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Fundamentals Test II


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Where is the apical HR?
Mitral valve, 5th intercostal, midclavicular line
S1 and S2: Lub- Dub sounds
S1: Atrial ventricular valves slapping shot
S2: Semilunar valves slapping shut
Cardiovascular System Primary Function and what the heart needs to do (3)
Primary function: transport oxygen to rest of body
Needs (3): 1. ability to generate and conduct electrical impules, 2. heart needs to be able to fill and empty properly, 3. Strong enough to contract
What vein becomes distended if their is excess of blood into superior vena cava?
Jugular Vein
If the left pulmonary vein has an excess of blood, what is likely to fill with blood?
Cardiac Output formula
Cardiac Output definition and normal range
Tells us how efficient the pump is, the cardiac output is the amount of blood pumped per minute (3.5-8L)
Stroke Volume definition and normal range
amount of blood pumped for every beat of contraction (70 ML)
Heart Rate Definition and normal range
Number of Beats per minute (60-100 BPM)
Cardiac Output Varies by (3 things)
body size, metabolic needs of tissues, age
Definition of Afterload
Amount of resistance the heart has to pump against (plague build up--heart has to pump harder)
4 areas of the heart to listen to
aortic, pulmonic, tricuspid, mitral valve
Risks for cardiovascular disease
age, gender, inheritance, smoking (most modifiable), hypertension (25% of adults), stress, high cholesterol, obesity, lack of exercise, and diabetes
excessive build up of plague
What is the most common factor of cardiovascular diesease?
P Wave
depolarization of the atria
T Wave
ventricular replorization
QRS complex
Depolarization of ventricles
Amount of blood that enters the heart)
Risk factors for hypertension
African American (genetics), overweight, inactiveness, pregnancy, alcohol, elderly men, high salt intake
What kind of fat is most important when talking about CV disease?
What does exercise do (physiologically speaking)
makes platelets less sticky, prevents thrombosis, increases HDL, increase muscle build-up
What other factors could affect cardiovascular disease?
medications, herbs, cocaine, emotional stress, pregnancy (weight on fetus puts pressure on pelvic vein, edema is likely, watch for CV problems!)
What should nurses inspect the chest for?
What should the nurse feel for? Over what area?
The nurse should feel for thrill (which sounds like a cat purring) over the PMI
4 indications that a patient is having cardiac problems
1. HR is above 100 bpm at rest.
2. If HR increases by 20BPM, changing body positions with mild activity.
3. No change in heart rate with exercise.
4. Short of breath with slight activity, or even just laying down.
Should examine all pulses bilaterally EXCEPT what pulse?
What should you feel the carotoid for?
feel for a thrill, or a swishing sound which is called a BRUIT
What does a bruit indicate?
Narrowing of the carotoid
What level should the bed be at when checking for jugular vein distention?
30-45 degress, or semi-fowler
What is indicated by no hair on the big toe?
Arterial clot
What is a PTT?
Partial thromobplastin time test, tells us about the body's ability to clot
What is a PT?
Prothroymbin test, tells us about the effects of Coumadin, and how lot it takes to clot
What macromolecule can lead to a edema?
Decrease in protein--specifically protein-albumin
What would be in a lipid profile?
Cholesterol (HDL, LDL, ratio), and triglycerides)
Hemoglobian (Hgb) normal ranges
13.5g/ dL
Hematocrit (HCT) normal ranges
ECG is used for what kind of diagnosis?
for electrical problems in heart
Cardiac Catherization
put through the femoral artery into the right atrium, checking for pressure. After care--watch for external bleeding, have to keep leg straight, make sure patient doesn't bend leg!!!!!!! Check to make sure they don't have any sort of dysrrthemias.
Echocardiogram checks what?
What do treadmills do?
Look at heart during exercise, what kind of electrical abnormalities do we see?
Where would edemas present?
feet, sacral area, periobrital (around the eye)
Hematoma definition
full of blood
Pitting edema
Push thumb down for 10-15 seconds and let go. If print is still there when you remove your thumb then pitting edema is present.
Pitting edema measurements
2 mm= +1 edema
4 mm= +2 edema
6 mm= +3 edema
8 mm= +4 edema
Brawny Edema Definiton
full of fluid, no pitting because it is so hard
4 Normal Solutions for edema
elevate edema above heart, measure circumfrence of limb or abdomen, where we have edema, might have to drain abdomen, may give diuretics
Holman's Sign
dorsiflex foot, if call hurts--positive, if it is positive it suggests that has a patient has a DVT
Ineffective Tissue Perfusion- what does it look like?
Depends on what part of the body it is in.
really pain, skin starts to "sluff off', treat like a burn
Sickle Cell Anemia
ischemia throughout the entire body, extremely painful
Who is at risk for impaired skin intergirty?
DVT patients
Arterial Clot vs. DVT clot pain differences
intermittent claudication vs. cramping-constant ahce
Arterial Clot vs. DVT clot
decreased or absent below the clot vs. no change (we don't feel pulses in veins)
Arterial Clot vs. DVT clot capillary reflex
greater than 3 seconds, vs. no change
Arterial Clot vs. DVT clot skin color
pale vs. red (getting engourged)
Arterial Clot vs. DVT clot temperature
cool vs. hot
Arterial Clot vs. DVT clot appearence
shiny no hair on the tow (if on the leg) vs. patch brown
Arterial Clot vs. DVT clot
none vs. present
Arterial Clot vs. DVT clot motor functions
impaired vs. no change
DVT Nursing care
Do NOT massage, warm (heat may dilate), do not want to cause vasoconstriction (encourage to change position often, can not cross their legs! Increase pressure, constricts blood flow), elevative, but never so that their knees are bent
Sequential compression device
-dilate certain amounts of pressure
-changes where the air is, constantly changing where pressure is to try and prevent clots
Other Measures to prevent clots (4)
1. passive or active ROM
2. Keep warm for vasodilation
3. encourage pt. to stop smoking
4. exercise regularly, and wear good shoes!
Indications of decreased CO (7)
1. HR would increase.
2. BP would go down after a while.
3. Decreased LOC, restlessness, anxiety, and confusion.
4. Looks and is syonotic, not perfusing.
5. O2 sats would drop.
6. As BP decreases, urine output would decrease
7. edema in dependent areas

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