Acute Cardiac Flashcards Preview

NURS 2501 > Acute Cardiac > Flashcards

Flashcards in Acute Cardiac Deck (48):
0

12 lead ECG Placement

V1 -4th Intercostal space to the right of the sternum

V2 - 4th Intercostal space to the left of the sternum

V3 -  Midway between V2 and V4

V4 - 5th Intercostal space at the midclavicular line

V5 - Anterior axillary line at the same level as V4

V6 - Midaxillary line at the same level as V4 and V5

RL- Anywhere above the ankle and below the torso

RA  -Anywhere between the shoulder and the elbow

LL- Anywhere above the ankle and below the torso

LA -  Anywhere between the shoulder and the elbow

1

12 Lead ECG Placement 

A image thumb
2

Measured from P wave - Q wave 

( R & L ventricles fill with blood ) 

Prolonged - delay through atria or AV nodal area 

 

PR interval 

0.12 - 0.2 (3-5 small boxes) 

3

Measured from Q wave - S wave 

Ventricular contraction ( depolarization) 

QRS complex 

less than 0.12 sec ( 3 small boxes)

4

Ventricles are relaxing ( repolarization ) 

T wave 

5

Begins at QRS - terminates at end of T wave 

Time of ventricular depolarization & repolarization & venticular refractory time 

Influenced by - electrolyte balance, drugs, and ischemia 

QT interval 

0.36-0.44 sec ( 9-11 small boxes)

6

Recovery of the Purkinje fibers ; upright and follows T wave 

U wave 

7

Label the EKG tracing 

A image thumb
8

Anticholinergic , inhibits vagus nerve ( parasympath. NS)

Atropine 

9

Atropine: used to treat 

1. Bradycardia 

2. Heart block 

3. Asystole 

10

Atropine : SE 

1. Dysrhythmias

2. Increased HR

3. Ischemia 

4. Restlessness

5. Anxiety

6. Mydriasis ( dilation of the pupils)

7. Thirst + urinary retention 

11

Antidysrhythimic , prolongs repolarization ; used in emergency tx of ventricular dysrhythmias when other antidysrhythmics are ineffective 

Amiodarone ( Cordarone ) 

12

Amiodarone TX: 

1. A-flutter

2. A-fib

3. PVC

4. V-tach

5. V-fib 

13

Amiodarone SE:

1. 2nd-3rd degree AV block 

2. Bradycardia 

4. Hypotension 

14

Antidysrhythmic, fast sodium channel blocker ( class 1 B) - decrese myocardial irritability - local anesthetic effect on heart 

Lidocaine 

15

Lidocaine TX :

1. PVC

2. V-tach

3. V -fib 

16

Lidocaine SE: toxicity !!!

1. Confusion

2. Drowsiness

3. Hearing impairment

4. Conduction defects

5. Myocardial depression

6. Muscle twitching + seizures 

 

17

Antidysrhythmic to treat paroxysmal supraventricular tachycardia (PSVT) - slows conduction through AV node 

Adenosine ( Adenocard ) 

18

Adenosine : SE 

1. Hypotension

2. Dysrhythmias

3. Short period of asystole following injection 

19

Defibrilation is used ...

1. V-fib

2. V-tach ( pt has no pulse ) 

20

Beta - adrenergic blockers - decrese the effects of sympathetic NS - decrese HR + BP

Metoprolol ( Lopressor) 

 

21

Beta-blockers  : SE

1. Bradycardia 

2. Dizziness

3. Hypotension 

22

Beta-blockers: TX

1. sinus tachycardia 

2. SVT

3. A-fib 

23

Calcium - channel blockers , negative chronotropic (rate)  + inotropic ( strength )

Verapamil + Ditiazem ( Cardizem ) 

24

CCB: TX 

1. Sinus tachycardia

2. SVT

3. A-flutter

4. A-fib 

25

CCB: SE

1. Hypotension 

2. Bradycardia

3. Myocardial depression 

26

Rate above 100; wide, uniform, regular ORS complexes, no P waves 

V-tach 

27

Wavy pattern with no P or QRS waves 

V-fib 

28

QRS is wider than normal ; T wave is opposite to QRS; P wave is absent; look the same 

Unifocal PVC 

29

ORS is wider than normal; T wave is opposite to QRS; P wave is absent ; look different 

Multifocal PVC

30

P waves - sharp. sawtooth; PRI cant be measured 

A-flutter 

31

Very irregular ; no characteristic P waves ( small) ; No PRI ; normal QRS 

A-fib 

32

HR > 150 BPM; difficult to see P waves 

SVT 

33

Prolonged PRI 

1st degree HB 

34

PRI gets gradually longer until P fails to conduct and QRS is dropped 

2nd degree HB - Morbitz type 1 

35

Each PRI is the same ; 2nd + 5th  P waves do not conduct to the ventricles - no QRS; Rate - 40-45 BPM ;

2nd degree HB - Morbitz type 2 

36

P waves unrelated to QRS 

3rd degree HB - Complete HB 

37

MI: ECG changes 

1. Inverted T waves - ischemia - repolarization is impaired 

2. ST elevation - injury 

3. Pathological Q waves - wide ( 1 sb) + more than 1/3 the height of the R wave - cells are dead 

38

Stable ( Classic Angina )

predictable ( occurs with activity ) ; consistent; relieved with rest

39

Unstable Angina 

preinfarction angina; can occur at rest; unpredictable 

40

Prinzmetal's Angina 

occurs at rest; due to spasm of coronary artery not plaque 

41

MI: Pain 

1. Radiates to back, abdomen, neck, jaw, left arm 

2. W: diffuse -all over the heart ; M: one artery

3. Impending doom 

4. Anxious

5. SOB

6. Cold sweat

7. Numbness/ tingling in one or both arms

 

42

MI - TX : MONA

Morphine 

Oxygen

Nitroglycerin ( SBP > 90 )

Aspirin  ( 325 mg chew ) 

43

MI: STEMI 

ST elevation MI - occlusion !!!

44

MI : NSTEMI

non ST elevation MI - ST depression - ischemia - early phase - if blocked area is opened up , it may not cause permanent damage 

45

Recovery from MI 

1. ST segment returns to normal ( 1-6 weeks )

2. T wave inverts for 1-2  weeks 

3. Q-wave  alternations usually permanent  ( can tell on EKG if patient has had an MI in the past ) 

46

Cardiac catheterization 

see where blockages are and how significant the blockage is 

47

Cardiac markers ( enzymes ) - released from damaged heart tissue 

1. Troponin  - cardiac muscle protein ( T and I ) - specific; increased within few hours; peak in 24 hrs; 

2. Creatinine Kinase ( CK MB ) - increased only when cardiac muscle is damaged ;

3. Myoglobin - protein found in cardiac and skeletal muscle ; non spesific - peaks in 12 hrs