Deck 3: Heart Failure

Question 1

____ is that which must be overcome to push blood through the circulatory system.

A) Cardiac resistance
B) Ventricular dysfunction
C) Vascular resistance
D) Intrinsic dysfunction

Answer 1

Vascular resistance

Question 2

Beta blockers are recommended in acute heart failure as they can raise the patient's blood pressure.

Answer 2

False

Question 3

Patients with heart failure typically have pain on inspiration.

Answer 3

False

Question 4

____ damage occurs when there is a direct injury to the myocardium.

A) Intrinsic myocardial
B) Diastolic dysfunction
C) Extrinsic myocardial
D) Systolic dysfunction

Question 5

A patient with a MAP of 60 or below can be classified as being in decompensated shock.

Question 6

The patient's mental status demonstrates the patient's perfusion, oxygenation, and ventilation status.

Question 7

Patients suffering from syncope will generally have complaints or symptoms based upon the underlying cause.

Question 8

If the heart is constantly exposed to increased systemic vascular resistance, the thickness of the ventricular wall undergoes hypertrophy.

Question 9

Before asking a patient where the pain starts, it is best for the Paramedic to ask him where it goes.

Question 10

The RAAS decreases the concentration of angiotensin II, a potent vasoconstrictor, by increasing the amount of angiotensin I that is converted with the angiotensin-converting enzyme (ACE).

Question 11

The sympathetic nervous system is immediately activated when the baroreceptors in the carotids and the aorta recognize a state of low pressure, sensing a drop in cardiac output.

Question 12

The ____ states that when there is an increase in blood return to the heart, creating a volume overload, it increases the stretch of the ventricle and subsequently the contraction.

A) Starling-Frank Law
B) Frank-Starling Law
C) Lowell-Starling Corollary
D) Starling-Lowell Corollary

Question 13

____ is the capability of muscle cells to shrink or contract.

A) Resistance
B) Contractility
C) Intrinsic factor
D) Extrinsic factor

Question 14

During an acute coronary event, the myocardial cells become akinetic and the affected ventricular wall becomes necrotic.

Question 15

Diabetes results in macrovascular disease that leads to coronary artery disease and peripheral vascular disease, both of which may lead to heart failure.

Question 16

Heart failure is a multisystem disorder whereby abnormalities in the cardiovascular and renal systems cause a state of low cardiac output and eventually lead to the development of impaired cardiac function.

Question 17

A Paramedic should ask a patient with dyspnea to lie down.

Question 18

To determine if the patient is in cardiogenic shock, the Paramedic should assess for the presence of pump failure, pulmonary edema, and hypotension.

Question 19

____ is a low serum potassium level.

A) Hyperkalemia
B) Hypervolemic
C) Hypovolemic
D) Hypokalemia

Question 20

Factors that may create an abnormally high volume load on the left ventricle include fluid retention or fluid overload.

Question 21

Patients who have high ____ levels may experience anorexia, nausea, vomiting, diarrhea, and visual disturbances (such as a green-yellow halo around lights), along with ECG changes including bradycardia and a ladle-shaped ST segment.

A) aldosterone
B) potassium
C) nitrate
D) digoxin

Question 22

____ are implanted "mechanical hearts" that perform the duties of the dysfunctional ventricle and are generally reserved for patients who have end-stage heart failure and are awaiting transplant.

A) Intra-aortic balloon pump
B) Ventricular assist devices
C) Ventricular pacemaker
D) Ventricular defibrillators

Question 23

____ is a potassium-sparing, commonly prescribed diuretic whose mechanism of action is not widely understood.

A) Spironolactone
B) Digoxin
C) Vasotec
D) Nitroglycerin

Question 24

____ are soft, short, high-pitched sounds usually heard in the late-inspiratory phase in the lower, or dependant, lung fields.

A) Rhonchi
B) Rales
C) Stridor
D) Wheezes

Question 25

____ provide temporary improvement of left ventricular function, but unfortunately these medications cause tachycardias and increase myocardial ischemia as oxygen demand increases.

A) Furosemides
B) Morphine sulfates
C) Beta blockers
D) Catecholamines

Question 26

____, a cardiac glycoside, is a positive inotrope that increases the force and velocity of the contraction of the ventricles while decreasing the velocity of conduction through the AV node.

A) Nitroglycerin
B) Aldosterone
C) Digoxin
D) Vasotec

Question 27

____ is quickly becoming a standard in the treatment of patients with APE and many other respiratory diseases like COPD.

A) Non-invasive pressure support ventilation
B) PEEP (positive end expiratory pressure)
C) CPAP (continuous airway pressure)
D) V/Q (ventilation/perfusion)

Question 28

Patients with APE due to heart failure generally want to, and need to, sit in a ____ position, with legs dependent.

A) semi-Fowler's
B) Fowler's
C) high-Fowler's
D) prone

Question 29

____ is the widening of blood vessels.

A) Exacerbation
B) Vasodilatation
C) Arterodilatation
D) Hypovolemia

Question 30

Patients with heart failure are often fatigued, having ____, and tend to be more sedentary, similar to those with COPD.

A) orthopnea on exertion
B) dyspnea on exertion
C) pain on inspiration
D) fainting spells on exertion

Question 31

To aid in the assessment of the patient in acute respiratory distress, the Paramedic can utilize the ____ mnemonic.

A) APISHOCS
B) HISAPOCS
C) HAPISOCS
D) HIPASOCS

Question 32

____, an increase in the muscle mass of the left ventricle, develops from increased resistance that the left ventricle must contract against to expel its contents, such as with hypertension.

A) Ventricular hypertrophy
B) Left ventricular hypertrophy
C) Right ventricular hypertrophy
D) Left atrial enlargement

Question 33

____ (low cardiac output) occurs when the impaired ventricle is unable to overcome the pressure in the receiving artery to expel its contents.

A) Diastolic dysfunction
B) Hypertrophic cardiomyopathy
C) Restrictive cardiomyopathy
D) Systolic dysfunction

Question 34

A(n) ____ is one that decreases during inhalation.

A) ventrial pulse
B) atrial pulse
C) cardiac pulse
D) paradoxical pulse

Question 35

Patients with decompensated left-sided heart failure may have a displaced apical beat typically to the left side because of ____.

A) LVH
B) ventricular infarction
C) cardiomegaly
D) right atrial infarction

Question 36

____ is a general term that describes any functional or structural disease of the myocardium as a result of hypertrophy, dilation, rigidity of the walls, or constriction of the ventricles.

A) Hypertension
B) Cardiac infections
C) Heart failure
D) Cardiomyopathy

Question 37

____ occurs when fluid accumulates in the lungs, causing bronchoconstriction.

A) Cardiac asthma
B) A pulmonary embolism
C) Orthopnea
D) Bronchial dyspnea

Question 38

____, a consequence of chronic heart failure, is evident on the ECG with greater-than-normal amplitude for the leads that are over that particular ventricle.

A) Hypercarbia
B) Dysrhythmias
C) Ventricular hypertrophy
D) Premature ventricular contractions

Question 39

____ inhibitors are designed to block the effects of the renin-angiotensin-aldosterone system through interfering with the conversion of angiotensin I into angiotensin II.

A) Cardiac glycoside
B) ACE
C) Beta
D) NCE

Question 40

Slowing respirations, or ____, is a sign of respiratory failure and impending respiratory arrest.

A) bradypnea
B) tachypnea
C) hypercarbia
D) dyspnea

Question 41

Remodeling, including hypertrophy, initially begins as a(n) ____________________ process.

Question 42

The Paramedic should assess for ____________________, serous fluid in the peritoneal cavity, by having one person press down firmly on the midline of the patient's abdomen while the Paramedic presses on one side of the abdomen, feeling for a wave transmission on the other side.

Question 43

____________________ is the best and safest drug to use to decrease preload.

Question 44

____________________ is a generalized term to define the heart's inability to meet the body's demands.

Question 45

A high EtCO₂in a well-perfused patient indicates ____________________ (too much carbon dioxide in the blood) and may alert the Paramedic to impending respiratory failure, allowing her to prepare accordingly.

Question 46

____________________ is the percentage of blood expelled by the heart with each contraction.

Question 47

When a patient with heart failure lies down fluid returns to the pulmonary capillaries, decreasing the patient's ability to diffuse gases, which is known as ____________________.

Question 48

Pulmonary ____________________ is a key finding suggestive of backward heart failure.

Question 49

____________________ is difficulty in breathing.

Question 50

Chronic heart failure patients whose symptoms are not managed often have fatigue and ____________________ on exertion.