Adult - Cardiology III Flashcards Preview

NP > Adult - Cardiology III > Flashcards

Flashcards in Adult - Cardiology III Deck (31):
1

Does nitroglycerin relieve MI pain?

it has very little effect

2

Does every patient with MI have ECG changes initially?

No - about 30% do not

3

When present, what are the ECG changes of MI?

peaked T waves
elevated ST segment
~ Q wave development

4

ECG changes in I, aVL indicate what MI location?

lateral

5

ECG changes in II, III, aVF indicate what MI location?

inferior

6

ECG changes in V leads,or V3 and V4 indicate what MI location?

anterior

7

Within 4 - 6 hours, what enzymes will be elevated after MI?

Troponin T
Troponin I
CK-MB

(second two are 100% cardio selective)

8

In order, what is acute management of MI?

ASA
nitro
O2

9

What medication may be given for MI pain?

morphine

10

What medication may be given for pulmonary edema in MI?

furosemide (Lasix)

11

If on coumadin, what is theraputic range of INR?

2 - 3 mg/dL

12

What are the coagulation studies?

INR
ACT
APTT
PT
PTT

13

ACT

Activated Coagulation Time

14

PT

Prothrombin Time

15

PTT

Partial Thromboplastin Time

16

What are the indications for clot busting with TPA?

aka pharmacologic revascularization / fibrinolytic

unrelieved chest pain (>30 min and <6 hours)
WITH
ST segment elevation

17

A partial or complete occlusion of a vein by thrombus with secondary inflammation to the wall of the vessel.

venous thrombosis

can be superficial or deep

18

What's going on in peripheral vascular disease?

decreased blood supply

(ARTERIOsclerotic)

19

Typical patient with peripheral vascular disease?

40 - 70 year old
smoker
hyperlipidemia
DM

20

Typical initial symptom of peripheral vascular disease?

claudication

21

What are physical findings of peripheral vascular disease?

shiny, hairless skin
dependent rubor
elevational pallor
reduced pulses

22

Diagnositics for peripheral vascular disease?

doppler U/S
ankle-brachial index
arteriography - most definative test

23

Management of peripheral vascular disease?

exercise - 1 hour per day, rest during pain
weight reduction PRN
bypass surgery
amputation

24

Medication management of peripheral vascular disease?

pentoxifylline (Trental)
cilostazol (Pletal)

25

What's going on in chronic venous insufficiency?

impaired venous return

26

Is chronic venous insufficiency more common in men or women?

women

27

Typical complaint of chronic venous insufficiency?

Lower leg:
ACHING relieved by elevation
EDEMA after prolonged standing
NIGHT CRAMPS

28

Physical findings in chronic venous insufficiency?

brownish discoloration
stasis leg ulcers
dermatitis
cool to touch

29

Diagnostics for chronic venous insufficiency?

clinical picture

30

Management of chronic venous insufficiency?

support stockings
weight loss PRN
treatment of dermatitis or ulcers

31

What is the treatment for acute weeping dermatitis related to chronic venous insufficiency?

wet compresses
hydrocortisone cream

ABT only if clearly infected