Chapter 22 Introduction to the Cardiovascular System
Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue?
endocardium
During auscultation of the lungs, what would a nurse note when assessing a client with left-sided heart failure?
wheezes with wet lung sounds
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving oxygenated blood from the lungs
left ventricle
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body?
left ventricle
A lipid profile has been ordered for a client who has been experiencing cardiac symptoms. When should a lipid profile be drawn in order to maximize the accuracy of results?
After a 12-hour fast
The nurse is doing discharge teaching with a client who has coronary artery disease. The client asks why he has to take an aspirin every day if he doesn't have any pain. What would be the nurse's best response?
An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks
The nurse is doing discharge teaching with a client who has coronary artery disease. The client asks why he has to take an aspirin every day if he doesn't have any pain. What would be the nurse's best response
An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks."
The nurse cares for a client with diabetes who is scheduled for a cardiac catheterization. Prior to the procedure, it is most important for the nurse to ask which question?
Are you allergic to shellfish?"
Which area of the heart that is located at the third intercostal space to the left of the sternum?
Erb point
The nurse reviews discharge instructions with a client who underwent a left groin cardiac catheterization 8 hours ago. Which instructions should the nurse include?
"Do not bend at the waist, strain, or lift heavy objects for the next 24 hours."
The nurse assesses a client with increasing shortness of breath and peripheral edema. The healthcare provider inserts a triple lumen catheter and orders a transduced central venous pressure (CVP). What CVP reading does the nurse suspect will correlate with the client's symptoms?
8 mmHg
The nurse is caring for a client who has a history of heart disease. What factor should the nurse identify as possibly contributing to a decrease in cardiac output?
A heart rate of 54 bpm
The nurse is assessing a patient who reports feeling "light-headed." When obtaining orthostatic vital signs, what does the nurse determine is a significant finding?
A heart rate of more than 20 bpm above the resting rate
The nurse is caring for a patient who has undergone peripheral arteriography. How should the nurse assess the adequacy of peripheral circulatio
By checking peripheral pulses
The nurse is caring for a client admitted with angina who is scheduled for cardiac catheterization. The client is anxious and asks the reason for this test. What is the best response?
Cardiac catheterization is usually done to assess how blocked or open a client's coronary arteries are
The nurse is caring for an acutely ill client who has central venous pressure monitoring in place. What intervention should be included in the care plan of a client with CVP in place?
Change the site dressing whenever it becomes visibly soiled.
The nurse is caring for a client who has just returned from the cardiac catheterization laboratory following a coronary angioplasty. What is the nurse's priority assessment?
Check the temperature, color, and capillary refill of the affected extremity
A nurse assessing a client who underwent cardiac catheterization finds the client lying flat on the bed. The client's temperature is 99.8° F (37.7° C). The client's blood pressure is 104/68 mm Hg. The client's pulse rate is 76 beats/minute. The nurse detects weak pulses in the leg distal to the puncture site. Skin on the leg is cool to the touch. The puncture site is dry, but swollen. What is the most appropriate action for the nurse to take?
Contact the health care provider and report the findings.
The physician has ordered a high-sensitivity C-reactive protein (hs-CRP) drawn on a client. The results of this test will allow the nurse to evaluate the role of what process that is implicated in the development of atherosclerosis?
Inflammation
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?
Current evidence indicates that estrogen is ineffective as a cardioprotectant; estrogen is actually potentially harmful and is no longer a recommended therapy."
A client is being scheduled for a stress test. The client is unable to exercise during the test. The nurse would include information about which medication used for pharmacologic stress testing?
Dipyridamole
A patient's gradual decline in activity tolerance and increased shortness of breath have prompted her health care provider to assess the structure and size of her heart. Which of the following diagnostic tests is most likely to yield these assessment data?
Echocardiography
A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult client who has been experiencing vital fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis?
Heart failure
The nurse is caring for a client with complex cardiac history. How should the nurse best explain the process of depolarization to a colleague?
Electrical stimulation of the heart muscles
During a shift assessment, the nurse is identifying the client's point of maximum impulse (PMI). Where should the nurse best palpate the PMI?
Left midclavicular line of the chest at the fifth intercostal space
A critical care nurse is caring for a client with a pulmonary artery catheter in place. What does this catheter measure that is particularly important in critically ill clients?
Left ventricular preload
The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer?
Metoprolol
The heart has valves between the atrium and the ventricles. What valve separates the left atrium and ventricle?
Mitral
A client has had a myocardial infarction and has been diagnosed as having damage to the layer of the heart responsible for the pumping action. This client experienced damage to what area of the heart?
Myocardium
A critically ill client is admitted to the ICU. The health care provider decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize?
Perfusion distal to the insertion site
The nurse is educating a patient at risk for atherosclerosis. What nonmodifiable risk factor does the nurse identify for the patient?
Positive family history
The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure?
Pulse pressure
The nurse is assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would the nurse document this?
S3
The critical care nurse is caring for a client who has been experiencing bradycardia after cardiovascular surgery. The nurse knows that the heart rate is determined by myocardial cells with the fastest inherent firing rate. Under normal circumstances where are these cells located?
SA node
The cardiac care nurse is reviewing the conduction system of the heart. The nurse is aware that electrical conduction of the heart usually originates in the SA node and then proceeds in what sequence?
SA node to AV node to bundle of His to Purkinje fibers
A client reports recent onset of chest pain that occurs sporadically with exertion. The client also has fatigue and mild ankle swelling, which is most pronounced at the end of the day. The nurse suspects a cardiovascular disorder. What other client report increases the likelihood of a cardiovascular disorder?
Shortness of breath
The nurse uses which term for the normal pacemaker of the heart?
Sinoatrial (SA) node
A nurse is preparing a client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which action would pose a threat to the client?
The client wears a watch.
A patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse understand occurred with this patient?
The patient had a vagal response.
The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from?
The sinoatrial node
The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located?
The thin fibrous sac encasing the heart
When assessing a patient with left-sided heart failure, what would be noted on auscultation of lungs?
Wheezes with wet lung sounds
The nurse is performing an intake assessment on a client with a new diagnosis of coronary artery disease. What would be the most important determination to make during this intake assessment?
Whether the client and involved family members are able to recognize symptoms of an acute cardiac problem and respond appropriately
The cardiologist has scheduled a client for drug-induced stress testing. What instructions should the nurse provide to prepare the client for this test?
You will receive medication via IV administration.
The nurse auscultates the apex beat at which anatomical location?
fifth intercostal space, midclavicular line
The nurse cares for a client in the emergency department who has a B-type natriuretic peptide (BNP) level of 115 pg/mL. The nurse recognizes that this finding is most indicative of which condition?
heart failure
A client's chart indicates an S4 heart sound, and is scheduled for a cardiac workup. The nurse is aware that this client may have which cardiac condition?
hypertensive heart disease
The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate?
international normalized ratio (INR)
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving oxygenated blood from the lungs?
left atrium
A nurse hears bilateral crackles in a client's lungs. What could be a cause of crackles in the bases of the client's lungs?
pulmonary congestion
What does decreased pulse pressure reflect?
reduced stroke volume
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving deoxygenated blood from the venous system?
right atrium
A nurse is conducting procedures to determine the extent of a client's left-sided heart failure. What adventitious lung sounds would the nurse expect to hear during auscultation of the lungs to support the diagnosis? Select all that apply.
wheezes wet lung sounds
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to the lungs to be oxygenated?
right ventricle
An obese client describes symptoms of palpitations, chronic fatigue, and dyspnea on exertion to the cardiologist. Upon completing the examination, the cardiologist schedules a procedure to confirm the suspected diagnosis. What diagnostic procedure would the nurse expect to be prescribed?
transesophageal echocardiography
Before a transesophageal echocardiogram, a nurse gives a client an oral topical anesthetic spray. When the client returns from the procedure, the nurse observes no active gag reflex. What nursing action is a priority?
withhold food and fluids
