Oxygenation

The resistance to left ventricular ejection is called:

This reflects the electrical activity of the conduction system

______implies that the impulse originates at the SA node and follows the normal sequence through the conduction system. (ECG)

This is a measure of cardiac output per square meter of BSA.
(Is determined by dividing cardiac output by the BSA)

The ventricles stretch when filling with blood. The more stretch on the ventricular muscle, the greater the contraction and the greater the stroke volume; this concept is referred to as __________

the amount of blood in the left ventricle at the end of diastole (end-diastolic volume)

The four cardiac chambers, two atria and two ventricles, fill with blood during _____ and empty during ______

Describe the Frank-Starling's (starling's) law of the heart.

During ventricular diastole the atrioventricular valves _____ & _____ open, and blood flows from the higher-pressure atria into the relaxed ventricles. This represents S1 (lub) sound

During the systolic phase semilunar (____ & _____) valves open, and blood flows from the ventricles into the aorta & pulmonary artery. Closure of these valves represents S2, (dub).

This is heard when a pt. w/valvular disease have backflow or regurgitation of blood through an incompetent valve

This is the branch of the systemic cirulation that supplies the myocardium with oxygen and nutrients and removes waste

The _________, the most abundant blood supply, feeds the left ventricular myocardium, which is more muscular and does MOST of the heart's work

This part of the heart is more muscular and does most of the heart's work

This is where the exhange of respiratory gases, nutrients, and wastes occurs, and the tissues are oxygenated

The amount of blood ejected from the left ventricle each minute is the _____

_______is the amount of blood ejected from the left ventricle with each contraction

The ______ is a good clinical measure of afterload

Related to the heartbeat:
The _________increases the rate of impulse generation and the speed of impulse transmission

Related to the heartbeat:
The ______decrease the rate of impulse generation

This is termed the "pacemaker" of the heart

List the intrisinsic rates for the following:
SA node: _______beats/min
AV node: _______beats/min
bundle of his & Purkinje network: ____beats/min

____is the process of moving gases into and out of the lungs

The major inspiratory muscle of respiration is the ________

______relates to the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs

_______is the process for the exchange of respiratory gases in the alveoli and the capillaries of the body tissues

______is the effort required to expand and contract the lungs

Concerning breathing: This is an active process, stimulated by chemical receptors in the aorta __________
_______is a passive process that depends on the elastic recoil properties of the lungs, requiring little or no muscle work.

This is a chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing

INFO:
Pt. w/advanced COPD lose the elastic recoil of the lungs & thorax. (which means they are not exhaling to fullest) Which means their Work of breathing increases (effort required to expand & contract the lungs)

During an assessment, this sign can indicate ventilatory fatigue, air hunger, or decreased lung expansion

This is the ability of the lungs to distend or to expand in response to increased intraalveolar pressure

_____measures the volume of air entering or leaving the lungs

______, which is a carrier for oxygen and carbon dioxide, transports most oxygen (approx. 97%)

This is a lower than normal hemoglobin level, and is a result of decreased heloglobin production, increased red blood cell destruction, and/or blood loss. Pt. have fatigue, decreased activity tolerance, and increased breathlessness, as well as pallor and increase in heart rate

This is the most common toxic inhalant decreasing the oxygen-carrying capacity of blood. It strongly binds with hemoglobin and is not easily dissociated, making hemoglobin unavailable for oxygen transport

INFO: When fever persists, the metabolic rate remains high and the body begins to break down protein stores, resulting in muscle wasting and decreased muscle mass, INCLUDING respiratory muscles such as the diaphragm and intercostal muscles!!!

Cervical trauma at ____ to ____ usually results in paralysis of the phrenic nerve. When this nerve is damaged, the diaphragm does not descend properly, reducing inspiratory lung volumes and causing hypoxemia.

Spinal cord trauma below the 5th cervial vertebra usually leaves the phrenic nerve intact but damages nerves that:

The physiological response to chronic hypoxemia is the development of increased red blood cells called _____.
This is the body's adaptive response to increase the amount of hemoglobin and increase the available oxygen binding sites.

INFO: Older adults experience alterations in cardiac function as a result of:
1. calcification of the conduction pathways
2. thicker & stiffer heart valves due to lipid accumulation & fibrosis
3. decrease in the number of pacemaker cells in the SA node

Electrical impulses that do not originate from teh SA node cause conduction disturbances. These rhythm disturbances are called ________, meaning a deviation from the normal sinus heart rhythm

Dysrhythmias occur as a primary conduction disturbance such as:

Cardiac response is ____ (>100 bts/min)
_______(<60 beats/min)
a ______(early beat) or a _______(delayed or absent) beat

Tachydysrhythmias & bradydysrhythmias ________cardiac output & BP.
_______reduce cardiac output by decreasing diastolic filling times & _____lower cardiac output because of the decreased heart rate

________is often described as an irregularly irregular rhythm

___________ & _______ are life threatening fhythms that require immediate intervention.

______ has a regular rhythm, rate 100-180 beats/min....usually a normal response to exercise, emotion or stressor such as pain, fever, caffine & certain drugs

________ has regular rhythm, rate <60 beats/min. Rate decrease is a normal response to sleep or in well conditioned athlete; diminished blood flow to SA node, vagal stimulation, hypothyroidism, increased intercranial pressure or pharmacological agents

_______chaotic, irregular atrial activity RESULTING in an irregular ventricular response. Caused by aging, calcification of the SA node, or changes in mycardial blood supply

______Rhythm slightly irregular, rate 100-200 beats/min.Caused by changes in teh normal pacemaker of the heart such as decreased blood flow, ischemia or embolus.

________uncoordinated electrical activity, Causes include sudden cardiac death, electrical shock, acute myocardial infarction, drowning or trauma

Every minute of a sudden cardiac arrest w/out defibrillation decreases the survival rate by _____% to ____%

________heart failure more commonly results from pulmonary disease

Signs of Right or Left sided heart failure?
fatigue, breathlessness, dizziness & confusion..pulmonary congestion...crackles on ausculation, hypoxia

Signs of Right or Left sided heart failure?
Elevated pulmonary vascular resistance (PVR)...weight gain, distended neck veins, hepatomegaly & splenomegaly & dependent peripheral edema....(due to the back up in the systemic circulation)

When _____occurs, the flow of blood through the valves is obstructed. (an abnormal condition characterized by the constriction or narrowing of an opening or passageway in a body structure.

When ______occurs, there is a backflow of blood into an adjacent heart chamber

two manifestations of myocardial ischemia are:

________is a transient imbalance between myocardial oxygen supply & demand. Results in chest pain that is aching, sharp, tingling or burning or feels like pressure. Usually left sided or substernal & radiates to the left or both arms, jaw, neck & back. Usually lasts from 1 to 15 minutes. Often precipitated by activities that increase myocardial oxygen demand (excercising, stress, heavy meals)

______results from sudden decreases in coronary blood flow or an increase in myocardial oxygen demand w/out adequate coronary perfusion

INFO: There is a significant difference between men and women in relation to coronary artery disease. As women get older their risk begins to rise

_____refers to a decrease in the amount of arterial oxygen

_____is a state of ventilation in excess of that required to eliminate the carbon dioxide produced by cellular metabolism

_____occurs when alveolar ventilation is inadequate to meet the body's oxygen demand or to eliminate sufficient carbon dioxide.

_____ a collapse of the alveoli; prevents normal exchange of oxygen and carbon dioxide

INFO: hyperventilation and hypoventilation refer to alveolar ventilation and not to the client's respiratory rate.

_____is inadequate tissue oxygenation at the cellular level

Causes of _________
1. decreased hemoglobin level & lowered oxygen-carrying capacity of the blood2. diminshed concentration of inspired oxygen (high altitudes)3. inability of tissues to extract oxygen from the blood (cyanide poisoning4. decreased diffusion of oxygen from alveoli to blood (pneumonia)5. poor tissue perfusion w/ oxygenated blood (shock)6. impaired ventilation (multiple rib fractures or chest trauma)

________is shortness of breath usually associated w/exercise or excitement, but in some pts, is present w/out any relation to activity of exercise

______is a clinical sign of hypoxia

______is associated w/exaggerated respiratory effort, use of the accessory muscles of respiration, nasal flaring, and marked increases in the rate & depth of respirations

_____is an abnormal condition iin which the pt uses multiple pillows when lying down or must sit with arms elevated & leaning forward to breath

Pt w/_______usually cough only in the early morning or immediatly after rising from sleep

Pt w/______generally cough and produce sputum all day, although greater amounts are produced after rising from a semirecumbent or flat position

_____bloody sputum

_______bleeding from the gastrointestinal tract

_____high-pitched musical sound caused by high-velocity movement of air through a narrowed airway

On average, client's will have _____colds a year

______is the absence of respirations

Use a scale of 0 to 3 to rate pulse
0 = ________
+1= ________
+2 =________
+3=_________

These lung sounds occur w/collapse of a lung segment, fluid in a lung segment, or narrowing or obstruction of an airway

What are some nursing diagnosis that are appropriate for the client with alterations in oxygenation?

INFO: relative humidity is the percentage of water in the gas. Air or oxygen with a high relative humidity keeps the airways moist and helps loosen and mobilize pulmonary secretions

_______adds moisture or medications to inspired air by mixing particles of varying sizes with the air

A ______is a collection of air in th pleural space

A _________is an accumulation of blood and fluid in the pleural cavity between the parietal & visceral pleurae, usually as a result from trauma

A rupture of small blood vessels from inflammatory processes, such as pneumonia or tuberculosis, can cause a _________

A ______ can occur spontaneously of as a result of chest trauma such as a stabbing or the chest striking the steering wheel in an auto accident

Handle a check drainage unit carefully and maintain the drainage device _____ the client's chest. If the tubing disconnects from the drainage unit, instruct the client to __________ & ____.

What is the best way to maintain thin secretion?