Adv. Med Surg Exam 3 Review (Chapters 22-31)

A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean blood pressure (BP) by up to which percentage in the first hour? 1 25% 2 35% 3 40% 4 45%

1

The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following? 1 Left ventricular function 2 Right ventricular function 3 Left atrial function 4 Right atrial function

1

The nurse understands that a client with which cardiac arrhythmia is most at risk for developing heart failure? 1 Atrial fibrillation 2 First-degree heart block 3 Supraventricular tachycardia 4 Sinus tachycardia

1

What is the term for the ability of the cardiac muscle to shorten in response to an electrical impulse? 1 contractility 2 depolarization 3 repolarization 4 diastole

1

Which feature is the hallmark of systolic heart failure? 1 Low ejection fraction (EF) 2 Pulmonary congestion 3 Limited activities of daily living (ADLs) 4 Basilar crackles

1

Which finding indicates that hypertension is progressing to target organ damage? 1 Retinal blood vessel damage 2 Urine output of 60 mL over 2 hours 3 Blood urea nitrogen concentration of 12 mg/dL 4 Chest x-ray showing pneumonia

1

Which is a characteristic of arterial insufficiency? 1 Diminished or absent pulses 2 Superficial ulcer 3 Aching, cramping pain 4 Pulses are present but may be difficult to palpate

1 A diminished or absent pulse is a characteristic of arterial insufficiency. Venous characteristics include superficial ulcer formation, an aching and cramping pain, and presence of pulses.

A client with a history of hypertension is receiving client education about structures that regulate arterial pressure. Which structure is a component of that process? 1 kidneys 2 parasympathetic nervous system 3 limbic system 4 lungs

1 The autonomic nervous system, the kidneys, and various endocrine glands regulate arterial pressure.

What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease? Select all that apply. 1 hypertension 2 diabetes 3 obesity 4 lowered triglyceride levels 5 active lifestyle 6 family history of early cardiovascular events

1, 2, 3, 6

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next? 1 Notify the health care provider. 2 Check the client's potassium level. 3Calculate the client's intake and output. 4 Administer potassium.

2

What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue? 1 Loose and wrinkled skin 2 Ulcers and infection in the edematous area 3 Evident scarring 4 Cyanosis

2

Assessment of a client on a medical surgical unit finds a regular heart rate of 120 beats per minute, audible third and fourth heart sounds, blood pressure of 84/64 mm Hg, bibasilar crackles on lung auscultation, and a urine output of 5 mL over the past hour. What is the reason the nurse anticipates transferring the client to the intensive care unit? 1 The client is experiencing heart failure. 2 The client is going into cardiogenic shock. 3 The client shows signs of aneurysm rupture. 4 The client is in the early stage of right-sided heart failure.

2 This client's findings indicate cardiogenic shock, which occurs when the heart fails to pump properly, impeding blood supply and oxygen flow to vital organs. Cardiogenic shock also may cause cold, clammy skin and generalized weakness, fatigue, and muscle pain as poor blood flow causes lactic acid to accumulate and prevents waste removal. Left-sided and right-sided heart failure eventually cause venous congestion with jugular vein distention and edema as the heart fails to pump blood forward. A ruptured aneurysm causes severe hypotension and a quickly deteriorating clinical status from blood loss and circulatory collapse; this client has low but not severely decreased blood pressure. Also, in ruptured aneurysm, deterioration is more rapid and full cardiac arrest is common.

A physician orders blood coagulation tests to evaluate a client's blood-clotting ability. The nurse knows that such tests are important in assessing clients at risk for thrombi, such as those with a history of atrial fibrillation, infective endocarditis, prosthetic heart valves, or myocardial infarction. Which test determines a client's response to oral anticoagulant drugs? 1 Bleeding time 2 Platelet count 3 Prothrombin time (PT) 4 Partial thromboplastin time (PTT)

2 PT determines a client's response to oral anticoagulant therapy. This test measures the time required for a fibrin clot to form in a citrated plasma sample following addition of calcium ions and tissue thromboplastin and compares this time with the fibrin-clotting time in a control sample. The physician should adjust anticoagulant dosages as needed, to maintain PT at 1.5 to 2.5 times the control value. Bleeding time indicates how long it takes for a small puncture wound to stop bleeding. The platelet count reflects the number of circulating platelets in venous or arterial blood. PTT determines the effectiveness of heparin therapy and helps physicians evaluate bleeding tendencies. Physicians diagnose appoximately 99% of bleeding disorders on the basis of PT and PTT values.

According to the DASH diet, how many servings of vegetables should a person consume each day? 1 2 or fewer 2 2 or 3 3 4 or 5 4 7 or 8

3

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client? 1 peripheral edema 2 right-sided heart failure 3 stroke 4 pulmonary insufficiency

3 A stroke occurs if vessels in the brain rupture and bleed. If an aneurysm has developed in the aorta from chronic hypertension, it may burst and cause hemorrhage and shock. Perpheral edema, right-sided heart failure, and pulmonary insufficiency are not usually consequences of untreated chronic hypertension.

When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures 1 must be equal in both arms. 2 may vary 10 mm Hg or more between arms. 3 differ no more than 5 mm Hg between arms. 4 may vary, with the higher pressure found in the left arm.

3 Normally, in the absence of disease of the vasculature, arm pressures differ by no more than 5 mm Hg. The pressures in each arm do not have to be equal to be considered normal. Pressures that vary more than 10 mm Hg between arms are an abnormal finding. The left arm pressure is not anticipated to be higher than the right as a normal anatomical variant.

A nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, what action should the nurse perform? 1 administer oxygen 2 have the client take deep breaths and cough 3 place the client in high Fowler's position 4 perform chest physiotherapy

3 The high Fowler's position will initially promote oxygenation in the client and relieve shortness of breath. Additional measures include administering oxygen to increase oxygen content in the blood. Deep breathing and coughing will improve oxygenation postoperatively but may not immediately relieve shortness of breath. Chest physiotherapy results in expectoration of secretions, which isn't the primary problem in pulmonary edema.

A nurse is assessing a client with congestive heart failure for jugular vein distension (JVD). Which observation is important to report to the physician? 1 No JVD is present. 2 JVD is noted at the level of the sternal angle. 3 JVD is noted 2 cm above the sternal angle. 4 JVD is noted 4 cm above the sternal angle.

4 JVD is assessed with the client sitting at a 45° angle. Jugular vein distention greater than 4 cm above the sternal angle is considered abnormal and is indicative of right ventricular failure.

A client with left-sided heart failure is in danger of impaired renal perfusion. How would the nurse assess this client for impaired renal perfusion? 1 Assess for reduced urine output. 2 Assess for reduced blood sodium levels. 3 Assess for elevated blood potassium levels. 4 Assess for elevated blood urea nitrogen levels.

4 Elevated blood urea nitrogen indicates impaired renal perfusion in a client with left-sided heart failure. Serum sodium levels may be elevated. Reduced urine output or elevated blood potassium levels do not indicate impaired renal perfusion in a client with left-sided heart failure.

Which of the following best defines stroke volume? A.The amount of blood ejected with each heartbeat B.Amount of blood pumped by the ventricle in liters per minute C.Degree of stretch of the cardiac muscle fibers at the end of diastole D.Ability of the cardiac muscle to shorten in response to an electrical impulse

A

What should the nurse palpate when assessing for an upper respiratory tract infection? A.Neck lymph nodes B.Nasal mucosa C.Tracheal mucosa D.All of the above

A The nurse should palpate the neck lymph nodes along with the trachea and the frontal and maxillary sinuses when assessing for an upper respiratory tract infection The nurse should inspect the nasal and tracheal mucosa when assessing for an upper respiratory tract infection

Atherosclerosis most common manifestation?

Angina pectoris condition in which fatty deposits called plaque build up on the inner walls of the arteries

____________ (hardening of the arteries) is the most common disease of the arteries.

Arteriosclerosis

The nurse is preparing a male patient to have a 12-lead ECG performed. When prepping the skin the nurse notices that the patient has abundant chest hair. What is the most appropriate nursing intervention to improve adhesion of the ECG leads? A.Use alcohol swabs to clean the skin before applying the leads B.Clip the chest hair with the patient's permission before applying the leads C.Apply the leads to the arms and legs only D.Reschedule the ECG

B

The nurse is assessing a patient admitted with a heart block. When placed on a monitor, the patient's electrical rhythm displays as progressively longer PR durations until there is a nonconducted P wave. Which type of heart block does the nurse expect that this patient has? A.First degree B.Second degree, type I C.Second degree, type II D.Third degree

B In first-degree heart block, the PR is constant but greater than 0.20 seconds. Second-degree AV block, type II has a constant PR interval and the presence of more P waves than QRS complexes. Third-degree AV block presents with irregular PR intervals

A neurohormone secreted by the heart in response to ventricular expansion. As these levels increase it can indicate heart failure.

B- type natriuretic peptide (BNP)

The nurse is caring for a patient who has severe chest pain after working outside on a hot day and is brought to the emergency center. The nurse administers nitroglycerin to help alleviate chest pain. What side effect should concern the nurse the most? A.Dry mucous membranes B.Heart rate of 88 bpm C.Blood pressure of 86/58 mm Hg D.Complaints of headache

C Nitroglycerin dilates vessels in the body. Dilation of the veins causes venous pooling of blood throughout the body. As a result, less blood returns to the heart, and filling pressure (preload) is reduced. If the patient is hypovolemic, the decrease in filling pressure can cause a significant decrease in cardiac output and blood pressure. This patient was working outside on a hot day, and the possibility of dehydration and hypovolemia should be considered. Dry mucous membranes can cause poor absorption of sublingual nitroglycerin but is not the most concerning. B and D are insignificant findings

__________ The amount of blood the heart pumps through the circulatory system in a minute. The amount of blood put out by the left ventricle of the heart in one contraction is called the stroke volume. The stroke volume and the heart rate determines this

Cardiac output SV X HR= CO

_________ occurs when decreased CO leads to inadequate tissue perfusion and initiation of the shock syndrome. most commonly occurs following acute MI when a large area of myocardium becomes ischemic and hypokinetic.

Cardiogenic shock

_________________ scanning provides cross-sectional images of soft tissue and visualizes the area of volume changes to an extremity and the compartment where changes take place

Computed tomography (CT)

Which of the following is the primary pacemaker for the myocardium? A. Atrioventricular junction B. Bundle of His C. Purkinje fibers D. Sinoatrial node

D

The nurse is caring for a patient with hypercholesterolemia who has been prescribed atorvastatin (Lipitor). What serum levels should be monitored in this patient? A.Complete blood count (CBC) B.Blood cultures C.Na and K levels D.Liver enzymes

D Atorvastatin (Lipitor) is an HMG-CoA reductase inhibitor and is hepatotoxic. Therefore, liver enzymes should be monitored in patients taking this medication

The nurse is caring for a patient after cardiac surgery. Which nursing intervention is appropriate to help prevent complications arising from venous stasis? A.Encourage crossing of legs B.Use pillows in the popliteal space to elevate the knees in the bed C.Discourage exercising D.Apply sequential pneumatic compression devices as prescribed

D : Sequential pneumatic compression devices should be used when prescribed to help prevent venous stasis and clotting complications such as deep vein thrombosis and pulmonary embolism. Patients should be discouraged to cross their legs. Pillows should not be used in the popliteal space to elevate the knees; rather, this should be avoided. Exercises, passive and active, should be encouraged

What is the primary clinical symptom of emphysema? A.Chest pain B.Productive cough C.Sputum D.Wheezing

D The primary symptom of emphysema is wheezing. Sputum and productive cough are the primary symptoms of chronic bronchitis

when distal pulses on the feet cannot be palpated a _________ device may be used to detect blood flow?

Doppler ultrasound device.

___________ measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction. 60 percent means that 60 percent of the total amount of blood in the left ventricle is pushed out with each heartbeat (how hard the heart is working and how effective its working)

Ejection fraction EF

T or F Bradypnea is the most common sign for a possible pulmonary embolism

False Tachypnea is the most common sign for possible PE

True or False For patients with chronic bronchitis, the nurse expects to see the major clinical symptoms of tachypnea and tachycardia

False. For patients with chronic bronchitis, the nurse expects to see the major clinical symptoms of sputum and productive cough

_______________: The hallmark symptom is intermittent claudication described as aching, cramping, or inducing fatigue or weakness that occurs with some degree of exercise or activity, which is relieved with rest.

PAD- peripheral artery disease

______________ an example of a peripheral vascular disease caused by atherosclerosis. Arteries are occluded.

Peripheral artery occlusive disease

________ also known as the left ventricular end-diastolic pressure (LVEDP), is the amount of ventricular stretch at the end of diastole. __________ is the pressure the heart must work against to eject blood during systole.

Preload Afterload

_____________ is the amount of blood ejected with each heartbeat. ____________ is the amount of blood pumped by the ventricle in liters per minute. _____________ is the degree of stretch of the cardiac muscle fibers at the end of diastole. ______________ is the ability of the cardiac muscle to shorten in response to an electrical impulse

Stoke volume Cardiac output Preload Contractility

T or F An early sign of cancer of the larynx includes changes in speech, the voice may sound harsh, raspy, and lower in pitch

True

T or F An initial characteristic symptom of a simple pneumothorax is sudden onset of chest pain

True

True or false Acute pharyngitis of a bacterial nature is most commonly caused by group A beta-hemolytic streptococci?

True

____________: detect changes in blood pressure

baroreceptors

_____________- hormones secreted by the adrenal medulla that affect the sympathetic nervous system in stress response (epinephrine, norepinephrine, dopamine)

catecholamines

DASH diet stands for?

dietary approach to stop hypertension

Although signs and symptoms of deep vein thrombosis (DVT) can vary, patients may report leg pain and swelling and the leg may appear erythematous and feel warm. Diagnosis of DVT can be confirmed by ________________ of the lower extremities. These clots can break off and travel through the inferior vena cava and through the right side of the heart into the pulmonary artery, where they can cause a pulmonary embolus.

duplex ultrasound

Although the exact cause of VTE remains unclear, three factors, known as Virchow triad, are believed to play a significant role in its development: _____________ ____________ _________________

endothelial damage, venous stasis, and altered coagulation

the beating in stethoscope when taking BP is called the ?

kortokoff sound Korotkoff sounds are first heard and blood passes in turbulent flow through the partially constricted artery. Korotkoff sounds will continue to be heard as the cuff pressure is further lowered. Noises heard through stethoscope resulting from collapsing arteries and producing turbulent blood flow

CRP (C-reactive protein) measures?

measure of inflammation and infection (cellulitis, vasculitis)

Paroxysmal nocturnal dyspnea (PND)??

shortness of breath that occurs suddenly during sleep

angioplasty means? Valvuloplasty means?

surgical repair of a blood vessel surgical repair of valve

chordae tendineae

thin bands of fibrous tissue that attach to the valves in the heart and prevent them from inverting

Lowering blood pressure to quickly in hypertensive emergencies can trigger ____________

transient ischemic attack or stroke

what condition can be described as "heart skipped a beat"?

PVC

STEMI??

ST elevation MI, real-time ongoing death of heart tissue due to ischemia

Which of the following is the key underlying feature of asthma? 1 Inflammation 2 Shortness of breath 3 Productive cough 4 Chest tightness

1 Inflammation is the key underlying feature and leads to recurrent episodes of asthma symptoms: cough, chest tightness, wheeze, and dyspnea.

Malignancy of the larynx can be a devastating diagnosis. What does a client with a diagnosis of laryngeal cancer require? 1 Emotional support 2 Referral for counseling 3 Family counseling 4 Referral for vocational training

1

thin bands of fibrous tissue that attach to the valves in the heart and prevent them from inverting

Chordae tendinease

Mitral valve stenosis most common cause? 1st symptom? Prevention of mitral stenosis primarily is minimizing risk of and treatment for __________________?

Rheumatic endoccarditis Dyspnea on exertion from pulmonary congestion

A _________ is a metal mesh that provides structural support to a vessel at risk of acute closure. It is initially positioned over the angioplasty balloon. When the balloon is inflated, the mesh expands and presses against the vessel wall, holding the artery open

Stent

Aspirin should be continued indefinitely and clopidogrel is continued for _______ following stent placement

one year

A client diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the client's condition does not improve and the oxygen saturation level continues to decrease, what procedure will the nurse expect to assist with in order to help the client breathe more easily? 1 Intubate the client and control breathing with mechanical ventilation 2 Increase oxygen administration 3 Administer a large dose of furosemide (Lasix) IVP stat 4 Schedule the client for pulmonary surgery

1

A client has been living with an internal, fixed-rate pacemaker. When checking the client's readings on a cardiac monitor the nurse notices an absence of spikes. What should the nurse do? 1 Double-check the monitoring equipment. 2 Do nothing; there is no cause for alarm. 3 Suggest the need for a new beta-blocker to the doctor. 4 Measure the client's blood pressure.

1

A client presents to the emergency room with characteristics of atherosclerosis. What characteristics would the client display? 1 Fatty deposits in the lumen of arteries 2 Cholesterol plugs in the lumen of veins 3 Blood clots in the arteries 4 Emboli in the veins

1

A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to 1 avoid caffeinated beverages. 2 request sublingual nitroglycerin. 3 apply supplemental oxygen. 4 lie down and elevate the feet.

1

A nurse evaluates a client with a temporary pacemaker. The client's ECG tracing shows each P wave followed by the pacing spike. What is the nurse's best response? 1 Document the findings and continue to monitor the client 2 Reposition the extremity and turn the client to left side 3 Obtain a 12-lead ECG and a portable chest x-ray 4 Check the security of all connections and increase the milliamperage

1

A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer? 1 Cough or change in chronic cough 2 Pain on inspiration 3 Obvious trauma 4 Shortness of breath

1

Statistics show an increase in the prevalence of infective endocarditis among older adults. Which factor places older adults at risk for developing infective endocarditis? 1 increased use of prosthetic valve replacements 2 greater incidence of a history of repaired congenital heart defects 3 increase in IV drug use 4 higher rate of tuberculosis

1

The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following? 1 Chordae tendineae 2 Atrioventricular tendons 3 Semilunar tendineae 4 Papillary tendons

1

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? 1 When the patient has less than 30 mL for 2 consecutive days 2 When the patient states that there is discomfort and requests removal 3 When the drainage tube comes out 4 In 1 week when the patient no longer has serous drainage

1

The nurse is placing electrodes for a 12-lead electrocardiogram (ECG). The nurse would be correct in placing an electrode on which area for V1? 1 Right side of sternum, fourth intercostal space 2 Left side of sternum, fourth intercostal space 3 Midway between V2 and V4 4 Mid-clavicular line, fifth intercostal space

1

The nurse is teaching a school community parent group about heart wellness. What risk factor is a common leading cause for mitral stenosis? 1 rheumatic fever 2 infective endocarditis 3 Marfan's syndrome 4 dissecting aortic aneurysm

1

The nurse accompanies a client to an exercise stress test. The client can achieve the target heart rate, but the electrocardiogram indicates ST-segment elevation. Which procedure will the nurse prepare the client for next? 1 cardiac catheterization 2 telemetry monitoring 3 transesophageal echocardiogram 4 pharmacologic stress test

1 An elevated ST-segment means an evolving myocardial infarction. A cardiac catheterization would be the logical next step. Telemetry monitoring will only provide dysrhythmia detection. A transesophageal echocardiogram is a diagnostic test to assess cardiac function. The pharmacologic stress test is diagnostic and will determine heart function.

You are doing an admission assessment on a client who is having outpatient testing done for cardiac problems. What should you ask this client during your assessment? 1 "Have you had any episodes of dizziness or fainting?" 2 "Have you had any episodes when you are to nauseous?" 3 "Have you had any episodes of mottling in your hands?" 4 "Have you had any episodes of pain radiating into your lower extremities?"

1 Ask if the client has episodes of dyspnea, dizziness, or fainting. Options B, C, and D are incorrect. Being nauseous, mottling of the hands, and pain radiating into the lower extremities are not indications of cardiac problems.

Which dysrhythmia has an atrial rate between 250 and 400, with saw-toothed P waves? 1 Atrial flutter 2 Atrial fibrillation 3 Ventricular fibrillation 4 Ventricular tachycardia

1 Atrial flutter occurs in the atrium and creates impulses at a regular atrial rate between 250 and 400 times per minute. The P waves are saw-toothed in shape. Atrial fibrillation causes a rapid, disorganized, and uncoordinated twitching of atrial musculature. Ventricular fibrillation is a rapid, disorganized ventricular rhythm that causes ineffective quivering of the ventricles. Ventricular tachycardia is defined as three or more PVCs in a row, occurring at a rate exceeding 100 beats per minute.

The nurse is assessing a client with mitral regurgitation. The nurse expects to note what finding in this client? 1 Dyspnea, fatigue, and weakness 2 Dizziness, syncope, and palpitations 3 Orthopnea, angina, and pulmonary edema 4 Dry cough, wheezing, and hemoptysis

1 Chronic mitral regurgitation is often asymptomatic, but acute mitral regurgitation can cause dyspnea, fatigue, and weakness. Dizziness, syncope, and palpitations are usually symptoms of mitral valve prolapse. Orthopnea, angina, and pulmonary edema are more likely with aortic stenosis. Dry cough, wheezing, and hemoptysis are more likely with mitral stenosis.

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include: 1 diminished or absent breath sounds on the affected side. 2 paradoxical chest wall movement with respirations. 3 tracheal deviation to the unaffected side. 4 muffled or distant heart sounds.

1 In the case of a pneumothorax, auscultating for breath sounds will reveal absent or diminished breath sounds on the affected side. Paradoxical chest wall movements occur in flail chest conditions. Tracheal deviation occurs in a tension pneumothorax. Muffled or distant heart sounds occur in cardiac tamponade.

A nurse has established a nursing diagnosis of ineffective airway clearance. The datum that best supports this diagnosis is that the client 1 Has wheezes in the right lung lobes 2 Has a respiratory rate of 28 breaths/minute 3 Reports shortness of breath 4 Cannot perform activities of daily living

1 Of the data listed, wheezing, an adventitious lung sound, is the best datum that supports the diagnosis of ineffective airway clearance. An increased respiratory rate and a report of dyspnea are also defining characteristics of this nursing diagnosis. They could support other nursing diagnoses, as would inability to perform activities of daily living.

The nurse is assessing a client with suspected postpericardiotomy syndrome after cardiac surgery. What manifestation will alert the nurse to this syndrome? 1 pericardial friction rub 2 hypothermia 3 decreased white blood cell (WBC) count 4 decreased erythrocyte sedimentation rate (ESR)

1 Postpericardiotomy syndrome is characterized by fever, pericardial pain, pleural pain, dyspnea, pericardial effusion, pericardial friction rub, and arthralgia. Leukocytosis (elevated WBCs) occurs, along with elevation of the ESR. Hypothermia is not a symptom of postpericardiotomy syndrome.

While the nurse is preparing a client for a cardiac catheterization, the client states that they have allergies to seafood. Which of the following medications may the nurse give prior to the procedure? 1 Methylprednisolone 2 Furosemide 3 Lorazepam 4 Phenytoin

1 Prior to cardiac catheterization, the patient is assessed for previous reactions to contrast agents or allergies to iodine-containing substances, as some contrast agents contain iodine. If allergic reactions are of concern, antihistamines or methylprednisolone (Solu-Medrol) may be administered to the patient before angiography is performed. Furosemide, Lorazepam, and Phenytoin do not counteract allergic reactions.

A client comes to the emergency department (ED) complaining of precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would the nurse suspect in this client? 1 Coronary artery disease 2 Raynaud's disease 3 Cardiogenic shock 4 Venous occlusive disease

1 The classic symptom of CAD is chest pain (angina) or discomfort during activity or stress. Such pain or discomfort typically is manifested as sudden pain or pressure that may be centered over the heart (precordial) or under the sternum (substernal). Raynaud's disease in the hands presents with symptoms of hands that are cold, blanched, and wet with perspiration. Cardiogenic shock is a complication of an MI. Venous occlusive disease occurs in the veins, not the arteries.

A young adult client has had a tonsillectomy and is in the immediate postoperative period. To make the client comfortable, the nurse intervenes by 1 Placing the client prone with the head turned to the side 2 Removing the oral airway before the gag reflex has returned for client comfort 3 Sitting the client in the semi-Fowler's position 4 Maintaining a warm compress around the client's neck area

1 The most comfortable position for the client in the immediate postoperative period is prone, not semi-Fowler's. The client's head is turned to the side to allow drainage from the mouth. The oral airway is removed after the gag reflex has returned. An ice collar, not warm compress, is applied to the neck area.

The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client 1 Exhales hard and fast with a single blow 2 Inhales deeply and holds the breath 3 Records in a diary the number achieved after one breath 4 Sits in a straight-back chair and leans forward

1 To use a peak flow meter, the client stands. Then the client takes a deep breath and exhales hard and fast with a single blow. The client repeats this twice and records a "personal best" in an asthma diary.

A nurse is caring for a client with pericarditis and auscultates a pericardial friction rub.What action does the nurse ask the client to do to distinguish a pericardial friction rub from a pleural friction rub? 1 The nurse asks the client to hold the breath during auscultation. 2 There is really no question to ask the client to tell the difference. 3 The nurse has the client stand during auscultation. 4 The nurse places the client flat for at least 4 minutes.

1 A pericardial friction rub occurs when the pericardial surfaces lose their lubricating fluid as a result of inflammation. The audible rub on auscultation is synchronous with the heartbeat. To distinguish between a pleural rub and a pericardial rub, the client should hold the breath. The pericardial rub will continue. Length of auscultation and standing would not assist in distinguishing one kind of rub from the other.

The nurse is providing discharge education for a client going home after cardiac catheterization. What information is a priority to include when providing discharge education? 1 Avoid tub baths, but shower as desired. 2 Do not ambulate until the healthcare provider indicates it is appropriate. 3 Expect increased bruising to appear at the site over the next several days. 4 Returning to work immediately is okay.

1 Guidelines for self-care after hospital discharge following a cardiac catheterization include showering as desired (no tub baths) and avoiding bending at the waist and lifting heavy objects. The healthcare provider will indicate when it is okay to return to work. The client should notify the healthcare provider right away if bleeding, new bruising, swelling, or pain are noted at the puncture site. The client will be able to ambulate after the puncture site has clotted.

The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125mg daily for a cardiac dysrhythmias. Which of the following assessment considerations is essential when caring for this age-group? 1 Digoxin level 2 Cardiac output 3 Activity level 4 Dyspnea

1 The action of Digoxin slows and strengthens the heart rate. Assessment of the pulse rate is essential prior to administration in all clients. Due to decreased perfusion common in geriatric clients, toxicity may occur more often. The nurse must monitor Digoxin levels in the body. Monitoring symptoms reflecting cardiac output, activity level, and dyspnea are also important assessment considerations for all clients.

The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions. What diagnostic tests can determine client ejection fractions? Select all that apply. 1 Echocardiogram 2 Cardiac catheterization 3 Magnetic resonance imaging 4 Positron emission tomography scan 5 Troponin levels

1 2 3 Echocardiogram, cardiac catheterization, and magnetic resonance imaging can provide ejection fraction estimates. The positron emission tomography scan reveals areas of decreased blood flow in the heart. Troponin levels are cardiac markers and do not measure ejection fractions.

Name the heart murmur intensity grades? Grade 1-6

1- Very faint, hard to hear 2- Quiet, but readily perceived 3. Moderately loud 4. Loud, associated with a THRILL 5- Very loud- head with stethoscope PARTIALLY off chest. 6. Extremely loud, heard with stethoscope OFF chest.

A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic? 1 Scar on the chest 2 "Spike" on the rhythm strip 3 Quality of the pulse 4 Vibration under the skin

2

A nurse is aware that the patient's heart rate is influenced by many factors. The nurse understands that the heart rate can be decreased by: 1 An excess level of thyroid hormone. 2 Stimulation of the vagus nerve. 3 An increased level of catecholamines. 4 2Sympathetic nervous system stimulation.

2

The nurse is removing a client's femoral sheath after cardiac catheterization. What medication will the nurse have available? 1 heparin 2 atropine sulfate 3 protamine sulfate 4 adenosine

2

A client is beginning to have more breathlessness with aortic stenosis. What is the treatment does the nurse anticipate for the client? 1 balloon angioplasty 2 balloon valvuloplasty 3 cardiac catheterization 4 cardiac graft procedure

2 Additional treatment eventually becomes critical because average survival is 2 to 3 years once symptoms develop. Balloon valvuloplasty is an invasive, nonsurgical procedure to enlarge a narrowed valve opening. Balloon angioplasty, cardiac catheterization, and cardiac graft procedure are not indicated treatments for symptomatic aortic stenosis.

The client asks the nurse to explain what is meant by a ventricular bigeminy cardiac rhythm. What is the best response by the nurse? 1 "It is when the heart conduction is primarily from the aterioventricular node." 2 "The rhythm has a normal beat, then a premature beat pattern." 3 "The rhythm is regular but fast." 4 "The heart rate is between 150 to 250 bpm."

2 Bigeminy is a rhythm in which every other complex is a premature ventricular contraction (PVC). In trigeminy, every third complex is a PVC. The rhythm is not regular and the rate should not be 150-250 bpm.

A surgeon completes a total laryngectomy. Postoperatively, the nurse explains to the patient's family that: 1 One vocal cord was removed along with a portion of the larynx. 2 The voice was spared and a tracheostomy would be in place until the airway was established. 3 A permanent tracheal stoma would be necessary. 4 A portion of the vocal cord was removed.

3

A nurse is checking laboratory values on a client who has crackles in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal? 1 Potassium 2 B-type natriuretic peptide (BNP) 3 C-reactive protein (CRP) 4 Platelet count

2 The client's symptoms suggest heart failure. BNP is a neurohormone that's released from the ventricles when the ventricles experience increased pressure and stretch, such as in heart failure. A BNP level greater than 51 pg/ml is commonly associated with mild heart failure. As the BNP level increases, the severity of heart failure increases. Potassium levels aren't affected by heart failure. CRP is an indicator of inflammation. It's used to help predict the risk of coronary artery disease. There is no indication that the client has an increased CRP. There is no indication that the client is experiencing bleeding abnormalities, such as those seen with an abnormal platelet count.

A client admitted to the telemetry unit has a serum potassium level of 6.6 mEq/L. Which electrocardiographic (ECG) characteristic is commonly associated with this laboratory finding? 1 Occasional U waves 2 Peaked T waves 3 Flattened P waves 4 Prolonged QT interval

2 The client's serum potassium level is high. The T wave is an ECG characteristic reflecting repolarization of the ventricles. It may become tall or "peaked" if a client's serum potassium level is high. The U wave is an ECG waveform characteristic that may reflect Purkinje fiber repolarization. It is usually seen when a client's serum potassium level is low. The P wave is an ECG characteristic reflecting conduction of an electrical impulse through the atria and is not affected by a client's serum potassium level. The QT interval is an ECG characteristic reflecting the time from ventricular depolarization to repolarization, and is not affected by a client's serum potassium level.

A physician orders triamcinolone and salmeterol for a client with a history of asthma. What action should the nurse take when administering these drugs? 1 Administer the triamcinolone and then administer the salmeterol. 2 Administer the salmeterol and then administer the triamcinolone. 3 Allow the client to choose the order in which the drugs are administered. 4 Monitor the client's theophylline level before administering the medications.

2 A client with asthma typically takes bronchodilators and uses corticosteroid inhalers to prevent acute episodes. Triamcinolone (Azmacort) is a corticosteroid; Salmeterol (Serevent) is an adrenergic stimulant (bronchodilator). If the client is ordered a bronchodilator and another inhaled medication, the bronchodilator should be administered first to dilate the airways and to enhance the effectiveness of the second medication. The client may not choose the order in which these drugs are administered because they must be administered in a particular order. Monitoring the client's theophylline level isn't necessary before administering these drugs because neither drug contains theophylline.

The nurse completes an assessment of a client with mitral regurgitation. What statement represents the appropriate physical finding for a client with this condition? 1 "I auscultated a mitral click." 2 "The high-pitched blowing sound at the apex is indicative of a systolic murmur." 3 "I heard a low-pitched diastolic murmur at the apex." 4 "I knew I would hear a diastolic murmur at the left sternal border."

2 A systolic murmur is heard as a high-pitched, blowing sound at the apex. Dyspnea, fatigue, and weakness are the most common symptoms. Palpitations, shortness of breath on exertion, and cough from pulmonary congestion also occur. A mitral click will be present with valve replacement. A diastolic murmur is not heard with mitral regurgitation.

The nurse is assessing a client admitted with infective endocarditis. Which manifestation would the nurse expect to find? 1 Involuntary muscle movements of the extremities 2 Small painful lesions on the pads of the fingers and toes 3 Raised red rash on the trunk and face 4 Bruising on the palms of the hands and soles of the feet

2 Primary presenting symptoms of infective endocarditis are fever and a heart murmur. In addition small, painful nodules (Osler nodes) may be present in pads of fingers or toes. Irregular red or purple, painless flat macules (Janeway lesions) may be present on palms, fingers, hands, soles, and toes. Hemorrhages with pale centers (Roth spots) caused by emboli may be observed in fundi of the eyes. Splinter hemorrhages (i.e., reddish-brown lines and streaks) may be seen under the proximal half of fingernails and toenails. Petechiae may appear in conjunctiva and mucous membranes. Cardiomegaly, heart failure, tachycardia, or splenomegaly may occur.

A nurse reviews an ECG strip for a client who is admitted with symptoms of an acute MI. The nurse should recognize what classic ECG changes that occur with an MI? Select all that apply. 1 Absent P-waves 2 Abnormal Q-waves 3 T-wave hyperactivity and inversions 4 ST-segment elevations 5 U-wave elevations

2, 3, 4.

A 52-year-old female patient is going through menopause and asks the nurse about estrogen replacement for its cardioprotective benefits. What is the best response by the nurse? 1 "That's a great idea. You don't want to have a heart attack." 2 "Current research determines that the replacement of estrogen will protect a woman after she goes into menopause." 3 "Current evidence indicates that estrogen is ineffective as a cardioprotectant; estrogen is actually potentially harmful and is no longer a recommended therapy." 4 "You need to research it and determine what you want to do."

3

After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. During assessment, the nurse expects to hear a murmur that is: 1 Easily heard with no palpable thrill. 2 Quiet but readily heard. 3 Loud and may be associated with a thrill sound similar to (a purring cat). 4 Very loud; can be heard with the stethoscope half-way off the chest.

3

The nurse recognizes that which laboratory test is a key diagnostic indicator of heart failure? 1 Blood urea nitrogen (BUN) 2 Creatinine 3 Brain natriuretic peptide (BNP) 4 Complete blood count (CBC)

3 BNP is the key diagnostic indicator of heart failure. High levels of BNP are a sign of high cardiac filling pressure and can aid in the diagnosis of heart failure. A BUN, creatinine, and CBC are included in the initial workup.

____________- removal of material, by mechanical means, from the surface of an object; in the context of cardiology, it is the purposeful destruction of heart muscle cells, usually in an attempt to correct or eliminate a dysrhythmia

Ablation

The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure? 1 Chemoreceptors 2 Sympathetic nerve fibers 3 Baroreceptors 4 Vagus nerve

3 Baroreceptor sense pressure in nerve endings in the walls of the atria and major blood vessels. The baroreceptors respond accordingly to raise or lower the pressure. Chemoreceptors are sensitive to pH, CO2, and O2 in the blood. Sympathetic nerve fibers increase the heart rate. The vagus nerve slows the heart rate.

The nurse is assessing a patient with a probable diagnosis of first-degree AV block. The nurse is aware that this dysrhythmia is evident on an ECG strip by what indication? 1 Variable heart rate, usually fewer than 90 bpm 2 Irregular rhythm 3 Delayed conduction, producing a prolonged PR interval 4 P waves hidden within the QRS complex

3 First-degree AV block may occur without an underlying pathophysiology, or it can result from medications or conditions that increase parasympathetic tone. It occurs when atrial conduction is delayed through the AV node, resulting in a prolonged PR interval.

A nurse should obtain serum levels of which electrolytes in a client with frequent episodes of ventricular tachycardia? 1 Calcium and magnesium 2 Potassium and calcium 3 Magnesium and potassium 4 Potassium and sodium

3 Hypomagnesemia as well as hypokalemia and hyperkalemia are common causes of ventricular tachycardia. Calcium imbalances cause changes in the QT interval and ST segment. Alterations in sodium level don't cause rhythm disturbances.

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: 1 pleural effusion. 2 pulmonary edema. 3 atelectasis. 4 oxygen toxicity.

3 In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn't cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn't one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough.

A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see? 1 Prolonged PR interval 2 Absent Q wave 3 Elevated ST segment 4 Widened QRS complex

3 Ischemic myocardial tissue changes cause elevation of the ST segment, an inverted T wave, and a pathological Q wave. A prolonged PR interval occurs with first-degree heart block, the least dangerous atrioventricular heart block; this disorder may arise in healthy people but sometimes results from drug toxicity, electrolyte or metabolic disturbances, rheumatic fever, or chronic degenerative disease of the conduction system. An absent Q wave is normal; an MI may cause a significant Q wave. A widened QRS complex indicates a conduction delay in the His-Purkinje system.

Stiffness of the neck or inability to bend the neck is referred to as 1 aphonia. 2 xerostomia. 3 nuchal rigidity. 4 dysphagia.

3 Nuchal rigidity is stiffness of the neck or inability to bend the neck. Aphonia is impaired ability to use one's voice due to distress or injury to the larynx. Xerostomia is dryness of the mouth from a variety of causes. Dysphagia is difficulty swallowing.

A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes 1 teaching the family how to perform postural drainage. 2 instructing the client on the signs of respiratory infection. 3 implementing measures to clear pulmonary secretions. 4 providing the client a low-calorie, high-fiber diet.

3 Nursing management focuses on alleviating symptoms and helping clients clear pulmonary secretions. Although teaching the family how to perform postural drainage and instructing the client on the signs of respiratory infection are important, they are not the nurse's primary focus. The presence of a large amount of mucus may decrease the client's appetite and result in inadequate dietary intake; therefore, the client's nutritional status is assessed and strategies are implemented to ensure an adequate diet.

The nurse reviews discharge instructions with a client who underwent a left groin cardiac catheterization 8 hours ago. Which instructions should the nurse include? 1 "You can take a tub bath or a shower when you get home." 2 "Contact your primary care provider if you develop a temperature above 102°F." 3 "Do not bend at the waist, strain, or lift heavy objects for the next 24 hours." 4 "If any discharge occurs at the puncture site, call 911 immediately."

3 The nurse should instruct the client to follow these guidelines: For the next 24 hours, do not bend at the waist, strain, or lift heavy objects if the artery of the groin was used; contact the primary provider if swelling, new bruising or pain from the procedure puncture site, or a temperature of 101°F or more occur. If bleeding occurs, lie down (groin approach) and apply firm pressure to the puncture site for 10 minutes. Notify the primary provider as soon as possible and follow instructions. If there is a large amount of bleeding, call 911. The client should not drive to the hospital.

A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction? 1 "Limit yourself to smoking only 2 cigarettes per day." 2 "Eat a high-sodium diet." 3 "Weigh yourself daily and report a gain of 2 lb in 1 day." 4 "Maintain bed rest."

3 The nurse should instruct the client to weigh himself daily and report a gain of 2 lb in 1 day. COPD causes pulmonary hypertension, leading to right-sided heart failure or cor pulmonale. The resultant venous congestion causes dependent edema. A weight gain may further stress the respiratory system and worsen the client's condition. The nurse should also instruct the client to eat a low-sodium diet to avoid fluid retention and engage in moderate exercise to avoid muscle atrophy.The client shouldn't smoke at all.

The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? 1 The AV node 2 The Purkinje fibers 3 The sinoatrial node 4 The ventricles

3 The sinoatrial node, the primary pacemaker of the heart, in a normal resting adult heart has an inherent firing rate of 60 to 100 impulses per minute; however, the rate changes in response to the metabolic demands of the body

The nurse is caring for a client diagnosed with enlarged adenoids. What condition is produced by enlarged adenoids? 1 Incrusted mucous membranes 2 Hardened secretions 3 Erosion of the trachea 4 Noisy breathing

4

The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker? 1 Date and time of insertion 2 Location of the generator 3 Model number 4 Pacer rate

4 After a permanent pacemaker is inserted, the patient's heart rate and rhythm are monitored by ECG.

The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? 1 Pulmonary embolism 2 Myocardial infarction 3 Pericarditis 4 Heart failure

4 An ejection fraction of less than 40% indicates that the patient has decreased left ventricular function and likely requires treatment for heart failure.

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? 1 Hypotension, hyperoxemia, and hypercapnia 2 Hyperventilation, hypertension, and hypocapnia 3 Hyperoxemia, hypocapnia, and hyperventilation 4 Hypercapnia, hypoventilation, and hypoxemia

4 The cardinal physiologic abnormalities of acute respiratory failure are hypercapnia, hypoventilation, and hypoxemia. The nurse should focus on resolving these problems.

The nurse is working on a monitored unit assessing the cardiac monitor rhythms. Which waveform pattern needs attention first? 1 Sustained asystole 2 Supraventricular tachycardia 3 Atrial fibrillation 4 Ventricular fibrillation

4 Ventricular fibrillation is called the rhythm of a dying heart. It is the rhythm that needs attention first because there is no cardiac output, and it is an indication for CPR and immediate defibrillation. Sustained asystole either is from death, or the client is off of the cardiac monitor. Supraventricular tachycardia and atrial fibrillation is monitored and reported to the physician but is not addressed first.

Normal ejection fraction range? Boderline? Reduced (HF)

50-70% 41-49% 40% or below Ejection fraction is how much blood the heart is pumping

What is C-reactive protein (CRP)?

A protein produced by the liver that is a nonspecific marker of inflammation

____________ is an emergent situation characterized by an acute onset of myocardial ischemia that results in myocardial death

Acute coronary syndrome (ACS)

______________: a type of percutaneous coronary intervention in which a balloon is inflated within a coronary artery to break an atheroma and open the vessel lumen, improving coronary artery blood flow

percutaneous transluminal coronary angioplasty (PTCA)

___________ sense pressure in nerve endings in the walls of the atria and major blood vessels. They respond accordingly to raise or lower the pressure. ____________ are sensitive to pH, CO2, and O2 in the blood. Sympathetic nerve fibers increase the heart rate. The vagus nerve slows the heart rate.

Baroreceptor sense pressure in nerve endings in the walls of the atria and major blood vessels. The baroreceptors respond accordingly to raise or lower the pressure. Chemoreceptors are sensitive to pH, CO2, and O2 in the blood. Sympathetic nerve fibers increase the heart rate. The vagus nerve slows the heart rate.

___________- nerve fibers located in the aortic arch and carotid arteries that are responsible for control of the blood pressure

Baroreceptors

A neurohormone that helps regulate BP and fluid volume. Serum laboratory test that is useful for prompt diagnosis of heart failure.

Brain (B-type) natriuretic peptide (BNP)

______________- smallest of the body's blood vessels. They are only one cell thick, and they are the sites of the transfer of oxygen and other nutrients from the bloodstream to other tissues in the body; they also collect carbon dioxide waste materials

Capillaries

___________ is the ability of the cardiac muscle to shorten in response to an electrical impulse. _____________ is the electrical activation of a cell caused by the influx of sodium into the cell while potassium exits the cell. ____________ is the return of the cell to the resting state, caused by reentry of potassium into the cell while sodium exits the cell. ___________ is the period of ventricular relaxation resulting in ventricular filling.

Contractility is the ability of the cardiac muscle to shorten in response to an electrical impulse. Depolarization is the electrical activation of a cell caused by the influx of sodium into the cell while potassium exits the cell. (D-S-P) Repolarization is the return of the cell to the resting state, caused by reentry of potassium into the cell while sodium exits the cell. (R-P-S) Diastole is the period of ventricular relaxation resulting in ventricular filling.

_ is a surgical procedure in which a blood vessel is grafted to an occluded coronary artery so that blood can flow beyond the occlusion; is a surgical procedure in which a blood vessel is grafted to an occluded coronary artery so that blood can flow beyond the occlusion;

Coronary artery bypass graft (CABG)

Pericardial Effusion and Cardiac Tamponade

Disorders of the pericardium that are the result of inflammation, infection, surgery, or trauma. Fluid in the pericardial sac

___________ is a test that uses sound waves to produce live images of your heart. The image is an _______________. This test allows your doctor to monitor how your heart and its valves are functioning. The images can help them spot: blood clots in the heart.

Echocardiography is a test that uses sound waves to produce live images of your heart. The image is an echocardiogram. This test allows your doctor to monitor how your heart and its valves are functioning. The images can help them spot: blood clots in the heart.

rheumatic fever/ endocarditis is caused by? Can cause _______ stenosis

Group A beta-hemolytic streptococcal pharyngitis can cause mitral stenosis

______________ is a microbial infection of the endothelial surface of the heart. ---It usually develops in people with prosthetic heart valves, cardiac devices (e.g., pacemaker), or structural cardiac defects (e.g., valve disorders, HCM) Why would someone who has a history of this need to get antibacterial medication before dental procedures??

Infective endocarditis is a microbial infection of the endothelial surface of the heart. Poor dental hygiene can lead to bacteremia, particularly in the setting of a dental procedure. Severity of oral inflammation and infection is a significant factor in the incidence and degree of bacteremia. Regular professional oral care combined with personal oral care may reduce the risk of bacteremia. Personal oral care includes using a soft toothbrush and toothpaste to brush teeth, gums, tongue, and oral mucosa at least twice a day, as well as rinsing the mouth with an antiseptic mouthwash for 30 seconds intermittently between tooth brushing. Patients must be advised to: Avoid using toothpicks or other sharp objects in the oral cavity Avoid nail biting Avoid body piercing, branding, tattooing

_________: the part of an ECG that reflects conduction of an electrical impulse through the atrium; atrial depolarization __________ the duration between the beginning of one P wave and the beginning of the next P wave; used to calculate atrial rate and rhythm ________: the part of an ECG that reflects conduction of an electrical impulse from the sinoatrial node through the atrioventricular node

P wave: PP intervals PR intervals

_______________- is a medical syndrome referring to an immune phenomenon that occurs days to months (usually 1-6 weeks) after surgical incision of the pericardium

Postpericardiotomy syndrome (PPS) is a medical syndrome referring to an immune phenomenon that occurs days to months (usually 1-6 weeks) after surgical incision of the pericardium

Most important way to prevent myocarditis?

Prevention of infectious diseases by means of appropriate immunizations (e.g., influenza, hepatitis) and early treatment appears to be important in decreasing the incidence of myocarditis Myocarditis usually results from viral (e.g., coxsackievirus A and B (hand, foot and mouth disease), human immune deficiency virus, influenza A)

___________: the part of an ECG that reflects conduction of an electrical impulse through the ventricles; ventricular depolarization _______________: the part of an ECG that reflects the time from ventricular depolarization through repolarization

QRS complex: the part of an ECG that reflects conduction of an electrical impulse through the ventricles; ventricular depolarization QT interval: the part of an ECG that reflects the time from ventricular depolarization through repolarization

_____________: the duration between the beginning of one QRS complex and the beginning of the next QRS complex; used to calculate ventricular rate and rhythm sinus rhythm: electrical activity of the heart initiated by the sinoatrial node ___________ the part of an ECG that reflects the end of the QRS complex to the beginning of the T wave _____________: the part of an ECG that reflects repolarization of the ventricles _____________l: the part of an ECG that reflects the time between the end of the T wave and the beginning of the next P wave; used to identify the isoelectric line _____________: the part of an ECG that may reflect Purkinje fiber repolarization; usually, it is not seen unless a patient's serum potassium level is low

RR interval: ST segment: T wave TP interval: U wave:

The most common type is an alteration in ventricular contraction called ___________, which is characterized by a weakened heart muscle. A second type is _____________, which is characterized by a stiff and noncompliant heart muscle, making it difficult for the ventricle

The most common type is an alteration in ventricular contraction called systolic heart failure, which is characterized by a weakened heart muscle. A second type is diastolic heart failure, which is characterized by a stiff and noncompliant heart muscle, making it difficult for the ventricle

intermittent claudication?

a condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries.

When a catheter is used to clear a narrowed or blocked artery, the procedure is called ___________. When a catheter is used to widen a narrowed heart valve opening, the procedure is called _______________

angioplasty valvuloplasty

percutaneous coronary intervention (PCI)??

balloon-tipped catheter is inserted into a coronary artery to open the artery; stents are put in place. Least invasive procedure

____________: process by which cardiac muscle cells change from a more negatively charged to a more positively charged intracellular state ____________ process by which cardiac muscle cells return to a more negatively charged intracellular condition, their resting state

depolarization: process by which cardiac muscle cells change from a more negatively charged to a more positively charged intracellular state repolarization: process by which cardiac muscle cells return to a more negatively charged intracellular condition, their resting state

An assessment of the _______________ is performed by echocardiogram to assist in determining the type of HF. EF is calculated by subtracting the amount of blood present in the left ventricle at the end of systole from the amount present at the end of diastole and calculating the percentage of blood that is ejected. A normal value is?

ejection fraction (EF) A normal EF is 55% to 65% of the ventricular volume;