NR 507 Week 2 Assignment; Cardiovascular Disorders

• Question: Coronary artery disease (CAD) is mainly the result of: • Question: Which of the following statements correctly describes the flow of blood between the heart and lungs: • Question: Which of the following is a non-modifiable risk factor for Coronary Artery Disease? • Question: Which of the following is a modifiable risk factor for Coronary Artery Disease (CAD)? • Question: In Coronary Artery Disease (CAD), pumping ability of the heart can be impaired due to the deprivation of oxygen. • Question: Identify whether each risk factor of coronary artery disease is modifiable or non-modifiable. • Question: The most common cause of right-sided heart failure is: • Question: In the healthy heart, the response to an increase in preload is for the stroke volume to increase. • Question: Which of the following conditions can decrease preload? • Question: CorPulmonale is: • Question: Hypertension has its most immediate effect on: • Question: Determine if the list of issues are associated with right-sided or left-sided heart failure and select the appropriate type of heart failure. • Question: Correctly match each class of heart failure to their proper description • Question: Correctly match each stage of heart failure to their proper description. • Question: The patient with aortic regurgitation would most likely present with: • Question: The patient with aortic stenosis would most likely present with: • Question: A patient with mitral regurgitation would most likely present with • Question: A patient with mitral stenosis would most likely present with: Review each patient scenario below for the presenting signs and symptoms to determine the type of heart valve disease prevalent for that patient. Question1/4 A 64-year old female reports to the primary care office with a complaint of“fainting”. She reported that the episode occurred while she was engaged inher usual low impact aerobics class.She also noticed, for the first time,during exercise that her heart “hurt”. The NP conducts a symptom analysis ofthechestpainanddeterminedthatthepatientdescribesitaschestpressure.The patient reports no dyspnea with exercise and denies orthopnea orparoxysmal nocturnal dyspnea. On examination, the NP notes that all vitalsigns are normal, lungs are clear to auscultation; There is a laterallydisplaced, sustained apical impulse and a grade 4/6 mid-systolic crescendo-decrescendomurmur,heardloudestatthebaseandradiatingtotheneck. There is also an S4 gallop. no peripheral edema noted.There is a laterallydisplaced,sustainedapicalimpulseandagrade4/6mid-systoliccrescendo-decrescendomurmur,heardloudestatthebaseandradiatingtotheneck. ThereisalsoanS4gallop.TheNPperformsanECGintheofficeanddiscovers left ventricularhypertrophy. Question2/4 A 60-year old male reports to the primary care office with “shortness of breath”that started a few days after being released from the hospital followingangioplastyandstentplacement.Uponexam,theNPobservesthat the patient does have dyspnea and jugular vein distention. Crackles are alsonoted in lung bases bilaterally. A blowing holosystolic murmur is also heard attheheart’s apexwithradiation intotheaxilla. Question3/4 Awomanbringsher67-yearoldfathertoseetheNPattheprimarycareclinic.The patient reports that he has experienced shortness of breath for the lasttwomonthsthathascontinuedtogetprogressivelyworse.Heexpressesgreat concern that this development has kept him from participating in hisSilver Sneaker’s program that he enjoys with his friends. He reports that hecanbarelywalkacityblockorwalkupthestairsinhishomewithoutbecoming short of breath.Upon exam, the NP notes a blood pressure of180/58 mmHg and peripheral pulses are palpable at 4+. The cardiac examrevealsseveralmurmurs:anearlydiastolicmurmurthatishigh-pitchedlocated loudest at the left lower sternal border; a diastolic rumbling soundheardatthe heart’sapexanda systoliccrescendo-decrescendo murmurheard at the left upper sternal border. A chest x-ray is performed at the officeandshowspulmonary edemaandcardiomegaly. Question4/4 A 40-year old male reports to the primary care office with a chief complaint ofdyspnea, especially with activity, over the last 5 days. He also notices thatseveral times during the last two days that he could feel his heart “poundingand racing”.On collecting the medical history, the patient indicates that hehadrheumaticheartdiseaseasayoungchildbutrememberslittleaboutit.Onexam, the NP determines that he is tachycardic with a heart rate of 120beats/minute that is irregularly irregular. A low-pitched murmur is alsoauscultated and is heard most prominently at the apex. The NP also notesjugular vein distention (JVD) and bilateral crackles in the lung bases. The NPperforms an ECG in the office that reveals atrial fibrillation and left atrialhypertrophy.