Anatomy & blood flow
Which side of the heart pumps blood to the lungs?
Right side
What's the formula for cardiac output (CO)?
HR x SV = CO
A patient's BNP is 150 pg/mL. What condition should the nurse expect?
HF
Name two signs of poor perfusion.
confusion - fatigue - decreased UOP - pallor - cyanosis - dyspnea - cool skin - edema - JVD
A patient with SOB is laying flat in bed. What nursing action should be performed first?
Elevate HOB
A nurse is tracing blood flow through the heart. After blood leaves the RV, where does it go next?
Pulmonary artery
A patient has severe HTN. Which factor affecting cardiac output is increased?
Afterload
A patient reports chest pain caused by myocardial ischemia. What condition is this finding most consistent with?
Angina
A patient becomes confused and the nurse notices their UOP has only been 15mL/hr. What should the nurse expect is happening?
Decreased tissue perfusion
A patient with HF gains 1.8kg in 2 days. What nursing action is most important?
Notify the provider and assess for fluid overload
A patient asks why the LV has thicker muscle than the RV. What's the best response?
The LV pumps blood to the entire body and must generate higher pressure.
A patient as an EF of 30%. What does this indicate?
Decreased systolic function / heart failure
A patient with a history of heart disease develops worsening shortness of breath and fluid overload. The nurse recognizes that the patient's heart is having difficulty pumping or filling adequately. What condition does this describe?
HF
A nurse notices cool, pale skin on a patient with low BP. What is causing these findings?
A patient with suspected decreased CO has cool, pale skin and new confusion. Which assessment should the nurse perform first?
Assess pt's vitals and oxygen saturation
A nurse hears S1 during auscultation. What is closing?
Tricuspid and Mitral valves
A patient with HF develops FVE. Which factor affecting CO has increased?
Preload
A patient is diagnosed with a disorder that causes impaired electrical conduction through the heart. What is it called?
Heart block
A patient has JVD, edema, and decreased urine output. Which nursing interventions are appropriate? (Select all that apply.)
A. Monitor intake and outputF. Assess for worsening edema
A - C - D - F
A patient is showing signs of decreased cardiac output. Which nursing interventions are appropriate? (Select all that apply.)
A. Monitor blood pressure and heart rate
B. Assess lung sounds and oxygen saturation
C. Encourage high intensity interval training activity to improve circulation
D. Assess skin color and temperature
E. Monitor UOP
A - B - D - E
A patient has inflammation of the pericardium. What abnormal heart sound might the nurse hear?
Friction rub
A patient's HR is 180. Instead of increasing CO, it decreases. Why?
Ventricles don't have time to fill, so SV decreases, which decreased CO
A patient has muffled heart sounds, hypotension, and JVD. What condition should the nurse expect the patient to be experiencing?
Bonus question: why are these findings called?
Cardiac tamponade - fluid around the heart is compressing it and interfering with its ability to fill and pump
These 3 findings are called Beck's triad
A patient with hemorrhage becomes dizzy, hypotensive, and confused. Explain the chain of events causing poor perfusion.
Blood loss causes decreased preload --> decreased SV --> decreased CO --> poor tissue perfusion
A patient with HF suddenly becomes confused, SOB, and has an oxygen saturation of 84%. Place the nursing actions in priority order:
1. notify provider
2. assess lung sounds
3. raise HOB
4. apply oxygen
1. Raise the head of the bed
2. Apply oxygen
3. Assess lung sounds
4. Notify the provider