NU 327 EXAM 4 TEST BANK QUESTIONS WITH CORRECT DETAILED ANSWERS

NU 327 EXAM 4 TEST BANK QUESTIONS WITH CORRECT DETAILED ANSWERS What are the mechanisms for cardio regulation? - Answer-- RAAS - natriuretic peptide - ADH - autonomic nervous system RAAS system - Answer-- renin-angiotensin-aldosterone system - raises BP and increases blood volume - in HR it continuously cycles and weakens the heart Natriuretic peptides - Answer-elevated BNP is how HF is diagnosed ADH - Answer-- decreased tissue perfusion - released by the pituitary - hold on to water - vasoconstriction autonomic nervous system - Answer-vasoconstricts and increases HR and force of contraction Etiology/ risk factors of HF - Answer-- ischemia heart disease - heart attack - HTN - risk factors commonly known ones (fam history, diabetes, obesity) Patho of HF acute and chronic - Answer-Acute: rapid, suddenly develop, massive MI and severe shock Chronic: most common and the heart weakens overtime Systolic vs diastolic HF - Answer-Systolic: - reduced contractibility - difficulty ejecting blood - SV and CO decrease Diastolic: - ventricles cant relax - poor filling - pumps out insufficient vol - low CO and SV Left HF etiology - Answer-- HTN - hypertrophy - insufficient CO - low O2 and nutrients backward effects of left sided heart failure - Answer-- coughing - shortness of breathe - crackles - orthopnea - cyanosis - all result of congestion behind pumping chamber Forward effects of left and right sided heart failure - Answer-- tired - oliguria - high HR - faint pulse - restlessness - confusion - anxiety - all result from decreased tissue perfusion orthopnea - Answer-difficulty breathing when lying down caused by fluid in the lung tissue Right HF etiology - Answer-- left side HF - lung disorders backward effects of right sided heart failure - Answer-- hepatomegaly - ascites - splenomegaly - anorexia - edema - jugular vein distention How is HF diagnosed? - Answer-- Echo - BNP lab - classical findings (FACE) Treatment of HF - Answer-- watch fluid (daily weight) - limit salt, cholesterol, and alcohol - exercise - diuretics - many meds what is the function of the valves? - Answer-open and close and prevent backflow What is stenosis? - Answer-failure of valves to open completely What is regurgitation? - Answer-failure to close completely What is prolapse? - Answer-valve balloons move backward into the supplying chamber Mitral stenosis - Answer-- narrowing of the mitral valve - stiff valve - caused by rheumatic fever - high LA pressure - high pulmonary resistance leads to pul HTN and RV hypertrophy S/S of mitral stenosis - Answer-- cough - DOE - orthopnea - PND - murmur at the apex - all due to pul congestion and increased LA pressure Treatment of mitral stenosis - Answer-- medication - surgery - prosthetic valves and antibiotics mitral regurgitation - Answer-- caused by blood flow back into LA because the valve doesnt close - S/S: pulmonary symptoms - Treatment: meds or surgery Mitral valve prolapse - Answer-- valve flutters back up into the chamber - women have it mostly and dont know - S/S: fatigue, dyspnea, and chest pain - may not have any treatment Aortic Stenosis - Answer-- aortic valve wont open causing left side hypertrophy which in turn causes syncope, dyspnea, and chest pain - Treated w meds or surgery - common in older people aortic regurgitation - Answer-- caused by rheumatic fever, infections, and marfans - blood leaks from aorta back into LV - s/s throbbing or bounding pulse What is shock? - Answer-inability of the body to provide blood flow to tissues What are the stages of shock? - Answer-Initial, progressive, and refectory/irreversible Initial Shock - Answer-- sudden drop in tissue perfusion - SNS increases HR - RAAS: increases blood volume and vasoconstriction - the pt will be anxious, pale, cold and clammy Progressive shock - Answer-- requires active therapeutic intervention or the pt will most likely not survive - decreased perfusino to lungs, kidenys, gut, pancreas, and liver - all available blood goes to heart and brain Refractory/ irreversible shock - Answer-- the pt is unresponsive to therapeutic interventions - brain and heart have decreased perfusion - widespread cellular hypoxia and extensive anaerobic metabolism - can cause death Inflammatory response (shock) - Answer-- increase neutrophils, macrophages, and killer T cells - demand for O2 - SIRS w injury to organs - endothelial injury - accumulation of interstitial edema