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Questions and Answers

What happens when both the SA node and the AV node fail in their pacemaker function?

  • The atria will generate impulses independently from the ventricles.
  • The heart will continue beating at the SA node rate.
  • The heart stops beating completely.
  • The ventricles will spontaneously depolarize at a rate of 30 to 40 impulses per minute. (correct)

Which phase of the cardiac action potential is characterized by the plateau due to calcium influx?

  • Phase 2 (correct)
  • Phase 3
  • Phase 1
  • Phase 0

During which phase does early cellular repolarization begin as potassium exits the intracellular space?

  • Phase 0
  • Phase 2
  • Phase 4
  • Phase 1 (correct)

What initiates the depolarization of the atrial and ventricular myocytes?

<p>Sodium influx through fast channels. (C)</p> Signup and view all the answers

Which property differentiates the depolarization of the SA and AV node cells from that of myocytes?

<p>They depolarize when calcium enters through slow channels. (C)</p> Signup and view all the answers

What characterizes the resting phase of the cardiac action potential?

<p>Return of the cell to its resting state before the next depolarization. (A)</p> Signup and view all the answers

Which structure is involved in transmitting impulses to the Purkinje fibers in the ventricular myocardium?

<p>AV bundle (bundle of His). (D)</p> Signup and view all the answers

Which phase of the cardiac action potential is marked by the completion of repolarization?

<p>Phase 3 (C)</p> Signup and view all the answers

What distinguishes an opening snap from an S3 sound?

<p>It has a high-pitched, snapping quality. (D)</p> Signup and view all the answers

What is the cause of a systolic click sound?

<p>Opening of a rigid and calcified valve. (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic used to describe murmurs?

<p>Blood pressure level. (B)</p> Signup and view all the answers

What is the primary function of the pericardium?

<p>To encase and support the heart (C)</p> Signup and view all the answers

During which phase of the cardiac cycle can a friction rub be heard?

<p>In both systole and diastole. (C)</p> Signup and view all the answers

Which heart chambers are responsible for receiving blood?

<p>Left atrium and right atrium (D)</p> Signup and view all the answers

Where is an opening snap best heard using a stethoscope?

<p>Medial to the apical area. (A)</p> Signup and view all the answers

What structure separates the left and right ventricles?

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

What causes a murmur to occur?

<p>Increased blood flow through normal structures. (B)</p> Signup and view all the answers

What is a common reason for confusion between a friction rub and a murmur?

<p>Both can be heard in systole and diastole. (A)</p> Signup and view all the answers

What type of valves separates the atria from the ventricles?

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

What occurs during myocardial infarction?

<p>Death of heart muscle due to lack of oxygen (B)</p> Signup and view all the answers

What condition may lead to the presence of murmurs during normal blood flow?

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

Which layer of the heart is responsible for the heart's contraction?

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

What function does the pericardial fluid serve?

<p>Reduces friction during heart movements (A)</p> Signup and view all the answers

Which part of the heart initiates the contraction sequence?

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

What is not a function of blood?

<p>Production of hormones (D)</p> Signup and view all the answers

Which component is not a characteristic of blood?

<p>Dark red color in arterial blood (B)</p> Signup and view all the answers

What is a common finding in patients with cardiac disorders?

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

Which of the following statements about plasma is incorrect?

<p>Plasma contains no proteins (A)</p> Signup and view all the answers

What do hemocytoblasts develop into after birth?

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

Which organ synthesizes albumin and clotting factors?

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

Red blood cells are characterized by which of the following?

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

Which physiological process is plasma NOT primarily involved in?

<p>Production of red blood cells (C)</p> Signup and view all the answers

What does an abnormal lymph node presentation, such as being fixed or hard, typically suggest?

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

How is the degree of liver enlargement measured?

<p>By the number of fingerbreadths it extends below the rib border (D)</p> Signup and view all the answers

Which skin condition is a common indicator of red blood cell disorders?

<p>Pallor or pasty skin (C)</p> Signup and view all the answers

Which hormone is produced by the kidneys in response to hypoxia?

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

Where is the best location to assess color changes in individuals with dark skin?

<p>Sclera and conjunctiva (B)</p> Signup and view all the answers

What skin finding is most likely associated with bleeding disorders?

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

What is the function of intrinsic factor in relation to vitamin B12?

<p>It protects vitamin B12 from digestion. (C)</p> Signup and view all the answers

What happens to RBCs after they live for 120 days?

<p>They are phagocytized by macrophages in several organs. (A)</p> Signup and view all the answers

Which of the following is a key component of assessing the cardiovascular system?

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

How is bilirubin processed after the breakdown of heme from hemoglobin?

<p>It is excreted by the liver into bile. (D)</p> Signup and view all the answers

What may cause a purple, mottled appearance on the skin, particularly in the face and fingers?

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

Which statement accurately reflects patients with hematologic disorders?

<p>They may have significant abnormalities in blood tests. (A)</p> Signup and view all the answers

How do blood types determine the compatibility in transfusions?

<p>They indicate the presence of antigens and corresponding antibodies. (A)</p> Signup and view all the answers

Which type of white blood cells are considered granular?

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

What role do eosinophils play in the immune response?

<p>They detoxify foreign proteins during allergic reactions. (A)</p> Signup and view all the answers

What is the primary function of T cells in the immune system?

<p>They recognize foreign antigens and destroy them. (C)</p> Signup and view all the answers

Flashcards

Pericardium

A thin, fibrous sac that encases the heart, composed of two layers: visceral and parietal pericardium.

Visceral Pericardium

The inner layer of the pericardium that adheres to the epicardium (heart's outer layer).

Parietal Pericardium

The tough, outer layer of the pericardium that attaches to surrounding structures and supports the heart.

Pericardial Space

The space between the visceral and parietal pericardium, filled with fluid to reduce friction during heart contractions.

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Myocardium

The muscular tissue forming the walls of the heart chambers.

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Endocardium

The inner lining of the heart chambers and valves, composed of smooth epithelial cells.

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Atrioventricular Valves

Valves separating the atria from the ventricles, allowing blood flow in one direction only.

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Semilunar Valves

Valves located at the exit of ventricles, preventing backflow of blood into the heart.

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SA Node

The natural pacemaker of the heart, located in the right atrium. It initiates the heartbeat and determines the heart rate.

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AV Node

A cluster of cells in the heart that delays the electrical signal from the atria to the ventricles, allowing the atria to contract first.

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Depolarization

The process of a cell becoming more positive inside, due to the influx of positive ions like sodium and calcium.

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Repolarization

The process of a cell returning to its resting state, becoming more negative inside, due to the outflow of positive ions like potassium.

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Cardiac Action Potential

The electrical signal that travels through the heart cells, initiating a heartbeat. It involves depolarization and repolarization phases.

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Fast Response Action Potential

Characteristic of atrial and ventricular heart cells, where depolarization is fast and driven mainly by sodium influx.

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Slow Response Action Potential

Characteristic of SA and AV node cells, where depolarization is slower and driven mainly by calcium influx.

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Plateau Phase

The period during repolarization where the cell stays partially depolarized due to a balance between calcium influx and potassium efflux.

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Opening Snap

A high-pitched, snapping sound heard in early diastole, caused by the rapid opening of a stiff mitral valve.

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Systolic Click

A short, high-pitched sound heard immediately after S1 in early systole, caused by the opening of a stiff aortic or pulmonic valve.

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Mid- to Late Systolic Click

A click heard in mid- to late systole caused by the displacement of a prolapsing mitral or tricuspid valve leaflet into the atrium.

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Murmur

A sound created by turbulent blood flow in the heart caused by various conditions.

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What causes a murmur?

A narrowed valve, a malfunctioning valve allowing backflow, a congenital defect in the ventricular wall, a defect between the aorta and pulmonary artery, or increased blood flow through a normal structure.

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Friction Rub

A harsh, grating sound heard during both systole and diastole, caused by inflamed pericardial surfaces rubbing together.

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How to best hear a pericardial friction rub?

Use the diaphragm of the stethoscope with the patient sitting upright and leaning forward.

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What differentiates an opening snap from S3?

An opening snap occurs too late for an S2 and too early for an S3. It also has a high-pitched, snapping quality.

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Hemoptysis

Coughing up blood, often a sign of respiratory issues or cardiovascular disorders.

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Crackles

Discontinuous, popping sounds heard during lung auscultation, indicating fluid in the alveoli.

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Wheezes

Continuous, whistling sounds during breathing, often caused by narrowed airways.

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Hepatojugular Reflux

An increase in jugular venous distension when pressure is applied to the liver, indicating potential heart failure.

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Blood's function: Regulation

Blood regulates body pH, temperature, and fluid balance. It helps maintain a constant internal environment.

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Plasma: 91% water

The watery component of blood, containing dissolved substances and proteins, responsible for transporting nutrients, wastes, and hormones.

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Red Blood Cells

Biconcave discs, containing hemoglobin, responsible for oxygen transport.

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Hemocytoblasts

Stem cells in the bone marrow that differentiate into various blood cells, including red blood cells.

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Erythropoietin

A hormone produced by the kidneys in response to low oxygen levels (hypoxia). It stimulates the red bone marrow to produce more red blood cells.

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Reticulocyte

An immature red blood cell that still contains some ribosomes. A high number indicates increased red blood cell production.

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Intrinsic Factor

A protein secreted by the stomach lining that binds to vitamin B12, protecting it from digestion and facilitating its absorption.

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Bilirubin

A yellow pigment produced from the breakdown of heme in red blood cells. It is excreted by the liver into bile.

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ABO Blood Types

A classification of blood based on the presence or absence of specific antigens on the surface of red blood cells.

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Rh Factor

A protein on the surface of red blood cells that can be either positive (Rh+) or negative (Rh-).

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Granular WBCs

White blood cells that contain granules in their cytoplasm, including neutrophils, eosinophils, and basophils.

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Agranular WBCs

White blood cells that lack granules in their cytoplasm, including lymphocytes and monocytes.

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Abnormal Node

A lymph node that is tender, hard, fixed, or enlarged, indicating a potential health issue requiring further investigation.

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Tender Node

A lymph node that is painful to the touch, usually indicating inflammation.

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Hard or Fixed Node

A lymph node that is firm and unmovable, suggesting cancer.

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Palpating the Liver

Feeling the liver with your hands to assess its size and consistency.

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Enlarged Liver

A liver that extends beyond the normal rib border, suggesting potential disease.

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Splenomegaly

An enlarged spleen, often due to underlying medical conditions.

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Skin Assessment for Hematologic Disorders

Examining the skin for signs of blood disorders: pale skin, cyanosis, petechiae, and ecchymoses.

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Clubbing of Fingers

Abnormal widening and thickening of the fingertips, often associated with chronic anemia.

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Study Notes

Nursing Care of At-Risk and Sick Adult Clients

  • This chapter provides an overview of cardiovascular and hematologic system anatomy and physiology, focusing on safe and appropriate care for at-risk and sick adult clients with oxygenation problems.
  • The general objective is for students to understand appropriate nursing care for at-risk and sick adult clients with oxygenation alterations or problems.

Lesson 1: Overview of Anatomy and Physiology & The Nursing Process

  • This lesson introduces significant concepts about the cardiovascular and hematologic systems.
  • Assessment skills used in dealing with clients having cardiovascular and hematologic problems are highlighted.

Lesson Objectives

  • Describe the cardiovascular and hematologic systems' parts and functions.
  • Perform proper techniques to assess at-risk and sick adult clients.
  • Differentiate normal and abnormal assessment findings.
  • Identify major symptoms of cardiovascular and hematologic alterations.

Anatomy of the Heart

  • The heart's function is to maintain homeostasis by pumping blood to deliver oxygen and nutrients, and remove waste.
  • It is located in the mediastinum of the thoracic cavity.
  • The heart has three layers: endocardium (inner layer), myocardium (middle, muscular layer), and epicardium (outer layer).

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