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Nursing
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May 24, 2024
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Week 2 Discussion Questions
Differentiate between systolic and diastolic heart failure.
In systolic heart failure, the left ventricle of the heart cannot contract fully or adequately. This condition is characterized by a reduced ejection fraction, which refers to the percentage of blood pumped out of the left ventricle with each heartbeat. As a result, less blood is pumped out of the heart with each beat, resulting in decreased cardiac output and associated symptoms like fatigue, shortness of breath, and fluid backing up into the lungs and body (Savarese et al., 2022). In diastolic heart failure, the heart's left ventricle cannot relax fully due to stiffness in the heart tissues. The primary problem in diastolic heart failure is impaired relaxation and filling of the heart during the resting phase of the cardiac cycle (Obokata et al., 2020). Hence, If the left ventricle cannot fully relax, it cannot hold the amount of blood that the body needs, thus leading to high pressure within the chambers of the heart and, in turn, increased pressure in the lungs.
State whether the patient is in systolic or diastolic heart failure.
In the case scenario, there is a mention of decreased wall motion of the anterior wall of the heart and an ejection fraction of 25%. The symptoms reported, such as shortness of breath, leg swelling, and fatigue, align with manifestations of systolic heart failure.
Explain the pathophysiology associated with each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea.
Dyspnea (shortness of breath) occurs when the body’s oxygen demand increases due to doing an activity. The body responds by increasing the respiratory rate and depth to enhance oxygen intake. The dyspnea on exertion manifests the mismatch between oxygen demand and supply (Schwinger,2021).
Pitting edema is the accumulation of fluid in the tissues, typically in the lower extremities. In heart failure, the weakened pumping action of the heart results in reduced
blood flow from the veins to the heart (McCance & Huether,2019). As a result, it leads to an increase in pressure within the veins and capillaries. The elevated pressure causes fluid to leak into the surrounding tissues, leading to edema.
Jugular vein distention (JVD) is the visible bulging of the jugular veins in the neck (Schwinger,2021). In heart failure, particularly right-sided heart failure, this inability leads to blood getting backed up into the pulmonary vein and then into the lungs. The right ventricle pumps blood into the lungs as well. Therefore, the right ventricle becomes weaker due to the backup of blood into the lungs (Schwinger, 2021).
Orthopnea refers to difficulty breathing while lying flat and is often relieved by sitting up
or standing (Schwinger,2021). In heart failure, fluid accumulation in the lungs (pulmonary congestion) is typical. The patient reports using three pillows propped to sleep in the case scenario. This subjective data supports orthopnea.
Explain the significance of the presence of a 3rd heart sound and ejection fraction of 25%.
The presence of a third heart sound (S3) is significant because it can indicate the presence
of cardiac dysfunction. An ejection fraction of 25% means that the heart is not pumping as efficiently as it should be, which can be due to various factors, including heart disease.
Reference:
McCance, K., & Huether, S. (2019).
Pathophysiology: The biologic basis for disease in adults
and children (8th ed.). Elsevier Health Sciences
Obokata, M., Reddy, Y. N., & Borlaug, B. A. (2020). Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction: Understanding Mechanisms by Using Noninvasive Methods. JACC: Cardiovascular Imaging
, 13
(1), 245-257. https://doi.org/10.1016/j.jcmg.2018.12.034
Schwinger R. H. G. (2021). Pathophysiology of heart failure.
Cardiovascular diagnosis and therapy
,
11
(1), 263–276. https://doi.org/10.21037/cdt-20-302
Savarese, G., Stolfo, D., Sinagra, G., & Lund, L. H. (2022). Heart failure with mid-range or mildly reduced ejection fraction. Nature Reviews Cardiology
, 19
(2), 100-116. https://doi.org/10.1038/s41569-021-00605-5
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Related Questions
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Question:-
3. Summarize the factors that affect stroke volume: preload, aAerload, and contracFlity. Describe how
each affects the end-diastolic volume/end-systolic volume. What happens to stroke volume when
each (preload, aAerload, and contracFlity) is increased?
4. Summarize the events of the cardiac cycle. What are the 5 stages? What happens during each stage?
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G4
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Q4.3. Under normal physiological conditions, the pressure-volume relationship for the heart is
described in Figure 4.3. Explaining your reasoning, approximate the work associated with the left
ventricle under these conditions.
150
125
Phase 3
100 -
75
50 -
Phase 4
Work
Phase 2
25
Phase 1
25
50
75
100
125
150
Left ventricular volume (mL)
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Provide ECG graphs for the following heart abnormalities;
1.Heart Attack
2.Cardiac hyperthrophy
3.Heart block
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Date
Pre-Lab Exercise 12-3
Pathway of Blood Flow through the Heart
Answer the following questions about the pathway of blood flow through the heart. Use your
textbook and Exercise 12-1 in this unit for reference.
1. Regarding veins:
a. Where do veins carry blood?
deoxygenated?
b. Is this blood generally oxygenated or
c. Does this rule have any exceptions? If yes, where?
2. Regarding arteries:
a. Where do arteries carry blood?
Is this blood generally oxygenated or deoxygenated?
c. Does this rule have any exceptions? If yes, where?
3. Where does each atrium pump blood when it contracts?
Right atrium:
a.
b. Left atrium:
4. Where does each ventricle pump blood when it contracts?
a. Right ventricle:
b. Left ventricle:
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Time remaining:
00:09:43
Nursing
Viva Voce Scenario
You are working as a registered nurse in a community setting, buddied with a nursing student, Greg. You are assigned to care for Mrs Neda, who requires an International Normalised Ratio (INR) test. You note that Mrs Neda is taking warfarin (Coumadin) as part of the management of her atrial fibrillation. Greg asks you if you could explain the mechanism of action of warfarin (Coumadin) to him.
Question 1:Explain to Greg the mechanism of action of warfarin (Coumadin).
Mrs Neda complains of gum bleeding when she brushes her teeth and asks you to explain why this is happening.
Question 2:Provide an explanation to Mrs Neda whybleeding is one of the side-effects of warfarin (Coumadin).
Greg noted that Mrs Neda also takes an antidysrhythmic. Greg asks you why two drugs are needed.
Question 3:Explain to Greg why multiple drugs are given when a patient has atrial fibrillation.
The INR comes back on the high side of normal. You speak…
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F6
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metaye yotelu Labeling Exercises
125
яте
LABELING EXERCISE 6-2: ELECTRICAL CONDUCTION SYSTEM
OF THE HEART (Textbook Figure 6-3) augaloodixT) BRUTOU
1. Write the name of each numbered structure of the electrical conduction system on the corresponding numbered line. Write the
names of hollow spaces and vessels that contain deoxygenated blood blue and those that contain oxygenated blood in red.
2. Color the structures in the drawing that conduct electrical impulses yellow. Color the vessels and structures that carry
deoxygenated blood blue, and those that carry oxygenated blood red.amul ads be loeasy boold botsys
3. Place a star on the drawing next to the number of the structure that originates the electrical impulse.
1.
2.
3.
4.
5.
2
5
woll boold to mousshib si inses
7
8
of zod
10
9
Adapted from Cohen BJ, Hull KL. Study Guide for Memmler's The Human Body in Health and Disease. 14th ed. Burlington, MA: Jones & Bartlett Learning: 2019:274
6.
7.
8.
9.
10.
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I need some characterization for the "Decellularization of Porcine Heart Valves"
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pls explain! please and thank you!
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Help on parts A and B
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Name:
Year and Section:
EXERCISE NO. 25
Anatomy of the Heart
POST-DISCUSSION QUESTIONS
I. Answer the following prompts:
1. What are the functions of the following heart structures?
a. Chordae Tendineae
b. Tricuspid Valve
The
the
c. Interventricular Septum
d. Bicuspid Valve
Date Submitted:
Group No.:
309
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Write the name of each numbered structure on the corresponding numbered line and then follow directions shown on the image to complete the problem
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15 and 17
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List two supplements that may be of benefit to Steven for a marathon. What are the potential mechanisms and benefits of using these two supplements?
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Ventricular contraction occur during which segment/interval?
Question options:
P-wave
QRS-complex
T-wave
P-R
R-R
S-T
T-P
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Exercise No. 7
1. Give the normal differential count of the different blood cells seen.
2. Briefly define the following:
a. Crenation
b. Hemolysis -
c. Rouleaux formation -
Exercise No. 8
1. Differentiate the three (3) types of muscles; tabulated form.
2. Define the sarcoplasmic triad. Where can it be found?
3. What is an intercalated disc?
Exercise No. 9
1. What are neuroglial cells?
2. Differentiate axon and dendrite.
3. What are other nerve endings?
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QUESTION:
4. Discuss major causes of heart valvular defects
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Time remaining:
01:59:56
Nursing
Kayla Christianson, CMA, has been employed six years by the cardiology practice of three physicians. She is a graduate of a CAAHEP-accredited school. Furthermore, Kayla received extensive hands-on training performing ECGs while doing her required externship.
Kayla has completed an ECG ordered by Dr. Hsu for Mrs. Warner, a 76-year-old patient. Dr. Hsu, Kayla’s boss, telephoned her explaining that he was behind schedule doing rounds at the hospital. He asked her to do him a favor and interpret Mrs. Warner’s ECG, sign his name, and fax the report to Mrs. Warner’s referring internist, who is expecting the results.
Given the scope of Kayla’s education, training, and years of experience as a CMA, would this “favor” fall within the AAMA guidelines of her responsibilities?
Would any portion of Dr. Hsu’s request fall within the guidelines? If so, which portion(s)? Is an exception to these guidelines ever allowed?
How should Kayla respond to Dr. Hsu?
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I need help with my homewok questions. Can you help me, please?
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10:37 1
K All Inboxes
hello
1. What are some tools that are used to gather
information about a patients heart?
2. What does the term "auscultation" mean?
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QUESTION 10
While performing the CVS assessment, the nurse will use which part of the equipment to assess for bruit in the
carotid artery?
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10:37
O X O 10 l ll 40%
As you are transporting the patient, you continue to reassess vital signs and perform another
more complete neuro exam to see if there are any deficits, and to see if there is any change in
symptoms over time. You note that the patient's pupils are 3 mm, equal and reactive to light. Her
speech remains slightly slurred and she is slow to respond on some questions, so you check a
blood glucose, which is 84 mg/dL. Hand grips and left-sided weakness remain the same
throughout transport.
Reassessment
Level of Consciousness
Recording Time: 7 minutes
A (Alert to person, place, and day)
Pale and cool
88 beats/min, regular
146/90 mmHg
Skin
Pulse
Blood Pressure
Respirations
SaO:
18 breaths/min
96%
ECG
Sinus rhythm with occasional PVCS
You arive at the hospital, and because you forewarned the hospital that you had a possible
stroke patient, you are told to bypass the triage line and bring the patient straight back to where
the "stroke team" is waiting. You quickly…
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Sinus bradycardia:
Sinus tachycardia:
Sinus arrhythmia:
Atrial fibrillation:
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Question completion Status:
omy
85 mV
Ventricular Action Potential
Phase 1
Phase 2
Phase 3
Effective Refractory Period
(ERP)
Na
Phase o
Ca
Phase 4
Na Na
Outside
Membrane
Inside
DE
Na
C
A 48-year-old female comes into the ER with chest pain. An electrocardiogram (EKG) is recorded. The QRS complex best
correlates with
phase of action potential of the ventricular myocyte shown in the image above? (enter a number 0 or 1 or
2 or 3 or 4)
ATP
PES
C
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Based on the cases mentioned below, what pattern can be observed on an ECG?
- Administration of alpha-2 agonists, hypercalcemia, cardiac glycoside toxicity, Lyme disease, endocarditis, traumatic myocarditis, cardiomyopathies, endocardiosis or myocardial fibrosis
a-1st degree AV block
b-AV block 2nd degree Mobitz type 1
c-AV block 2nd degree Mobitz type 2
d-3rd degree AV block
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<
11:22
My Files Lecture13Activities U.pdf
Superior vena cava
Activity 2 Sheep Heart Dissection Pre-lab
Use the following link to label the pictures below: https://www.youtube.com/watch?v=-ZbXiOrlFJI
←
Chordae
tendinae
Chordae tendinae
Left anterior
descending artery
Diagonal branch
PRO
☑
☑
Nils Tack
|||
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