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NCLEX: Mark Klimek Lectures > Cardiac > Flashcards

Cardiac Flashcards

1
Q

what is the difference between negative and positive inotropic meds

A
  • negative = cardiac depressant, relax the heart
  • positive = cardiac stimulants
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2
Q

calcium channel blockers are which type of med?

A
  • negative inotropic meds
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3
Q

ca channel blockers are used for?

A

Antihypertensives

Anti-Anginals

Anti Atrial Arrythmia (any arrythmia that says atrial, NOT ventricular, ex. afib, atrial flutter, etc. with the exception of supraventricular tachy (bc supraventricular means atria)

(think A, AA, AAA)

DO NOT USE IF HAS CHF

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4
Q

what are 2 side effects of ca channel blockers

A
  • headache
  • hypotension
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5
Q

ca channel blockers end in…

A
  • dipine
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6
Q

what are 2 ca channel blockers that don’t end in ___dipine

A
  • verapamil
  • cardizem (diltiazem)
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7
Q

which ca channel blocker can be given IV drip?

A
  • cardizem (diltiazem)
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8
Q

what should be monitored with continuous IV cardizem

A
  • BP before
  • BP during
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9
Q

what BP parameters are used with cardizem/diltiazem

A

hold if systolic <100, titrate so >100

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10
Q

4 cardiac arrythmias to know by sight:

A
  • NSR
  • v fib
  • v tach
  • asystole
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11
Q

NSR looks like…

A
  • peaks of P wave equal distance from each other
  • P for every QRS
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12
Q

v fib looks like..

A
  • chaotic squiggly line
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13
Q

if a question says “lack of QRS”, what arrythmia do you assume it is?

A
  • asystole
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14
Q

if a question says “QRS polarization” assume it has to do with…

A
  • ventricular
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15
Q

if a question says “P wave”, assume it has to do with…

A
  • atrial
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16
Q

if a question says “sawtooth” P wave, assume it is…

A
  • atrial flutter
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17
Q

if a question says “chaotic”, assume it means

A

fibrillation

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18
Q

if a question says “chaotic QRS”, assume it is…

A
  • ventricular fibrillation
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19
Q

if a question says “chaotic P wave”, assume it is..

A
  • atrial fibrillation
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20
Q

if a question says “bizarre”, assume it is?

A
  • tachycardia

ex. “bizarre QRS” = ventricular tachycardia

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21
Q

if a question says “periodic” wide bizarre QRS, what do you assume it is

A
  • PVC
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22
Q

describe the prioritiy if your pt has PVCs

A
  • low
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23
Q

what would make the priority of a pt with PVCs moderate? (3)

A

1) >6 PVCs in 1 min
2) >6 PVCs in a row
3) PVC falls on T wave of previous beat

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24
Q

what are 2 lethal arrythmias

A
  • asystole
  • v-fib
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25
Q

what arrythmia is potentially life-threatening

A
  • v tach (do have CO, where with v-fib and systole you do not)
26
Q

what is the treatment for asystole (2)

A
  • epi (#1)
  • then atropine
27
Q

what is the treatment for v-fib

A
  • de-fib (think v-fib rhymes with de-fib)
28
Q

what is the treatment for PVC & v-tach

A
  • lidocaine
  • amiodarone (think V upside down is an A)
29
Q

what is the treatment for atrial & supraventricular arrythmias (ex. afib, atrial flutter)

A

Adenocard/Adenosine

Beta blockers

Ca channel blockers

Digitalis/Digoxin

30
Q

adenosine is given how?

A
  • IV push over 8 seconds
31
Q

IV push adenosine can cause…

A
  • temporary (<30 sec) asystole
32
Q

beta blockers are..

A
  • negative intropic
33
Q

beta blockers end in…

A

____lol

34
Q

beta blockers are used for…

A

Anti hyptensives
Anti Anginals
Anti Atrial Arrythmias

35
Q

in what case are beta blockers vs Ca channel blockers used?

A
  • if the pt has asthma
36
Q

what is the purpose of a chest tube

A
  • re-establish negative pressure in pleural space, so the lung expands when the chest wall moves
37
Q

a pneumothorax removes…

hemothorax removes…

and pneumohemothorax removes…

A
  • pneumo = air
  • hemo = blood
  • pneumohemo = blood and air
38
Q

ex. a pt has a hemothorax with a chest tube placed. what finding would you report?

a. chest tube not bubbling
b. drained 800mL in an hour
c. no drainage
d. intermittently bubbling

A

C

(with questions like these, look at the reason why it was placed - hemo = expect blood drainage. If pt had a pneumothorax in this question, you would answer a & b)

39
Q

chest tubes can be placed in what 2 locations?

A
  • atrial
  • basilar
40
Q

describe the apical location of a chest tube, what does it remove?

A
  • up high = remove air

(think A and A)

41
Q

describe the basilar location of a chest tube, what does it remove?

A
  • lower = remove blood

(think B and B)

42
Q

how many chest tubes for a unilateral pneumohemothorax?

A

2 –> apical and basilar

43
Q

how many chest tubes for a bilateral pneumo

A

2 –> apical on right and left side

44
Q

how many chest tubes for a postop chest surgery

A

2 –> apical & basilar on right side of surgery

45
Q

how many chest tubes for a postop right pneumoectomy?

A

0

46
Q

what do you do if you know over the plastic collection container of a chest tube?

A
  • pick up and DB (as long as its not broken)
47
Q

what do you do if the water seal breaks

A

1) clamp it
2) cut away from broken device
3) submerge in sterile water (if asked the best option when this happens, this is it)
4) unclamp

48
Q

what do you do if a chest tube is pulled out

A
  • first: cover with gloved hand
  • best option: cover with vaseline gauze
49
Q

bubbling in the water seal that is intermittent is ____

A

good

50
Q

bubbling in the water seal that is continuous is _____

A

bad, indicates a leak (find tape and cover)

51
Q

bubbling in the suction control chamber and intermittent is _____

A

bad, indicates not enough suction (turn up suction)

52
Q

bubbling in the control chamber that is continue is _____

A

good

53
Q

what is the rule when clamping a chest tube

A
  • do not clamp for longer than 15 sec without doctors order
54
Q

congenital heart diseases are either…

A
  • trouble or not trouble
54
Q

what type of clamp should be used when clamping a chest tube

A
  • rubber tip double clamp
55
Q

what are characteristics of “trouble” congenital heart diseases

A
  • require emergency surgery
  • growth and development is delayed
    -causes stress, anxiety
  • needs cardiology
  • longer hospital stays
    etc.
56
Q

all congenital heart diseases that start with ____, are “trouble”

A

T

57
Q

trouble congenital heart defects shunt blood which way? the pt is ?

A
  • shunt from right to left
  • cyanotic

(think when spelling trouble, right comes before left)

58
Q

no trouble congenital heart defects shunt blood which way? and the pt is?

A
  • left to right
  • acyanotic
59
Q

all congenital heart defect kids will have…. (whether trouble or not)

A
  • murmur
  • echo done
60
Q

what are the 4 defects of tetralogy of fallot

A

1) Ventricular defect
2) pulmonary stenosis
3) overriding aorta
4) right ventricular hypertrophy

(think: Valentine’s Day Pick Someone Out A Red Heart)

61
Q
A

NCLEX: Mark Klimek Lectures (20 decks)

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