Cardiopulm Nursing 102 Exam 3 With Complete Solutions
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Thoracentesis - ANSWER>>• Aspiration of fluid from the pleural space
- surgical puncture
• Microscopic examination of the pleural fluid
• Relieving pulmonary compression
Pulmonary Monitoring O2 Saturations - SpO2 - ANSWER>>• Location
• On fingers, toe, nose, earlobe, or forehead
• 95-100% normal
• Normals a little lower in older adults and patients with dark skin
• Troubleshooting
• Pleth
• Ambient light
• Hypothermia
• Movement
• Decreased peripheral blood flow
• Decreased hemoglobin
• Edema
• Fingernail polish
• CO2 Monitoring
• Capnography - measuring CO2 in exhaled air, ETCO2
• Normal = 35-45
,The Cardiopulmonary Picture - ANSWER>>• Are the lungs doing their job?
• How do you know?
• What are signs or symptoms that tell you the
lungs are not working optimally?
• How does the problems of one system affect
the other?
Pulmonary - ANSWER>>1. Respiratory system as part of acid-base and fluid
homeostasis
2. Care of patients requiring oxygen therapy or
tracheostomy
3. Chronic Pulmonary
i. Obstructive sleep apnea
ii. Asthma
iii. COPD
iv. Pulmonary hypertension
v. Pulmonary fibrosis
where is the heart located? - ANSWER>>- anterior to and between the lungs in the
mediastinum
-The apex is above the diaphragm tilted slightly left of the midline
- Mechanical pump regulated by electricity
heart wall - ANSWER>>•3 layers of pericardial
membranes:
1. Fibrous pericardium
2. Parietal pericardium: covering on the outside
3. Visceral pericardium: covering over the heart
,•Myocardium: pumps the heart (heat m.)
•Endocardium: lining on the inside of the heart
how much ml of fluid should be in the pericardial space? - ANSWER>>between 2-10ml
anything more can be fluid overload changing the hearts ability to pump
automaticity - ANSWER>>The ability of the heart to generate and conduct electrical
impulses on its own.
excitability - ANSWER>>response to stimulation
conductivity - ANSWER>>the ability of the heart cells to receive and transmit an
electrical impulse (communicate)
contractility - ANSWER>>the heart's ability to contract
refractoriness - ANSWER>>rest period that cells require after having been fired before
they are again capable of responding to a stimulus
How many chambers does the heart have? - ANSWER>>4 chambers
• right: atria, ventricle
• left: atria, ventricle
cardiac circulation - ANSWER>>blood comes from superior and inferior vena cava →
inters the right atrium → goes through the tricuspid valve → goes into the right ventricle
→ blood goes through through pulmonary valve → travels into the pulmonary artery
(deoxygenated) → travels out into the lungs → returns through the left pulmonary veins
→ enters in through the left upper atrium → fills and passes through the mitral/bicuspid
valve → fills into the left ventricle → blood goes through the aortic valve → then travels
into the aorta → blood perfuses the heart through the coronary arteries
, Coronary Arteries - ANSWER>>•Supply oxygen to the myocardium
•Right and left branches come off the ascending aorta.
•Blockage of coronary artery causes ischemia or infarction (hypoxia - leading to
necrosis)
(know the right and left - and that they perfuse the heart during diastole)
When are coronary arteries perfused? - ANSWER>>during diastole - when the Aortic
valve closes (resting)
Systole - ANSWER>>= Squeeze (contract)
• Lub: hearing the closure of the tricuspid/bicuspid valves (two biggest valves)
• 1/3 of cardiac cycle
• Contraction and emptying of atria and ventricles
Diastole - ANSWER>>= Relax (dilate)
• Dub
• 2/3 of cardiac cycle: heart is resting 2/3 of the time which means the heart is getting
blood and O2 perfused to it 2/3 of the time (this is good).
• Relaxation and filling of atria and ventricles
• Coronary arteries perfuse heart
Oxygen Basics - Oxygen is a Drug! - ANSWER>>- Indication: hypoxemia
• Hypoxemia - low levels of oxygen in the blood
• Hypoxia - decreased tissue oxygenation
- Goal:
• Use lowest fraction of inspired oxygen for acceptable blood
oxygen level without causing harmful side effects
100% Verified!!
Thoracentesis - ANSWER>>• Aspiration of fluid from the pleural space
- surgical puncture
• Microscopic examination of the pleural fluid
• Relieving pulmonary compression
Pulmonary Monitoring O2 Saturations - SpO2 - ANSWER>>• Location
• On fingers, toe, nose, earlobe, or forehead
• 95-100% normal
• Normals a little lower in older adults and patients with dark skin
• Troubleshooting
• Pleth
• Ambient light
• Hypothermia
• Movement
• Decreased peripheral blood flow
• Decreased hemoglobin
• Edema
• Fingernail polish
• CO2 Monitoring
• Capnography - measuring CO2 in exhaled air, ETCO2
• Normal = 35-45
,The Cardiopulmonary Picture - ANSWER>>• Are the lungs doing their job?
• How do you know?
• What are signs or symptoms that tell you the
lungs are not working optimally?
• How does the problems of one system affect
the other?
Pulmonary - ANSWER>>1. Respiratory system as part of acid-base and fluid
homeostasis
2. Care of patients requiring oxygen therapy or
tracheostomy
3. Chronic Pulmonary
i. Obstructive sleep apnea
ii. Asthma
iii. COPD
iv. Pulmonary hypertension
v. Pulmonary fibrosis
where is the heart located? - ANSWER>>- anterior to and between the lungs in the
mediastinum
-The apex is above the diaphragm tilted slightly left of the midline
- Mechanical pump regulated by electricity
heart wall - ANSWER>>•3 layers of pericardial
membranes:
1. Fibrous pericardium
2. Parietal pericardium: covering on the outside
3. Visceral pericardium: covering over the heart
,•Myocardium: pumps the heart (heat m.)
•Endocardium: lining on the inside of the heart
how much ml of fluid should be in the pericardial space? - ANSWER>>between 2-10ml
anything more can be fluid overload changing the hearts ability to pump
automaticity - ANSWER>>The ability of the heart to generate and conduct electrical
impulses on its own.
excitability - ANSWER>>response to stimulation
conductivity - ANSWER>>the ability of the heart cells to receive and transmit an
electrical impulse (communicate)
contractility - ANSWER>>the heart's ability to contract
refractoriness - ANSWER>>rest period that cells require after having been fired before
they are again capable of responding to a stimulus
How many chambers does the heart have? - ANSWER>>4 chambers
• right: atria, ventricle
• left: atria, ventricle
cardiac circulation - ANSWER>>blood comes from superior and inferior vena cava →
inters the right atrium → goes through the tricuspid valve → goes into the right ventricle
→ blood goes through through pulmonary valve → travels into the pulmonary artery
(deoxygenated) → travels out into the lungs → returns through the left pulmonary veins
→ enters in through the left upper atrium → fills and passes through the mitral/bicuspid
valve → fills into the left ventricle → blood goes through the aortic valve → then travels
into the aorta → blood perfuses the heart through the coronary arteries
, Coronary Arteries - ANSWER>>•Supply oxygen to the myocardium
•Right and left branches come off the ascending aorta.
•Blockage of coronary artery causes ischemia or infarction (hypoxia - leading to
necrosis)
(know the right and left - and that they perfuse the heart during diastole)
When are coronary arteries perfused? - ANSWER>>during diastole - when the Aortic
valve closes (resting)
Systole - ANSWER>>= Squeeze (contract)
• Lub: hearing the closure of the tricuspid/bicuspid valves (two biggest valves)
• 1/3 of cardiac cycle
• Contraction and emptying of atria and ventricles
Diastole - ANSWER>>= Relax (dilate)
• Dub
• 2/3 of cardiac cycle: heart is resting 2/3 of the time which means the heart is getting
blood and O2 perfused to it 2/3 of the time (this is good).
• Relaxation and filling of atria and ventricles
• Coronary arteries perfuse heart
Oxygen Basics - Oxygen is a Drug! - ANSWER>>- Indication: hypoxemia
• Hypoxemia - low levels of oxygen in the blood
• Hypoxia - decreased tissue oxygenation
- Goal:
• Use lowest fraction of inspired oxygen for acceptable blood
oxygen level without causing harmful side effects
