Cardiac 1 Flashcards by Samantha Gordon

Name normal blood flow through the heart

superior and inferior vena cava, right atrium and ventricle, pulmonary artery, lungs, pulmonary vein, left atrium and ventricle, then aorta.

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Whats is preload

amount of blood flow returning to the heart and the muscle stretch that the volume causes.

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Preload release what

ANP atrial natriuretic peptide

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What is ANP

when the atrium promotes vasodilation and natriuresis

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What is after load

the pressure in the aorta and peripheral arteries that the left ventricle has to pump against to get the blood out

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Why does htn lead to hf

due to the additional resistance. high after load decreases c/o and decrease forward flow and wears out the heart.

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what is stroke volume

the amount of blood pumped out of the ventricles with each beat.

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what is meant by co = hr x sv

example: 72bpm x 70ml stroke volume = 5ltrs of cardiac output p.m

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what is capillary defusion exchange

the exchange of waste products, nutrients and gases between the blood and body cells by movement(leakage) of vessels into interstitial fluid outside the vessel walls.
arteries->capillaries->veins

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factors that affect cardiac output are

heart rate- brady or tachy
Blood volume: Hypotension-(decreased)- burns, surgery, shock and Hypertension-(increased)- kidney problems, retaining sodium, diabetes, smoking.
MI medication
Cardiac muscle disease

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decreased left ventricle c/o sings and symptoms.

reduced loc, chest pain, wet sounds in lungs, sob, cold clammy skin, uo decreases, peripheral pulse weak

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name 3 cardiac arrhythmias that are serious

Pulseless v-tach
V-fib
Asystole

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what are shockable cardiac rhythms and non-shockable rhythms

Shockable- pulseless ventricular tachycardia or ventricular fibrillation.
Non-shockable- asystole and pulseless electrical activity(PEA)

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what is a PEA

PEA- refers to cardiac arrest where egg shows a heart sinus rhythm but no pulse.

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what is coronary artery disease

most common cardiovascular disease. it includes chronic stable angina and acute coronary syndrome.

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what is chronic stable angina

ischemia(decreased blood flow) or necrosis to the heart causing pain on exertion due to low o2

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Treatment for chronic angina

rest and nitroglycerin

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Gtn can be administered how many times.

3 times every 5mins

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Name some beta blockers and what they do

propranolol, metoprolol, atenolol and carvedilol

they decrease contractility which decreases the workload to the heart

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name some calcium channel blockers

verapamil, amlodipine, diltiazem, nifedipine

they dilate coronary arteries which decreases after load and increase o2 to the heart muscle.

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cardiac catheterisation pre-op must do’s

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confirm not allergic to iodine or shellfish

check kidney function- might need prescribed acetylcysteine(NAC) to protect kidneys

cardiac catheterisation post-op must do’s

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monitor vs (vital signs)
monitor puncture site
assess extremity distal to puncture site- 5 P’s
pulseless, pallor, pain, paresthesia(burning sensation) and paralysis
keep extremity straight for 4-6hrs
if on metformin hold for 48hrs post procedure due to contrast induced renal failure.

what is acute coronary syndrome

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ischemia(decreased blood flow), necrosis or both to the heart. unstable angina, MI

signs and symptoms of acute coronary syndrome

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crushing chest pain, radiating to the left arm, left jaw
n&amp;v
pain between shoulder blades
number 1 s/s is SOB
bp drops
ecg changes

MI lab values are

CPK-creatine phosphokinase elevates 3-6hrs peaks 12-24hrs. women normal range 12-192u/l men normal range 39-308u/l Troponin- elevates 3-4hrs and remains for unto 3weeks. normal range 0.00-0.40 Myoglobin- elevates 1hr peaks in 12hrs negative result rules out MI normal range 0-85ng/ml

if defibrillator unsuccessful what medication is used in V-Fib

Epinephrine | Amiodarone and lidocaine are used to prevent second episode of V-Fib

What medications are used for chest pain

``` MONA morphine oxygen nitrates aspirin-(160mg-325mg)(chewable or tablet works faster) ``` Head up position as it decreases workload on the heart.

whats the purpose of thrombolytics

to dissolve the clot blocking the blood flow to the heart muscle medications- alteplase, tenecteplase(1 time push), reteplase and streptokinase.

how soon after onset of MI should thrombolytics

within 6-8hrs

can you do abc's with patient on thrombolytics

No high risk of bleeding

what is PCI

percutaneous coronary interventions- this includes PTCA(percutaneous transluminal coronary angioplasty) and also stents.

major complications of angioplasty

MI or reoccluding vessel after procedure

what medication is given to high risk patients who have been stented or those waiting to go to Cath lab

aspirin, clopidogrel, prasugrel, abciximab or eptifibatide

What is CABG

coronary artery bypass-when patient has coronary artery occlusion they reroute vessels.

what is widow maker

Left main coronary artery occlusion-Sudden death!

whats included in cardiac rehabilitation

smoking cessation, diet changes, exercise-walking, teach s/s to patient

after MI when can you resume sex

1 week to 10 days and safest time of day is in the morning.

what are the s/s of right sided (right lung) HF

``` weight gain distended neck veins edema pitted enlarged organs ascites ```

what are the s/s of left sided (left lung) HF

``` pulmonary congestion dyspnea cough blood tinged frothy sputum restlessness tachycardia s-3 orthopnea nocturnal dyspnea ```

Right sided HF causes

lung related- pulmonary embolus->hypoxia->pulmonary htn->right sided increased workload. End stage COPD always ends in HF due to low o2 which cause increased spin the arteries of the lungs (pulmonary htn), pitted edema and ascites.

whats the difference between systolic and diastolic HF

systolic- heart can't contract and eject | diastolic- ventricles can't relax and fill

what is BNP

B-type natriuretic peptide- blood test that if elevated can confirm HF when CXR can't.

HF medications are

Ace inhibitors-help arterial dilation and increased stroke volume. ARB's- decrease arterial resistance and decrease bp. Beta blockers- relax the vessels decrease bp decrease after load and workload.

what do you have to monitor closely with ace inhibitors and arb's

they both block aldosterone which makes us lose sodium and water and retain potassium. must monitor for hyperkalemia.

patients with HF normally go home with prescribed

ace inhibitors and beta blockers because these drugs decrease after load by preventing vasoconstriction and increase cardiac output forward flow.

when do you use digoxin

makes the heart contractions stronger and slows it down. used in HF and AF

what are normal digoxin levels

0.5-2ng/ml(1.3-2nmol/l) anything above 2ng= toxic

caution with digoxin

hypokalaemia + digoxin = toxicity | an electrolyte imbalance can cause digoxin toxicity

nursing considerations with severe HF

IV in tropes- milrinone, dobtamine Vasodilators- nitroprusside, nitroglycerin diuretics low sodium diet-decrease fluid retention weigh daily and report 2-3pounds gain.

what is decompensating HF

a sudden worsening of the signs and symptoms of HF

Cardiac 1 Flashcards

(50 cards)