NURSING 214 Medical-Surgical Nursing 1 Test 1 Exam solution guide_ Updated Spring 2022.

Medical surgical N214 Test one Exam Review 2022 Q&A Each heart beat pumps approxamately how many ml's? Answer- 60mls How many liters per minute does are heart beat? Answer- 5 liters Heart is enclosed in a sac called the? Answer- pericardium which has 10-30ml of fluid so to prevent friction between the layers as the heart pumps. Right side of the heart receives blood from? Answer- deoxygenated blood from the body and the coronary sinus. Right sided heart failure no matter what the reason what physical assessment will you find? Answer- *peripheral edema *ascites/Liver swollen/Jaundice *JVD *Loss of appitie Mnemonic for right and left sided failure is? Answer- L is for Lungs R is for GI/Liver Left sided heart failure you will see? Answer- fluid in the lungs short of breathe Organs swell when they don't get enough fluid and then they? Answer- fail What are the two atrioventricular valves? Answer- *tricuspid *mitral valve What are the two semilunar valves? Answer- Pulmonic valve aortic valve What physical properties of cardiac cells regulates the heart and rthymn, and it not the SA or AV. Answer- sodium potassium pump What is the automaticity-pacing function of the heart? Answer- *ability of the cardiac cells to generate an electrical impulse spontaneously and repetively. What is the primary pace make of the heart? Answer- sinoatrial node Depolarization occurs when the Answer- negatively charged cells within the heart develop a positive charge. What is conductivity? Answer- ability to transmit an electrical stimulus from cell membranes to cell membrane. What causes disturbances in conduction? Answer- *blocked pathway *too fast *too slow **this is the heart total block equal cardiac arrest and too fast equals tachycardia arrhythmia and too slow equals bradycardia. SA node is our primary pace maker and it generally paces at? Answer- 60-100bpm What actually give the heart itself blood and gas exchange? Answer- coronary arteries Left main coronary artery devices into two branches. name them?? Answer- *left anterior descending *left circumflex Which one is called the "widow maker" because if it is in trouble potential death can occur? Answer- left anterior descending Right coronary artery supplies the Answer- right atrium right ventricle sa node Remember your assessment of the heart and the landmarks? Answer- *aortic *pulmonic *tricuspid *mitral valve Mnemonic for this is ? Answer- All Patient Take Meds If you have a SA to AV disassociation your AV node isn't getting the message and you will need a ? Answer- pace maker Two types of pace makers? Answer- *temporary *permanent Nursing interventions for cardiovascular disorders? Answer- *pt needs activity *alternate periods of rest and activity *teach a patient how to conserve energy while performing ADL's. *sit in a chair while dressing *wear light weight clothing that fastens with Velcro *slips on shoes *large buttons For patients with decreased cardiac output monitor and record their? Answer- *LOC *heart rate and rhythm *oxygen saturation *blood pressure *EVERY four hours Big signs that you need a pace maker are? Answer- *low pulse *arrythmias *SOB *light headiness *palpations *neck throbbing *fatigue *uncomfortable feeling *orthostatic hypotension *rapid heart rate *dig toxicity *valve replacement Cardiac tests one may need if they are having cardiac issues? Answer- *Ekg *digoxin level *Echocardiogram *cardio version Components of a pacemaker are? Answer- *leads *pulse generator *wires to the heart A pace maker may have how many leads on it? Answer- one to three How long does an average pacemaker battery last? Answer- 10-12 years People with cardiac issue can not lye Answer- flat, they can't breathe The heart is about the size of your fist and its located in the? Answer- mediastinum The heart is located in the Answer- 2nd to 5th intercostal space Leading into and out of the heart are the? Answer- *inferior vena cava *superior vena cava *aorta *pulmonary arteries *pulmonary veins Blood feeding the heart itself returns through the? Answer- coronary sinuses Blood pump from the right side is pumped to the? Answer- lungs Oxygenated blood comes from the lungs to the left side of the heart where it is pumped out of Answer- aorta to the body Which side of the heart is bigger ? Answer- Left ventricle is three times as thick because it has to pump blood against a much higher pressure. Diastole is when the heart relaxes Answer- and fills with blood Systole is when the? Answer- ventricular contraction sends blood outward on its journey. Why do arterys have a thick wall? Answer- Arteries has a thick walk because they transport blood under pressure. All arteriers have? Answer- pulses when they are near the skin. Blood exchange occurs at the capillaries, why? Answer- because they are thin walls and diffusion can occur. Veins are thinner and more pliable than Answer- arteries Assessment of the patient with cardiac problems typically cite specific complaints like? Answer- *chest, neck, arm, or jaw discomfort *difficulty breathing, SOB *fluttering feeling in their chest *cyanosis, pallor or skin changes (such as decreased hair distribution and thin shinny appearance to the skin) *high or low blood pressure *weakness/dizziness/fatigue *diaphoresis *cheyne-stoke breathing *irritability ****frothy pink sputum/right sided failure Assessing your patient with cardiac problems start with? Answer- *vital signs *physical appearance then move on to: *inspection *palpation *percussion *ausculation How many blood pressures in a row over 140/90 indicates hypertension? Answer- 3 If the patient blood pressure is high give them a few minutes to relax and ? Answer- repeat the blood pressure. Take bp on both arms a difference of 10mmHg can indicate? Answer- thoracic outlet syndrome or other forms of arterial obstruction. If you suspect cardiac disease ausculate the Answer- apical pulse for one minute to detect any arrythmias. Normal pulse of an adult is? Answer- 60-100bpm Tachypnea may indicate? Answer- low cardiac output Dyspnea at rest is a sign of Answer- cardiac failure Patients with pericarditis will breathe how? Answer- shallowly to reduce pain Plus two pulse is Answer- normal What is a murmur? Answer- turbulent blood flow through a narrow point What can cause heart failure? Answer- *atherosclerotic heart disease *MI *hypertension *rheumatic heart disease *congenital heart disease *ischemic heart disease *cardiomyopathy *valvular diseases *arrhythmia's *pregnancy and childbirth *increased environmental temperature and humidity *severe physical or mental stress *thyrotoxicosis *acute blood loss *pulmonary embolism *severe infection *COPD Heart failure is commonly caused from ? Answer- systolic or diastolic overloading or myocardial weakness What happens to the heart over long term heart failure? Answer- hypertrophy Heart failure can be? Answer- *left or right *systolic or diastolic *acute or chronic What lab is a big indicator of heart failure? Answer- BNP Patient with heart failure are put on a cocktail of drugs? Answer- *diuretic *ace-inhibitor *digoxin Cardiac patient must be on a ? Answer- sodium restricted diet Nursing monitoring for heart failure patient? Answer- *bun *serium creatine *electrolytes (sodium, potassium, magnesium, chloride) ***wieght patient daily *suquentials *lung sounds *vitals * Big sign of congestive heart failure is? Answer- unable to do ADL's without becoming short of breathe Teach the patient to? Answer- *eat a high potassium diet *take dig as prescribed *notify the doctor for the following reasons: Continued.......................