NCLEX Cardiovascular System Master Review Flashcards

Comprehensive flashcards for NCLEX preparation focused on the cardiovascular system, including anatomy, ECG interpretation, hemodynamics, disease processes, and nursing pharmacology.

In the context of the NCLEX, what is the policy regarding the delegation of cardiovascular assessment (auscultating heart sounds or interpreting ECGs) to unlicensed assistive personnel (UAP)?

Assessment and interpretation are the responsibility of the RN and should never be delegated to a UAP.

When a patient presents with a new or changing cardiovascular symptom, such as dropping blood pressure or a new dysrhythmia, who is responsible for the nursing assessment according to NCLEX guidelines?

The RN is responsible for the assessment; these tasks should not be assigned to a UAP or LPN/PN.

What is the correct sequence of blood flow through the heart and lungs?

Vena cava $\rightarrow$ Right atrium $\rightarrow$ Tricuspid valve $\rightarrow$ Right ventricle $\rightarrow$ Pulmonic valve $\rightarrow$ Pulmonary artery $\rightarrow$ Lungs $\rightarrow$ Pulmonary veins $\rightarrow$ Left atrium $\rightarrow$ Mitral valve $\rightarrow$ Left ventricle $\rightarrow$ Aortic valve $\rightarrow$ Aorta $\rightarrow$ Body.

If the heart's natural pacemaker, the SA node, fails, at what rate will the AV node typically initiate impulses?

$$40–60\,bpm$$

What is the typical intrinsic pacing rate of the ventricles (idioventricular rhythm) if both the SA and AV nodes fail?

$$20–40\,bpm$$

What clinical condition is indicated by a prolonged PR interval (>$0.20\,sec$) on an ECG?

AV block.

What does a QRS complex duration of >$0.12\,sec$ indicate on an ECG?

A bundle branch block, indicating impaired ventricular conduction.

What symptoms are characteristic findings in Right-sided heart failure?

Systemic edema, including jugular venous distension (JVD) and peripheral edema.

What symptoms are characteristic findings in Left-sided heart failure?

Pulmonary congestion, including crackles and dyspnea.

What level of urine output is considered an NCLEX red flag for decreased cardiac output?

<$30\,mL/hr$

How does tachycardia affect coronary perfusion?

Tachycardia shortens diastolic filling time, which reduces the time coronary arteries have to perfuse the heart, potentially worsening ischemia.

What are the timing and measurement values for one small square and one large square on an ECG grid?

A small square represents $0.04\,sec$ horizontal / $1\,mm$ vertical. A large square represents $0.20\,sec$ horizontal / $5\,mm$ vertical.

What does peaked T waves typically represent on an ECG?

Hyperkalemia.

What ECG findings constitute a ST-elevation myocardial infarction (STEMI) requiring immediate protocol activation?

ST elevation $\ge 1\,mm$ in $\ge 2$ contiguous leads.

What is the first-line medication treatment for symptomatic or unstable sinus bradycardia?

IV atropine $0.5–1\,mg$.

What is the nursing priority when a patient presents with sinus tachycardia?

Identify and treat the underlying cause (e.g., pain, fever, hypovolemia) rather than using antiarrhythmics.

What patient education is required for a patient with stable angina prescribed sublingual nitroglycerin regarding emergency care?

Call 911 if chest pain is not relieved by $3$ nitroglycerin tablets taken over $15\,min$.

Compare the assessment findings of Peripheral Artery Disease (PAD) versus Peripheral Venous Disease.

PAD presents with the 5 P's (Pain, Pallor, Pulselessness, Paresthesia, Paralysis), cool/pale skin, and non-healing wounds. Venous disease presents with edema, warmth, redness, and varicosities.

What are the gold standard biomarkers for evaluating Acute Coronary Syndrome (ACS), and what is the required timing for draws?

High-sensitivity troponin (hs-cTn) draws at $0$ and $1–3\,hours$.

What are the nursing priorities for a patient following a cardiac catheterization via the femoral approach?

Monitor the access site for bleeding or hematoma, assess neurovascular status of the extremity, keep the extremity flat, and monitor for retroperitoneal bleed.

What is the classic triad of symptoms for Digoxin toxicity?

Nausea/vomiting, bradycardia, and visual disturbances, such as yellow-green halos.

What electrolyte imbalance increases the risk of Digoxin toxicity and must be checked before administration?

Hypokalemia.

What is the primary NCLEX priority assessment for patients prescribed ACE Inhibitors like Lisinopril?

Monitor for hyperkalemia ($K^+$), renal function, and a dry cough.

What is a major contraindication for ARBs (Angiotensin II Receptor Blockers) like Losartan?

Pregnancy, as they are teratogenic.

Under what conditions should a nurse hold a Beta Blocker such as Metoprolol?

If HR is <$60\,bpm$ or SBP is <$90\,mmHg$.