NURS 334 EXAM QUESTIONS AND ANSWERS A
+ GRADED
three layers of the heart
endocardium, myocardium, epicardium
4 chambers with atroventricular valves including ____ and ____ and semiluar
valves including ___ and ___
tricuspid, mitral, pulmonic, aortic
2 necessary functions of the heart
the pump of muscle, electrical activity
t or f: ineffective work of the heart can impair perfusion and oxygenation on vital
organs (insuff CO)
t
contraction of the heart, allows heart to function as pump, manifested a pulse,
necessary to ensure CO
mechanical activity
initiation and transmission of electrical impulses, prepares heart for contraction,
recorded on paper as the ECG, not always followed my mechanical activity
electrical activity
t or f: mechanical activity precedes electrical activity
f
all cardiac cells have the capability to start an electrical activity... ____ is the
pacemaker of the heart
SA (sinoatrial) node
electrical activation of cell caused by influx of sodium into cells while potassium
exits cell
depolarization
return of cell to resting state caused by reentry of potassium into cell while
sodium exits
repolarization
phase in which cells are incapable of depolarizing
effective refractory period
phase in which cells require stronger-than-normal stimulus to depolarize
relative refractory period
cardiac action potential cycle...
phase 1 -
phase 2-
phase 3-
phase 4-
rapid repolarization, plateau, final repolarization, resting
normal impulse generation:
sa node -
av node-
,ventricular pacer cell -
purkinje fibers-
60-100 bpm
40-60 bpm
40 bpm
20 bpm
goal of the electrical system/pathway is to produce sufficient ___
CO
refers to the events that occur in the heart from the beginning of one heartbeat to
the next
cardiac cycle
the number of cycles depends on
HR
each cycle has 3 major sequential events
diastole, atrial systole, ventricular systole
The nurse cares for a client with a dysrhythmia and understands that the P wave
on an electrocardiogram (ECG) represents which
phase of the cardiac cycle?
• Atrial depolarization
• Early ventricular repolarization
• Ventricular depolarization
• Ventricular repolarization
atrial depolarization
amount of blood ejected with each heartbeat
stroke volume
degree of stretch of cardiac muscle fibers at end of diastole right before systole
preload
resistance to ejection of blood from ventricle
afterload
blood pressure = ___ x ____
CO, SVR
ability of cardiac muscle to shorten in response to electrical impulse
contractility
precent of end diastolic volume ejected with each heartbeat
ejection fraction
left ventricle EF; nl is ___%; less than ___% indicates heart failure
55-65, 40
amount of blood pumped by ventricle in liters per minute (4-6 L/min)
cardiac output
CO = ____ x ____
SV, HR
_____ controls heart rate
autonomic nervous system (symp and parasymp baroreceptors)
___ (left vent end-diastolic pressure... frank sterling law) and ____ (affected by
SVR and PVR) control stroke volume
afterload
, contractility increased by ________ and result in increased ____
catecholamines, SNS response, some medications (digoxin)
SV
decreased contractility by _____
hypoxemia, acidosis, certain meds (metoprolol)
age related changes to the atria
thickening of endocardium
age related changes to left ventricles
endocardial fibrosis, myocardial hypertrophy
age related changes to valves
rigidity, calcification
age related changes to conduction system
connective tissue in SA node, AV node, and bundle branches
age related changes to SNS and baroceptor response
decreased response
age related changes to aorta and arteries
decreased elasticity
electrocardiography= 12-lead ECG, continuous monitoring
hardwire-
telemetry-
lead systems:
real time, transmission of electrical signals via radio waves, 3 and 5
on skin, external, wireless
holter: 24-48 hours at home, this record the EKG... pt is instructed to anticipate
event markers with symptoms and keep diary of activities
ambulatory monitoring
ECG at central station (hospital)
continuous real-time
pacemakers and internal cardiac defibrillators
cardiac implantable device
on an ECG, each lead has a ___ and ___ pole... the electrical impulse is measures
as it moves between the 2 poles... conduction can be detected through skin
positive, negative
with electrical conduction and ECG: upright toward; downward away
lead I:
lead II:
lead III:
right arm, left arm
right arm, left leg
left arm, left arm
pt care with ECG
positioning, decrease skin impedance (shave or clip), away from movement areas, skin
should be free of oil, never place over wounds, removed before MRI
dx tests to determine cardiac rhythm defects
stress test, radionuclide imaging, echocardiogram, cardiac catheterization
+ GRADED
three layers of the heart
endocardium, myocardium, epicardium
4 chambers with atroventricular valves including ____ and ____ and semiluar
valves including ___ and ___
tricuspid, mitral, pulmonic, aortic
2 necessary functions of the heart
the pump of muscle, electrical activity
t or f: ineffective work of the heart can impair perfusion and oxygenation on vital
organs (insuff CO)
t
contraction of the heart, allows heart to function as pump, manifested a pulse,
necessary to ensure CO
mechanical activity
initiation and transmission of electrical impulses, prepares heart for contraction,
recorded on paper as the ECG, not always followed my mechanical activity
electrical activity
t or f: mechanical activity precedes electrical activity
f
all cardiac cells have the capability to start an electrical activity... ____ is the
pacemaker of the heart
SA (sinoatrial) node
electrical activation of cell caused by influx of sodium into cells while potassium
exits cell
depolarization
return of cell to resting state caused by reentry of potassium into cell while
sodium exits
repolarization
phase in which cells are incapable of depolarizing
effective refractory period
phase in which cells require stronger-than-normal stimulus to depolarize
relative refractory period
cardiac action potential cycle...
phase 1 -
phase 2-
phase 3-
phase 4-
rapid repolarization, plateau, final repolarization, resting
normal impulse generation:
sa node -
av node-
,ventricular pacer cell -
purkinje fibers-
60-100 bpm
40-60 bpm
40 bpm
20 bpm
goal of the electrical system/pathway is to produce sufficient ___
CO
refers to the events that occur in the heart from the beginning of one heartbeat to
the next
cardiac cycle
the number of cycles depends on
HR
each cycle has 3 major sequential events
diastole, atrial systole, ventricular systole
The nurse cares for a client with a dysrhythmia and understands that the P wave
on an electrocardiogram (ECG) represents which
phase of the cardiac cycle?
• Atrial depolarization
• Early ventricular repolarization
• Ventricular depolarization
• Ventricular repolarization
atrial depolarization
amount of blood ejected with each heartbeat
stroke volume
degree of stretch of cardiac muscle fibers at end of diastole right before systole
preload
resistance to ejection of blood from ventricle
afterload
blood pressure = ___ x ____
CO, SVR
ability of cardiac muscle to shorten in response to electrical impulse
contractility
precent of end diastolic volume ejected with each heartbeat
ejection fraction
left ventricle EF; nl is ___%; less than ___% indicates heart failure
55-65, 40
amount of blood pumped by ventricle in liters per minute (4-6 L/min)
cardiac output
CO = ____ x ____
SV, HR
_____ controls heart rate
autonomic nervous system (symp and parasymp baroreceptors)
___ (left vent end-diastolic pressure... frank sterling law) and ____ (affected by
SVR and PVR) control stroke volume
afterload
, contractility increased by ________ and result in increased ____
catecholamines, SNS response, some medications (digoxin)
SV
decreased contractility by _____
hypoxemia, acidosis, certain meds (metoprolol)
age related changes to the atria
thickening of endocardium
age related changes to left ventricles
endocardial fibrosis, myocardial hypertrophy
age related changes to valves
rigidity, calcification
age related changes to conduction system
connective tissue in SA node, AV node, and bundle branches
age related changes to SNS and baroceptor response
decreased response
age related changes to aorta and arteries
decreased elasticity
electrocardiography= 12-lead ECG, continuous monitoring
hardwire-
telemetry-
lead systems:
real time, transmission of electrical signals via radio waves, 3 and 5
on skin, external, wireless
holter: 24-48 hours at home, this record the EKG... pt is instructed to anticipate
event markers with symptoms and keep diary of activities
ambulatory monitoring
ECG at central station (hospital)
continuous real-time
pacemakers and internal cardiac defibrillators
cardiac implantable device
on an ECG, each lead has a ___ and ___ pole... the electrical impulse is measures
as it moves between the 2 poles... conduction can be detected through skin
positive, negative
with electrical conduction and ECG: upright toward; downward away
lead I:
lead II:
lead III:
right arm, left arm
right arm, left leg
left arm, left arm
pt care with ECG
positioning, decrease skin impedance (shave or clip), away from movement areas, skin
should be free of oil, never place over wounds, removed before MRI
dx tests to determine cardiac rhythm defects
stress test, radionuclide imaging, echocardiogram, cardiac catheterization
