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Back To Basics > Cardiac > Flashcards

Cardiac Flashcards

1
Q

CVP:
Measures
Normal parameter
Which port to use

A

Measures: preload (right atrial pressure)
Norm: 2-6 mm Hg
Port: proximal port

Catheter placement outside line markers:
RA/CVP = 25-30cm
RV= 35-45 cm
PA= 50-55 cm

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2
Q

Contraindications for thrombolytics

A

History of hemorrhagic stroke, CVA last 12 months, SBP over 180, pregnancy or 1 month postpartum

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3
Q

Normal values:

CVP/RAP

A

CVP: 2-6

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4
Q

Normal values:

Cardiac output

A

CO:SV x HR (4-8 L/min)

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5
Q

Cardiac index

A

CI: 2.5-4.2

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6
Q

Pulmonary artery systolic/diastolic

A

PAS/PAD: 15-25/8-15

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7
Q

Wedge (PAWP/PCWP)

A

8-12

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8
Q

SVR

A

800-1200 dynes/sec/cm-5

-when assessing CVP or PA, pressures on a mechanically ventilated patient, assess pressures at the end of exhalation

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9
Q 
Cardiogenic shock:
CVP
Cardiac output 
PAS/PAD
PAWP
SVR
Heart rate
A 
CVP:high
CO:low
CI: low
PAS/PAD: high
PCWP: high
SVR: high
Heart rate: initially fast, then slows down
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10
Q

CHF considerations:
Preload
Lab test
Medications

A

Many CHF patients are relatively hypovolemic. Careful with diuretics and medications that can decrease preload

BNP= lab test nonspecific >500
No beta-blockers, except for carvidolol(Coreg)
Natracor(neseritide)= synthetic version of BNP

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11
Q

Digoxin

  • class
  • causes what electrolyte imbalance
  • ECG changes
A
  • cardiac glycoside
  • hypokalemia
  • “dig dip” ST depression
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12
Q

PAWP/PCWP

  • Function
  • Normal
A

Pulmonary artery wedge pressure/Pulmonary capillary wedge pressure

  • looks at the left side of the heart, if high can indicate pulmonary congestion, CHF, and cardiogenic shock
  • PAWP/PCWP:8-12mmHg
  • do not keep wedge for more than 15 seconds, make sure that balloon is deflated and have patient cough forcefully
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13
Q

Arterial line

  • sites
  • purpose
A

Radial, femoral
Monitor pressure, blood draw, ABGs
Maintain pressure bag at 300 mmHg
-under dampening:caused by having air in the system, loose connection, low pressure bag, and altitude changes
-over dampening: caused by kinking, increased bag pressure, and tip against the wall

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14
Q

ECG

  1. Most common reperfusion dysrhythmia
  2. Most common hypothermia dysrhythmia
  3. Hypokalemia on ECG
  4. Hyperkalemia on ECG
A
  1. Reperfusion: AIVR
  2. Hypothermia: VF, (Osborn wave)
  3. Peaked P’s, flat T’s
  4. Flat P’s, peaked T’s (treat with calcium)
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15
Q 
12-lead ECG
Inferior
Septal
Anterior
Lateral
Posterior
A 
"I See All Leads"=inf/sept/ant/lat
Inferior:II, III, aVF
Septal: V1, V2
Anterior: V3, V4
Lateral: I, aVL, V5, V=Posterior:ST segment depression or reciprocal changes noted in V1-V4, ST elevation V6
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16
Q

Cardiac

  • Ischemia
  • Injury
  • Infarct
A

Ischemia:ST depression (1 mm in 2 leads)
Injury: ST elevation ( 1 mm in 2 leads)
Infarct: Q wave>25% the height of the R wave

17
Q

Normal cardiac index

A

CI: 2.5-4.3

18
Q

Thrombolytics must be administered within?

A

Three hours of onset of chest pain

19
Q

Tetralogy of Fallot (TOF)

A 
Remember PROV
P= pulmonary stenosis
R= right ventricular hyper trophy 
O= overriding aorta
V= ventricular septal defect
20
Q

What is a tet spell?

A

During a “tet” spell, blood flow across the right ventricular outflow tract is significantly decreased, resulting in shunting right-to-left through the VSD out of the aorta, thus bypassing in the lungs.
Causes include: spasms, sudden decrease in systemic vascular resistance secondary to hypovolemic, dehydration, hot weather, or defecation. Tet spells are usually seen in the neonatal period, and peak in incidence between two and four months of life.

21
Q

Cardiac output

A

Heart rate x stroke volume = CO

22
Q

CPK> 20,000

A

CPK (muscle enzyme) levels greater than 20,000 is ominous and is an indication of later DIC, acute renal failure and is potentially dangerous hyperkalemia in the heatstroke patient

23
Q

Drugs for AAA

A

Nipride and beta-blockers

Back To Basics (7 decks)

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