Cardiac 2

Question 0

What 3 issues cause left sided heart failure?

Answer 0

Hypertension, cad, valvular disease

Question 1

Etiology: 75% of all heart failure cases come from what?

Answer 1

Systemic hypertension

Question 2

What type of left sided heart failure is described by the heart not pumping enough blood out?

Answer 2

Systolic heart failure

Question 3

What type of left sided heart failure is described as insufficient filling of the chambers and a stiffening of the left ventricle?

Answer 3

Diastolic heart failure

Question 4

What type of heart failure is described by: the heart backing up into the lungs

Answer 4

Left sided heart failure

Question 5

What is the term for the percentage of blood ejected from the heart during systole? And what is normal?

Answer 5

Ejection fraction. 60-75%

Question 6

What is this process? Abnormal relaxation and stiffness of heart-elevated left ventricle filling pressure-elevated pulmonary pressure-reduced exercise tolerance.

Answer 6

Diastolic dysfunction

Question 7

What 3 things cause right sided heart failure?

Answer 7

Left sided heart failure, right side mi, pulmonary hypertension

Question 8

What happens when the right ventricle cannot fully empty causing an increase in Volume and pressure in the venous system resulting in peripheral edema?

Answer 8

Right sided heart failure

Question 9

True or false: all compensatory mechanisms add to increase need for o2

Answer 9

True

Question 10

Name the disease: clinical manifestations –weakness, confusion, sob, pulmonary congestion, no urine output

Answer 10

Left sided heart failure

Question 11

Name the disease: clinical manifestation- dependent edema, weight, distended neck veins, hepatomegaly, ascities

Answer 11

Right sided heart failure

Question 12

How many lbs of water must a person gain before putting edema sets in?

Answer 12

10-15 lbs

Question 13

What does a bnp lab test tell?

Answer 13

How much fluid overload is in the body

Question 14

Sob + elevated bnp=

Answer 14

Heart failure

Question 15

Sob + normal bnp =

Answer 15

Pulmonary cause

Question 16

What are the goals of interventions for impaired gas exchange?

Answer 16

Increased pulse of and reduce o2 given

Question 17

What medicine is the first line of defense for decreased cardiac output?

Answer 17

Ace inhibitor

Question 18

What medication do you use to enhance contractility of the heart?

Answer 18

Beta blocker

Question 19

What is the widespread abnormal cellular metabolism that occurs when human need for o2 and tissue perfusion is not met for function?

Answer 19

Shock

Question 20

What are the 3 classifications for shock?

Answer 20

Cardiogenic, hypovolemic, and distributive

Question 21

What are the 4 causes of shock?

Answer 21

Fluid loss, hypo-perfusion, injury, weakened cardiac contractility

Question 22

What are the 3 components of the cascade of metabolic metabolism?

Answer 22

Hypothermia, coagulopathy, acidosis

Question 23

True or false: manifestations of shock are similar regardless of what starts the process.

Answer 23

True

Question 24

What measures tissue perfusion?

Answer 24

Mean arterial pressure

Question 25

What is the normal range for MAP?

Answer 25

75-110mmHg

Question 26

How do you calculate MAP

Answer 26

(2 x diastolic + systolic) / 3

Question 27

What factors influence MAP?

Answer 27

Total blood volume, cardiac output, sz of vascular bed

Question 28

True or false: Increased blood volume, cardiac output, and vasoconstriction increases MAP

Answer 28

True

Question 29

True or false: decreased blood volume and cardiac output with vasodilation cause decreased MAP

Answer 29

True

Question 30

What 4 factors determine the severity of hypovolemic shock?

Answer 30

Co-morbidity, age, time before treatment, venous vs arterial

Question 31

What are the four stages of shock?

Answer 31

Initial- early Non-progressive- compensatory Progressive- immediate stage Refractory- irreversible

Question 32

In what stage of shock does shunting occur?

Answer 32

Non-progressive compensatory

Question 33

What is shunting?

Answer 33

Blood is used for important organs first

Question 34

What is the goal of compensatory shock?

Answer 34

Keep volume in central blood vessels

Question 35

True or false: a person can stay In the non-progress phase for hours and not have lasting damage.

Answer 35

True

Question 36

Name the state of shock: compensatory is working but not enough 02 for organs, anoxic cell death, life threatening

Answer 36

Progressive immediate

Question 37

Name the state of shock: rapid loss of confusion, non palpable pulses, cold mottled skin, cell/tissue death, depressed heart, can lead to MODS

Answer 37

Refractory - irreversible

Question 38

Name the disease: massive release of toxins, trigger small clots, blocks tissue oxygenation, damage more cells

Answer 38

MODS

Question 39

What are the odds of surviving progressive shock?

Answer 39

50/50

Question 40

True or false: you can have more than one type of shock at the same time

Answer 40

True

Question 41

What is the triad of shock

Answer 41

Coagulopathy, hypothermia, acidosis

Question 42

What determines the amount for transfusion for a pt?

Answer 42

Amount loss in 24 hrs

Question 43

What is the best monitor for tissue perfusion?

Answer 43

Pulse ox

Question 44

What is interesting about BP in hypovolemic shock?

Answer 44

Systolic decrease diastolic increase

Question 45

What is a lactate test?

Answer 45

Determines how much lactic acid is in the blood. Lower the better

Question 46

True or false: 02 should remain around 95% to ensure safety. Any higher can cause organ and lung damage

Answer 46

True

Question 47

What are synthetic plasma expanders?

Answer 47

Used by military, no cross match needed

Question 48

What do you use to pre medicate before a transfusion?

Answer 48

Antipyretic and anti inflammatory

Question 49

What is the only solution that can be a primary with a blood transfusion?

Answer 49

Normal saline only

Question 50

What disease will a pt present with kussmaul breathing?

Answer 50

Dka

Question 51

What disease will a patient present with biots breathing pattern?

Answer 51

Neuro issues

Question 52

Breath sound= high pitched, narrowing, musical sound

Answer 52

Wheeze

Question 53

Breath sound: crowing in trach and upper airway

Answer 53

Stridor

Question 54

Breath sound: fluid in lungs, light popping sound, not musical

Answer 54

Crackles

Question 55

What monitors co2 and ph

Answer 55

Brain stem

Question 56

What is the name for the constant change of o2 and co2?

Answer 56

Diffusion

Question 57

What is the most common cause of hypoxemia?

Answer 57

Abn ventilation to perfusion rate

Question 58

What patients get hypercapneia ( too much co2)?

Answer 58

Unconscious pt, drug overdose, copd

Question 59

What is atelectasis?

Answer 59

Complete collapse of alveoli

Question 60

What does carbonic acid regulate?

Answer 60

Regulates ph

Question 61

What is aat relating to copd?

Answer 61

Protein that protects the lungs

Question 62

Name the disease: abn permanent enlargement of air space, loss of lung elasticity, alveoli wall fibrosis, hyperinflation/distension of alveoli, flattened diaphragm

Answer 62

Emphysema

Question 63

What is an avelolar bleb?

Answer 63

When it bursts open

Question 64

What is an avelolar bullae?

Answer 64

Collapse of alveola

Question 65

Poor gas exchange in lungs leads to vasoconstriction that leads to pulmonary hypertension. Right ventricle fails die to pumping against high pressure in lungs . Right sided failure

Answer 65

Cor pulmonale