Porth Chapter 17

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 bestcaptures a component of cardiac function? "Efficient heart function requires that the ventricles not retain any blood at the end of the cardiac cycle. "Recall that the heart sounds that we listen to as part of our assessments are the sounds of the myocardium contracting." "The diastolic phase is characterized by relaxation of ventricles and their filling with blood." "Aortic pressure will exceed ventricular pressure during systole."

"The diastolic phase is characterized by relaxation of ventricles and their filling with blood."

A client has suffered chest injuries following a automobile accident. The chest injury has resulted in an increase in intrathoracic pressure. There can be a transient shift from the pulmonary to the systemic circulation of how much blood?

250 mL

A number of clients on an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which client is most deserving of immediate medical attention? A 46-year-old man whose cardiac telemetry shows him to be in ventricular tachycardia A 69-year-old woman who has entered ventricular fibrillation A 60-year-old man with premature ventricular contractions (PVC) and a history of atrial fibrillation A 60-year-old woman who has just been diagnosed with a first-degree AV block

A 69-year-old woman who has entered ventricular fibrillation

In which situation is blood most likely to be rapidly relocated from central circulation to the lower extremities? A client undergoes a stress test on a treadmill. A client does isotonic exercises in a wheelchair. A client is helped out of bed and stands up. A client reclines from a sitting to supine position.

A client is helped out of bed and stands up.

A client is admitted to the cardiac unit with a diagnosis of pericarditis. The nurse is teaching th 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? The outer muscular layer of the heart The innermost lining of the heart chambers A membranous sac that encloses the heart The electrical conduction system of the heart

A membranous sac that encloses the heart

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: Tricuspid valve Pulmonic valve Bicuspid valve Aortic valve

Bicuspid valve

The heart controls the direction of blood flow. What is the role of the aortic valve? Controls the direction of blood flow from the atria to the ventricles Controls the direction of blood flow from the left side of the heart to the lungs Controls the direction of blood flow from the left side of the heart to the systemic circulation Controls the direction of blood flow from the ventricles to the artia

Controls the direction of blood flow from the left side of the heart to the systemic circulation

A client comes to the emergency department reporting a "racing" heart and feeling "anxious." On a heart monitor, the nurse notes a heart rate of 134 and proceeds to monitor for which complications related to tachycardia? Select all that apply. Decrease in blood pressure Decrease in oxygen levels Decrease in stroke volume Increase in cardiac output Risk for angina

Decrease in blood pressure Decrease in oxygen levels Decrease in stroke volume Risk for angina

A client's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The client is unconscious and without a pulse. Which priority intervention should the nurse take? Defibrillate the client Administer IV push atropine Perform synchronized cardioversion Notify the client's attending physician

Defibrillate the client

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? Distribute oxygenated blood to the tissues Collect deoxygenated blood from the tissues Exchange gases, nutrients, and wastes Pump blood

Exchange gases, nutrients, and wastes

Which enzyme has a powerful vasodilator effect on arterioles and increases capillary permeability? Histamine Serotonin Prostaglandins Arachidonic acid

Histamine

The nurse is assisting a client who had a myocardial infarction 2 days ago during a bath. The client suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the client was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. What is a priority intervention at this time? Immediate defibrillation Synchronized cardioversion Applying a transcutaneous pacemaker Administration of atropine

Immediate defibrillation

Which of the following is true regarding pulmonary circulation? The system functions with an increased arterial pressure to circulate through the distal parts of the body. It is a low-pressure system that allows for improved gas exchange. It is the larger of the two circulatory systems. It consists of the left side of the heart, the aorta, and its branches.

It is a low-pressure system that allows for improved gas exchange.

The nurse is evaluating a client with cardiac problems and notes that the client's peripheral pulse is different than the apical pulse. To which physiologic response would the nurse attribute the difference in rates? Premature beats not following normal conduction pathways An overexcited electrical impulse Confusion within the sinus node Multiple ectopic respond at various cycles

Premature beats not following normal conduction pathways

he heart consists of four valves. Which are the semilunar valves? Select all that apply.

Pulmonary Aortic

A client has had an acute myocardial infarction (MI). 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? Chest pain with angina only occurs during the day; MI pain is more likely at night. Chest pain with angina only occurs at rest; MI pain occurs during a stressful time. Pain is more severe and lasts longer with angina than with an MI. Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI.

Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI.

What is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction? SA node - AV node - bundle of His - bundle branches - Purkinje fibers AV node - SA node - bundle of His - bundle branches - Purkinje fibers SA node - AV node - bundle branches - Purkinje fibers - bundle of His AV node - bundle of HIS - bundle branches - SA node - Purkinje fibers

SA node - AV node - bundle of His - bundle branches - Purkinje fibers

The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply. The heart exchanges gases, nutrients, and wastes. The arterial system distributes oxygenated blood to the tissues. The venous system collects deoxygenated blood from the tissues. The capillaries pump blood.

The arterial system distributes oxygenated blood to the tissues. The venous system collects deoxygenated blood from the tissues.

A client is visiting the primary physician and appears extremely nervous. The intake nurse does his vital signs and notes an increase in both his heart rate and blood pressure. In an effort to better understand the client's presenting signs and symptoms the nurse asks the client about his concerns and the client states that the person who performed his pre-visit told him that he had a dysrhythmia. Which is the most therapeutic response about cardiac dysrhythmias that the nurse can make? They are cause for concern and indicate a heart disease. They are really not anything to worry about. They can occur in diseased or healthy hearts. They are always life-threatening.

They can occur in diseased or healthy hearts.

The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply. Tricuspid Mitral Pulmonary Aortic

Tricuspid Mitral

Which blood vessel layer is made primarily of muscle?

Tunica media

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. Atria contract and blood is ejected from the heart. Ventricles relax and blood fills the heart. Atria relax and blood fills the heart.

Ventricles contract and blood is ejected from the heart.

In the ICU, the nurse hears an emergency cardiac monitor go off. The nurse looks at the telemetry and notices the client has gone into ventricular tachycardia. The nurse will likely assess for signs/symptoms of: development of hypertension with BP 190/98. oxygen deprivation with O2 saturation decreasing to ~90%. decreasing cardiac output due to less ventricular filling time. increasing cardiac index by correlating the volume of blood pumped by the heart with an individual's body surface area.

decreasing cardiac output due to less ventricular filling time.

The nurse identifies the blood vessel layer that constricts to regulate and control diameter as:

tunica media

The cardiologist just informed a client that he has a reentry circuit in the electrical conduction system in his heart. This dysrhythmia is called Wolff-Parkinson-White (WPW) syndrome. After the physician has left the room, the client asks the nurse to explain this. Which statement most accurately describes what is happening? "This means that the SA node (which is the beginning of your heart's electrical system) has been damaged and is no longer functioning normal." "You must have a large clot in one of your arteries that supply oxygenated blood to the special conduction cells in your heart." "There is an extra, abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly, in a circular pattern, causing the heart to beat too fast." "For some reason, your electrical system is not on full charge so they will have to put in new leads and a pacemaker to make it work better."

"There is an extra, abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly, in a circular pattern, causing the heart to beat too fast."