NSG 6001 FINAL EXAM STUDY GUIDE
Abdominal Aneurysm
1. Causes: Know the causes of an abdominal aortic aneurysm.(493)
a. The proposed cause of AAA includes atherosclerosis, inflammation, mycotic
infection, inheritable connective tissue disorder, and trauma
2. Risk factors: Understand risk factors for abdominal aortic aneurysm. (493)
a. risk factors for AAA include atherosclerotic vascular disease, white race, male
gender, advance, hypertension, hypercholesterolemia, smoking, chronic obstructive
pulmonary disease (COPD), history of hernias, family history of AAA, and
presence of other aneurysms
3. Saccular: What is a Saccular Abdominal Aneurysm? (494)
a. A saccular aneurysm is an asymmetric weakness or bleb on the side of the aorta.
These defects result from trauma or an internal wall defect caused by an ulcer
4. Symptoms: Know the symptoms of an abdominal aortic aneurysm. (494)
a. In thin patients, a supine abdominal examination may readily show a pulsatile
abdominal mass.
b. Chronic abdominal or back pain, ureteral obstruction
CAD - Coronary Artery Disease
5. Flow: Understand the coronary flow related to CAD.
a. CAD exist when coronary arteries are narrowed by atherosclerotic plaque
formation, plaque rupture, or spasm. This narrowing impedes coronary blood flow,
resulting in hypoperfusion of the myocardium.
b. The hypoperfusion produces first diastolic, and then systolic dysfunction, with
characteristic signs and symptoms, including chest pain.
c. Typical ECG changes of ischemia result, although the ST-segment and T-wave
changes that are central to demonstration of ischemia occur relatively late in the
ischemic cascade.
6. Test: What diagnostic test is used for CAD? (488)
a. The standard 1st line approach to initial testing is exercise stress test, or ETT. The
patient is attached to a 12-lead electrocardiogram is continuously monitored during
graded exercise. The bicycle and treadmill are the two most often used.
b. Myocardial perfusion imaging, or MPI, offers a method of visualizing blood
flow to the heart by injection of a radioactive cardiac-specific tracer. This improves
the diagnostic accuracy of a stress test because it gives another method of detecting
perfusion defects aside from measuring ST depression on the electrocardiogram. It
, is used when baseline ECG abnormality that would interfere with measurement of
stress-induced ST-segment changes, such as left ventricular hypertrophy, bundle
branch blocks, and digoxin use. MPI is also a useful tool for use with high-risk
diabetic patients. Thallium chloride T1 01 and technetium Rc 99m sestamibi are
the radiopharmaceutical agents used for the detection of CAD in MPI
c. Cardiac Magnetic Resonance Imaging (MRI) with further technologic
refinement, anticipated to provide accurate data to distinguish between stable and
unstable plague and to assist with quantifying CAD, replacing the diagnostic
cardiac catherization
d. Exercise echocardiography images enhance the sensitivity and specificity of
CAD detection to an extent comparable to the provided by nuclear techniques. The
2DE evidence for ischemia includes an abnormal left ventricular ejection fraction
(LVEF) response to exercise or the development of regional wall motion
abnormalities. The exercise is performed with bicycle or treadmill, and dobutamine
is the most common pharmacologic agent used simultaneously with the
echocardiography imaging. The image quality may be enhanced by the injection of
echogenic microbubbles.
7. Values: What predictive value does a significant ST-segment elevation have for
CAD? (488)
a. Significant elevation on the ST-segment has minimal predictive valve for CAD
Cardiovascular
8. Afib: Study atrial fibrillation and at what age is it more common.
a. A-fib is the most common sustained cardiac rhythm disturbance, more common in
men and increasing in prevalence with age. It is estimated that 2.3 million
Americans have a-fib, and more commonly occurs after the age of 60.
9. Arrhythmias: Where do most arrhythmias occur in the heart?
a. More than 50% of all cardiac arrhythmias arise from or involve the atria
10. Atrial: Atrial arrhythmia treatment
a. Sotalol to manage a-fib
b. Digoxin assist in rate control
c. Electrical and pharmacologic cardioversion
d. Anticoagulation therapy to reduce thromboembolism risk associated with
cardioversion
e. AV nodal ablation or modification, and pacemaker implantation
f. Pulmonary vein isolation
11. Bradycardia: Symptomatic bradycardia
a. Symptomatic bradycardia is defined as a documented bradyarrhythmia that is
directly responsible for the development of frank syncope, or near-syncope,
transient dizziness, or lightheadedness and confusion states resulting from
Abdominal Aneurysm
1. Causes: Know the causes of an abdominal aortic aneurysm.(493)
a. The proposed cause of AAA includes atherosclerosis, inflammation, mycotic
infection, inheritable connective tissue disorder, and trauma
2. Risk factors: Understand risk factors for abdominal aortic aneurysm. (493)
a. risk factors for AAA include atherosclerotic vascular disease, white race, male
gender, advance, hypertension, hypercholesterolemia, smoking, chronic obstructive
pulmonary disease (COPD), history of hernias, family history of AAA, and
presence of other aneurysms
3. Saccular: What is a Saccular Abdominal Aneurysm? (494)
a. A saccular aneurysm is an asymmetric weakness or bleb on the side of the aorta.
These defects result from trauma or an internal wall defect caused by an ulcer
4. Symptoms: Know the symptoms of an abdominal aortic aneurysm. (494)
a. In thin patients, a supine abdominal examination may readily show a pulsatile
abdominal mass.
b. Chronic abdominal or back pain, ureteral obstruction
CAD - Coronary Artery Disease
5. Flow: Understand the coronary flow related to CAD.
a. CAD exist when coronary arteries are narrowed by atherosclerotic plaque
formation, plaque rupture, or spasm. This narrowing impedes coronary blood flow,
resulting in hypoperfusion of the myocardium.
b. The hypoperfusion produces first diastolic, and then systolic dysfunction, with
characteristic signs and symptoms, including chest pain.
c. Typical ECG changes of ischemia result, although the ST-segment and T-wave
changes that are central to demonstration of ischemia occur relatively late in the
ischemic cascade.
6. Test: What diagnostic test is used for CAD? (488)
a. The standard 1st line approach to initial testing is exercise stress test, or ETT. The
patient is attached to a 12-lead electrocardiogram is continuously monitored during
graded exercise. The bicycle and treadmill are the two most often used.
b. Myocardial perfusion imaging, or MPI, offers a method of visualizing blood
flow to the heart by injection of a radioactive cardiac-specific tracer. This improves
the diagnostic accuracy of a stress test because it gives another method of detecting
perfusion defects aside from measuring ST depression on the electrocardiogram. It
, is used when baseline ECG abnormality that would interfere with measurement of
stress-induced ST-segment changes, such as left ventricular hypertrophy, bundle
branch blocks, and digoxin use. MPI is also a useful tool for use with high-risk
diabetic patients. Thallium chloride T1 01 and technetium Rc 99m sestamibi are
the radiopharmaceutical agents used for the detection of CAD in MPI
c. Cardiac Magnetic Resonance Imaging (MRI) with further technologic
refinement, anticipated to provide accurate data to distinguish between stable and
unstable plague and to assist with quantifying CAD, replacing the diagnostic
cardiac catherization
d. Exercise echocardiography images enhance the sensitivity and specificity of
CAD detection to an extent comparable to the provided by nuclear techniques. The
2DE evidence for ischemia includes an abnormal left ventricular ejection fraction
(LVEF) response to exercise or the development of regional wall motion
abnormalities. The exercise is performed with bicycle or treadmill, and dobutamine
is the most common pharmacologic agent used simultaneously with the
echocardiography imaging. The image quality may be enhanced by the injection of
echogenic microbubbles.
7. Values: What predictive value does a significant ST-segment elevation have for
CAD? (488)
a. Significant elevation on the ST-segment has minimal predictive valve for CAD
Cardiovascular
8. Afib: Study atrial fibrillation and at what age is it more common.
a. A-fib is the most common sustained cardiac rhythm disturbance, more common in
men and increasing in prevalence with age. It is estimated that 2.3 million
Americans have a-fib, and more commonly occurs after the age of 60.
9. Arrhythmias: Where do most arrhythmias occur in the heart?
a. More than 50% of all cardiac arrhythmias arise from or involve the atria
10. Atrial: Atrial arrhythmia treatment
a. Sotalol to manage a-fib
b. Digoxin assist in rate control
c. Electrical and pharmacologic cardioversion
d. Anticoagulation therapy to reduce thromboembolism risk associated with
cardioversion
e. AV nodal ablation or modification, and pacemaker implantation
f. Pulmonary vein isolation
11. Bradycardia: Symptomatic bradycardia
a. Symptomatic bradycardia is defined as a documented bradyarrhythmia that is
directly responsible for the development of frank syncope, or near-syncope,
transient dizziness, or lightheadedness and confusion states resulting from
