Cardiovascular and Hematologic System Practice Flashcards

This set covers cardiac anatomy, heart failure, valve disease, hematologic assessment, and transfusion protocols from the provided lecture transcript.

What is the first structure blood passes through in the order of flow through the heart?

Superior and inferior vena cava

In the sequence of blood flow through the heart, which valve is located between the right atria and the right ventricle?

Tricuspid valve

After leaving the right ventricle, which valve does the blood pass through?

Pulmonic valve

Blood traveling through the pulmonary arteries is headed toward which organ?

Lungs

Which vessels return oxygenated blood from the lungs back to the left atria?

Pulmonary veins

What is the alternative name for the bicuspid valve?

Mitral valve

Which heart valve allows blood to leave the left ventricle and enter the systemic circulation?

Aortic valve

What are the two specific atrioventricular (AV) valves?

Tricuspid valve (right) and Mitral valve (left)

Which two valves are categorized as semilunar valves?

Pulmonic valve and aortic valve

What does MAP stand for in cardiovascular assessment?

Mean Arterial Pressure

What range of Mean Arterial Pressure ($MAP$) is required to maintain adequate organ perfusion?

Between $60$ and $70\,mm\,Hg$

Which organs are specifically mentioned as being at risk for poor perfusion if $MAP$ is too low?

Brain and kidneys

During the cardiac cycle, which valves close first?

Mitral and tricuspid (AV) valves

What is the term for the phase in the cardiac cycle where the heart muscle contracts but no blood is ejected yet?

Isovolumetric contraction

After the semilunar valves open, what process occurs next?

Ventricular ejection

What mechanical property of the heart is defined by the volume of blood pumped per minute?

Cardiac output ($CO$)

What identifies the amount of blood pumped by the heart in one contraction?

Stroke volume

What term refers to the degree of stretch of the cardiac muscle fibers at the end of diastole?

Preload

What is the pressure the heart must work against to eject blood during systole?

Afterload

Which system delivers oxygen and nutrients to various body tissues?

Arterial system

Why do arteries have thicker walls than veins?

To handle higher pressure and to constrict or contract better

What are the four main systems or components that regulate blood pressure?

Autonomic nervous system, kidneys, endocrine system, and baroreceptors

What is systolic blood pressure?

The pressure during the contraction of the left ventricle

When does diastolic blood pressure occur?

When the left ventricle is relaxing, refilling, and getting ready to contract again

Which receptors in the vessels sense stretching or lack of fullness to stimulate an increase in blood pressure?

Baroreceptors

Which factor most significantly affects preload?

Blood volume

Which factor has the most affect on afterload?

Blood pressure

What is the primary function of the venous system?

To complete circulation of blood by returning it from capillaries to the right side of the heart

What happens to the efficiency of veins as a consequence of aging?

They become less efficient at pushing blood back up to the heart

What change occurs in the sinoatrial ($SA$) node as a person ages?

The number of pacemaker cells decreases

How does aging affect the electrical conduction time in the heart?

The time it takes for electricity to get from place to place increases

What two heart rhythm issues become more common with increased age?

Heart blocks and a-fib (atrial fibrillation)

What anatomical change typically occurs in the left ventricle with age?

It tends to increase in size because it is working harder

How do the aorta and large arteries change with age, affecting blood pressure?

They tend to stiffen, which increases blood pressure

Which ethnic populations are noted to have a higher prevalence of hypertension and vascular related issues?

African-American, Hispanic, and Native American populations

Which serum cardiac enzymes are highly specific to heart damage?

Troponin T and I

What total cholesterol level is generally considered good?

Less than $200\,mg/dL$

Which type of lipid is referred to as 'good cholesterol'?

HDL

What does a CRP laboratory test measure?

Inflammation

What is an INR test used to monitor?

Coagulation

Which diagnostic test uses dye to visualize blockages in the blood vessels?

Angiography (arteriography)

In cardiac catheterization, what system is evaluated during a right-sided procedure?

Venous system

A left-sided cardiac catheterization assesses which system?

Arterial system

What is required regarding food intake before a cardiac catheterization?

The patient must be NPO

How long should a patient remain supine and on bed rest following a cardiac catheterization?

$2$ to $6$ hours

What assessments should the nurse perform if a pedal pulse is weak after a cardiac catheterization?

Assess color and temperature of the extremity

What does a cool or pale extremity signify after a catheterization?

Arterial obstruction

Patients undergoing left-sided cardiac catheterization are at a specific risk for what condition?

CVA (Cerebrovascular Accident/Stroke)

What neurological signs should be monitored in a patient post-left-sided cardiac catheterization?

Slurred speech and confusion

What post-cardiac catheterization occurrence requires prompt nursing action?

Rhythm change

What is the function of an electrophysiologic study ($EPS$)?

To look at the electricity or conductivity of the heart

What are the expected physiologic responses to a stress test?

Increased heart rate and decreased blood pressure

What imaging technique is used to check for heart failure and assess ejection fraction ($EF$)?

Echocardiogram (ultrasound of the heart)

What is the advantage of a transesophageal echocardiogram ($TEE$)?

It allows a view behind the heart and the right side due to its esophageal placement

Why might an MRI scan of the heart ($MNPI$) be contraindicated for some patients?

If the patient has a pacemaker, as it could deactivate it

What occurs to the mitral and aortic valves during the aging process?

Calcification and mucoid degeneration

What heart sound should the nurse assess for in aging patients with valve calcification?

Murmurs

In older adults, increased fibrous tissue and fat are found in which specific heart structure?

The sinoatrial ($SA$) node

What percentage of older adults experience premature ventricular contractions ($PVCs$)?

$$80\%$$

What ECG changes are associated with the stiffening and fibrotic changes of the left ventricle in aging?

Widening QRS complex and a longer QT interval

By how much does the speed of early diastolic filling decrease in the aging left ventricle?

About $50\%$

What is the term for a decrease in blood pressure of $10\,mm\,Hg$ or more when changing positions?

Orthostatic (postural) changes

What teaching is essential for patients with ineffective baroreceptors?

Change positions slowly

Which type of chest pain is sudden, lasts less than $15$ minutes, and is relieved by rest or nitroglycerin?

Angina

What are the characteristics of Myocardial Infarction ($MI$) pain?

Sudden, intense stabbing, viselike pain, often in the early morning, not relieved by rest

What relieves the pain associated with Pericarditis?

Sitting upright, analgesia, or anti-inflammatory agents

Which type of chest pain is described as a moderate ache that worsens on inspiration?

Pleuropulmonary pain

What type of pain is relieved by antacids, food, or a sitting position?

Esophageal-Gastric pain

What are the three major types of heart failure?

Left-sided, right-sided, and high-output

What was Left-sided heart failure formerly known as?

Congestive heart failure

What is considered the 'powerhouse' of the heart?

The left ventricle

Where is the left ventricle located in relation to the heart's anatomy?

At the apex

What is the most common cause of left-sided heart failure?

Uncontrolled hypertension

In the acronym 'LAMB', what does 'Left AV' stand for?

Mitral or Bicuspid valve

If left-sided heart failure causes fluid accumulation, where does the fluid primarily back up?

The lungs (pulmonary edema)

Where does fluid accumulate in right-sided heart failure?

Peripheral tissues (peripheral edema)

In high-output heart failure, is the cardiac output typically low, normal, or high?

Normal or above-normal

What are four hyperkinetic conditions that can lead to high-output heart failure?

Septicemia (sepsis), high fever, severe anemia, and hyperthyroidism

According to the NYHA classification, what characterizes Class IV?

Refractory end-stage heart failure

What effect does a thickened heart muscle have on ventricular filling?

It makes the muscle stiff, leading to less filling and decreased cardiac output

What hormone is released by the heart when the ventricles are stretched by pressure or volume?

B-type natriuretic peptide ($BNP$)

What is the sequence of the body's compensatory cycle for decreased cardiac output?

$SNS$ activation $\rightarrow$ $RAAS$ activation $\rightarrow$ vasoconstriction and fluid retention

Right-sided heart failure in the absence of left-sided failure is often the result of what?

Pulmonary problems

Heart failure is more common in which group under the age of $50$?

Black individuals

What does PAWP stand for in hemodynamic monitoring?

Pulmonary artery wedge pressure

What positions should a dyspneic patient be placed in to improve gas exchange?

High Fowler’s

To improve gas exchange, the nurse should maintain the patient's oxygen saturation above what percentage?

$$90\%$$

How do ACE inhibitors work to treat heart failure?

They prevent Angiotensin I from converting to Angiotensin II, reducing vasoconstriction

Lisinopril is an example of which drug class?

ACE Inhibitor

How do Angiotensin II Receptor Blockers ($ARBs$) differ from ACE inhibitors in their mechanism?

They block the receptors themselves rather than the formation of Angiotensin II

Valsartan and Losartan are examples of what medication class?

Angiotensin II Receptor Blockers ($ARBs$)

What is the specific goal of using ARNIs in heart failure?

To prevent the harmful effects of Angiotensin and reduce afterload

What should the nurse observe for in an older adult taking loop diuretics?

Signs of dehydration like acute confusion and decreased urinary output

Which medications are examples of venous vasodilators used to decrease preload?

Nitrates and nitroglycerin

What is a common side effect of nitroglycerin resulting from vasodilation?

Headache

Spironolactone is categorized as what type of diuretic?

Aldosterone antagonist (potassium-sparing)

Which diuretic is a non-potassium-sparing medication that can cause hypokalemia?

Furosemide (Lasix)

What is the suffix usually associated with beta blockers?

-olol

What vital signs must the nurse check before administering a beta blocker?

Heart rate and blood pressure

What are the signs of digoxin toxicity?

Fatigue, muscle weakness, confusion, and loss of appetite