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Med Surg 2 > Cardiac > Flashcards

Cardiac Flashcards

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1
Q

s/s heart disease

A

dyspnea
orthopnea
paroxysmal nocturnal dyspnea
consider also sleep apnea

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2
Q

CPAP

A

constant positive airway pressure

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3
Q

BiPAP

A

bi level positive airway pressure

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4
Q

BiPAP function

A

assists in breathing

helps keep airway open and lungs inflated

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5
Q

cardiac assessment

A 
edema
weight gain
syncope
palpations
fatigue
chest pain
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6
Q

cardiac conditions causing chest pain

A

ischemic heart disease
pericarditis
aortic dissection

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7
Q

non cardiac conditions causing chest pain

A

pleurisy
pulmonary embolism
hiatal hernia
anxiety

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8
Q

chest pain assessment

A 
quality
intensity
association manifestations
aggravating factors
relieving factors
age 
gender
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9
Q

troponin I

A

enzyme specific to heart muscle, immediately released, lasts for 1 week

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10
Q

LDH

A

lactic dehydrogenase
rises within 8-12 hours post MI
persists for 8-14 days

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11
Q

CK-MB

A

creatine kinase myoglobin

rises for first 3 days POST MI

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12
Q

ESR

A

erythrocyte sedimentation rate
elevated in cardiac muscle damage
females - up to 20 mm/hr
males - up to 15 mm/hr

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13
Q

myoglobin

A

O2 binding protein found in cardiac and skeletal muscle

peaks in 4-6 hours

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14
Q

CK

A

poor marker

injured skeletal muscle peaks in 12-18 hours

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15
Q

CRP

A

marker for inflammation, may include infection

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16
Q

homocysteine levels

A

elevated levels are associated with coronary vessel disease

elevated >16 pmol/L

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17
Q

BNP

A

brain natriuretic peptide

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18
Q

what is BNP specific to?

A

CHF

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19
Q

what does BNP help regulate

A

BP and fluid volume

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20
Q

where is BNP excreted from?

A

ventricles

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21
Q

what response is BNP excreted due to

A

in response to increase preload

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22
Q

what level of BNP is considered mild vs severe CHF

A

mild - 51.2pg/mL

severe - >1000pg/mL

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23
Q

nursing interventions for cardiac disease

A

lifestyle changes
behavioral modifications
education about pharmacological therapy

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24
Q

what kinds of lifestyle changes are involved

A 
dietary 
exercise
smoking cessation
reduction of stress
use of support system
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25
how many calories are allotted per day by AHA and ADA?
1200 women | 1600 men
26
nutrition can impact?
HTN dyslipidemia glucose levels
27
DASH diet
an eating plan for lowering HTN and reducing obesity
28
DASH diet emphasis
fruits, nuts, veggies low fat diary complex carbs restricts saturated fats and sodium
29
mediterranean diet characteristics?
doesn't emphasize low fat dairy no Na restriction required favorable impact on obesity and other metabolic factors
30
is mediterranean diet vs DASH diet in reducing HTN
not as effective
31
result of reducing intake of simple carbs
reduces avg glycosylated hb (A1C)
32
atherogenic diet
eating pattern compromised of high level of fat and refined carbs. linked to elevated triglycerides and reduced levels of high density lipoprotein cholesterol (HDL -C)
33
which fats do you consume less of to reduce weight?
saturated fats transfats refined carbs
34
which oil reduces plasma lipid profile and reduces blood pressure?
Fish oil - omega 3
35
recommended exercise?
aerobic 30 min/day 5 days/week undertaken slowly increases based on client tolerance
36
smoking interventions
``` educate patient on benefit record # of cigs smoked daily for 1 week review diary and ask patient to select time they can avoid recommend support group medications ```
37
which hormones does stress release?
NE, epinephrine, cortisol
38
types of meds for cardiac patients
cardiac meds cholesterol lowering meds antithrombotic meds
39
patient teaching for cardiac
monitor BP | keep journal of diet, exercise, BP, Glucose
40
types of meds prescribed for CHF or HTN
diuretics
41
common diuretics
Loop - Furosemide (Lasix) | Potassium sparing - Spironolactone (Aldactone)
42
s/e of thiazides
increase Glu | decrease K+
43
s/e of loop diuretics
low K+ levels dizziness may need sunscreen
44
s/e of K+ sparing diuretics
monitor K+ levels | avoid Na and K substitutes
45
purpose of ace inhibitors
vasodilation | inhibits conversion of angiotensin from the lung
46
ARBS
angiotensin II receptor blockers ie: Benicar restructures the heart
47
how are ace inhibitors and arbs effective
protect the kd function control HTN prevent inschemic cardiovascular disease
48
ace inhibitor s/e
persistent cough | may increase K+
49
ARB s/e
dizziness | may increase K+ levels
50
when are Ca Chan blockers prescribed?
post CHF and MI (Procardia) | for HTN
51
beta blockers are also used for?
``` HTN post CHF (inderal) ```
52
example of alpha blocker
Minipress
53
s/e of Ca chan blockers
SOB, peripheral edema, slows heart rate
54
education about Ca chan blockers
use TED hose
55
beta blocker s/e
dizziness fatigue exercise intolerance wheezing
56
beta blocker teaching
monitor VS do not stop abruptly - rebound selective vs non selective masks low blood sugar
57
alpha blockers teaching
orthostatic hypotension | masks low blood sugar
58
who is prescribed alpha blockers
Bph patients
59
direct vasodilators s/e | Apresoline
h/a fluid retention fast heart rate
60
Catapres teaching
do not stop abruptly | fatigue
61
digoxin
cardiac glycoside | prescribed post CHF and tachyarrhythmia
62
action of digoxin
increases intracellular ca and allows more ca to enter cell during depolarization prolongs action potential slows conduction and HR increases force of myocardial contraction
63
interventions for digoxin
check apical HR before administer - need to check > 1 min; > 60 BPM watch for toxicity - drowsy, abd pain, anorexia, vomiting, visual disturbance and yellow halos check other labs - K, Ca, Mg monitor digoxin levels -
64
statin s/e
Lv Kd function affected | muscle pain - Rhabdomyolysis
65
fibric acid derivative s/e (Lopid)
Lv function | muscle pain
66
Niacin s/e
flushing - feels like skin burning off Lv affected increase Glu level
67
what else is prescribed in addition to statin (lipitor) for high cholesterol
``` fibrate acid derivative (Lopid) Niacin cholesterol absorption inhibitor (Zetia) Lipid combo (Vytorian) Bile Acid sequestrant (Questran) ```
68
Bile acid sequestrant teaching
can't take with other meds | aka metamucil
69
Zetia s/e
monitor Lv enzymes
70
Vytorian s/e
muscle pain | monitor Lv enzymes
71
Questran s/e
GI disturbance | watch dosing schedule
72
mechanism of drug food interaction with grapefruit
involving specific isoform of cytochrome p450 cyp3a4 present in Lv and intestinal wall

Med Surg 2 (1 decks)

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