AN 3: NUR 325
Unit 1: CV Exam Blueprint
Most missed for exam: Nursing priorities cardioversion, PEA nursing priority, s/s HF (right,
left, mixed), effects/indications of NTG, CAD risk factors, Nursing interventions angina clients,
hemodynamic lines normal values and what diseases would cause elevations, PTCA inditcations
- glucose intolerance
- 16 mmHg
- PRBC for GI bleed
- relevel stopcock w position changes
-
This test is 60 questions in total. Questions require critical thinking regarding the disease
process, priority nursing intervention, anticipated provider orders, and expected patient response
to all interventions.
● Type of questions: multiple choice, select all that apply, fill in the blank, Case
study with fill in the blank
25 questions on EKG and TREATMENT and PRIORITY
For each disease:
● Nursing considerations, priority nursing interventions & expected patient responses, and
clinical manifestations.
Medications:
● Side effects, mechanism of action, and nursing considerations
Notes from class:
● Quizzes 8/29 and 9/5 -10 points each
● Mitral valve regurgitation you would hear a blowing murmur sound at the apex of the
heart
o Apex of the heart: left midclavicular intercostal space during systole (5th)
● Aortic regurgitation pts would have a widened pulse pressure and shortness of breath
● The A line is measuring blood pressure- invasive way of measuring BP- good to compare
to normal BP
● The A line can also draw blood
● Complication of an A line- thrombosis/embolism, hemorrhage, infection
I AN3 1
, ● 3 things that helps our heart maintain an adequate cardiac output: preload, afterload,
contractility
● Preload can be increased by hypervolemia/ anything that increases the blood volume-
edema, HF, mitral stenosis and regurgitation
● Afterload can be increased by aortic stenosis and systemic hypertension
Hemodynamic Lectures: 10 questions
● Heart valve disease- Mitral and atrial:
o Stenosis and regurgitation
▪ REGURGITATION- valves don’t close properly, blood flow backward
▪ STENOSIS- valves don’t open completely, blood flow is reduced,
“kinked hose”, narrowing
▪ Mitral = 5th midclavicular line intercostal space
▪ Aortic
● Stenosis = 2nd R intercostal space
● Regurg = L sternal border intercostal 3-4
▪ Mitral Regurgitation
● Blood flows from left ventricle back into the left atrium during
systole
● Valve leaflets don’t close completely
● May be chronic or less commonly acute
● Common causes: degenerative changes mitral valve, ischemia of
left ventricles and rheumatic heart disease
● Other causes: infective endocarditis, lupus, cardiomyopathy, and
ischemic heart disease
▪ Mitral Stenosis
● Reduced blood flow from left atrium into left ventricle
● Causes – rheumatic endocarditis
● Valve orifice narrows- increased resistance – left atrium less able
to push blood into left ventricle
I AN3 2
, ● Over time left atrial hypertrophy and dilation
● Decreased blood flow causes decreased cardiac output &
pulmonary pressures increase.
● can turn into a fib
▪ Aortic Regurgitation
● Backward flow blood into the left ventricle from the aorta during
diastole
● Over time left ventricle hypertrophies
● Causes- congenital valve abnormality, inflammatory lesions, or
dilatation of aorta
● Also from infections- rheumatic endocarditis/syphilis or dissecting
aortic aneurysm, blunt trauma, or deterioration replaced aortic
valve
● Expect an increase in systolic BP- trying to expel more blood
against the force, reduces diastolic BP- widened pulse pressure
▪ Aortic Stenosis
● Narrowing of orifice between left ventricle and aorta
● Adults caused by degenerative calcification
● Rheumatic endocarditis may cause adhesions and stiffening
● Gradual progression of left ventricle wall hypertrophy
● When compensatory mechanisms fail develop signs of heart failure
● Will develop signs and symptoms of HF
o Assessment & complications atrial/mitral stenosis and or regurgitation
▪ Mitral Regurgitation
● Clinical Manifestations
o Chronic often asymptomatic
o Acute- resulting from myocardial infection- manifests as
sudden CHF
o Symptoms: dyspnea, fatigue, weakness, palpitations, SOB
on exertion and cough (pulmonary congestion)
o Systolic murmur blowing sound apex, regular or irregular
pulses
I AN3 3
Unit 1: CV Exam Blueprint
Most missed for exam: Nursing priorities cardioversion, PEA nursing priority, s/s HF (right,
left, mixed), effects/indications of NTG, CAD risk factors, Nursing interventions angina clients,
hemodynamic lines normal values and what diseases would cause elevations, PTCA inditcations
- glucose intolerance
- 16 mmHg
- PRBC for GI bleed
- relevel stopcock w position changes
-
This test is 60 questions in total. Questions require critical thinking regarding the disease
process, priority nursing intervention, anticipated provider orders, and expected patient response
to all interventions.
● Type of questions: multiple choice, select all that apply, fill in the blank, Case
study with fill in the blank
25 questions on EKG and TREATMENT and PRIORITY
For each disease:
● Nursing considerations, priority nursing interventions & expected patient responses, and
clinical manifestations.
Medications:
● Side effects, mechanism of action, and nursing considerations
Notes from class:
● Quizzes 8/29 and 9/5 -10 points each
● Mitral valve regurgitation you would hear a blowing murmur sound at the apex of the
heart
o Apex of the heart: left midclavicular intercostal space during systole (5th)
● Aortic regurgitation pts would have a widened pulse pressure and shortness of breath
● The A line is measuring blood pressure- invasive way of measuring BP- good to compare
to normal BP
● The A line can also draw blood
● Complication of an A line- thrombosis/embolism, hemorrhage, infection
I AN3 1
, ● 3 things that helps our heart maintain an adequate cardiac output: preload, afterload,
contractility
● Preload can be increased by hypervolemia/ anything that increases the blood volume-
edema, HF, mitral stenosis and regurgitation
● Afterload can be increased by aortic stenosis and systemic hypertension
Hemodynamic Lectures: 10 questions
● Heart valve disease- Mitral and atrial:
o Stenosis and regurgitation
▪ REGURGITATION- valves don’t close properly, blood flow backward
▪ STENOSIS- valves don’t open completely, blood flow is reduced,
“kinked hose”, narrowing
▪ Mitral = 5th midclavicular line intercostal space
▪ Aortic
● Stenosis = 2nd R intercostal space
● Regurg = L sternal border intercostal 3-4
▪ Mitral Regurgitation
● Blood flows from left ventricle back into the left atrium during
systole
● Valve leaflets don’t close completely
● May be chronic or less commonly acute
● Common causes: degenerative changes mitral valve, ischemia of
left ventricles and rheumatic heart disease
● Other causes: infective endocarditis, lupus, cardiomyopathy, and
ischemic heart disease
▪ Mitral Stenosis
● Reduced blood flow from left atrium into left ventricle
● Causes – rheumatic endocarditis
● Valve orifice narrows- increased resistance – left atrium less able
to push blood into left ventricle
I AN3 2
, ● Over time left atrial hypertrophy and dilation
● Decreased blood flow causes decreased cardiac output &
pulmonary pressures increase.
● can turn into a fib
▪ Aortic Regurgitation
● Backward flow blood into the left ventricle from the aorta during
diastole
● Over time left ventricle hypertrophies
● Causes- congenital valve abnormality, inflammatory lesions, or
dilatation of aorta
● Also from infections- rheumatic endocarditis/syphilis or dissecting
aortic aneurysm, blunt trauma, or deterioration replaced aortic
valve
● Expect an increase in systolic BP- trying to expel more blood
against the force, reduces diastolic BP- widened pulse pressure
▪ Aortic Stenosis
● Narrowing of orifice between left ventricle and aorta
● Adults caused by degenerative calcification
● Rheumatic endocarditis may cause adhesions and stiffening
● Gradual progression of left ventricle wall hypertrophy
● When compensatory mechanisms fail develop signs of heart failure
● Will develop signs and symptoms of HF
o Assessment & complications atrial/mitral stenosis and or regurgitation
▪ Mitral Regurgitation
● Clinical Manifestations
o Chronic often asymptomatic
o Acute- resulting from myocardial infection- manifests as
sudden CHF
o Symptoms: dyspnea, fatigue, weakness, palpitations, SOB
on exertion and cough (pulmonary congestion)
o Systolic murmur blowing sound apex, regular or irregular
pulses
I AN3 3
