Disease NCLEX PN Questions and
Answers
(2) to transport agents which serve the body in allergic, immune,
and infectious responses;
(3) to initiate clotting and thereby prevent blood loss;
(4) to maintain body temperature;
(5) to produce, carry and contain blood;
(6) to transfer body reserves, specifically mineral salts, to areas
of need.
The circulatory system consists of the heart, blood vessels, blood and lymphatics.
Course of Circulation (systemic route)
Circulatory system - ✔a. Arterial system. Blood is delivered by the pulmonary veins (two
from each lung) to the left atrium, passes through the bicuspid (mitral) valve into the
left ventricle and then is pumped into the ascending aorta; backflow here is
prevented by the aortic semilunar valves. The aortic arch toward the right side
gives rise to the brachiocephalic (innominate) artery which divides into the right
subclavian and right common carotid arteries. Next, arising from the arch is the
common carotid artery, then the left subclavian artery.
The subclavians supply the upper limbs. As the subclavian arteries leave the axilla
(armpit) and enter the arm (brachium), they are called brachial arteries. Below the
elbow these main trunk lines divide into ulnar and radial arteries, which supply the
forearm and eventually form a set of arterial arches in the hand which give rise to
common and proper digital arteries. The descending (dorsal) aorta continues along
the posterior aspect of the thorax giving rise to the segmental intercostals arteries.
After passage "through" (behind) the diaphragm it is called the abdominal aorta.
At the pelvic rim the abdominal aorta divides into the right and left common iliac
arteries. These divide into the internal iliacs, which 36
Copyright © StudyGuideZone.com. All rights reserved.
supply the pelvic organs, and the external iliacs, which supply the lower limb.
b. Venous system. Veins are frequently multiple and variations are common. They
return blood originating in the capillaries of peripheral and distal body parts to the
heart.
Hepatic Portal System
(circulatory system) - ✔Blood draining the alimentary tract (intestines),
pancreas, spleen and gall bladder does not return directly to the systemic
circulation, but is relayed by the hepatic portal system
,of veins to and through the liver. In the liver, absorbed foodstuffs and wastes are
processed. After processing, the liver returns the blood via hepatic veins to the inferior
vena cava and from there to the heart.
Pulmonary Circuit
(circulatory system) - ✔blood is oxygenated and depleted of metabolic products such as CO2 in
the lungs
Lymphatic Drainage
(circulatory system) - ✔A network of lymphatic capillaries permeates the body
tissues. Lymph is a fluid similar in composition to blood plasma, and tissue fluids not
reabsorbed into blood capillaries are transported via the lymphatic system
eventually to join the venous system at the junction of the left internal jugular and
subclavian veins.
Heart - ✔pumps 72 times per minute and propels about 4,000 gals (about 15,000 liters) of blood
daily to the tissues.
Composed of:
Endocardium (lining; epithelium) Myocardium
(mid coat; cardiac muscle)
Epicardium (external coat or visceral layer of pericardium; epithelium and mostly connective tissue)
Impulse conducting system
Cardiac Nerves - ✔Modification of the intrinsic rhythmicity of the heart muscle is produced by
cardiac nerves of the sympathetic and parasympathetic nervous system. Stimulation of the sympathetic
system increases the rate and force of the heartbeat and dilates the coronary arteries.
Cardiac Cycle - ✔alternating contraction and relaxation is repeated about 75 times per minute;
the duration of one cycle is about 0.8 secs.
Three phases succeed one another during the cycle:
a) atrial systole: 0.1 second
b) ventricular systole: 0.3 second
c) diastole: 0.4 second
Blood - ✔Blood volume= 5 or 6 liters (7% of body wt)
Plasma constitutes about 55% of blood volume and cellular elements about 45%
Cardiogenic Shock - ✔heart is unable to meet the demands of the body. This can be caused by
conduction system failure or heart muscle dysfunction.
Sx: rapid breathing, rapid pulse, anxiety, nervousness, thread pulse, mottled skin color, profuse sweating,
poor capillary refill
,Tx: Amrinone, norepinephrine, dobutamine, IV fluids, PTCA, Extreme cases- pacemaker, IABP
Tests: nuclear scans, electrocardiogram, echocardiogram, electrocardiogram, ABG, Chem-7, chem-
20, electrolytes, cardiac enzymes
Aortic Insufficiency - ✔heart valve disease that prevents the aortic volve from closing completely.
Backflow of blood into the left ventricle.
Cx: Rheumatic fever, congenital abnormalities, endocarditis, marfan's syndrome, ankylosing spondylitis
Reiter's Syndrome - ✔type of reactive arthritis that happens as a reaction to a bacterial
infection in the body.
Sx: fainting, weekness, bounding pulse, angina on occasion, SOB, fatigue
Tests: palpation, increase pulse pressure and diastolic pressure, pulmonary edema present, auscultation,
left heart cath, aortica angiography, dopper US, Echocardiogram
Tx: digoxin, dieuretics, surgical aorta valve repair
Monitor for: PE, Left-sided HF, Endocarditis
Hypovolemic Shock - ✔poor blood volume prevents the heart from pumping enough blood to the
body
Cx: trauma, diarrhea, burns, GI bleeding
Cardiogenic shock - ✔enough blood is available, however the heart is unable to move the blood in
an effective manner
Sx: anxiety, weakness, sweating, rapid pulse, confusion, clammy skin
Tests: CBC, echocardiogram, CT scan, endoscopy, CT scan, endoscopy c GI bleeding, swan-ganz cath
Tx: increase fluids via IV, Avoid hypothermia, epinephrine, norepinephrine, dobutamine, dopamine
Myocarditis - ✔inflammation of the heart muscle
Cx: bacterial or viral infections, polio, adenovirus, coxsackie, virus
, Sx: Leg edema, SOB, Viral symptoms, joint pain, syncope, HA (pain), fever, unable to lie flat, irregular
heart beats
Tests: CXR, echocardiogram, ECG, WBC & RBC count, blood cultures
Tx: Diuretics, pacemaker, antibiotics, steroids
Monitor for: pericarditis, cardiomyopathy
Heart valve infection - ✔endocarditis, probable valvular heart disease. Can be caused by fungi or
bacteria
Sx: weakness, fever, murmur, SOB, Night sweats, joint pain, janeway lesions
Tests: CBC, ERS, ECG, blood cultures, enlarged spleen, presence of splinter, hemorrhages,
Tx: IV antibiotics, surgery may be indicated
Monitor for: Jaundice, arrhythmias, CHF, Glomerulonephritis, emboli
Pericarditis - ✔inflammation of the pericardium
Cx: viral (coxsackie, adenovirus, influenza, rubella viruses), bacteria (various microorganisms), fungi,
surgery, of often associated with TB, renal failure, AIDS, and autoimmune disorders
Sx: dry cough, pleuritis, fever, anxiety, crackles, pleural effusion, LE swelling, chest pain, unable to lie
down flat
Tests: auscultation, MRI scan, CT scan, echocardiogram (key test), ESR, CXR, blood cultures, CBC
Tx: NSAIDS, Pericardiocentesis, analgesics, pericardiectomy
Monitor for: constrictive pericarditis, A fib, Supraventicular tachycardia (STV)
Arrhythmias - ✔irregular heart beats and rhythms disorder
Types:
Bradycardia, Tachycardia, ventricular fib, ectopic heart beat, ventricular tachycardia, woldd-
parkinson-white syndrome, atrial fib, sick sinus syndrome, sinus tachy, sinus brady
Sx: SOB, Fainting, Palpitations, dizziness, chest pain, irregular pulse
Answers
(2) to transport agents which serve the body in allergic, immune,
and infectious responses;
(3) to initiate clotting and thereby prevent blood loss;
(4) to maintain body temperature;
(5) to produce, carry and contain blood;
(6) to transfer body reserves, specifically mineral salts, to areas
of need.
The circulatory system consists of the heart, blood vessels, blood and lymphatics.
Course of Circulation (systemic route)
Circulatory system - ✔a. Arterial system. Blood is delivered by the pulmonary veins (two
from each lung) to the left atrium, passes through the bicuspid (mitral) valve into the
left ventricle and then is pumped into the ascending aorta; backflow here is
prevented by the aortic semilunar valves. The aortic arch toward the right side
gives rise to the brachiocephalic (innominate) artery which divides into the right
subclavian and right common carotid arteries. Next, arising from the arch is the
common carotid artery, then the left subclavian artery.
The subclavians supply the upper limbs. As the subclavian arteries leave the axilla
(armpit) and enter the arm (brachium), they are called brachial arteries. Below the
elbow these main trunk lines divide into ulnar and radial arteries, which supply the
forearm and eventually form a set of arterial arches in the hand which give rise to
common and proper digital arteries. The descending (dorsal) aorta continues along
the posterior aspect of the thorax giving rise to the segmental intercostals arteries.
After passage "through" (behind) the diaphragm it is called the abdominal aorta.
At the pelvic rim the abdominal aorta divides into the right and left common iliac
arteries. These divide into the internal iliacs, which 36
Copyright © StudyGuideZone.com. All rights reserved.
supply the pelvic organs, and the external iliacs, which supply the lower limb.
b. Venous system. Veins are frequently multiple and variations are common. They
return blood originating in the capillaries of peripheral and distal body parts to the
heart.
Hepatic Portal System
(circulatory system) - ✔Blood draining the alimentary tract (intestines),
pancreas, spleen and gall bladder does not return directly to the systemic
circulation, but is relayed by the hepatic portal system
,of veins to and through the liver. In the liver, absorbed foodstuffs and wastes are
processed. After processing, the liver returns the blood via hepatic veins to the inferior
vena cava and from there to the heart.
Pulmonary Circuit
(circulatory system) - ✔blood is oxygenated and depleted of metabolic products such as CO2 in
the lungs
Lymphatic Drainage
(circulatory system) - ✔A network of lymphatic capillaries permeates the body
tissues. Lymph is a fluid similar in composition to blood plasma, and tissue fluids not
reabsorbed into blood capillaries are transported via the lymphatic system
eventually to join the venous system at the junction of the left internal jugular and
subclavian veins.
Heart - ✔pumps 72 times per minute and propels about 4,000 gals (about 15,000 liters) of blood
daily to the tissues.
Composed of:
Endocardium (lining; epithelium) Myocardium
(mid coat; cardiac muscle)
Epicardium (external coat or visceral layer of pericardium; epithelium and mostly connective tissue)
Impulse conducting system
Cardiac Nerves - ✔Modification of the intrinsic rhythmicity of the heart muscle is produced by
cardiac nerves of the sympathetic and parasympathetic nervous system. Stimulation of the sympathetic
system increases the rate and force of the heartbeat and dilates the coronary arteries.
Cardiac Cycle - ✔alternating contraction and relaxation is repeated about 75 times per minute;
the duration of one cycle is about 0.8 secs.
Three phases succeed one another during the cycle:
a) atrial systole: 0.1 second
b) ventricular systole: 0.3 second
c) diastole: 0.4 second
Blood - ✔Blood volume= 5 or 6 liters (7% of body wt)
Plasma constitutes about 55% of blood volume and cellular elements about 45%
Cardiogenic Shock - ✔heart is unable to meet the demands of the body. This can be caused by
conduction system failure or heart muscle dysfunction.
Sx: rapid breathing, rapid pulse, anxiety, nervousness, thread pulse, mottled skin color, profuse sweating,
poor capillary refill
,Tx: Amrinone, norepinephrine, dobutamine, IV fluids, PTCA, Extreme cases- pacemaker, IABP
Tests: nuclear scans, electrocardiogram, echocardiogram, electrocardiogram, ABG, Chem-7, chem-
20, electrolytes, cardiac enzymes
Aortic Insufficiency - ✔heart valve disease that prevents the aortic volve from closing completely.
Backflow of blood into the left ventricle.
Cx: Rheumatic fever, congenital abnormalities, endocarditis, marfan's syndrome, ankylosing spondylitis
Reiter's Syndrome - ✔type of reactive arthritis that happens as a reaction to a bacterial
infection in the body.
Sx: fainting, weekness, bounding pulse, angina on occasion, SOB, fatigue
Tests: palpation, increase pulse pressure and diastolic pressure, pulmonary edema present, auscultation,
left heart cath, aortica angiography, dopper US, Echocardiogram
Tx: digoxin, dieuretics, surgical aorta valve repair
Monitor for: PE, Left-sided HF, Endocarditis
Hypovolemic Shock - ✔poor blood volume prevents the heart from pumping enough blood to the
body
Cx: trauma, diarrhea, burns, GI bleeding
Cardiogenic shock - ✔enough blood is available, however the heart is unable to move the blood in
an effective manner
Sx: anxiety, weakness, sweating, rapid pulse, confusion, clammy skin
Tests: CBC, echocardiogram, CT scan, endoscopy, CT scan, endoscopy c GI bleeding, swan-ganz cath
Tx: increase fluids via IV, Avoid hypothermia, epinephrine, norepinephrine, dobutamine, dopamine
Myocarditis - ✔inflammation of the heart muscle
Cx: bacterial or viral infections, polio, adenovirus, coxsackie, virus
, Sx: Leg edema, SOB, Viral symptoms, joint pain, syncope, HA (pain), fever, unable to lie flat, irregular
heart beats
Tests: CXR, echocardiogram, ECG, WBC & RBC count, blood cultures
Tx: Diuretics, pacemaker, antibiotics, steroids
Monitor for: pericarditis, cardiomyopathy
Heart valve infection - ✔endocarditis, probable valvular heart disease. Can be caused by fungi or
bacteria
Sx: weakness, fever, murmur, SOB, Night sweats, joint pain, janeway lesions
Tests: CBC, ERS, ECG, blood cultures, enlarged spleen, presence of splinter, hemorrhages,
Tx: IV antibiotics, surgery may be indicated
Monitor for: Jaundice, arrhythmias, CHF, Glomerulonephritis, emboli
Pericarditis - ✔inflammation of the pericardium
Cx: viral (coxsackie, adenovirus, influenza, rubella viruses), bacteria (various microorganisms), fungi,
surgery, of often associated with TB, renal failure, AIDS, and autoimmune disorders
Sx: dry cough, pleuritis, fever, anxiety, crackles, pleural effusion, LE swelling, chest pain, unable to lie
down flat
Tests: auscultation, MRI scan, CT scan, echocardiogram (key test), ESR, CXR, blood cultures, CBC
Tx: NSAIDS, Pericardiocentesis, analgesics, pericardiectomy
Monitor for: constrictive pericarditis, A fib, Supraventicular tachycardia (STV)
Arrhythmias - ✔irregular heart beats and rhythms disorder
Types:
Bradycardia, Tachycardia, ventricular fib, ectopic heart beat, ventricular tachycardia, woldd-
parkinson-white syndrome, atrial fib, sick sinus syndrome, sinus tachy, sinus brady
Sx: SOB, Fainting, Palpitations, dizziness, chest pain, irregular pulse
