PCCN Flashcards: Coronary Artery Perfusion
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Questions and Answers

What characterizes Wernicke's aphasia?

Difficulty understanding language but ability to understand gestures and produce language.

The most appropriate first-line drug for treatment of a seizure is:

  • Midazolam (Versed)
  • Phenytoin (Dilantin)
  • Phenobarbital
  • Lorazepam (Ativan) (correct)

    • One complication that the nurse can protect the patient from within the first 24 hours after stroke is:

  • Aspiration (correct)
  • Speech abnormality
  • Decreased level of consciousness
  • Bleeding

    • Which of the following options is the most appropriate nursing action for a patient having a generalized grand mal seizure?

    <p>Position the patient on his or her side with head flexed forward</p> Signup and view all the answers

    Coronary artery perfusion is dependent upon:

    <p>Diastolic pressure</p> Signup and view all the answers

    What is the most common serious side effect of an ACE inhibitor for a post-STEMI patient?

    <p>Swelling of the tongue and face</p> Signup and view all the answers

    Which of the following best describes the fourth heart sound (S4)?

    <p>It occurs during late diastole when the atria contracts</p> Signup and view all the answers

    Which pathologic changes on a 12-lead ECG indicate myocardial ischemia?

    <p>ST-segment depression and T-wave inversion</p> Signup and view all the answers

    Positive inotropic agents are used to:

    <p>Improve cardiac output and tissue perfusion</p> Signup and view all the answers

    Which of the following is not considered a contraindication for alteplase use?

    <p>Current antibiotic use</p> Signup and view all the answers

    The two major components that determine blood pressure are:

    <p>Systemic vascular resistance (SVR) (afterload) and cardiac output</p> Signup and view all the answers

    The layer of the arterial vessel wall responsible for changes in the diameter of the artery is the:

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

    Which of the following findings correspond to a patient in acute distress with respiratory symptoms?

    <p>Pulmonary congestion, low perfusion</p> Signup and view all the answers

    When listening to heart sounds, what does S1 signify?

    <p>The beginning of ventricular systole</p> Signup and view all the answers

    A patient with pulmonary edema has impaired diffusion due to:

    <p>Increased thickness of the alveolar capillary membrane</p> Signup and view all the answers

    What would the hemodynamic profile assessment of a patient in cardiogenic shock be?

    <p>Decreased cardiac index, increased preload, increased afterload</p> Signup and view all the answers

    Essential education at the time of discharge for a patient with severe peripheral vascular disease includes:

    <p>Smoking cessation counseling</p> Signup and view all the answers

    What results from a medication that dilates both the venous and arterial beds?

    <p>Decreased preload, decreased afterload</p> Signup and view all the answers

    Stable angina is best defined as:

    <p>Pain that has a predictable pattern over time</p> Signup and view all the answers

    The gold standard diagnostic tool for identifying coronary artery disease is:

    <p>Cardiac catheterization</p> Signup and view all the answers

    What is the most common complication after a STEMI?

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

    What is the most common cause of heart failure in the US?

    <p>Ischemic heart disease</p> Signup and view all the answers

    Systolic left ventricular dysfunction is best defined as:

    <p>The impaired ability of the left ventricle to contract and effectively eject blood</p> Signup and view all the answers

    Neurohormonal responses in heart failure with long-term consequences include:

    <p>Increased activation of the sympathetic nervous system and the renin-angiotensin system</p> Signup and view all the answers

    Common medications used in the treatment of heart failure include:

    <p>ACE inhibitors, beta blockers</p> Signup and view all the answers

    What is the heart's primary compensatory response to chronic aortic stenosis?

    <p>Left ventricular hypertrophy</p> Signup and view all the answers

    Patients with pericardial effusions should be assessed for the development of which complication?

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

    Common causes of hypoxemia include:

    <p>Ventilation decreases</p> Signup and view all the answers

    The primary cause of hypercapnia is:

    <p>Abnormal alveolar minute ventilation</p> Signup and view all the answers

    Assessment of the patient with acute respiratory failure should include:

    <p>All of the above</p> Signup and view all the answers

    The patient goals for acute respiratory failure include:

    <p>Improve oxygenation greater than 60 mmHg</p> Signup and view all the answers

    The prevention of pulmonary emboli is geared toward prevention of:

    <p>Deep vein thrombus formation</p> Signup and view all the answers

    One major complication of pulmonary embolus is:

    <p>Pulmonary infarction</p> Signup and view all the answers

    The most common cardiac complication of post-thoracic (lung) surgery is:

    <p>Atrial fibrillation</p> Signup and view all the answers

    Which of the following parameters is used as an estimate of alveolar ventilation?

    <p>PaCO2</p> Signup and view all the answers

    At which level of FiO2 support is oxygen toxicity thought to develop?

    <p>More than 50% for longer than 24-28 hrs</p> Signup and view all the answers

    Which of the following is a goal for positive end-expiratory pressure (PEEP) therapy?

    <p>To allow reduction in FiO2 support</p> Signup and view all the answers

    Which of the following is a complication of mechanical ventilation and positive end-expiratory pressure (PEEP) therapy?

    <p>Reduced cardiac output</p> Signup and view all the answers

    Pulmonary emboli produce all of the following physiologic changes except:

    <p>Left ventricular failure</p> Signup and view all the answers

    A patient just admitted to your floor from the PACU is agitated and has tingling of the fingers. ABG on room air reveals: pH 7.49, PaCO2 25, PaO2 95, HCO3 24. Which of the following is correct?

    <p>Uncompensated respiratory alkalosis</p> Signup and view all the answers

    In preparation for assisting a physician doing a thoracentesis, the patient should be positioned in which of the following manners?

    <p>Patient upright and slightly bent forward</p> Signup and view all the answers

    Which of the following is a complication after a bedside thoracentesis?

    <p>All of the above</p> Signup and view all the answers

    Which of the following indicates an active pleural air leak for a patient with a chest tube attached to a pleural drainage system?

    <p>Bubbling in the water-seal chamber</p> Signup and view all the answers

    Which type of condition can lead to a tension pneumothorax?

    <p>Closed pneumothorax</p> Signup and view all the answers

    A patient is one day following surgery for peripheral vascular disease. She is increasingly short of breath and develops a low-grade fever, hiccoughs, dyspnea, cough, tachycardia, and chest pain. Which of the following diagnoses is the most likely?

    <p>Pulmonary embolism</p> Signup and view all the answers

    The most sensitive and one of the earliest indicators of changes in intracranial pressure in a patient who is unresponsive is:

    <p>Change in pulse pressure</p> Signup and view all the answers

    Nursing interventions in the patient with pericarditis include all the following except?

    <p>Administering anticoagulants to prevent thrombus in the pericardium</p> Signup and view all the answers

    Which of the following are measures that would improve the cerebral perfusion pressure (CPP)?

    <p>Increase mean arterial pressure (MAP)</p> Signup and view all the answers

    A patient with a closed head injury has developed a fever of 104F (40C). The nurse understands that an increasing temperature:

    <p>May cause increased oxygen requirements of the brain tissue</p> Signup and view all the answers

    Epinephrine is indicated as the first-line drug for any pulseless condition because it has the following actions:

    <p>Inotropic and selectively shunts blood to brain and heart</p> Signup and view all the answers

    With increasing intracranial pressure (ICP), the patient's blood pressure will change. What is the blood pressure response to increasing ICP?

    <p>Systolic blood pressure will increase with a decrease in diastolic blood pressure</p> Signup and view all the answers

    The most common postoperative complication of coronary artery bypass (CABG) surgery is?

    <p>Atrial fibrillation</p> Signup and view all the answers

    An NSTEMI is differentiated from unstable angina by?

    <p>Cardiac biomarker elevation</p> Signup and view all the answers

    What are the signs of Cushing's triad, which indicates increasing intracranial pressure?

    <p>Elevated systolic blood pressure, decreased heart rate, widened pulse pressure</p> Signup and view all the answers

    After a spinal tap, the patient complains of severe headache, visual disturbances, and nausea. An autologous blood patch may be injected near the puncture site in order to:

    <p>Plug the puncture hole in the dura</p> Signup and view all the answers

    The nurse auscultates an S3 on a patient just admitted with NSTEMI. What does that indicate?

    <p>Fluid overload</p> Signup and view all the answers

    The primary function of beta blocker therapy in heart failure is to?

    <p>Block compensatory vasoconstriction and increase heart rate</p> Signup and view all the answers

    Two months after an ischemic stroke, a patient has difficulty understanding and producing language in speaking, reading, and writing but can understand gestures, pictures, and diagrams. This type of aphasia is:

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

    Which of these is considered a first line drug of choice for acute pulmonary edema?

    <p>Oxygen, nitroglycerin, loop diuretics, and morphine</p> Signup and view all the answers

    Early symptoms of fluid overload and pulmonary edema are?

    <p>Complaint of shortness of breath and orthopnea</p> Signup and view all the answers

    What is a therapeutic range for anticoagulation for an elderly patient on warfarin for atrial fibrillation?

    <p>INR between 2.5 and 3.5</p> Signup and view all the answers

    Which test would provide the most accurate information to diagnose a myocardial infarction after four days?

    <p>Troponin and its isomers (C, I, and T)</p> Signup and view all the answers

    What medications would the nurse anticipate for a patient with Type III aortic dissection for blood pressure control?

    <p>Metoprolol and lisinopril</p> Signup and view all the answers

    In assessing a patient on cyclosporine for antirejection, the nurse should monitor?

    <p>Serum creatinine</p> Signup and view all the answers

    Which nursing action is correct for a patient complaining of flank pain and showing signs of hypotension after a procedure?

    <p>Notify a physician immediately and stop anticoagulation therapy</p> Signup and view all the answers

    What is the antidote for warfarin overdose?

    <p>Vitamin K</p> Signup and view all the answers

    Which of the following increases the risk of abciximab induced coagulopathy?

    <p>Recent warfarin therapy</p> Signup and view all the answers

    A physiologic reason for sinus tachycardia is?

    <p>Tissue hypoxia</p> Signup and view all the answers

    What drug can be added to reduce preload in a patient with decompensated heart failure?

    <p>Spironolactone (Aldactone)</p> Signup and view all the answers

    In a normal heart, a decrease in heart rate should cause the stroke volume to:

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

    Beck's triad indicates which condition?

    <p>Cardiac tamponade</p> Signup and view all the answers

    Which condition would stimulate renin production?

    <p>Decreased blood pressure</p> Signup and view all the answers

    Cardiac ischemia on a 12-lead ECG is characterized by:

    <p>Inverted T wave</p> Signup and view all the answers

    Symptoms of acute endocarditis of the mitral valve cause?

    <p>Symptoms similar to heart failure</p> Signup and view all the answers

    With acute arterial insufficiency, the extremity will appear?

    <p>Cool with pale color</p> Signup and view all the answers

    An atrial septal defect is characterized by:

    <p>Shunting of blood returning from the lungs through the left atrium back to the right atrium</p> Signup and view all the answers

    Signs and symptoms of acute myocardial infarction may indicate?

    <p>Acute ventricular septal defect (VSD) with heart failure</p> Signup and view all the answers

    The jugular venous pulse is particularly valuable for assessing:

    <p>Right atrial function</p> Signup and view all the answers

    Which of the following vasodilators primarily dilates coronary arteries?

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

    What medication may be helpful in the prevention of rupture of an abdominal aortic aneurysm?

    <p>Metoprolol (Lopressor)</p> Signup and view all the answers

    Which symptoms are consistent with cardiogenic shock?

    <p>Hypotension with systolic blood pressure less than 90 mm Hg</p> Signup and view all the answers

    During the treatment of supraventricular tachycardia, which medication is given rapidly intravenous (IV) push?

    <p>Adenosine (Adenocard)</p> Signup and view all the answers

    Which of the following ECG findings would you anticipate in an inferior wall MI?

    <p>Q wave formation and ST segment elevation in leads II, III, and aVF</p> Signup and view all the answers

    What possible problem should a nurse suspect if a patient develops shortness of breath after ambulating post-aortic aneurysm repair?

    <p>Pulmonary embolus</p> Signup and view all the answers

    A thoracic aortic aneurysm causes chest pain that?

    <p>Radiates through to the back</p> Signup and view all the answers

    The most common new-onset dysrhythmia seen in acute decompensated heart failure is:

    <p>Atrial fibrillation</p> Signup and view all the answers

    Which of the following is among the important aspects for developing a treatment plan from an arterial blood gas?

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

    The most common ECG changes that occur during pulmonary embolus are?

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

    The anterior left ventricle receives blood via the?

    <p>Left anterior descending coronary artery</p> Signup and view all the answers

    After pancreatic resection, what condition could acute shortness of breath indicate?

    <p>Acute respiratory distress syndrome</p> Signup and view all the answers

    For a patient with acute decompensated heart failure and pulmonary edema, what therapy will be started aside from oxygen therapy?

    <p>Diuretic therapy</p> Signup and view all the answers

    Patients with occlusion of the right coronary artery are at high risk for the development of Mobitz type I heart blocks because it supplies which part of the conduction system?

    <p>Artrioventricular (AV) node</p> Signup and view all the answers

    The amount of oxygen delivered to the tissues is determined by what factor?

    <p>All of the above</p> Signup and view all the answers

    What is the interpretation of an arterial blood gas with pH 7.55 and CO2 28?

    <p>Non-compensated respiratory alkalosis</p> Signup and view all the answers

    The findings of respiratory failure with a pH of 7.30 and elevated PaCO2 are consistent with:

    <p>Respiratory acidosis</p> Signup and view all the answers

    When assessing myocardial chest pain, which of the following is not a common characteristic of angina?

    <p>Pain that is intermittent and that comes and goes</p> Signup and view all the answers

    The major physiologic derangements in acute respiratory distress syndrome include:

    <p>All of the above</p> Signup and view all the answers

    Signs of venous peripheral vascular disease in the legs include?

    <p>Brown pigmentation at the ankles, warm legs, open area over the lateral malleolus</p> Signup and view all the answers

    A patient presents with pulmonary edema characterized by tachycardia, hypertension, and cough with frothy sputum. What initial treatments are most common?

    <p>Oxygen, nitroglycerin, loop diuretics, and morphine</p> Signup and view all the answers

    A hallmark of acute respiratory distress syndrome is:

    <p>Refractory hypoxemia</p> Signup and view all the answers

    The primary goal in treatment of acute respiratory distress syndrome is to:

    <p>Restore oxygenation</p> Signup and view all the answers

    The major early signs of respiratory failure include:

    <p>Increased respiratory rate, tachycardia, change in mental status</p> Signup and view all the answers

    Study Notes

    Coronary Artery Perfusion

    • Dependent on diastolic pressure which creates a pressure gradient for blood flow.
    • Decreases in diastolic pressure diminish coronary artery blood flow.
    • Not impacted by systolic pressure, afterload, or systemic vascular resistance (SVR).

    Post-STEMI Management

    • Common serious side effect of ACE inhibitors is swelling of the tongue and face, requiring immediate medical attention.
    • Nonproductive cough also occurs but is less severe.

    Fourth Heart Sound (S4)

    • Indicates presence of a stiff left ventricle and occurs during late diastole when the atria contract.
    • Best heard with the bell of the stethoscope and signifies poor compliance, often associated with hypertension and other conditions.

    Myocardial Ischemia on ECG

    • Characterized by ST-segment depression and T wave inversion, indicating subendocardial ischemia.
    • ST-segment elevation signifies acute injury, while Q-wave formation indicates total infarction.

    Inotropic Agents

    • Used to improve cardiac output and enhance tissue perfusion by increasing myocardial contraction force.

    Alteplase Contraindications

    • Current antibiotic use is not a contraindication; recent abdominal surgery, gastrointestinal bleed, and intracranial bleed are.

    Determinants of Blood Pressure

    • Blood pressure is influenced by systemic vascular resistance (SVR) and cardiac output.
    • Equation: BP = SVR x cardiac output, maintains BP despite changes in resistance and output.

    Arterial Vessel Wall Structure

    • The media layer contains smooth muscle responsible for controlling arterial tone and diameter changes.

    Patient Assessment in Cardiac Distress

    • Presenting symptoms of pulmonary congestion due to rales, elevated jugular venous distention (JVD), and cool clammy skin denote low perfusion state.

    Heart Sound S1

    • Signifies the beginning of ventricular systole and the opening of aortic and pulmonic valves.

    Pulmonary Edema and Impaired Diffusion

    • Increased thickness of the alveolar-capillary membrane due to interstitial and alveolar edema hinders oxygen diffusion.

    Anterior-wall STEMI in Cardiogenic Shock

    • Hemodynamic profile includes decreased cardiac index with increased preload and afterload due to vasoconstriction.

    Education for Peripheral Vascular Disease

    • Smoking cessation counseling is crucial for improving symptoms alongside medication and walking regimens.

    Effects of Vasodilation

    • Dilation of both venous and arterial beds leads to decreased preload and decreased afterload, impacting hemodynamics.

    Definition of Stable Angina

    • Characterized by a predictable pattern of pain, typically induced by exertion and relieved by rest or nitrates.

    Gold Standard for Coronary Artery Disease Diagnosis

    • Cardiac catheterization is the most reliable method for assessing coronary artery disease's location and severity.

    Common Complications Post-STEMI

    • Dysrhythmia is the most frequent complication, with bradycardia or tachydysrhythmias following different STEMI locations.

    Prevalent Causes of Heart Failure

    • Ischemic heart disease is the leading cause of heart failure in the US.

    Systolic Left Ventricular Dysfunction

    • Defined as impaired ability to contract and eject blood effectively, leading to decreased ejection fraction.

    Neurohormonal Response to Heart Failure

    • Increased activation of the sympathetic nervous system and renin-angiotensin system exacerbates heart failure.

    Medications for Heart Failure

    • ACE inhibitors and beta blockers are essential for treatment, aiding in preload and afterload reduction.

    Effects of Chronic Aortic Stenosis

    • Leads to left ventricular hypertrophy due to the increased workload over time.

    Complications of Pericardial Effusions

    • Assessment for cardiac tamponade is crucial, as fluid buildup can compress the myocardium.

    Nursing Interventions in Pericarditis

    • Focus on pain relief, monitoring for signs of tamponade, and avoiding anticoagulants due to bleeding risks.

    Epinephrine in Pulseless Conditions

    • It is the first-line drug for its inotropic effects, enhancing contractility and redirecting blood flow to vital organs.

    CABG Surgery Complications

    • Atrial fibrillation is the most common postoperative complication, occurring in about 33% of patients.### Postoperative Myocardial Edema
    • Can lead to atrial stretch, causing electrophysiological abnormalities.
    • Other complications: bleeding, stroke, ventricular fibrillation; however, these are less common.

    NSTEMI vs Unstable Angina

    • NSTEMI is distinguished by cardiac biomarker elevation.
    • Both conditions may exhibit similar pain location and ST-T wave depression on ECG.
    • Unstable angina lacks cardiac enzyme changes, while NSTEMI results in elevated enzyme levels.

    S3 Heart Sound in NSTEMI

    • The presence of an S3 heart sound indicates fluid overload in the left ventricle.
    • An S3 is abnormal in adults, signaling poor ventricular function.

    Beta Blocker Therapy in Heart Failure

    • Primary function: to block compensatory vasoconstriction and regulate heart rate.
    • Reduces the actions of the sympathetic nervous system and afterload.

    Symptoms of Fluid Overload

    • Patients may complain of shortness of breath and orthopnea.
    • Early signs include rales and hypoxia, but these are measured rather than patient-reported symptoms.

    Warfarin Therapy in Atrial Fibrillation

    • Therapeutic INR range for anticoagulation: 2.5-3.5, regardless of age.
    • INR values less than 1.0 or greater than 4.5 are not therapeutic.

    Monitoring Patients on Cyclosporine

    • Serum creatinine levels should be monitored closely to assess renal function.
    • Cyclosporine is eliminated through the kidneys and can cause renal injury.

    Antidote for Warfarin Overdose

    • Vitamin K is the specific antidote for warfarin, counteracting its anticoagulant effects.

    Sinus Tachycardia Causes

    • Commonly a compensatory response to tissue hypoxia.
    • Other triggers include fever and hypovolemia.

    Medication to Reduce Preload in Heart Failure

    • Spironolactone (Aldactone) is an appropriate addition for managing volume overload.
    • Aldosterone inhibitors help decrease renal sodium reabsorption.

    Renin Production Stimulation

    • Decreased blood pressure triggers renin secretion from the kidneys.
    • Renin initiation leads to vasoconstriction and sodium/water reabsorption.

    Symptoms of Acute Endocarditis

    • Similar to heart failure, presenting as pulmonary pressure increases.
    • Requires treatment for both infection and potential heart failure.

    Appearance of Extremity with Acute Arterial Insufficiency

    • Will appear cool and pale due to inadequate blood flow.

    Presentation of Acute Ventricular Septal Defect

    • Following a septal wall infarction, may lead to acute heart failure signs like rales and decreased oxygen saturation.

    Medications for Abdominal Aortic Aneurysm

    • Metoprolol (Lopressor) helps prevent aneurysm rupture through blood pressure management.

    Rapid IV Medication for Supraventricular Tachycardia

    • Adenosine (Adenocard) is administered rapidly and may cause a brief sinus pause.

    ECG Findings in Inferior Wall MI

    • Anticipated findings include Q waves and ST segment elevation in leads II, III, and aVF.

    Thoracic Aortic Aneurysm Pain Characteristics

    • Typically presents as severe chest pain radiating to the back.

    Common ECG Changes with Pulmonary Embolism

    • Tachycardia is a frequent finding, along with the potential for atrial fibrillation.

    Anterior Left Ventricle Blood Supply

    • Supplied by the left anterior descending coronary artery, encompassing the anterior left ventricle and septum.

    Risk of AV Node Ischemia with Right Coronary Artery Occlusion

    • Ischemia of the AV node can lead to Mobitz type I heart blocks.

    Factors Determining Oxygen Delivery to Tissues

    • Oxygen delivery is influenced by cardiac output, hemoglobin levels, and oxygen saturation.

    Characteristics of Angina

    • Typical angina is precipitated by exercise, described as pressure or tightness, and relieved with rest or nitroglycerin.
    • Intermittent pain that comes and goes is not characteristic of myocardial ischemia.

    Signs of Venous Peripheral Vascular Disease

    • Include brown pigmentation at ankles, warm legs, and ulcers over the lateral malleolus.

    Initial Treatments for Pulmonary Edema

    • Common treatments include oxygen, nitroglycerin, loop diuretics, and morphine for relief and fluid management.

    Diagnostic Test for Myocardial Infarction After Days

    • Troponin levels and isomers remain elevated for up to two weeks and are the most accurate test after an MI.

    Blood Pressure Control in Type III Aortic Dissection

    • Metoprolol (Lopressor) and lisinopril (Prinivil) are first-line medications for managing blood pressure.

    Nursing Actions Post-Angioplasty with Flank Pain

    • Immediate notification of a physician and preparation for potential blood/IV fluid administration in case of a retroperitoneal bleed.

    Contraindications for Abciximab Use

    • Recent warfarin therapy is a contraindication due to the increased risk of induced coagulopathy.### Warfarin Therapy and Abciximab
    • Abciximab contraindicated for patients with recent oral anticoagulation using warfarin, recent bleeding or stroke in the past 2 years, or a platelet count < 100,000.
    • Abciximab is used to prevent cardiac ischemia and re-occlusion after procedures like angioplasty and stenting.
    • It inhibits platelet aggregation and works synergistically with aspirin and low-dose heparin.

    Cardiac Output and Heart Rate

    • Stroke volume increases with a decrease in heart rate due to prolonged filling time in the ventricle.

    Beck's Triad

    • Beck's triad: hypotension, muffled heart sounds, and jugular venous distention (JVD) indicates cardiac tamponade.
    • Associated symptoms include tachycardia and narrow pulse pressure, signaling low cardiac output.

    Cardiac Ischemia on ECG

    • Inverted T waves are the earliest sign of myocardial ischemia on a 12-lead ECG.
    • Other signs like ST segment elevation and Q wave development occur later in the ischemic process.

    Atrial Septal Defect (ASD)

    • ASD leads to left-to-right shunt, causing pulmonary congestion and returning oxygenated blood back to the pulmonary circulation.

    Jugular Venous Pulse

    • Valuable for assessing right atrial function; increased pulsations indicate right atrial overload or failure.

    Diltiazem in Angina

    • Diltiazem, a non-dihydropyridine calcium channel blocker, primarily dilates coronary arteries and treats supraventricular tachycardia.

    Cardiogenic Shock Symptoms

    • Characterized by hypotension (systolic BP < 90 mm Hg), tachycardia, dysrhythmias, and tachypnea due to reduced cardiac output.

    Postoperative Shortness of Breath

    • Acute shortness of breath in a postoperative patient may indicate pulmonary embolism, especially after ambulation.

    Atrial Fibrillation in Heart Failure

    • Atrial fibrillation is the most common new-onset dysrhythmia in patients experiencing acute decompensated heart failure.

    Importance of pH in Arterial Blood Gas Analysis

    • pH is crucial for determining compensation and guiding treatment strategies for patients with respiratory or metabolic abnormalities.

    Acute Respiratory Distress Syndrome (ARDS)

    • ARDS presents with acute shortness of breath, bilateral rales, and increased oxygen requirements due to an inflammatory response leading to fluid in the lungs.

    Treatment Goals in Respiratory Failure

    • The primary treatment goal in ARDS is to restore oxygenation and manage associated complications effectively.

    Prevention of Pulmonary Emboli

    • Aimed at preventing deep vein thrombus (DVT) formation, as most pulmonary emboli result from DVT.

    Pulmonary Infarction from Emboli

    • Major complication of pulmonary embolism; occurs when a clot blocks blood flow to parts of the lung.

    Common Cardiac Complication in Lung Surgery

    • Atrial fibrillation often arises after thoracic surgery due to pulmonary pressure changes leading to atrial stretch.

    Alveolar Ventilation Estimate

    • PaCO2 level is a good estimate of alveolar ventilation; increased levels indicate respiratory failure.

    Oxygen Toxicity Threshold

    • Oxygen toxicity can develop when FiO2 exceeds 50% for more than 24-28 hours, leading to complications like atelectasis from decreased surfactant.

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    This quiz focuses on the important relationship between diastolic pressure and coronary artery perfusion, a critical concept in cardiovascular nursing. Test your knowledge with questions related to key factors affecting blood flow within the coronary arteries.

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