Questions and Answers
Which of the following correctly describes the primary pacemaker of the heart?
Which sequence correctly represents the conduction system of the heart during an action potential?
What is cardiac output and how is it measured?
Which factor does NOT influence stroke volume?
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What does the T-wave in an electrocardiogram (ECG) represent?
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What does preload refer to in cardiovascular physiology?
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Which of the following symptoms is most commonly associated with the imbalance of arterial oxygen supply and demand?
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What is the primary purpose of the 'COLD SPA' acronym in assessing patient symptoms?
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Which component of stroke volume is influenced by afterload?
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In the PQRST assessment method, what does the 'R' stand for?
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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.
