Glossary of Nursing 3
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- While each cell in the cardiac muscle is _______, it is not healthy for each cell to contract individually.
- There is a network of specialized cells and pathways called the _____ conduction system that normally has control over the way the heart beats.
- Stroke volume x heart rate= ?
- cardiac output/minute
- What is the amount of blood ejected from the heart with each beat?
- stroke volume
- What is the number of beats per minute?
- heart rate
- What is the ability of the heart muscle fibers to contract or shorten?
- What is the degree to which the muscle fibers in the ventricle are stretched when full and ready to eject blood; the more these fibers are stretched, the stronger the contraction (Frank-Starling Law of the Heart)?
- With preload, if these fibers are overstretched, the capacity to increase contraction strength may decrease, thereby decreasing what?
- carbon dioxide
- What is the resistance against which the heart must pump to eject blood into the circulation? This is impacted by systemic (or peripheral) vascular resistance or systemic(or peripheral) vascular dilation?
- The afterload resistance is determined by what three things?
- viscosity or thickness of the blood
blood vessel lenth and
blood vessel diameter
- What is the primary reason we have a circulatory system?
- Transport oxygen, nutrients and hormones to the cells of the body and to transport metabolic wastes from the cells for elimination.
- What nonmodifiable factor retrieved during assessment is a positive family history of CAD in a first degree relative is a major risk factor?
- Age is nonmodifiable risk. Incidence of CAD and valvular disease increases with age. Post menopausal women are 2-3 times more likely to have CAD than __________ women. Women are often underdiagnosed, usually thought to have gallbladder pain
- What modifiable risk factor according to the department of health and human services, is directly responsible for 21 % of all deaths from CAD.
- cigarette smoking
- What three modifiable factors that are presence of chronic diseases that are not diagnosed or in which the patient does not follow a treatment plan for control?
- diabetes, serum lipid levels and hypertension
- Obesity is a modifiable risk factor. A particular problem especially when the obesity is abdominal and measurement greater than ______ measurement.
- Less than ___ minutes of activity a day is a modifiable risk factor concerning CAD
- Extreme exposure to heat or cold increases the ____ on the heart, maybe enough to stress a marginally well heart into pathology.
- The normally healthy body ahs built-in mechanisms to compensate for temporary decreases in oxygenation of the cells and tissues. For example, Increased heart rate, increased depth of respirations
In the unhealthy heart, these compensatory mech
- no answer
- While some stress may be tolerated without problem, there is an increased ___?___ workload on the heart.
The amount of "tolerable" stress will depend upon the underlying physical condition of the patient. There is also research into the wa
- Diet: the well knownn connections are with high fat diets (leading to the modifiable risk factor of elevation of ______ ______ levels), increased salt intake (leading to or making worse a tendency to hypertension).
Also consider potassium and
- serum lipid
- How many oz. of alcohol per day may be protective of the heart?
Greater amounts may cause such problems as decreased oxygenation, malnutrition, hypertension, as well as poor impulse control and decision making.
- 1-2 oz
- What is an amino acid that research has shown to often be elevated in people with atherosclerosis. Since atherosclerosis is the precursor to plaque development and occlusion of the coronary arteries (thereby MI), elevatin of this may indicate an increase
- Current health problem or chief complaint
Pain or discomfort: physiologically can be from ischemia, pericarditis, aortic dissection.
Be sure to use alternative words for pain such as discomfort, heaviness, pressure, indigestion.
- no answer
- What can occur as a result of both cardiac and pulmonary disease?
- What is dyspnea that occurs when a patient lies flat?
- What dypsnea occurs after the patient has been lying down for several hours. the blood from the lower extremeties redistributes to the venous system and increases venous return to the heart. this overloads the heart, causing pulmonary congestion. The pat
- Paroxysmal nocturnal dyspnea (PND)
- What is a feeling of fluttering in the chest and awareness of the heartbeat, which may be irregular; may be caused from ischemia to the hearts conductions system or muscle?
- What is transient loss of consciousness (fainting), the result of poor perfusion to the brain, can be caused by decreased cardiac output or problems with venous flow to the brain?
- Near _____ is dizziness with an inability to remain in an upright position without loss of consciousness.
- What is the term for severe cramping sensation in the legs or buttocks associated with an activity such as walking? it is relieved by rest
- intermittent claudication
- What is a myocardial muscle protein released into the bloodstream with injury to the myocardial muscle?
This is not found in healthy individuals, so any rise is significant for myocardial damage. Peak levels are in 12 hours, but there is a hi
- What is an enzyme specific to cells of the brain, myocardium, and skeletal muscle, the MB band is specific to the myocardium (peak rise is 24 hours post injury)
- Creatine kinase
- This are predominantly cholesterol and high levels are positively correlated with CAD.
- LDL's low-density lipoproteins
- This are mainly protein with 20% cholesterol; high levels are negatively correlated with CAD and appear to be a protective factor?
- HDL- high-density lipoproteins
- These are the main storage form of lipids? High levels are linked to the progression of CAD
- What levels may be decreased by a diet rich in B complex vitamins, especially folic acid?
These may be a greater significance in women
- ______ is a critical component in the development of atherothrombosis.
- Highly sensitive ______ protein is the most studied marker of inflammation and a level over 3 mg/dL places the patient at high risk for heart disease. These can be elevated by hypertension, infection, and smoking.
- These help to determine heart size, presence of pulmonary congestion, and presence of cardiac calcifications.
- chest xray
- This is a test that includes placement of a catheter that infuses radiopaque dye into the coronary arteries. The flow of the dye is observed radiiographically and the degree of occlusion present in the coronary arteries is determined.
- cardiac catheterization
- This is a simple rhythm strip analysis?
- Cardiac monitoring
- This is a routine part of every cardiac evaluation this test records the electrical activity of the heart. Variance from normal electrical activity indicates variance from healthy heart function.
- Basic ____ also termed EKG is a noninvasive test done by connecting the patient to a ECG machine in a prescribed manner with 5 skin electrodes. The placement of these "leads" allows the health care provider to view myocardial electrical conduct
- This is a form of continuous ECG that allows recording of cardiac activity during an extended period of time (often 24-48 hours) while the patient goes about their regular daily activities.
Useful to assess the impact of these activities on the CV
- Holter Monitoring
- In this test the patient is connected to ECG monitoring and is exercised on a treadmill or stationary bicycle. The ECG and B/P are monitored during the exercise period for changes
- Exercise stress testing
- This uses ultrasound waves to assess cardiac structure and mobility. Helps to assess and diagnose cardiomyopathy, valvular disorders, pericardial effusion, left ventricular function, ventricular aneurysms, and cardiac tumors. This is a noninvasive, risk
- This nursing diagnosis is "decrease in oxygen resulting in the failure to nourish the tissues at the capillary level".
- altered b/p, oliguria, altered mental status, restlessness, chest pain, dyspnea, sense of impeding doom, capillary re
- Ineffective tissue perfusion
- This nursing diagnosis is "Inadequate blood pumped by the heart to meet the metabolic demands of the body"
May be related to altered rate/rhythm (arrhythmias), altered preload (JVD, edema, weight gain), altered afterload (cold, clammy kin,
- Decreased Cardiac output
- This nursing diagnosis is "Insufficient physiologic or psychological energy to endure or complete required or desired daily activities"
Pt. report of fatigue or weakness, exertional discomfort or dyspnea, abnormal heart rate or B/P respons
- Activity Intolerance
- The broad goals for these patients include:
Maintaining or improving tissue perfusion
Absence of pain, improvement in color
Maintaining or restoring adequate cardiac output
Demonstrating understanding o CV risk factors
- no answer
Encourage frequent postition changes, ambulation, and exercise
_____ is very detrimental to CV function
- The best position for a cardiac patient is ____?_____ as this position decrease preload and pulmonary congestion and helps to improve cardiac function.
- high Fowler's
- Patients with poor venous return may benefit from being postitioned with legs _____ to promote venous return
This can be very helpful for a patient who needs increased cerebral blood flow (someone who has become light headed, hypotensive, or fainte
- Avoidance of venous ____ , which puts the patient at risk for development of varicose veins, hypercoagulability, and formation of clots (venous thrombosis) which can dislodge and become emboli.
Avoid use of pillow under the knees or more than 15 deg
- Use of _________ and or TED hose may also help prevent venous status
- SCD, sequential compresison devices
- Patient with _____ claudication often benefit from a mild exercise program
- If the patient is confined to bed encourage ___ exercises (alternate flexion and extension of the feet and/or contraction and relaxation of calf muscles).
Encourage ambulation as quickly as possible
Encourage or provide frequent postition
- Medications can be used to help reduce vasoconstriction, thereby reducing the workload on the heart
Calcium channel blockers: nifedipine (Procardia)
Ace inhibitors: captopril (Capoten)
- Medications can be used to prevent or treat arrhythmias: Procainamide (Procan), Lidocaine, flecaninide (Tamocor), ______ (inderal), amiodarone (Cordarone)
- What medication can be used to increase contractile strength of the heart?
- digitalis (Lanoxin)
- What two medications can be used to block sympathetic nervous system action to reduce myocardial oxygen consumption?
- metoprolol (Lopressor) or propranolol (Inderol)
- The ____ atrium basically serves as a reserve.
- ________ walls are more muscular because it must pump the blood everywhere else.
- Blood oxygen exchange takes place at the ______ level.
- After the blood goes to the lungs it goes back to the _______ and then into the left ventricle.
- left atrium
- The body must have a certain amount of vascular tone, if you don't have that your body will go into ______.
- What can cause the blood to get thicker?
- The _____ ______ is in control of all the cells, this electricity produced by this travels everywhere else in the heart.
- SA node
- What is an oversized heart?
- cardio myopathy
- ______ MI's are common in diabetics and women. These people never know about until an EKG reveals it.
- What is the term used for not enough blood flow to the tissues?
- What kind of echocardiogram is invassive, it is when they put a scope down your esophagus?
- transesophageal electrocardiogram
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