chapter 16, 18, 19, 20 pathophysio

hypotension, distended neck veins and muffled heart sounds are classic manifestations of

cardiac tamponade

patent ductus arteriosus is accurately described as a(n)

communication between the aorta and the pulmonary artery

administration of a vasodilator to a patient in shock would be expected to

decrease left ventricular afterload

Increased preload of the cardiac chambers may lead to which patient symptom?

edema

in contrast to all other type of shock, the hyperdynamic phase of septic shock is associated with

high cardiac output

a patient has a history of falls, syncope, dizziness, and blurred vision. the patient's symptomology is most likely related to

hypotension

constrictive pericarditis is associated with

impaired cardiac filling

lusitropic impairment refers to

impaired diastolic relaxation

tumor necrosis factor a and interleukin-1 contribute to shock states because they induce production of

nitric oxide

the prevalence of high blood pressure is higher in

non-hispanic black adults

first-degree heart block is characterized by

prolonged PR interval

left-sided heat failure is characterized by

pulmonary congestion

hypertrophy of the right ventricle is compensatory response to

pulmonary stenosis

the majority of tachydysrhytmias are believed to occur because of

reentry mechanisms

atherosclerotic plaques with large lipid cores are prone to

rupture

a patient presenting with fever, hypotension, and lactic acidosis is most likely to experiencing what type of shock?

septic

a laboratory test that should be routinely monitored in patients receiving digitalis therapy is

serum potassium

a patient with significant aortic stenosis is likely to experience

syncope

Improvement in a patient with septic shock is indicated by an increase in

systemic vascular resistance.

Pulse pressure is defined as

systolic pressure - diastolic pressure

the progressive stage of hypovolemic shock is characterized by

tachycardia

what compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stoke volume?

tachycardia

the effect of nitric oxide on systemic arterioles is

vasodilation

a patient with heart failure who reports intermittent shortness of breath during the night is experiencing

paroxysmal nocturnal dyspnea

a patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/min on a ECG is most likely in which rhythm?

ventricular escape rhythm

an example of acyanotic heart defect is

ventricular septal defect

In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing?

Class II, Compensated Stage

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?

Septic

in which dysrhythmias should treatment be instituted immediately?

atrial fibrillation with a ventricular rate of 220 beats/minute

Patent ductus arteriosus is accurately described as a(n)

communication between the aorta and the pulmonary artery.

after being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. the patient reports "moderate" adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. what is the most appropriate intervention for this patient at this time?

continue lifestyle modifications only

angiotensin-converting enzyme (ACE) inhibitors block the

conversion of angiotensin I to angiotensin II

administration of which therapy is most appropriate for hypovolemic shock?

crystalloids

aortic regurgitation is associated with

diastolic murmur

second-degree heart block type I (wenckebach) is characterized by

lengthening PR intervals and droppped P wave

which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?

128/82

massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

anaphylactic

the majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with

antibiotics

chronic elevation of myocardial wall tension results in atrophy

F. Chronic elevation of myocardial wall tension results in hypertrophy

new-organ damage is a function of both the stage of hypertension and its duration

F. End-organ damage is a function of both the stage of hypertension and its duration

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding?

Increased LDL levels are associated with increased risk of coronary artery disease.

rheumatic heart disease is most often a consequence of

B-hemolytic streptococcal infection

high blood pressure increases the workload of the left ventricle, because it increases

afterload

the most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is

ST-segment elevation

Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100?

Sitting BP 88/60, HR 118

restriction of which electrolytes is recommended in the management of high blood pressure?

Sodium

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes

T

disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body

T

the ingestion of certain drugs, foods, chemicals can lead to secondary hypertension

T

Sepsis has been recently redefined as

a systemic inflammatory response to infection.

a patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing

acute cardiogenic pulmonary edema

myocarditis should be suspected in a patient who presents with

acute onset of left ventricular dysfunction

Tachycardia is an early sign of low cardiac output that occurs because of

baroreceptor activity.

a middle- aged patient has a follow up visit for a recorded blood pressure of 162/96mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly and exercises infrequently. this patient is about 40 lbs overweight and admits to a high-fat, high-calorie diet. at the office visit today, the patient's blood pressure is 150/92 mm Hg. what is the LEAST appropriate intervention for this patient at this time?

begin antihypertensive drug therapy

a type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic

F. a " " " is neurogenic shock

a patient is diagnosed with heart failure with normal ejection fraction. this patient is most likely characterized by a(n)

elderly woman without previous history of MI

critically ill patients may have parenterally administered vasoactive drugs that are adjust according to their ___ pressure

mean arterial

a loud pansystolic murmur that radiates to the axilla is most likely a result of

mitral regurgitation

which dysrhythmia is thought to be associated with reentrant mechanisms?

preexcitation syndrome tachycardia (wolf-parkinson-white-syndrome)

An abnormally wide (more than 0.10 second) QRS complex is characteristic of

premature ventricular complexes.

mitral stenosis is associated with

pressure gradient across the mitral valve

angina caused by coronary artery spasm is called ____ angina

prinzmental variant

a patient with pure left-sided heart failure is likely to exhibit

pulmonary congestion with dyspnea

beta-blockers are advocated in the management of heart failure because they

reduce cardiac output

cor pulmonale refers to

right ventricular hypertrophy secondary to pulmonary hypertension

after sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema . His edema is most likely a consequence of

right-sided heart failure

patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class?

Class 1

the most commonly recognized outcome of hypertension is pulmonary disease

F. the " " " of hypertension is cardiovascular disease

a patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of

hypertensive crisis

hypertension is closely linked to

obstructive sleep apnea

An erroneously low blood pressure measurement may be caused by

positioning the arm above the heart level.

hypertension with a specific, identifiable cause is known as ____ hypertension

secondary