Nursing Care Management 112: Oxygenation & Perfusion
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Questions and Answers

Which of the following correctly describes the primary pacemaker of the heart?

  • Ventricular cells with an intrinsic heart rate of 20-45 bpm
  • Tricuspid valve responsible for heart pacing
  • SA node with an intrinsic heart rate of 60-100 bpm (correct)
  • AV node with an intrinsic heart rate of 40-60 bpm
  • Which sequence correctly represents the conduction system of the heart during an action potential?

  • AV node → SA node → Bundle of HIS → Atria
  • Purkinje fibers → Atria → AV node → SA node
  • SA node → AV node → Bundle of HIS → Purkinje fibers (correct)
  • Bundle of HIS → Purkinje fibers → SA node → AV node
  • What is cardiac output and how is it measured?

  • The amount of blood ejected by each ventricle per heartbeat
  • The electrical impulses generated by the SA node per minute
  • The total amount of blood ejected by one of the ventricles in liters per minute (correct)
  • The flow of blood through the heart's valves during diastole
  • Which factor does NOT influence stroke volume?

    <p>Heart rate</p> Signup and view all the answers

    What does the T-wave in an electrocardiogram (ECG) represent?

    <p>Ventricular relaxation</p> Signup and view all the answers

    What does preload refer to in cardiovascular physiology?

    <p>The degree of stretch of the ventricular muscle fibers at the end of diastole</p> Signup and view all the answers

    Which of the following symptoms is most commonly associated with the imbalance of arterial oxygen supply and demand?

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

    What is the primary purpose of the 'COLD SPA' acronym in assessing patient symptoms?

    <p>To characterize and detail physical symptoms</p> Signup and view all the answers

    Which component of stroke volume is influenced by afterload?

    <p>The resistance to ejection of blood from the ventricle</p> Signup and view all the answers

    In the PQRST assessment method, what does the 'R' stand for?

    <p>Region/radiation of pain</p> Signup and view all the answers

    Study Notes

    Cardiovascular System Overview

    • Composed of heart, blood, and blood vessels, essential for the transportation system of the body.
    • Functionally tied to oxygenation and perfusion.

    Heart Anatomy

    • Hollow, muscular organ with four chambers located in the mediastinum.
    • Chambers include:
      • Right Atrium (RA)
      • Right Ventricle (RV)
      • Left Atrium (LA)
      • Left Ventricle (LV)
    • Valves include:
      • Tricuspid
      • Pulmonic
      • Bicuspid
      • Aortic

    Cardiac Electrophysiology

    • Nodal and Purkinje cells are key in impulse generation and transmission, facilitating heart contractions.
    • Three characteristics of nodal cells:
      • Automaticity
      • Excitability
      • Conductivity

    Heart Pacemakers

    • SA Node: Dominant pacemaker, intrinsic heart rate of 60-100 bpm.
    • AV Node: Backup pacemaker, intrinsic heart rate of 40-60 bpm.
    • Ventricular cells: Intrinsic heart rate ranging from 20-45 bpm.

    Cardiac Cycle and Action Potential

    • Action potential involves depolarization and repolarization processes.
    • Impulses spread through the atria (P wave), then the ventricles (QRS complex), followed by relaxation (T wave).

    Cardiac Output and Stroke Volume

    • Cardiac output: Total blood ejected by one ventricle per minute.
    • Stroke volume: Amount of blood ejected per heartbeat, influenced by:
      • Preload: Ventricular muscle stretch at diastole end.
      • Afterload: Resistance to blood ejection.
      • Contractility: Force generated by myocardium contraction.

    Blood Vessels

    • Main types include arteries, veins, and capillaries.

    Cardiovascular Assessment

    • Subjective Data Gathering involves:
      • Biographic & demographic data (age, race, gender, heredity).
      • History of present illness—chief complaint.
      • Presenting symptoms using COLD SPA (Character, Onset, Location, Duration, Severity, Pattern, Associated factors).

    Clinical Manifestations

    • Common symptoms include:
      • Chest pain
      • Palpitations (sensation of racing or irregular heartbeat)
      • Dyspnea (shortness of breath)
      • Orthopnea (dyspnea when lying flat)
      • Cough (may indicate pulmonary congestion)
      • Nocturia (increased nighttime urination)

    Pain Assessment (PQRST)

    • P: Precipitating factors
    • Q: Quality of pain
    • R: Region/radiation
    • S: Severity (scale of 0-10)
    • T: Timing (onset, duration)

    Past Medical History Considerations

    • Childhood illnesses, prior hospitalizations, diagnostic/interventional procedures, and current medications.

    Family Health History

    • Important conditions: Hypertension, myocardial infarction, coronary artery disease, diabetes mellitus.

    Cardiovascular Risk Factors

    • Non-Modifiable: Gender, family history, race.
    • Modifiable: Lifestyle factors like smoking, hypertension, high cholesterol, inactivity, diabetes, stress, and obesity.

    Social Context in Assessment

    • Assess stress levels related to occupation, cultural influences, and environmental exposure (pollutants, chemicals).

    Health Habits and Lifestyle

    • Investigate smoking history using a formula (packs/day x years smoked).
    • Assess coping mechanisms for anxiety and depression.
    • Evaluate alcohol consumption and eating habits.
    • Review exercise patterns, with attention to changes in activity levels and fatigue.

    Nutrition and Other Considerations

    • Assess current height, weight, waist measurement, and blood pressure.
    • Evaluate self-monitoring and dietary practices.

    Elimination Patterns

    • Monitor nocturia, straining during urination/defecation, and digestive symptoms (bloating, diarrhea, etc.).

    Self-Perception and Relationships

    • Explore the ability to make lifestyle changes, such as quitting smoking.
    • Evaluate living arrangements and support systems in place for a safe home environment.

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    Description

    This quiz focuses on the concepts of oxygenation and perfusion within the context of nursing care management. It covers the anatomical structures and physiological functions of the cardiovascular system and includes assessment techniques for patients with cardiovascular disease.

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