NUR 311 Ch 12 Review Questions and Correct Answers
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Course
NUR 311
Institution
NUR 311
Point of Maximal impulse At the apex of the heart (apical HR) - Base is the top of the heart; apex is the bottom.
The coronary arteries Originate from the aorta just above the aortic valve - They supply arterial blood to the heart - Receive most of the blood from diastole, when the aortic valve cl...
NUR 311 Ch 12 Review Questions and
Correct Answers
Point of Maximal impulse ✅At the apex of the heart (apical HR)
- Base is the top of the heart; apex is the bottom.
The coronary arteries ✅Originate from the aorta just above the aortic valve
- They supply arterial blood to the heart
- Receive most of the blood from diastole, when the aortic valve closes.
Sinoatrial node (SA node) ✅the primary pacemaker of the heart
- initiates electrical impulses at an inherent rate of 60-100 beats per minute.
Depolarization ✅sodium ions move into the cell and potassium ions move out of the
cell
- leads to contraction of the myocardium
Repolarization ✅the exchange of ions reverts back to its polarized state
- rest period after contraction
Diastole ✅period in which the atria and ventricles are in a relaxed state, allowing the
ventricles to fill with blood
Systole ✅refers to the period of myocardial contraction
AV vavles ✅mitrial and tricuspid
Nursing Alert: Loss of atrial kick... ✅decreases CO, leading to the development of
symptoms in a patient such as:
- dizziness, lightheadedness, syncope, decreased activity tolerance, & hypotension.
- Atrial fibrillation is an arrhythmia that is known to be associated with the loss of this.
- Loss of coordinated contraction into the ventricle will decrease the left ventricular
preload and significantly lower CO.
Semilunar valves ✅aortic and pulmonic
Cardiac output ✅refers to the amount of blood pumped by each ventricle in L per min.
- adults = 4-6 L/min but varies greatly
- a function of the stroke volume and the heart rate
Stroke volume ✅is the amount of blood ejected with each heartbeat
- average is about 70 ml
, Ejection fraction ✅only a fraction of the blood present in the ventricles is ejected.
- EF on the left ventricle = 50-70% is commonly assessed because it is a noninvasive
measure of myocardial contractility
- the EF is lower in conditions that depress myocardial contractility (heart failure &
myocardial infarction)
Baroreceptors ✅located in the aortic arch and the right and left internal carotid arteries
- During HTN, these cells increase their rate of discharge transmitting impulses to the
medulla. This initiates PNS activity & inhibits SNS response; lowering the heart rate and
BP. (does just the opposite if responding to low BP)
Preload ✅refers to the pressure generated in the ventricles at the end of diastole and
the resultant stretching of the muscle fibers.
- is decreased by a reduction in the vol. Of blood returning to the ventricles.
- Vasodilation, diuresis, bleeding, vomiting, all reduce this.
- Therefore, it is increased with blood transfusion, IV continuous solutions, etc.
Afterload ✅The amount of resistance to ejection of blood from the ventricle, is the
second determinant of stroke volume.
Pulmonary vascular resistance ✅the right side of the heart collects venous blood,
which has a very low pressure and is met with little resistance as blood is ejected into
the pulmonary vascular system.
Systemic vascular resistance ✅the left side of the heart requires significantly higher
pressures to overcome resistance created by the arteries in the systemic circulation
.Nursing Alert: Preload reflects the... ✅volume of blood returning to the right and left
ventricles at the end of diastole.
- Central venous pressure monitoring measures right heart preload, whereas, PA
monitoring measures left ventricular preload.
Contractility ✅refers to the force generated by the contracting myocardium under any
given condition
- is enhanced by circulating catecholamines, SNS, and certain meds (digoxin, IV
dopamine)
- An increase in this results in an increase in SV.
- But this is depressed by hypoxemia, acidosis and certain meds (beta blockers)
Gender considerations: Heart ✅Heart of a woman is smaller
- coronary arteries of the female heart are smaller and thus occlude from
atherosclerosis more easily
- this makes procedures such as cardiac catheterization and percutaneous coronary
interventions more difficult
- resting HR, SV, and EF are generally higher than males
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