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ACLS > CEN 2 Cardiovascular > Flashcards

CEN 2 Cardiovascular Flashcards

1
Q

Normal cardiac output is __ - __ L/minute

A

4 - 8

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2
Q

the normal heart rate for a neonate is

A

140 BPM

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3
Q

the normal heart rate for a toddler is

A

120 BPM

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4
Q

the normal heart rate for a school age is

A

100 BPM

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5
Q

the normal heart rate for an adult is

A

60 - 100

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6
Q

the normal respiratory rate for a neonate is

A

40

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7
Q

the normal respiratory rate for a toddler is

A

30

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8
Q

the normal respiratory rate for a school age is

A

20

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9
Q

the normal heart rate for an adult is

A

12-16

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10
Q

normal stroke volume is

A

60 - 130 ml/contraction

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11
Q

average pressure over
the entire cardiac cycle
[(2 x diastolic + systolic)/3]

A

mean arterial pressure

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12
Q

these cardiac medications affect automaticity, rate at which electricity moves through the heart.

A

dromotropes

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13
Q

these cardiac medications affect heart rate

A

chronotropes

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14
Q

these affect contractility

A

Inotropes

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15
Q

To determine the normal systolic blood pressure for

children aged 1 - 10, what do you do

A

add twice their age to 90 mm/Hg, to determine

systolic hypotension, add twice their age to 70 mm Hg.

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16
Q

what does atropine do

A

reverses cholinergic-mediated decreases in heart rate

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17
Q

what are some considerations when using atropine

A

Use with caution in cases of coronary ischemia and MI
Unlikely to be effective after cardiac transplantation
Not useful in Type II second-degree or third degree heart block

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18
Q

what is epinephrine

A

positive inotrope, dromotrope and chronotrope

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19
Q

what does dopamine do

A

Doses between 2 and 10 mcg/kg/minute effective to increase heart rate.

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20
Q

when is pacemaker therapy used

A

pacemakers are used when the heart’s intrinsic pacemaking system is inadequate. Most effective for bradycardia, heart block and idioventricular rhythms.

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21
Q

Two methods of pacing in ED:

A

External (transcutaneous) -Large electrodes are placed on the skin, one on the back at the midthoracic level of the spine and a second on the front at the chest lead level of V3.
Transvenous - involves threading a catheter electrode into the right atrium or ventricle via the subclavian, internal jugular, brachial, or femoral vein.

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22
Q

what do Calcium channel blockers (-depine) do

A

Vasodilators, negative inotrope, negative chronotrope, negative dromotrope.

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23
Q

what does Epinephrine (Adrenalin) do

A

Positive inotrope, dromotrope and chronotrope as well as vasoconstrictor

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24
Q

what does Isoproterenol, or Isuprel, do

A

increases alpha, beta-one and beta-two stimulation - can increase myocardial workload, can cause myocardial ischemia.

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25
Q

what does Dopamine, or Intropin, Dopastat do

A

increases alpha, beta-one and beta-two stimulation.
2 - 10 mcg/kg/minute increases cardiac output
> 10 mcg/kg/minute increases BP

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26
Q

what does Norepinephrine bitartrate, or Levophed do

A

Peripheral venous and arterial vasoconstrictor and cardiac stimulant considered in the treatment of hypotension or shock.

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27
Q

what does Phenylephrine, or Neo-Synephrine do

A

Pure alpha-agonist

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28
Q

Angiotensin Converter Enzymes (ACE Inhibitors). End in -_____, and do what

A
  • pril

decrease preload and afterload through vasodilation and diuresis

29
Q

what is MONA and what is it used to treat

A

Morphine, Oxygen, Nitroglycerin, and Aspirin.

treatments for MI

30
Q

what are some contraindications for thrombolytics (8)

A

Recent internal bleeding (less than one month prior to arrival)
• Known bleeding diathesis
• History of cerebrovascular accident
• Recent surgery
• Intracranial arteriovenous malformations
• Uncontrolled hypertension (SBP > 180 mm Hg, DBP > 110 mm Hg)
• Trauma within the past ten days
• Recent cardiopulmonary resuscitation efforts

31
Q

what is the cause of Printzmetal’s angina and what is it caused by

A

Variant angina, also known as variable angina, Prinzmetal’s angina or coronary artery spasms - caused by ischemia secondary to a spasm in the coronary artery.

32
Q

Which of the following patients carries the highest risk of contracting endocarditis?

a. An 81-year old patient being treated for acute hypertension
b. A 39-year-old patient who had a large tattoo engraved two weeks previously
c. A 22-year old patient who has had two cases of conjunctivitis in the past three weeks
d. A 51-year old patient who had an inferior wall myocardial infarction four weeks previously

A

b. A 39-year-old patient who had a large tattoo engraved two weeks previously

33
Q

Which of the following assessment findings is more consistent with a peripheral vascular venous occlusion?

a. A burning discomfort in an extremity
b. A fever associated with a pale, cool extremity
c. Excruciating pain which is relieved with activity
d. An aching pain localized to one area of an extremity

A

d. An aching pain localized to one area of an extremity

34
Q

A pediatric patient weighing 12 kg is to be cardioverted. What is the appropriate initial energy level?

a. ) 3 Joules
b. ) 12 Joules
c. ) 36 Joules
d. ) 50 Joules

A

b.) 12 Joules

35
Q

A patient presents to the ED with a blood pressure of 234/144 mm Hg. If pharmacological treatment is undertaken for this disorder, which of the following blood pressure readings would be optimal within 30 minutes of treatment initiation?

a. 120/80 mm Hg
b. 140/90 mm Hg
c. 164/100 mm Hg
d. 200/100 mm Hg

A

c. 164/100 mm Hg

36
Q

the type of aneurysm that dilates only a portion of the artery is a ________ aneurysm.

A

saccular
In fusiform aneurysms, a segment of the artery is dilated around the entire circumference of the artery. A saccular aneurysm dilates only a portion of the artery. A dissecting aneurysm results in a tear in the artery.

37
Q

cardiac tamponade can be clinically assessed by the presence of what

A

Hypotension, muffled heart tones, and distended neck veins, called Becks Triade. Distended neck veins caused by compression of the heart. Secondary symptoms may include air hunger, agitation and decreased level of consciousness.

38
Q

An accumulation of fluid in the pericardial sac which manifest Beck’s triad is called

A

Pericardial tamponade

39
Q

what is the treatment for blunt force cardiac injury, such as being kicked in the chest by a horse?

A

Ensure continuous cardiac monitoring. Echo may help determine the extent of the injury. Nitro will not help with the pain. Cardiac enzymes are not predictive of injury from blunt force.

40
Q

Preload refers to what

A

the end diastolic volume that stretches the right of left ventricle to its greatest dimension right before systole.

41
Q

A patient presents to the ED with fever, HR of 94, and pleuritic chest pain. Patient is an IV drug abuser. What is the likely diagnosis?

A

Endocarditis. Infections are usually caused by enterococci or staph aureus.

42
Q

Also known as variant angina, episodic chest pain, usually at rest, often seen in the middle of the night and early morning. Caused by coronary vasospasm.

A

Prinzmetal angina

43
Q

what are the characteristics of hypertensive crisis?

A

systolic pressure greater than 180 or diastolic of greater than 120 and have signs of acute, targeted organ damage. Encephalopathy, altered LOC, dizzyness, visual changes, renal damage, chest pain with ischemia, epistaxis.

44
Q

what are Kussmaul’s respirations and what are they associated with?

A

Deep and rapid breathing with no pauses. Patient will gasp and be air hungry. Commonly seen with acidosis, specifically DKA

45
Q

an agonist is anything that does what?

A

stimulates a system

46
Q

bleeding between the skull and the dura mater is called what?

A

Epidural bleed. Usually an arterial bleed, which is most commonly caused by trauma, specifically to the temporal region of the head. Causes initial LOC, then arouses in Lucid states, then decline in LOC.

47
Q

the current recommendation for magnesium sulfate for a pediatric patient in cardiac arrest includes

A

Torsades de pointes with suspected hypomagnesemia

48
Q

intravenous fluids which contain larger insoluable molecules that do not pass easily across the vascular wall are

A

colloid fluids

blood, albumin, plasma

49
Q

rhythmic rate and depth of respirations, appearing as a crescendo and decrescendo with brief periods of apnea. Commonly seen with increased CO2 levels in the brain.

A

Cheyne-Stoke respirations

50
Q

anything that causes a diminished response of the system - blocks the action of the agonist

A

antagonist

51
Q

These fluids, aqueous solutions of mineral salts or other water- soluble molecules can easily pass across the vascular wall. What are they and give two examples.

A

saline and lactated ringers

52
Q

what are the parameters of stage I hypertension

A

systolic pressure of 140-159

53
Q

what are the parameters of stage II hypertension?

A

systolic pressure of greater than 160

54
Q

an accumulation of fluid in the pericardial sac which manifest Beck’s triad is known as

A

pericardial tamponade

55
Q

When suctioning during a cardiac arrest, suctioning should be limited to which of the following?
5, 10, 20, 30 seconds

A

less than 10 seconds

56
Q

what is a normal PETCO2 level?

A

Quantitative waveform capnography provides a good indication of the quality of CPR. Levels < 10 mm HG indicate either a problem with the quality of CPR or with the placement of the ETT. EtCO2 levels of ≤10 mmHg predicted death in adult patients with cardiac arrest. Measurement of EtCO2 varies directly with the cardiac output produced by chest compression . Goal is 35-45mmg HG or 5-6% CO2. The correct action would be to increase the amount of O2 being delivered.

57
Q

what does PETCO2 stand for and what are the normal levels?

A

Percent End Tidal CO2Normal values are around 5% or 35-37mmhg. Higher than 5% would indicate low quality CPR or a need to increase O2 delivery.

58
Q

Can you cardiovert V fib?

A

No. You can shock V fib into an organized rhythm, but you cannot cardiovert a disorganized rhythm.

59
Q

what are the H’s and T’s?

A

The H’s and T’s include Hypovolemia, Hypothermia, Hypo/Hyperkalemia, Hydrogen Ion excess, Hypoxia, Hypoglycemia, Tamponade, Tension pneumothorax, Thrombosis, Toxins, and Trauma.

60
Q

what is the best way to treat asymptomatic bradycardia?

A

If the bradycardic patient does not have any symptoms, the most prudent intervention is to monitor and observe the patient and attempt to determine the underlying cause of the bradycardia.

61
Q

what is the first line of treatment for Hyperkalemia?

A

calcium

62
Q

what is the second line of treatment for hyperkalemia?

A

insulin, folloewed by dextrose, to push K back into the cells and out of the syrum

63
Q

when calcium and insulin have failed to resolve hyperkalemia, what is the next line of treatment?

A

hemodialysis

64
Q

what are some causes of hypokalemia?

A

losses from vomiting and diarrhea, alcoholism with malnutrition

65
Q

low potassium or hypokalemia can be detected on an EKG how

A

the U wave, or camel hump T wave

66
Q

treatment of hypokalemia includes what

A

potassium supplements

67
Q

hypokalemia is known to coexist with what?

A

magnesium imbalances

68
Q

high magnesium results in what

A

decreased muscular irritability and activity

69
Q

low magnesium results in what?

A

increased muscular irritability and activity

ACLS (6 decks)

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