NSG-4100 EXAM 3 100% correct
when the heart contracts to pump blood systole
out(depolarization)
the heart relaxes after Diastole
contraction(repolarization)
volume of blood ejected duringventricular Stroke volume
contraction
amount of blood the heartpumps from each Cardiac output
ventricle per minutemeasured in liters
per minute
amount of ventricular stretch at the end Preload
ofdiastole.
-initial stretching of the ventricles prior YOU CAN GIVE FLUIDS TO INCREASE THIS
tocontraction.
-the heart loading up for the next big
squeeze of the ventricles during systole.
,(systemic vascular resistance Afterload
(SVR):amount of resistance the heart
must overcome toopen the aortic valve VASOCONSTRICTION can increase this
and push the blood volumeout into the
systemic circulation.
Measurement of the vena cava or Central Venous Pressure
rightatrium and reflects the filling
pressure ofthe right ventricle (preload)
right arterial pressure
• CVP > 6 mm Hg indicates an Central Venous Pressure
elevated rightventricular preload.
(Hypervolemic)
• CVP < 2 mm Hg indicates
reduced right ventricular preload
(hypovolemic)
- Used to obtain direct and continuous Arterial Blood Pressure
BP measurements
- Frequent ABG measurements and
blood samples.
Assess left ventricular function: Pulmonary Artery Pressure
- Right atrial pressure
- Pulmonary artery pressure
- Pulmonary artery wedge pressure
What do you not infuse into the Dextrose
monitoring systems?
Bathing with monitoring systems - Do not submerge the catheter site in water
- Showering is permitted if the catheter andrelated tubing
are placed in an impermeablecover.
• Abnormal fast heart rate of Sinus Tachycardia
more than 100beats per minute:
.- Compensatory response to increased
demandfor cardiac output or reduced
stroke volume.
- Sympathetic activation
- Decreased parasympathetic activity
Greater than 100 but less than 120 BPM
What is a complication of the monitoring Pneumothorax
Infection
air embolism
,Cause of Sinus Tachycardia • Fever
• Hyperthyroidism
• Pain
• Increased metabolism
• Low blood pressure
• Hypoxia
Sinus tachycardia nursing interventions Assess for cause
Preform vegal
manuvers
What meds can you give for CCB (adenosine)
sinus tachycardia Beta Blockers (Propanalol)
What can cause Sinus bradycardia? - Increased parasympathetic activity
- Sleep
- Drugs
- Increased Stroke Volume
- HTN
- Physically Trained Individuals
Less than 60 BPM Sinus Bradycardia
Medications for bradycardia Atropine
Dopamine
(infusion)
Epinephrine
(infusion)
Completely disorganized and irregularatrial Atrial Fibrillation
rhythm accompanied by an
irregularventricular rhythm of variable
rate
Atrial depolarizations are blocked at the
AVNode, with a few reaching the ventricles
andinitiating ventricular contractions.
Causesthe atria to quiver rather than
contractforcefully
Atrial and ventricle rates during a fib Atrial rate is300 to 600 bpm; ventricular rate is
usually120 to 200 bpm in untreated atrialfibrillation
P wave during A Fib No discernible P waves, Cannot bemeasured, Irregular, and
shape are referredas fibrillatory waves
, Etiology of A Fib - Increasing age
- Hypertension
- Diabetes
- Obesity
- Valvular heart disease
- Heart failure
- Obstructive sleep apnea
- Alcohol consumption
—moderate (1-3drinks/day) and high
- Cardiac ischemia
- Cardiac inflammatory disease
(pericarditis,myocarditis,amyloidosi
s)
- Myocardialhypertrophy, fibrosis, or dilation
- Atrial remodeling- Postoperative cardiac surgery
S/S of A Fib • Some patients are asymptomatic
• Palpitations• Heart Failure
• Shortness of Breath
• Hypotension
• Dyspnea on Exertion
• Fatigue
What is there a risk for in A Fib Thrombus formation
As the nurse, what do you want the INR to 2.0-3.0
stay at?
A Fib treatment Prevent emboli
events
Cardioversion
Catheter ablation
Regular atrial impulse at a ratebetween A flutter
250 and 400 bpm
Atrial flutter treatment Adenosine
antithrombin therapy
electric cardioversion
• The absence of impulse Asystole
initiation in theheart results in
electrical asystole.
• Results in zero cardiac output
Cause of Asystole • MI
• Electrical Shock
• Electrolyte Disturbances
• Acidosis
• Parasympathetic Activity
when the heart contracts to pump blood systole
out(depolarization)
the heart relaxes after Diastole
contraction(repolarization)
volume of blood ejected duringventricular Stroke volume
contraction
amount of blood the heartpumps from each Cardiac output
ventricle per minutemeasured in liters
per minute
amount of ventricular stretch at the end Preload
ofdiastole.
-initial stretching of the ventricles prior YOU CAN GIVE FLUIDS TO INCREASE THIS
tocontraction.
-the heart loading up for the next big
squeeze of the ventricles during systole.
,(systemic vascular resistance Afterload
(SVR):amount of resistance the heart
must overcome toopen the aortic valve VASOCONSTRICTION can increase this
and push the blood volumeout into the
systemic circulation.
Measurement of the vena cava or Central Venous Pressure
rightatrium and reflects the filling
pressure ofthe right ventricle (preload)
right arterial pressure
• CVP > 6 mm Hg indicates an Central Venous Pressure
elevated rightventricular preload.
(Hypervolemic)
• CVP < 2 mm Hg indicates
reduced right ventricular preload
(hypovolemic)
- Used to obtain direct and continuous Arterial Blood Pressure
BP measurements
- Frequent ABG measurements and
blood samples.
Assess left ventricular function: Pulmonary Artery Pressure
- Right atrial pressure
- Pulmonary artery pressure
- Pulmonary artery wedge pressure
What do you not infuse into the Dextrose
monitoring systems?
Bathing with monitoring systems - Do not submerge the catheter site in water
- Showering is permitted if the catheter andrelated tubing
are placed in an impermeablecover.
• Abnormal fast heart rate of Sinus Tachycardia
more than 100beats per minute:
.- Compensatory response to increased
demandfor cardiac output or reduced
stroke volume.
- Sympathetic activation
- Decreased parasympathetic activity
Greater than 100 but less than 120 BPM
What is a complication of the monitoring Pneumothorax
Infection
air embolism
,Cause of Sinus Tachycardia • Fever
• Hyperthyroidism
• Pain
• Increased metabolism
• Low blood pressure
• Hypoxia
Sinus tachycardia nursing interventions Assess for cause
Preform vegal
manuvers
What meds can you give for CCB (adenosine)
sinus tachycardia Beta Blockers (Propanalol)
What can cause Sinus bradycardia? - Increased parasympathetic activity
- Sleep
- Drugs
- Increased Stroke Volume
- HTN
- Physically Trained Individuals
Less than 60 BPM Sinus Bradycardia
Medications for bradycardia Atropine
Dopamine
(infusion)
Epinephrine
(infusion)
Completely disorganized and irregularatrial Atrial Fibrillation
rhythm accompanied by an
irregularventricular rhythm of variable
rate
Atrial depolarizations are blocked at the
AVNode, with a few reaching the ventricles
andinitiating ventricular contractions.
Causesthe atria to quiver rather than
contractforcefully
Atrial and ventricle rates during a fib Atrial rate is300 to 600 bpm; ventricular rate is
usually120 to 200 bpm in untreated atrialfibrillation
P wave during A Fib No discernible P waves, Cannot bemeasured, Irregular, and
shape are referredas fibrillatory waves
, Etiology of A Fib - Increasing age
- Hypertension
- Diabetes
- Obesity
- Valvular heart disease
- Heart failure
- Obstructive sleep apnea
- Alcohol consumption
—moderate (1-3drinks/day) and high
- Cardiac ischemia
- Cardiac inflammatory disease
(pericarditis,myocarditis,amyloidosi
s)
- Myocardialhypertrophy, fibrosis, or dilation
- Atrial remodeling- Postoperative cardiac surgery
S/S of A Fib • Some patients are asymptomatic
• Palpitations• Heart Failure
• Shortness of Breath
• Hypotension
• Dyspnea on Exertion
• Fatigue
What is there a risk for in A Fib Thrombus formation
As the nurse, what do you want the INR to 2.0-3.0
stay at?
A Fib treatment Prevent emboli
events
Cardioversion
Catheter ablation
Regular atrial impulse at a ratebetween A flutter
250 and 400 bpm
Atrial flutter treatment Adenosine
antithrombin therapy
electric cardioversion
• The absence of impulse Asystole
initiation in theheart results in
electrical asystole.
• Results in zero cardiac output
Cause of Asystole • MI
• Electrical Shock
• Electrolyte Disturbances
• Acidosis
• Parasympathetic Activity
