamic monitoring?
Which patient population typically requires hemodynamic monitoring?
What is the primary pacemaker of the heart responsible for initiating electrical impulses?
What is the primary pacemaker of the heart responsible for initiating electrical impulses?
Which artery supplies the right side of the heart?
Which artery supplies the right side of the heart?
What allows the atria to contract before the electrical impulse is relayed to the ventricles?
What allows the atria to contract before the electrical impulse is relayed to the ventricles?
What is the purpose of using a stent in fluid balance procedures?
What is the purpose of using a stent in fluid balance procedures?
What is the process called when the heart's muscle cells return to their resting state after depolarization?
What is the process called when the heart's muscle cells return to their resting state after depolarization?
How can a nurse help prevent pressure sores in patients with edematous skin?
How can a nurse help prevent pressure sores in patients with edematous skin?
What are the specialized tracts that conduct electrical impulses along the myocardial cells of the atria called?
What are the specialized tracts that conduct electrical impulses along the myocardial cells of the atria called?
What is the inherent firing rate of a normal resting adult heart initiated by the SA node?
What is the inherent firing rate of a normal resting adult heart initiated by the SA node?
What dietary recommendations are suggested for patients in the acute phase of heart failure?
What dietary recommendations are suggested for patients in the acute phase of heart failure?
What nursing intervention should be prioritized for a patient with ineffective tissue perfusion?
What nursing intervention should be prioritized for a patient with ineffective tissue perfusion?
Which part of the heart receives its blood supply from the posterior descending artery?
Which part of the heart receives its blood supply from the posterior descending artery?
What term describes the continuous cycle of depolarization and repolarization in the heart?
What term describes the continuous cycle of depolarization and repolarization in the heart?
Why is it important to provide oxygen and monitor oxygen saturation in patients with decreased cardiac output?
Why is it important to provide oxygen and monitor oxygen saturation in patients with decreased cardiac output?
Which of the following is not a recommended intervention for promoting fluid balance?
Which of the following is not a recommended intervention for promoting fluid balance?
In patients with right-sided heart failure, which of the following symptoms is commonly observed?
In patients with right-sided heart failure, which of the following symptoms is commonly observed?
Which measurement is essential for evaluating the effectiveness of diuretics in managing heart failure?
Which measurement is essential for evaluating the effectiveness of diuretics in managing heart failure?
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
- Non-pharmacologic therapies:
- 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.
