Pharmacology Prep U Chapter 42: Introduction to the Cardiovascular System
Which client diagnosis is related to left-sided heart failure?
Pulmonary edema
A client's ventricles are not contracting effectively and the problem has been determined to be at the cellular level. What component of the heart's conduction system will be evaluated first?
Purkinje fibers
Which is responsible for transmitting the nerve impulse to the ventricular cells?
Purkinje fibers
A nurse is reviewing a patient's electrocardiogram. Which would the nurse identify as indicating depolarization of the bundle of His and ventricles?
QRS complex
A client has severe aortic valve disease. When educating the client about anatomy, what would the nurse include?
The aortic valve separates the left ventricle and aorta.
After explaining an electrocardiogram to a patient, which statement indicates that the patient understands this test?
"It will show how impulses are moving through my heart."
A health care provider is teaching a group of medical students about the physiological basis for damage to the circulatory and neurological systems that can accompany hypotension. Which response by a student would warrant correction?
"Tension and vessel thickness increase proportionately."
As part of their orientation to a cardiac care unit, a group of recent nursing graduates is receiving a refresher in cardiac physiology from the unit educator. Which teaching point best captures a component of cardiac function?
"The diastolic phase is characterized by relaxation of ventricles and their filling with blood."
A client has a blood pressure of 130/90 mm Hg. What is the filling pressure of the client's coronary arteries?
40 mm Hg (130-90=40)
In which situation would blood be most likely to be rapidly relocated from central circulation to the lower extremities?
A client is helped out of bed and stands up
When describing circulation, which would a nurse include?
A closed system
What is the primary client result of a dysfunctional cardiovascular resistance system?
Abnormal BP
What is the primary client result of a dysfunctional cardiovascular resistance system?
Abnormal blood pressure
What information should the nurse present when discussing the functional unit of a muscle cell? (Select all that apply.)
Actin is a component of this muscle cell. The cell's molecules are arranged in layers. The term used to identify this unit is a sarcomere. Myosin molecules are essential to the formation of these cells.
After teaching a group of students about the events that occur when blood flow to the kidneys is reduced, the students demonstrate understanding when they identify that what occurs last?
Aldosterone release
A nurse is explaining to a client the physiology of the heart with reference to the cardiac valves. Which statement by the client about the function of the cardiac valves demonstrates the correct understanding of the nurse's explanation?
Allow blood to flow in one direction only
A cardiovascular clinical nurse specialist describes the dysfunctional endothelium in relation to cardiovascular disease. What is the major factor in the development of the dysfunctional endothelium?
Atherosclerosis
The nurse is reviewing a patient's electrocardiogram and notes that the P waves are sawtoothed in shape and there are three P waves for every QRS complex. The nurse would interpret this as suggesting:
Atrial flutter
What property allows the heart cells to generate an action potential without an external stimulus?
Automaticity
When considering vital signs, which assessment is focused on the functioning of the body's resistance system
Blood pressure
Which heart valve controls the flow of blood between the left atria and the left ventricle?
Bicuspid valve
A client is diagnosed with an atrial septal defect (ASD) that has caused a hole between the two upper chambers of the heart. What is the direct result of such a defect?
Deoxygenated and oxygenated blood will mix
Pathologic changes in the structure of the capillary and venular endothelium can result in the accumulation of fluid in interstitial space. What term refers to this accumulation?
Edema
A client is diagnosed with an issue that affects their syncytia fibers. Which cardiac structure should be the focus of assessment and treatment? (Select all that apply.)
Cardiac atriums Cardiac ventricles
Which property is related to the ability of the heart cells to transmit an action potential of electrical impulse?
Conductivity
While intubated for surgery, a patient has inadvertently had his vagus nerve stimulated. What effect would the surgical team expect to observe?
Decreased heart rate as a result of parasympathetic innervation of the heart
A client is experiencing signs and systems associated with a possible problem with delivery and transport of deoxygenated blood to and through the heart. What information should the nurse include in a discussion of this problem with the client? (Select all that apply.)
Deoxygenated blood enters the heart at the right atrium. Deoxygenated blood first passes through the tricuspid valve Deoxygenated blood passes into the right ventricle
When reviewing a patient's ECG, the nurse identifies the QRS complex, understanding that this reflects:
Depolarization of the bundle of His and ventricles
The nurse assists and educates clients about blood pressure regulation. Based on this information, the nurse asks the client what the number 80 in the blood pressure 120/80 represents. Which response by the client demonstrates correct understanding of the basic concepts of blood pressure?
Diastolic pressure
A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which statement is the most relevant phenomenon?
High afterload because of backpressure against the left ventricle
Fluid moves into the arterial end of a capillary due to:
Hydrostatic pressure
With an understanding of how hydrostatic forces effect the capillaries, which would increase the capillary hydrostatic pressure?
Increase in venous pressure
The principles of Starling's law attempt to explain the cause of which cardiovascular dysfunction?
Ineffective contractibility of the heart's left ventricle
An electrocardiogram (ECG) is prescribed for a client experiencing signs and symptoms associated with a cardiac dysfunction. Which function of the heart will this diagnostic tool help evaluate?
Ineffective pumping
A nurse is explaining blood flow through the heart to a patient who has experienced a myocardial infarction. How would the nurse explain flow from the lungs to the heart?
Oxygenated blood from the lungs enters the left atrium through the pulmonary veins.
What component of the normal ECG waveform immediately precedes the contraction of the atria?
P wave
Proper function of the cardiovascular system relies on blood following the correct pathway through the heart. Valves within the heart separate the organ's chambers and prevent blood from flowing in the wrong direction. What valve separates the left atrium and left ventricle?
Mitral
If the production of actin is disrupted, what component of the human body will be affected?
Muscles
Which increases the heart's output, and is dependent on the actions of the heart and the vasculature before contraction?
Preload
A nurse is measuring the BP of a client. The client asks what the BP measures. What is the best response by the nurse about the measurement of BP?
Pressure of blood within the arteries
Which is released initially when blood flow to the kidneys is decreased?
Renin
The pathway for blood flow through the heart is:
Right atria to right ventricle to pulmonary artery through lungs to pulmonary veins to left atria and then to left ventricle.
A patient has a diminished flow of deoxygenated blood from the lower extremities. Which chamber of the heart receives deoxygenated blood from the lower extremities?
Right atrium
Which area of the heart is supplied by the right coronary artery?
Right side of the heart
After teaching a group of students about the conduction system of the heart, the instructor determines that the teaching was successful when the students identify what as the origination of the impulse?
SA node
The electrical impulses flow in the following manner:
Sinoatrial node, the atrioventricular node, bundle of His, right and left bundle branches, and Purkinje fibers.
The nurse is reviewing a patient's ECG and notes that the ECG is normal, but the rate is 110 beats/minute. The nurse would identify this as:
Sinus tachycardia
Considering the phases of the action potential of the cardiac muscle cell, what is the characteristic event associated with phase 1?
Sodium is present in equal amounts both inside and outside of the cell
These are activities involved in the action potential of cardiac muscle. Place them in the proper sequence beginning with activities in phase 0 through phase 4.
Sodium rushes into the cell. Sodium ion concentration equalizes. Calcium slowly enters and potassium begins to leave the cell. Potassium rapidly moves out of the cell. Sodium is outside the cell and potassium is inside the cell.
A client who has been diagnosed with blood pressure problems is eager to know more about the condition. What should the nurse explain is one of the internal processes that attempt to maintain blood pressure within normal limits?
Special sensory receptors in blood vessel walls called baroreceptors are stimulated.
It is determined that a client's cardiac rhythm is being originated in the sinoatrial (SA) node. What mechanism is responsible for the triggering of this node?
Specialized cells within the node itself
An instructor is describing an action of the heart, likening it to that of stretching a rubber band. The instructor is describing:
Starling's law of the heart
What primary event has occurred when a client experiences an ectopic focus?
The location of the heart's functioning pacemaker is no longer the sinoatrial (SA) node
A client is diagnosed with a dysfunctional syncytia. What assessment finding supports this diagnosis?
The pumping of the heart's chambers of are not properly coordinated
The nurse is reviewing the arteries and veins of the heart with the client. Based on this information, which statements by the client demonstrate the correct understanding of the arteries and veins of the heart? (Select all that apply.)
The right coronary artery supplies the heart muscle with blood. The left coronary artery supplies the heart muscle with blood.
A client has been diagnosed with a problem associated with the heart's right atrium. Which statement indicates the client
The top chamber, responsible for receiving blood from my body's veins, is the problem.
The nurse is reviewing with the client the three major layers of the heart wall and how they relate to the pericardium. What is the best description by the nurse to the client about the myocardium layer of the heart?
Thick, strong muscles making up the middle layer
A nurse is assessing the vital signs of a client. The client inquires about the functions of the arteries. What should the nurse include in the client education about the function of arteries?
To carry oxygenated blood to the body cells
Which statement most accurately captures a principle of blood flow
With constant pressure, a small increase in vessel radius results in an exponential increase in blood flow.
After teaching a group of students about circulation, the instructor determines that the teaching was successful when the students identify it as:
a high to low pressure system.
A male client had a myocardial infarction. He was told that his infarction size was decreased as a result of collateral circulation. This means the client likely had:
atherosclerosis, which caused resultant dilation of the artery and increased circulation.
An instructor is describing the venous system, which is distensible and flexible and able to hold a large amount of blood. The instructor is describing:
capacitancy.
While reviewing a patient's electrocardiogram, the nurse observes a P-R interval of 0.26 seconds. This is indicative of:
first-degree heart block.
When explaining blood supply to the heart muscle, the nurse explains that the left circumflex artery supplies the:
left ventricle
What structure makes it possible for the heart to be harvested for transplantation when donated by a client who is declared "brain dead"?
sinoatrial (SA) node
When describing Starling's law of the heart, the instructor compares this to:
stretching of a rubber band
A client is experiencing signs and systems associated with a possible problem with delivery and transport of deoxygenated blood to and through the heart. What information should the nurse include in a discussion of this problem with the client? (Select all that apply.)
• Deoxygenated blood enters the heart at the right atrium. • Deoxygenated blood first passes through the tricuspid valve • Deoxygenated blood passes into the right ventricle
Which are components of the heart's conduction system? (Select all that apply.)
• SA node • Purkinje fibers • Bundle branches • AV node
