Patho Ch 25
The difference between the end-diastolic and end-systolic volumes is called what?
Stroke volume
The nurse identifies the blood vessel layer that constricts to regulate and control diameter as:
Tunica media
The heart is a four-chambered pump. What is the function of the right ventricle?
Pumps blood to the lungs
Colloidal osmotic pressure acts differently than the osmotic effects of the plasma proteins. What is its action?
Pulls fluid back into the capillary
Which blood vessel layer is made primarily of muscle?
Tunica Media
A nurse is teaching a client the correct technique for taking an arterial pulse. The nurse explains that the pulsations are:
Pressure pulses
A client with heart failure has an echocardiogram performed, revealing an ejection fraction (EF) of 40%. The nurse knows this EF is below normal and explains to the client:
"This means your heart is not pumping as much blood out of the heart with each beat."
A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is:
"You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked."
The heart is a four-chambered muscular pump. In one day, how many gallons of blood are pumped throughout the body?
1800
A client is lying in a recumbent position. In this client, approximately how much total blood volume is in the central circulation?
25% - 30%
A client with a history of heart failure has the following echocardiogram results: heart rate 80 beats/minute; end-diastolic volume 120 mL; and end-systolic volume 60 mL. What is this client's ejection fraction (EF)?
50%
Which client is most likely to be experiencing vasodilation?
A 51-year-old man with a history of hypertension who is taking a medication that blocks the effect of the renin-angiotensin-aldosterone system
A client is admitted to the cardiac unit with a diagnosis of pericarditis. The nurse is teaching the client about the anatomical location of the infection. The nurse evaluates the effectiveness of the teaching when the client correctly identifies which of the following as the location of the pericardium?
A membranous sac that encloses the heart
Which neurotransmitter is associated with the parasympathetic nervous system?
Acetylcholine
A client diagnosed with secondary hypertension has begun to experience manifestations that are consistent with decreased cardiac output. Which determinants of cardiac output is hypertension most likely to affect directly?
Afterload
When reviewing diagnostic test results and physical assessment data for a client with a history of stage II hypertension, which of the following would be of most concern to the nurse?
An ejection fraction of 40%
A nurse is reviewing an echocardiogram for a client with a congenital defect in the papillary muscles of the heart. Based on this result, which assessment should the nurse complete?
Auscultate for a murmur caused by the backward expulsion of blood through the atrioventricular valves.
Which blood vessels function without the benefit of having walls comprised of three muscular layers?
Capillaries
Select the correct sequence of blood return to the heart.
Capillaries, venules, veins, right atrium
What response to exercise should be further assessed?
Client's blood pressure decreases from 130/90 to 80/50 mm Hg
What response to exercise should be further assessed?
Client's blood pressure decreases from 130/90 to 80/50 mm Hg.
The distensibility of the blood vessel is the major factor in which of the vessel's characteristics?
Compliance
The heart controls the direction of blood flow. What is the role of the aortic valve?
Controls the direction of blood flow from the left side of the heart to the systemic circulation
The school nurse is doing a health class on the functional organization of the circulatory system. What is the function of the capillaries in the circulatory system?
Exchange gases, nutrients, and wastes
The heart valves control the direction of blood flow. What is the function of the pulmonic valve?
Controls the direction of blood flow from the right side of the heart to the lungs
A client is experiencing a sudden increase in heart rate resulting in less time in diastole. This can result in which potential complication?
Decreased stroke volume
Which enzyme has a powerful vasodilator effect on arterioles and increases capillary permeability?
Histamine
A grandmother who works as a cook at a nearby school was recently hospitalized when she lost an extensive amount of blood in a work-related accident. The grandmother tells the nurse that she heard that she would keep feeling faint until the brain made more blood. The nurse knows that when the blood pressure dropped, the pressure in the carotid arteries decreased. This was detected by baroreceptors in the carotid arteries. What did the baroreceptors do?
Increase sympathetic stimulation of the heart and blood vessels
If a client experiences sympathetic nervous stimulation of the heart, the nurse will observe which changes in manifestations?
Increased heart rate and increased contractility
Which structure within the myocardium contains gap junctions that allow impulses to travel rapidly so the heart can contract as a single unit?
Intercalated disks
Which of the following is true regarding pulmonary circulation?
It is a low pressure system that allowed for improved gas exchange.
The lymph system correlates with the vascular system without actually being a part of the vascular system. Among other things, the lymph system is the main route for the absorption of fats from the gastrointestinal system. The lymph system empties into the right and left thoracic ducts, which are the points of juncture with the vascular system. What are these points of juncture?
Junctions of the subclavian and internal jugular veins
When the semilunar valves open it signals the onset of the ejection period. The aortic pressure reflects changes in the ejection of blood from which part of the heart?
Left Ventricle
The physician states that a client has adequate collateral circulation. The nurse interprets this as:
Long-term compensatory regulation of blood flow
A nurse is assessing a female client and notes that her left arm is swollen from the shoulder down to the fingers, with non-pitting edema. The right arm is normal. The client had a left-sided mastectomy 1 year ago. What does the nurse suspect is the problem?
Lymphedema
Which related circulatory complication can result from surgical treatment for metastatic breast cancer?
Lymphedema in the affected arm
Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissues?
Nitric oxide
The pericardium is a tri-layer sac. Which layer prevents acute dilation of the heart chambers and exerts a restraining effect on the left ventricle?
Outer fibrous layer
Resistance to flow is determined by the diameter of the blood vessels and the blood vessel itself. An equation has been developed for understanding the relationship between the diameter of the blood vessel, the viscosity of the blood, and resistance. What is the equation called?
Poiseuille law
The nurse is teaching a client diagnosed with heart failure about preload. Which principle would be most appropriate to provide to the client?
Preload represents the volume work of the heart.
The heart consists of four valves. Which are the semilunar valves? Select all that apply.
Pulmonary Aortic
When a client is experiencing a parasympathetic nervous system response to sever chest pain, the nurse will likely see which change in the client's vital signs?
Pulse rate below 59 beats/minute
The nurse is reviewing the anatomy and physiology of the heart. What is the function of the right atrium?
Receives blood returning to the heart from the systemic circulation
The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent?
Repolarization of the ventricles
If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern?
Slowing of heart rate to below 60 beats/minute
A nurse is evaluating a client to determine the effectiveness of medications given to reduce left ventricular afterload. Which hemodynamic parameter is most appropriate for the nurse to monitor?
Systemic vascular resistance (SVR)
The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply.
The arterial system distributes oxygenated blood to the tissues. The venous system collects deoxygenated blood from the tissues.
During an assessment of a client with ankle swelling, the nurse observes jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. What is the correct interpretation of this finding?
The client has increased pressure related to right-sided heart failure.
What does the nurse teach is the principal factor that determines how long the client can exercise?
The client's heart and lung capacity
Downstream peripheral pulses have a higher pulse pressure because the pressure wave travels faster than the blood itself. What occurs in peripheral arterial disease?
The pulse decreases, rather than increases, in amplitude.
An angiogram reveals 80% to 90% occlusions in several coronary arteries but the client's troponin I level is normal. The client asks the nurse, "How it was possible to have such blockage yet have no symptoms?" How should the nurse respond?
To compensate for long-standing narrowing of the vessels, new arteries formed to increase blood supply.
The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply.
Tricuspid Mitral
Preload, the stretch on the heart before contraction, is largely determined by which factor?
Venous blood return
A client has a blood pressure of 68/38 mm Hg and fainted after donating a unit of blood. The client is experiencing low preload from loss of blood volume. What is preload?
Venous return to the heart
The cardiac cycle describes the pumping action of the heart. Which statement is correct about systole?
Ventricles contract and blood is ejected from the heart.
In the circulatory system, pressure is inversely related to which factor?
Volume
A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the:
bicuspid valve
Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability.
histamine
A client with aortic insufficiency is experiencing an increase in afterload. The client will experience fatigue and activity intolerance due to:
resistance to ejection of blood from the heart.
What sequence is the correct pathway for blood flow through the heart?
right atrium - tricuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aorta
A nurse working with a client in heart failure is explaining why the symptoms of the heart failure were not evident for a long period of time. When describing the Frank-Starling mechanism, the nurse will explain:
the relationship between venous return and stroke volume
A nurse working with a client in heart failure is explaining why the symptoms of the heart failure were not evident for a long period of time. When describing the Frank-Starling mechanism, the nurse will explain:
the relationship between venous return and stroke volume.
A client has just experienced stimulation of the vagus nerve. Which sign would the nurse anticipate the client to manifest?
Decreased heart rate
Release of which humoral factors will result in vasodilation?
Histamine
The circulatory system is divided into two parts. What does the pulmonary circulation include? Select all that apply.
Right heart Pulmonary artery Pulmonary veins
A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins?
Right-sided heart failure
The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?
Left ventricle
A client has had an acute myocardial infarction. The brother of the client has a history of angina. The client asks how he will know if his brother's pain is angina or if the brother is actually having an MI. Which statement is correct?
Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI.
A nurse is assessing a client who lost consciousness during a wrestling match when his opponent applied a neck hold. The client likely lost consciousness because:
a baroreceptor was stimulated.