Cardiac Flashcards
(24 cards)
What is the concern with muffled heart tones
Muffled heart tones in a patient with a pericardial effusion can indication cardiac tamonade (Build up of fluid around the heart, limiting ventricular filling.
What is Pulsus Paradoxus
A rapid fall in systolic BP during inspiration. Inidcating Cardiac tamponade
What does V-fib look like on an ECG
Large peaks with no pattern. Described as Chaotic QRS complexes
What does V-tach look like on an ECG
Sharp peaks with pattern. Described as Bizzare QRS complexes
What does a-fib look like on an ECG
Described as chaotic, too many P waves
What to PVCs look like on an ECG
Periodic Bizzare QRS complexes
Under what circumstances are PVC high priority
3 or more PVCs in a Row or Minute
How to treat supra-ventricular arrythmias
A- Adenosine
B - Beta Blocker
C - Calcium Channel Blocker
D - Digoxin (LANOXIN)
What does a-flutter look like on an ECG
Described as saw-tooth, too many p-waves
Aortic Anuerysm and NI
Weakening of the aorta wall causing a blood filled buldge that will continue to expand until bursts
- pulsating abdominal mass
- If ruptutred (intense abdominal and flank pain, decreased BP, increased HR, signs of hypovolemic shock)
- Post op ressection monitor I/O, peripheral pulses
Aortic Dissection and NI
Tear developed in inner layer of arota , blood will surge through causing a separation in the wall (think blister).
- Chest pain, radiating
- HTN
- diaphoretic
- BP different on each arm (if subclavian involved
- Complication of cardiac tamponade
- NI: manage BP
What are the three types of angina
Stable: fixed stable partial obstruction. Triggered on exertion, releived with rest and nitro
Unstable: rupture of unstable plaque. Unpredictable. Not relieved with nitro
Vasopasmic: coronary vasospasm, occurs at rest. Triggered by smoking
Main differerence between MI and unstable angina
In unstable angina there is no tissue death
MI management
- Aspirin (decrese platelet aggregation)
- nitrates - subL ( vasodilator, decrease BP)
- Morphine (decrease pre-load)
- Oxygen (if spo2 <94 or dyspnea)
- Betablockers (decrease BP and HR)
- IV heparin (increase blood flow)
- statin (decrease cholesterol)
CVI vs PAD
CVI
Incompetent valves = blood pooling = vericose veins = edema = ulcreation
- tx: elevate legs
PAD
narrowing of arteries d/t atherosclerosis resulting in decreased peripheral tissue perfusion (think leg angina)
- tx: dangle legs or take breaks when walking
- s/s: loss of hair, brittle nails, gangrene
Pericarditis
Inflamation of pericardial membrane
- may hear friction rub
- watch for signs of cardiac tamponade
What does failure to capture mean
It indicates that the pacemaker is fireing but the myocardium is not responding.
If the patient is hemodynamically stable transcutaneous pacing is the appropriate intervention
What is pink tinged sputum a sign of when accompanied by an MI
Pulmonary edema. The back pressure in the lungs causes vessels to burst causing the pink tinged sputum
Arterial Insufficency VS Venous Insufficiency
Arterial
- ischemic muscle pain, relieved with rest
- hair loss and brittle nails
- gangrene
- decreased peripheral pulses
- cool, dry, shiny skin
- small, circular, deep ulcer
- relief with dangle
Venous
- varicose veins
- warm, thick, indurated skin
- brown, hyperpigmentation
- large irregular, superficial ulcer with drainage
- edema
- relief with elevation
Symptoms of R vs L Congestive HF
R
- jugular vein distention
- edema
L
- Pulmonary congestion/audible crackles
What do murmurs sound like
turbulent blood flow that can be described as musical, blowing, or swooshing sound
For how long is pulselessness normal post AAA repair
4-12hrs (d/t vasospasm)
Aortic stenosis
The narrowing of arotic valve, causing small ejection fractions and a narrowed pulse pressure.
Pt may get dizzy or experience syncope
Interventions for DIC
- Initiate Vasopressors to increase blood pressure and restore tissue perfusion
- Monitor coagualtion studies
- Tranfuse fresh frozen plasma and platelets
