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NUS 210 Oxygenation & Cardiac - Test 1 > Cardiac > Flashcards

Cardiac Flashcards

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1
Q

this occurs when there is a blockage of the coronary arteries

A

myocardial infarction

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2
Q

does heparin dissolve clots already formed

A

no - it prevents cloth growth

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3
Q

signs and symptoms of MI

A

-pain in jaw, back, epigastric (feels like heartburn), shoulder
-SOB
-nausea
-sweating
-pale cool skin
-anxiety

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4
Q

what are the key words to listen for re MI when pt is describing the pain

A

sudden, crushing, radiating

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5
Q

what are the risk factors for MI

A

S-stress, smoking, simulants
O-obesity
D-diabetes, HTN
D-diet - high cholesterol (animal fats)
A-african american males & 50+ years old

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6
Q

if troponin is over what number, it means MI occured

A

0.4ng/ml

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7
Q

what medications are given to lower cholesterol

A

statins

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8
Q

what are the cautions for statins

A

no grapefruit
liver toxicity
muscle pain

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9
Q

what is antidote for heparin

A

protamine sulfate

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10
Q

signs of right sided heart failure

A

peripheral edema
weight gain
JVD - big neck veins
abdominal growth

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11
Q

signs of left sided heart failure

A

pulmonary edema (fluid in lungs)
crackles in lungs
pink frothy sputum
orthopnea (difficulty breathing when lying flat)

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12
Q

what causes right sided heart failure

A

HTN
pulmonary HTN
fibrotic lungs (stiff)
left sided HF

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13
Q

what causes left sided heart failure

A

weak heart (after heart attack)
CAD
ACS

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14
Q

patient with heart failure who is constipated. what would nurse recommend

a. walking
b. increase fiber
c. stool softeners
d. drink more water

A

a. walking
b. increase fiber
c. stool softeners

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15
Q

risk factors for heart failure

A

HTN - #1 risk factor
atrial fibrillation
mitral valve regurgitation
cardiomyopathy

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16
Q

which food item should the heart failure pt avoid
select all that apply

chips
fruits
veggies
grilled chicken and ff
canned beans
bread

A

canned beans
grilled chicken and ff
chips

all have sodium

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17
Q

a client with CHF took cold medicine for her flu. she presents with new productive cough with pink forthy sputum and worsening crackles
what action should the nurse do first

  1. assess lung sounds
  2. give bumetanide IV push
  3. notify HCP
  4. clock out for lunch
A
  1. give bumetanide IV push

new, sudden, worsening, rapid symptoms
#1 action is furosemide = body dried

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18
Q

priority interventions for pulmonary edema crisis

A

HOB 45 degrees
Oyxgen
Push furosemide + morphine, positive inotropes
End sodium & fluids — stop IV fluids

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19
Q

what to watch for if pt is on digoxin

A

take apical 1 min before
look for toxicity - 2.0+ = vision changes & N/V
watch potassium. 3.5 -5.0 is normal

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20
Q

if pt is on furosemide, what do you need to watch for

A

potassium. K+ wasting

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21
Q

what do beta blockers do for heart

A

blocks both BP and HR

LOL = LOW

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22
Q

cautions for beta blockers (LOL)

A

bradycardia
wheezing (asthma & COPD)
bad for HF pts
hides S/S of blood sugar for diabetics

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23
Q

calcium channel blockers do what for heart

A

calms BP & HR

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24
Q

nitroglycerin is what kind of medication

A

vasodilator

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25
lisinopril & losartan do what
lowers BP
26
nursing interventions for heart failure pts - 7
diet - low sodium & fluid risk for falls - change position slowly BP & BNP should not increase elevate legs with pillows daily weights sex - only if can do 2 flight of stairs with no SOB stockings
27
do you massage pt's legs if they have CHF
never
28
what OTC meds can a pt have with HF
none. no NSAIDS, no cough or flu meds, no Antacids
29
-this is comprised of lipid deposition in intimal layer of artery -narrows vessel and impairs blood flow -smooth muscle proliferates, fibrous cap with lipid center
atherosclerosis
30
what can create chronic endothelial injury which can lead to atherosclerosis
HTN tobacco use hyperlipidemia diabetes toxins hyperhomocysteinemia
31
this is the break down of aminoacids. it can be from diet, lifestyle or hereditary
hyperhomocysteinemia
32
when the plaque ruptures in artery. thrombus formation total occlusion or narrowing of vessel. what can occur
myocardial infarction
33
this is the pain that occurs if you have chronic endothelial injury and then you exercise
angina
34
nonmodifiable risk factors of artherlosclerosis
age gender - men younger - 55- , men and women- 55+ race - african, native, asian and mexican americans hereditary - 40-60% genetic disposition
35
modifable risk factors of atherosclerosis
HTN tobacco use sedentary lifestyle high serum lipids obese metabolic syndrome stress diabetes homocysteine substance abuse
36
what is metabolic syndrome
high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels.
37
is LDL or HDL the bad cholesterol
LDL
38
this occurs when there is complete blockage and damage to vessel, but blockage starts to dissolve
non ST segment elevation MI
39
why does angina occur
no oxygen to heart but not long enough to cause damage
40
this is a complete blockage, and blockage does not dissolve
ST segment elevation MI
41
the cells die in heart and there is muscle damage
ST segment elevation MI
42
what are the diagnostic tests for angina
12 lead EKG echocardiogram cardiac cath stress test troponin
43
this bloodwork is essential to find out if person had MI. enzymes are released when there is muscle damage to heart
troponin 0-0.04ng/ml normal range
44
clinical manifestations of angina
chest pain - severe, crushing skin clammy/cool sob anxiety n/v dysrhythmias
45
what medications are used to treat angina
nitroglycerine - vasodilator beta blockers - dialates blood vessels, lowers HR calcium channel blockers - lowers HR aspirin or clopidogrel heparin
46
what medications are used to treat MI
aspirin, nitroglycerine, morphine, beta blocker, oxygen
47
when do you use ACE inhibitors
when there is damage to the heart you use ACE inhibitors to prevent necrosis from getting worse
48
nursing considerations for acute coronary syndrome
-relieve pain and symptoms of ishcemia -monitor cardiac output -monitor respiratory status -monitor fluid volume status -reduce anxiety -monitor and manage complications
49
what are the complications of acute coronary syndrome
dysrhythmias cardiogenic shock pericarditis valve dysfunction
50
how does left sided heart failure work
backs up into left ventricle then backs up into lungs fluid in lungs --- so you'll hear crackles at base pt eventually drowns to death
51
how does right sided heart failure work
right ventricle can't pump as strong so the blood backs up into the body. this causes welling in the body, edema and abdominal fullness
52
s/s of left sided hf
dyspnea, orthopnea cough pulmonary crackles decrease O2 levels oliguria nocturia decreased perfusion to systemic organs
53
s/s of right sided hf
lower extremity edema ascites (acc. of fluid in peritoneal cavity) hepatomegaly (enlargement of liver) anorexia nausea weight gain due to fluid retention decreased perfusion weakness/fatigue, impaired cognition
54
this is the contraction of LV
contractivity
55
LV stretches beyond normal and it doesn't contract back. this leads to decrease CO. like a rubberband without the snap
fluid overload
56
this medication works on contractility 2 examples
inotrope digoxin, dobutamin
57
amount of blood pump out of LV in one heartbeat
stroke volume
58
how do you calculate the ejection fraction
it is the % of blood pumped out each heartbeat normal is 50-70%
59
this is when the heart muscle is huge. but has good ejection fraction.
diastolic HF
60
the heart is big and boggy but can't pump it, ejection fraction is abnormal. -poor pumping action -boggy LV taht can't pump
systolic hf
61
this is the volume or pressure exerted on LV right before contraction
preload
62
amount of pressure that LV exerts to pump out blood
afterload
63
does the afterload increase or decrease with tight vessels
increase afterload
64
does the afterload increase or decrease with open vessels
decrease afterload
65
if there is a lot of blood in the preload this is called
hypervolemia
66
diastole is when the heart is what
at rest
67
systole is when the heart is
pumping
68
pt has clinical manifestations of coronary ischemia but ECG or cardiac biomarkers show no evidence of acute MI this is called what
unstable angina
69
the patient has elevated cardiac biomarkers but no definite ECG evidence of acute MI
non stemi
70
the patient has ECG evidence of acute MI with characteristics changes in two ECG leads. Significant damage occurs
STEMI
71
what is the cardiac specific isoenzyme
CK-MB = creatine kinase myocardial band
71
this medication blocks sympathetic response. affects the afterload
beta blocker
72
what is an example of a beta blocker
metoprolol
73
what do you monitor for when taking beta blocker
orthostatic hypotension
74
this reduces preload and afterload
nitroglycerine
75
how often do you replace nitroglycerine medication
every 6 mos
76
this dilates the arteries (reduced afterload) resulting in decreased BP and decreased work of heart
nitroglycerine
77
this is used to treat angina, htn, tachycardia
calcium channel blockersq
78
do calcium channel blockers affect preload or afterload
afterload decreases HR, BP, decreases myocardial contractility, slows conduction
79
if pt has HF the pt will be on which type of medication
ACE or ARB
80
this is used to prevent remodeling after MI used dto treat systolic HF
ACE and ARBs
81
this creates vasodilation to decrease afterload to improve CO in HF
ACE/ARB
82
patient teaching for ARB and ACE
monitor BP avoid salt substitutes bc contain K+
83
pt teaching for calcium channel blockers
-report weight gain or swelling in lower extremities peripheral edema
84
waht do statins do
decrease LDL increase HDL decrease triglycerides
85
when do you take your statin
in the evening when cholesterol is highest
86
pt teaching for statins
grapefuit juice - no go report muscle soreness
87
what medications lower cholesterol
statins
88
which medication decreases triglyerides
fibrates
89
this is used to treat HF to increase myocardial contractility
digoxin inotropes
90
nursing consideration for inotrope
-drug level that's safe 0.5-2 -listen to apical before giving -monitor HR -monitor serum K+
91
this creates a loss of K+, Na and Mg
diuretics
92
medication is used to treat HF and HTN by reducing fluid volume
furosemide
93
this is K+ sparing diuretic
spironolactonw
94
this is used to prevent MI and stroke taken when ACS is suspected decreases platelet aggregation
aspirin
95
antiplatelet medication - name two
prasugrel clopidogrel
96
what do you assess for after pt has PCI
1. vital signs 2. look for bleeding 3. avoid affected arm for bp and draws for 24 hours 4. leave band on for min two hours 5. neurovascular checks 6. leave pulse ox on
97
waht changes do you report to HCP after PCI
chance in pts vital signs any change in pt's extremity - sensation, pain, bleeding, hematoma, lack of pulse, etc
98

NUS 210 Oxygenation & Cardiac - Test 1 (4 decks)

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