Module 4: Cardiac Function Pt. 2 (exam 2)

PVD - thromboangiitis obliterans ("Buerger disease")

**Chronic inflammatory condition of the arteries -"Buerger disease"​-- gross black BOY toes! -May lead to thrombosis and eventual complete occlusion of small/medium arteries in extremities​ -Most commonly affects males 20-40 years old who smoke; obese patients

Myocardial infarction (MI) ("HEART ATTACK" or acute coronary syndrome)

**Death of the heart from the sudden blockage of coronary blood flow​-- NECROSIS -Ineffective tissue perfusion r/t atherosclerosis, thrombus, or vasospasm.​ -**Myocardium 02 supply cannot meet body's oxygen demand bc heart arteries are blocked​---->cell death=tissue necrosis Risk factors: -dyslipidemia -diabetes -HTN -stress -tobacco use Manis: -**Unstable angina​ (chest pain even when resting) -Coughing, SOB -indigestion -diaphoresis

Heart failure cont.

**Left (LUNG)-sided failure -CO falls; blood backs up to pulmonary circulation= pulmonary issues -Manis: 1. pulmonary congestion= blood pooling into lungs (cough, crackles, tachypnea) 2. cyanosis 3. exertional dyspnea ** Right-sided failure -Blood backs up to peripheral circulation, causing edema/weight gain​ -Manis: 1. peripheral edema 2. JVD 3. ascites (belly fluid build up) 4. weight gain

Types of Cardiac Dysrhythmias

- Sinus rhythms (normal heart rhythm) - V-fib (DANGEROUS/DEADLY--- ventricles do most of the contracting) - A-fib (atria doesn't have a good squeeze) - PVCs (heart skipped a beat) - heart blocks (delay of conduction system)

Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply: A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction. B. A 55 year old female with a health history of asthma and hypoparathyroidism. C. A 30 year old male with a history of endocarditis and has severe mitral stenosis. D. A 45 year old female with lung cancer stage 2. E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction. C. A 30 year old male with a history of endocarditis and has severe mitral stenosis. E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

Hallmark characteristic of unstable angina​ Chest pain relieved by rest.​ Chest pain relieved by nitroglycerin​ Chest pain not relieved by treatment​ Chest pain that is brought on by smoking

Chest pain not relieved by treatment​

Electrical alterations

Dysrhythmias classified by origin; affect cardiac output (CO) and BP​ Causes: -acid-base imbalance -heart defects -drug toxicity -electrolyte imbalances -stress -ischemia ***Manis: varied based on dysrhythmia

What are patients who experience episodes of orthostatic hypotension at risk for? Essential Hypertension​ MI​ CAD​ Falls

Falls

Understanding the potential cause of unstable angina, what are likely some acute signs and symptoms of an MI? SATA Fatigue Nausea, vomiting and GI disturbances Syncope Coma Diaphoresis

Fatigue Nausea, vomiting and GI disturbances Syncope Diaphoresis

A patient with hypertension is receiving information from the nurse about modifying their diet to include less fats to decrease their lipid levels. What statement by the patient requires a need for further teaching? SATA "I can eat regular amounts of processed fats. I cannot give up my McDonald's and hotdogs." "I need to decrease my HDL fats in my body". "Dyslipidemia can eventually lead to CAD and worsening HTN if I dont try to change my lifestyle habits". "Decreasing my overall lipid levels is important to keep my cholesterol in a good range".

"I can eat regular amounts of processed fats. I cannot give up my McDonald's and hotdogs." "I need to decrease my HDL fats in my body".

A patient that has recently been moved to the PCU for post-op care is receiving instructions from the nurse about staying active to prevent infection and pressure ulcers. Which of the following statements made by the patient indicates the teaching was successful? "I will get up with assistance in order to prevent falls from potential orthostatic hypotension." "I will get up on my own if I feel strong enough." " I will use my incentive spirometer by blowing out forcefully to help my lungs from developing pneumonia." "I am post-op. I should not really have to move or cough as needed because I am in pain".

"I will get up with assistance in order to prevent falls from potential orthostatic hypotension."

PVD- Raynaud Phenomenon

"The GIRL said I'm raynauding!" -Vasospasms associated with autoimmune conditions (i.e., lupus and scleroderma)​ -Increased vessel occlusion may lead to ischemia of affected tissue​ -Most commonly affects females between 18-30 years old.​

You're assessing a patient's health history for peripheral vascular disease. What signs and symptoms reported by the patient would indicate the patient may be experiencing peripheral arterial disease? Select all that apply: A. "I often wake up at night with leg pain and have to dangle my leg out of the bed to ease the pain." B. "If I stand or sit too long my legs start to feel heavy and achy." C. "It hurts to elevate my legs." D. "Sometimes when I'm walking my legs start to cramp and tingle to the point where I can't walk until the pain goes away."

A. "I often wake up at night with leg pain and have to dangle my leg out of the bed to ease the pain."*"Rest Pain" = when the legs are horizontal the blood flow down is compromised - dangling the legs will help ease the pain (causes blood flow down) C. "It hurts to elevate my legs."*Elevation of the legs further compromises the arterial flow of blood D. "Sometimes when I'm walking my legs start to cramp and tingle to the point where I can't walk until the pain goes away." *Intermittent Claudication = hallmark sign of PAD - pain in the legs when exercising that is relieved by rest *The lower extremities are being deprived of blood flow - causing pain

A patient is diagnosed with Raynaud's Disease. Which explanations below most accurately describe this condition? Select all that apply: A. Raynaud's Disease is triggered by cold temperatures or stress. B. Raynaud's Disease occurs due to a vasospasm of the peripheral veins. C. Raynaud's Disease affects the toes, fingers, and sometimes the ears and nose. D. Raynaud's Disease is prevented by glucose control.

A. Raynaud's Disease is triggered by cold temperatures or stress. C. Raynaud's Disease affects the toes, fingers, and sometimes the ears and nose. *Raynaud's Diseases occurs when vasospasms of peripheral arteries occurs - mainly affecting fingers and toes (also ears/nose) *triggered by cold exposure or during stress - can be prevented by avoiding these situations

​A 56-year-old male came into the ER complaining of chest pain that is not relieved by his nitroglycerin. Pt states that he is having trouble breathing, noted by tripod positioning and an O2 sat of 84%. Pt noted to have hx of HF and has had to be defibrillated back in 1992 due to an MI. What is the nurses priority action? Shave pts chest in order to put defibrillator pads on.​ Obtain a blood draw to send to the lab to obtain the pts BNP levels.​ Administer 3L of oxygen via nasal cannula.​ Check pts capillary blood glucose.

Administer 3L of oxygen via nasal cannula.​

CAD- coronary microvascular disease

Affects the SMALLEST ARTERIES of the myocardium​ caused by molecular changes in small vessels as a part of NORMAL AGING -Arteries do not respond to signals to vasodilate with increased 02 demands on the myocardium​

Risk factors for dilated cardiomyopathy include: (SATA)​ Asian-American men​ Caucasian men and women​ African American Men​ Those of advancing age

African American Men​ Those of advancing age

Which person is most at risk for varicose veins? An obese and pregnant hair dresser A person that loves to play video games for 8+ hours a day but still regularly exercises A track athlete A pregnant nurse.

An obese and pregnant hair dresser

3. Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply: A. Jugular venous distention B. Persistent cough C. Weight gain D. Crackles E. Nocturia F. Orthopnea

B. Persistent cough D. Crackles F. Orthopnea (shortness of breath while lying down- goes away when standing up) *All s/s of LEFT-sided HF

A potential complication of valve regurgitation that we need to look out for is: Blood pooling in the atria​ Fever​ Cough​ Edema​

Blood pooling in the atria​

Chronic inflammatory condition of the arteries that may lead to occlusion of small/medium arteries in the extremities.​ Raynaud's Disease​ Coronary Artery Disease​ Varicose Veins​ Buerger Disease

Buerger Disease

Which patient(s) are most at risk for developing coronary artery disease? Select-all-that-apply: A. A 25 year old patient who exercises 3 times per week for 30 minutes a day and has a history of cervical cancer. B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day. C. A 45 year old female that reports her father died at the age of 42 from a myocardial infraction. D. A 29 year old that has type I diabetes.

B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day. C. A 45 year old female that reports her father died at the age of 42 from a myocardial infraction. D. A 29 year old that has type I diabetes. Risk Factors: - family hx - dyslipidemia - cigarette smoking - diabetes and insulin resistance - obesity/sedentary lifestyle

Ineffective tissue perfusion- Aneurysms

Caused by weakening of an artery​ (BALLOONS shaped-- can't be sustained very long) -#1 risk factors--- HYPERTENSION & ATHEROSCLEROSIS -Commonly: abdominal or thoracic aorta -Exsanguination (severe blood loss) is a possible consequence of rupture True aneurysms affect all three vessel layers:​ 1. TRUE Saccular aneurysm: bulge on the side​ 2. TRUE Fusiform aneurysm: affects entire circumference​ 3. **Dissecting aneurysm: occurs in inner layers, not a true aneurysm​ **ruptured aneurysm is a MEDICAL EMERGENCY

Which of the following symptoms should the nurse teach the client with unstable angina to report immediately to her physician? Change in the pattern of the pain Pain during intercourse Pain during an argument with her husband Pain during or after an activity such as lawn mowing

Change in the pattern of the pain

A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no electrocardiogram complexes on the screen. The first action of the nurse is to: Check the client status and lead placement. Press the recorder button on the electrocardiogram console. Call the physician. Call a code blue.

Check the client status and lead placement.

Which of the following patients does not have a risk factor for hypertension? A. A 25 year old male with a BMI of 35 B. A 40 year old female with a family history of hypertension and diabetes. C. A 35 year old female with a total cholesterol level of 100. D. A 68 year old male who reports smoking 2 packs of cigarettes a day.

C. A 35 year old female with a total cholesterol level of 100. A "normal" cholesterol level is <200.

The MOST common cause of peripheral arterial disease is? A. Diabetes B. Deep Vein Thrombosis C. Atherosclerosis D. Pregnancy

C. Atherosclerosis The collection of fatty plaques on the artery wall blocks blood flow.

Which of the following systems of the body are affected by hypertension? A. Cardiovascular, gastrointestinal, reproductive, and kidney B. Brain, respiratory, kidney, cardiovascular C. Cardiovascular, brain, kidney, eyes D. None of the options are correct

C. Cardiovascular, brain, kidney, eyes Cardio = MI (inc. workload with diminished blood flow through coronary arteries) & coronary arteries (acc. atherosclerosis) Brain = reduced blood flow and oxygen supply Kidneys = reduced blood flow, inc. arteriolar pressure, RAAS and SNS stimulation, inflammation Eyes = retinal vascular sclerosis, inc. retinal artery pressures

The nurse is assessing a patient, who has many risk factors for the development of a DVT, for signs and symptoms of a deep vein thrombosis. What signs and symptoms below would possibly indicate a deep vein thrombosis is present? SATA: A. Cool extremity B. Decreases pulses C. Redness D. Pain E. Warm extremity F. Swelling G. Cyanosis

C. Redness D. Pain E. Warm extremity F. Swelling S/S of DVT = redness, swelling, warm extremity, pain, positive Homan's sign (calf pain at dorsiflexion of the foot)

Your patient is diagnosed with Buerger's Disease (thromboangiitis obliterans). The nurse will make it priority to educate the patient about implementing? A. Low fat diet B. Blood glucose control C. Smoking cessation D. Blood pressure control

C. Smoking cessation *most common causes of Buerger's Disease is tobacco usage *Occurs when the blood vessels of the hands and feet become inflamed and clots form - clots will block blood flow.

A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the pain goes away when he rests. This is known as: A. Unstable angina B. Variant angina C. Stable angina D. Prinzmetal angina

C. Stable angina Stable Angina = chest pain d/t ischemia - relieved at rest

Atherosclerosis is a type of endothelial injury that is characterized by: Venous pooling in the lower extremities An embolism Ischemia to the myocardium Chronic inflammation and thickening lesions (plaque) that stick to the arterial walls

Chronic inflammation and thickening lesions (plaque) that stick to the arterial walls

Virchow's Triad that leads to the formation of thrombi include: (SATA)​ Circulatory Stasis​ Hypercoagulability​ HTN​ Vascular damage

Circulatory Stasis​ Hypercoagulability​ Vascular damage

Manifestations for Left-Sided HF include: (SATA)​ Cough​ Cyanosis​ Peripheral edema​ Tachypnea

Cough​ Cyanosis​ Tachypnea

PVD-Varicose veins

Dilated, engorged veins r/t improper venous valve formation. -***Increased venous pressure and blood pooling causes venous enlargement -most common in legs but can happen in esophagus, rectum and testicles Risk factors: -genetics -pregnancy -obesity -**PROLONGED SITTING/STANDING Manis: -Irregular purplish, bulging veins​ -Shiny, hairless pigmented skin on the legs and feet​ -Skin ulcer formation​

Your patient has severe peripheral arterial disease. When the lower extremities are elevated you would expect them to appear _______________ and, when they are in the dependent position you would expect them to appear _________________. Fill in the blanks: A. cyanotic; rubor B. rubor; pallor C. cyanotic, pallor D. pallor; rubor

D. pallor; rubor PAD:Elevated = pallor d/t decreased blood flow Dependent (dangling) = rubor d/t increased blood flow

Orthostatic (postural) hypotension

Decrease in BOTH systolic and diastolic BP upon standing -Systolic DECREASES at least 20mmHg -Diastolic decreases at least 10mmHg -PTS FALL RISK

A patient is being discharged home after hospitalization of left ventricular systolic dysfunction. As the nurse providing discharge teaching to the patient, which statement is NOT a correct statement about this condition? A. "Signs and symptoms of this type of heart failure can include: dyspnea, persistent cough, difficulty breathing while lying down, and weight gain." B. "It is important to monitor your daily weights, fluid and salt intake." C. "Left-sided heart failure can lead to right-sided heart failure, if left untreated." D. "This type of heart failure can build up pressure in the hepatic veins and cause them to become congested with fluid which leads to peripheral edema."

D. "This type of heart failure can build up pressure in the hepatic veins and cause them to become congested with fluid which leads to peripheral edema." This is indicative of RIGHT sided HF - body s/s

A significant cause of venous thrombosis is: A. Altered blood coagulation B. Stasis of blood C. Vessel wall injury D. All of the above

D. All of the above Virchow's Triad: 1. intravascular vessel wall damage 2. stasis of flow 3. presence of a hypercoagulable state *Three categories of factors thought to contribute to thrombosis

A nurse in the emergency room has clients that are all complaining of pain. The nurse knows that the client having pain in which of the following areas is the priority? A. Bilateral flank B. Lower back C. Lower abdomen D. Jaw and neck

D. Jaw and neck These s/s can occur in a client having a myocardial infarction (esp. the female pt.) - see this client first to rule out an MI.

What type of heart failure does this statement describe? The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to experience shortness of breath. A. Left ventricular systolic dysfunction B. Left ventricular ride-sided dysfunction C. Right ventricular diastolic dysfunction D. Left ventricular diastolic dysfunction

D. Left ventricular diastolic dysfunction Diastolic Dysfunction = decreased filling LEFT=lungs

A client with a recent diagnosis of myocarditis is at risk for which complication? ​ ​ Dilated cardiomyopathy ​ Hypertrophic cardiomyopathy ​ Aortic stenosis ​ Chronic venous insufficiency​

Dilated cardiomyopathy ​

After a recent visit to their primary care provider, an African American was recently diagnosed with hypertension without an underlying cause with a BP of 150/85. The doctor wants to start the patient on an ACE inhibitor. What kind of hypertension is the patient experiencing? Hypertensive crisis Essential hypertension Secondary hypertension Malignant hypertesnion

Essential hypertension

True or False: Peripheral venous disease can occur due to narrowing of the valves in the veins of the lower extremities.

FALSE PVD can occur due to overstretched valves of the veins (not narrowed) - it can also occur when the veins become damaged.

A nurse is teaching a new grad the importance for monitoring a patient who recently underwent a valve replacement surgery. The nurse teaches the new grad that it is imperative to watch for symptoms of infective endocarditis. The new grad shows signs of understanding when she states that she needs to watch for: (SATA)​ Fever​ New onset heart murmur​ Serum sodium of 135​ Osler's nodes

Fever​ New onset heart murmur​ Osler's nodes

The patient just received an abdominal CT scan ordered by the physician. The CT scan revealed an abdominal aortic aneurysm that takes up the circumference of the artery. What kind of aneurysm is this? Saccular aneurysm Fusiform aneurysm Dissecting aneurysm False aneurysm

Fusiform aneurysm

Baby Joseph was born at 10:11 am today and nurse Stephanie is performing her head-to-toe on the new baby. What cardinal sign is Stephanie looking for while listening to the baby's heart to rule out a congenital heart defect? Vomiting​ Crying​ Heart murmur​ Tachycardia

Heart murmur

You are educating your patient on modifiable risk factors for atherosclerosis. The patient shows understanding of the teaching when they say:​ I can keep eating fried chicken and fried eggs as long as I watch my weight.​ I can keep my routine of working my desk job and going home and watching the office until bedtime.​ My genes plays a role in my diagnosis of atherosclerosis.​ I will monitor my weight, eat more vegetables, and exercise more.

I will monitor my weight, eat more vegetables, and exercise more.

A 64-year-old female smoker comes into the ER stating that she gained 5 pounds in the past week, and has been experiencing foot swelling, fatigue, and bloating. What kind of HF is the patient most likely experiencing? Right sided​ Left sided

Right sided

Ineffective tissue perfusion- Dislipidemia

High levels of lipids in the blood, increases risk of chronic disease​ Classified based on density, triglycerides (low density) and protein (high density)​ -Low-density lipoproteins (LDLs): "bad" cholesterol, WE WANT THE BAD TO BE LOW -High-density lipoproteins (HDLs): "good", "protective" cholesterol, WE WANT TO BE HIGH

What 3 conditions promote thrombus formation within the cardiovascular system? Hypercoagulability Endothelial injury Stagnant blood flow

Hypercoagulability Endothelial injury Stagnant blood flow

Heart failure (CHF)

Inadequate pumping that leads to decreased CO Causes: congenital, myocardial infarction, ***HYPOthyroidism -Compensatory mechanisms (i.e. sympathetic nervous system) help at first, but perpetuate heart failure -Systolic dysfunction: decreased contractility​ -Diastolic dysfunction: decreased filling​ -Mixed dysfunction: decreased contractility and filling

Non-obstructive CAD

LARGE arteries occluded < 50%​ -Also caused by damage or injury to the lining of the coronary arteries that impact the ability to vasodilate in response to increased myocardial oxygen demand​

Jackie is administering an IV into a patients right forearm. Jackie noticed that the patient is experiencing lymphedema in her right arm from having lymph nodes removed due to breast cancer. What is nurse Jackie's main priority? Administer the IV in the right forearm to administer fluids to reduce the swelling in the right arm.​ Do not administer the IV and call the physician.​ Look for a line of access in the patients left arm.​ Call the IV team to administer a central line.

Look for a line of access in the patients left arm.

Congenital heart defects

Most common type of birth defect; structural heart issues present at birth​ Risk factors: -heredity -**genetic disorders (Down's Syndrome) -fetal substance exposure -maternal health status Manis: -**difficulty gaining weight​ (babies difficulty feeding) -**Heart murmurs -dyspnea -tachypnea -cyanosis

The nurse receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased level in cardiac biomarkers suggests which of the following? Hypertension Cancer Myocardial infarction Liver disease

Myocardial infarction

​​Valve stenosis: Insufficient closure​ Failure to open​ Narrowing of a valve

Narrowing of a valve

Ineffective tissue perfusion- Peripheral vascular disease (PVD)

Narrowing of the peripheral vessels - arteries and/or veins​ -Commonly atherosclerosis in the arteries​ -May also be caused by a thrombus, inflammation, or vasospasm

coronary artery disease (CAD)

Narrowing or blockage of the outside arteries supplying the myocardium--usually caused by atherosclerosis​ Manis: 1. Angina that may radiate (neck, jaw, arm, or back)​ 2. **Indigestion-like sensation 3. Sleep disturbances 4. Diaphoresis 5. N/v Nonmodifiable risk factors:​ -Age: males > 45 years; females > 55 years or premature menopause​ -Family history: premature CAD in first-degree male relatives​ Modifiable risk factors:​ -Tobacco use, obesity, physical inactivity, stress, etc. 3 main types: 1. obstructive 2. nonobstructive 3. coronary microvascular disease​

A patient is CAD who is noncompliant with diet, exercise and medications poses a risk for heart failure. As a nurse, we know that specifically right-sided heart failure can manifest as: Orthopnea and cough Shortness of breath and hemoptysis Peripheral edema and hepatomegaly Pulmonary edema

Peripheral edema and hepatomegaly

Obstructive CAD

Plaque accumulates in the LARGE arteries causing narrowing and decreased blood supply to the heart > 50%​ -Blood flow may become completely occluded

Hypertension (HTN)

Prolonged HYPERTENSION creates **excessive cardiac workload due to vasoconstriction **(1) Primary (essential) hypertension: most common, develops gradually over time​ (No identifiable cause) **(2) Secondary hypertension- SOMETHING ELSE CAUSING IT: more sudden and severe, caused by other factors​ (Renal disease, diabetes, drug use)​ Pregnancy-induced hypertension:​ -Preeclampsia that may lead to eclampsia (increased BP may lead to seizures)​ ***Malignant hypertension (hypertensive crisis): -intense and nonresponsive to interventions​ -BP is at least ***180/120 & symptomatic​

What are some secondary risk factors that can cause HTN? (SATA) Gender​ Renal Failure​ Age​ Diabetes

Renal Failure​ Diabetes

A patient with breast cancer recently had metastasis to her lymphatic system in the upper extremities causing her right arm to swell. What may she be suffering from? Primary Lymphedema Secondary Lymphedema Peripheral venous disease Peripheral artery disease

Secondary Lymphedema *SECONDARY= something happened before to cause the current disease

CAD- angina

Stable angina (PREDICTABLE): -Chest pain caused by ischemia (lack of blood) that is **initiated by increased oxygen demand and **relieved by rest -usually doesn't cause permanent ischemia​ Unstable angina (UNPREDICTABLE): -Unpredictable Chest pain that is NOT RELIEVED W REST/happens whenever -increases in frequency and/or intensity -"preinfarction" state​

What are some if the life-threatening complications of atherosclerosis? SATA Thrombi Peripheral vascular disease Stroke MI

Thrombi Stroke MI

A male with a smoking history is more likely to experience what kind of peripheral vascular disease? Thromboangitis Obliterates (Buerger Disease) Raynaud Phenomenon Myocardial Infarction Aneurysm

Thromboangitis Obliterates (Buerger Disease)

A patient was recently diagnosed with non-obstructive coronary artery disease following a visit with her PCP after having infrequent periods of chest pain upon exertion. What are some modifiable risk factors that patient could consider working on to prevent further occlusion of her arteries? SATA Her age Tobacco use Gender Her weight History of diabetes and hypertension

Tobacco use Her weight History of diabetes and hypertension

Ineffective tissue perfusion- Atherosclerosis

Triggered by a vessel wall injury...Thickening/hardening lesions calcifying (plaque) on the arterial wall​ -Leads to sticking blood platelets (eventually a thrombi), and vasoconstriction (hypertension). -Manis: asymptomatic until complications develop

T/F: Cardiac tamponade is a life-threatening cardiac compression.​

True

T/F: Hypertension due to atherosclerosis can lead to an MI?

True

True or False: Peripheral arterial disease leads to a decrease in rich oxygenated blood being delivered to the lower extremities, which leads to ischemia and necrosis of skin tissue.

True

True/False. Hypertension increases the cardiac workload which could eventually lead the patient into heart failure.

True

True/False: Thrombi that travel from the left-side of the heart can lead to DVT and stroke.

True

True/False: Venous thrombosis is more likely to occur over arterial thrombosis.

True **True. Venous thrombosis is indeed more likely to occur over arterial thrombosis. It is because veins, particularly those in the legs, have to work against gravity to return blood to the heart and can often slow down, leading to clot formation. This condition is more common compared to arterial thrombosis.

A patient is experiencing chest pain that occurred at rest that seems to be increasing in frequency and pain since the episode started? What is the patient most likely experiencing? Stable angina Angina from exertion Unstable angina

Unstable angina

Lymph edema

Unusual swelling in the extremities r/t lymph obstruction​ (unilateral or bilateral) (1) Primary causes (RARE) - rare and caused by congenital absence or decrease in number of lymphatics. ​ (2) Secondary causes- SOMETHING ELSE caused it (COMMON):​ -Surgical removal (i.e., mastectomy)​ -Scarring -Occlusions -Obstructions related to infection​ (i.e. tumors) -Injury/trauma​ Manis: 1. Edema and skin changes​ 2. Hyperpigmentation, ulceration, and thickening​ 3. Thick and rough skin ("elephant skin")​

As a nurse, we know that most elderly are as risk for falls which is typically caused by small obstacles or orthostatic hypertension. How do we know that a patient is experiencing orthostatic hypotension? When the patient gets up really fast, the systolic and diastolic pressure drops by at least 20 mm Hg When the patient gets up really fast, the systolic pressure drops by at least 10 mm Hg and the diastolic drops by at least 20 mm Hg When the patient gets up really fast, the systolic pressure drops by at least 20 mm Hg and the diastolic drops by at least 10 mm Hg When the patient gets up really fast, the systolic pressure drops by at least 30 mm Hg and the diastolic drops by at least 10 mm Hg

When the patient gets up really fast, the systolic pressure drops by at least 20 mm Hg and the diastolic drops by at least 10 mm Hg

Which condition is characterized by the enlargement and weakening of the heart chambers, leading to reduced blood ejection? ​ ​ a) Dilated cardiomyopathy ​ b) Hypertrophic cardiomyopathy ​ c) Hypertensive hypertrophic cardiomyopathy ​ d) Restrictive cardiomyopathy​

a) Dilated cardiomyopathy ​

The nurse is assessing a client with mitral regurgitation. Which of the following statements accurately describes this condition? ​ ​ a) Incomplete closure of the mitral valve, leading to backflow of blood into the left atrium ​ b) Narrowing of the mitral valve orifice, obstructing blood flow from the left atrium to the left ventricle ​ c) Inflammation and infection of the mitral valve, resulting in valvular destruction ​ d) Thickening and calcification of the mitral valve, impairing its ability to open properly​ ​

a) Incomplete closure of the mitral valve, leading to backflow of blood into the left atrium ​

A client with coronary artery disease (CAD) experiences angina pectoris. What is the primary cause of angina in CAD? ​ ​ a) Insufficient blood supply to the myocardium due to coronary artery blockage ​ b) Inflammation and infection of the coronary arteries ​ c) Increased myocardial contractility leading to oxygen demand exceeding supply ​ d) Impaired relaxation of the coronary arteries, reducing blood flow to the myocardium

a) Insufficient blood supply to the myocardium due to coronary artery blockage ​

In mitral valve stenosis, the narrowing of the valve impedes blood flow from the: ​ ​ a) Left atrium to the left ventricle ​ b) Left atrium to the right atrium ​ c) Left ventricle to the aorta ​ d) Right atrium to the right ventricle​ ​

a) Left atrium to the left ventricle ​

Which type of cardiomyopathy is characterized by the thickening of the heart muscle, particularly the left ventricle? ​ ​ a) Dilated cardiomyopathy ​ b) Hypertrophic cardiomyopathy ​ c) Restrictive cardiomyopathy ​ d) Valvular hypertrophic cardiomyopathy​

b) Hypertrophic cardiomyopathy ​

What is the primary difference between primary and secondary hypertension? ​ ​ a) Primary hypertension is caused by lifestyle factors, while secondary hypertension is caused by genetic factors. ​ b) Primary hypertension has no identifiable cause, while secondary hypertension is caused by an underlying condition. ​ c) Primary hypertension is more common in young individuals, while secondary hypertension is more common in older adults. ​ d) Primary hypertension is reversible with lifestyle changes, while secondary hypertension requires medication for management.​ ​

b) Primary hypertension has no identifiable cause, while secondary hypertension is caused by an underlying condition. ​

Which of the following conditions is characterized by the backward flow of blood through a heart valve during systole? ​ ​ a) Valvular stenosis ​ b) Valvular regurgitation ​ c) Hypertensive hypertrophic cardiomyopathy ​ d) Chronic venous insufficiency​

b) Valvular regurgitation ​

Thrombus

blood clot that forms anywhere in the circulatory system​ Three conditions promote thrombus formation (Vertile's triad): 1. endothelial injury-- **vascular damage -trauma -microtrauma to vessel wall 2. sluggish blood flow-- **circulatory stasis -bradycardia -congenital deformities affecting veins 3. **hypercoagulability​--- blood (someone who clots MORE) -estrogen therapy -inflammation -dehydration

A client with left-sided heart failure is likely to present with which symptom? ​ ​ a) Peripheral edema ​ b) Jugular vein distention ​ c) Dyspnea on exertion ​ d) Ascites​

c) Dyspnea on exertion ​

What is the primary cause of chronic venous insufficiency? ​ ​ a) Valvular stenosis ​ b) Valvular regurgitation ​ c) Increased venous pressure ​ d) Arterial occlusion​

c) Increased venous pressure ​

A client is diagnosed with secondary hypertension. What is the most likely underlying cause? ​ ​ a) Family history of hypertension ​ b) Sedentary lifestyle ​ c) Renal disease ​ d) Age-related changes in blood vessels​

c) Renal disease ​

Which of the following is a modifiable risk factor for developing coronary artery disease (CAD)?​ ​ a) Age ​ b) Gender ​ c) Family history ​ d) Smoking​ ​

d) Smoking​

Emboli ("mobile")

portion or all of a thrombus breaks loose, travels circulatory system RIGHT side of the heart origin:​ Venous circulation that travels first to pulmonary circulation, creating a pulmonary embolism​ LEFT side of the heart origin:​ Arterial circulation and travel to other organs such as brain and heart, causing an infarction​