Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NCLEX > Cardiac > Flashcards

Cardiac Flashcards

1
Q

preload

A

the amount of blood returning to the right side of the heart and the muscle stretch that the volume causes. ANP is released when we have this stretch.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

afterload

A

the pressure in the aorta and peripheral arteries that the left ventricle has to pump against to get the blood out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

with HTN there’s even more ____ for the left ventricle to pump against. that’s why ____ can eventually lead to HF and pulmonary edema, because high afterload ____ CO and ____ forward flow. plus, it wears your heart out

A

resistance
HTN
decreases
decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

stroke volume

A

the amount of blood pumped out of the ventricles with each beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CO= ____

A

HR times SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

less pressure = ___ CO

more pressure = ___ CO

A

decrease

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q 
If you CO is decreased, 
will you perfuse properly?
brain: LOC will go \_\_\_
heart: client reports of \_\_\_
Lungs: SOB? Lung sounds?
Skin: 
Kidneys: UO \_\_\_
peripheral pulses:
A 
No
down
chest pain
yes and lungs sound wet
cool and clammy
down
weak and thready
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are 3 arrhythmias that are a big deal?!

A
  1. pulseless vtach
  2. vfib
  3. asystole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

chronic stable angina

A

decreased blood flow to the myocardium—ischemia–temp. pain/pressure in the chest

pain comes on by low o2 usually due to excretion

rest relieves pain or nitro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q 
nitroglycerin:
 \_\_\_\_ preload and afterload.
take 1 every \_\_\_ , \_\_ doses
okay to swallow?
renew how often?
A

decreases
5 mins, 3 doses
no
3-5months, spray 2 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what should you do before giving beta blocker?

A

check HR and BP!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is beta blocker?

A

[propanolol,metoprolol,]
for prevention of angina
-decrease BP,HR, myocardial contractility
-decreases the workload of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

calcium channel blockers?

A 
[verapamil,amlodipine]
prevention of angina
-decreases BP
-causes vasodilation
-decrease afterload and increase o2 to the heart muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

aspirin

A

use to keep platelets from sticking together

-dose it determined by the physician (81-225mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

treatment for chronic stable angina

A
  • nitro
  • beta blocker
  • calcium channel
  • asa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

the 5 p’s

A 
pulselessness
pallor
pain
paresthesia
paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

preprocedure for cardiac cath:

A

ask if they are allergic to shellfish or iodine

also check kidney function (because you excrete dye through the kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q 
post procedure for cardiac cath:
bed rest, leg straight for \_\_\_ hours
watch for bleeding
5 p's extremity distal to puncture site
major complication?\_\_\_
if the client is on metformin, you should?
A

4 to 6 hours
hemmorage
hold the medicine for 48 hours post procedure. we are worried about the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the women triad of symptoms for acute MI?

A 
GI S/S
epigastric complaints 
pain between the shoulders
aching jaw
choking sensation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when a patient is having an STEMI, this indicates that the client is having a heart attack and the goal is ___

A

is to get them to the cath lab for PCI in less than 90 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what increases with damage to the cardiac cells?

when does it elevate?

A

CPK-MB
(cardiac specific iso-enzyme)

3-12 hours and peaks in 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

troponin elevates within ____ and remains elevated for ___.

A

cardiac biomaker with high specificity to myocardial damage.

3-4 hours
3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

myoglobin increases within ____ hours and peaks in __ hours.

A

1 hour
12 hours
(negative results are a good thing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

which cardiac biomarker is the most sensitive indicator for an MI?

A

troponin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

which enzymes or markers are most helpful when the client delays seeking care for an MI?

A

tropinin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what untreated arrhythmias will put the client at risk for sudden death?

A

pulseless v-tach
vfib (dfib the vfib!)
asystole
bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

if the first shock doesn’t work and the client remain in vfib, what is the first vasopressor we give?

A

epinephine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

lab value for troponin

A

T less than 0.10. I less than 0.03

29
Q

____ is an anti-arrthythmic and is used when v-fib and pulseless VT are resistant to treatment, also for fast arrhythmias

A

amiodarone (drug of choice)

30
Q

what anti-arrhythmic drugs are commonly given to prevent a second episode of v-fib?

A

amirodarone and lidocaine

31
Q

lidocaine toxicity: _____

A

any neuro changes

32
Q

amiodorone is _____.

important side effect is ____.

A

the first anti-arrhythmic of choice

hypotension

33
Q

what drugs are used for chest pain when they get to theED?

A

oxgyen
ASA (chewable, absorbs faster)
nitro
morphine (if pain isnt relieved)

head up position.. because decreases workload on the heart and increases CO

34
Q

what are the fibrinolytics drugs?

how soon after the onset of myocardial pain should these drugs be administered?

A

-dissolves the clot that is blocking the blood flow to the heart muscle—-decreased the size of the infarction

streptokinase,alteplase

within 6-8hours
(exception to this is CVA, time loss is brain loss! 3hr with CVA)

35
Q

what is the widow maker (sudden death)?

A

left main coronary artery occulsion

36
Q

left side heart failure

A

the blood is not moving forward into the aorta and out to the body…. IF it does not move forward, then it will go backwards into the LUNGS!

37
Q

s/s of left side heart failure

A 
left=lungs!!
pulmonary congestion
dyspnea
cough
blood tinged frothy sputum
restlessness
tachycardia
S-3
 orthopnea
nocturnal dyspnea
38
Q

right side heart failure

A

the blood is not moving forward into the lungs…IF it does not move forward then it goes backwards into the VENOUS system

39
Q

s/s of right side heart failure

A 
right=venous thing
distended neck veins
edema
enlarged organ
weight gain 
ascities
40
Q

systolic heart failure

A

heart cant contract and eject

41
Q

diastolic heart failure

A

ventricles cant relax and fill 

42
Q

BNP (b-type natriuretic peptide):

A
  • secreted by the ventricular tissue in the heart when the ventricular volumes and pressure in the heart increased
  • sensitive indicator
  • can be positive for HF when the CXR does not indicate the problem
  • if the pt is on nesiritide, turn it off 2 hr prior to drawing BNP
43
Q

how do you diagnose heart failure?

A

BNP
CXR
echocardiogram

44
Q

what is the standard medication for HF?

A

ACE inhibitors and ARBs

45
Q

ACE inhibiotors:

A

drug of choice for HF
suppress the renin angiotensin system
prevent conversion of angiotensin 1 to angiotensin 2
results in the arterial dilation and increased SV

46
Q

ARBs

A

-block angiotenin 2 receptors, and cause a decrease in arterial resistance and decreased BP

47
Q

ace inhibitors and ARBS block ____.

A

aldosterone. when we block aldosterone, we lose sodium and water and retain potassium.

48
Q

digoxin is used with ….

A

sinus rhythm or afib and accompanying chronic HF.

makes contractions stronger
slows HR down
CO up
kidney perfusion UP

49
Q

normal digoxin level

A

0.5-2

50
Q

s/s of digoxin toxicity

A

early: anorexia, N/V
late: arrhythmias and visual changes (halos around the lights)

51
Q

_____ + digoxin= toxcity

A

hypoglycemia

52
Q

diuretic decrease ___.

when should you give diuretic?

A

preload

in the morning

53
Q

loss of capture with pacemaker

A

no contraction will follow the stimulus

54
Q

who is at risk for pulmonary edema?

A

any person :
receiving IV fluid really fast
very young and very old
any person with history of heart or kidney disease

55
Q

what is pulmonary edema?

A

fluid is backing up into the LUNGD. the heart is unable to move the volume forward.
pulmonary edema usually occurs at night, when the client goes to lie down.

56
Q

s/s of pulmonary edema?

A 
sudden onset
breathless
restless/anxious
severe hypoxia
productive cough (pink frothy sputum)
57
Q

tx for pulmonary edema?

A

diuretics
nitro
morphine
nesiritide

58
Q

furosemide, you should give _____ to prevent hypotension and ototoxicity

A

40 mg IV push slowly over 1-2 mins

59
Q

bumetanide can be given _____ to provide rapid fluid removal.

should be given ___ over 1-2 mins

A

IV push or as a continuous iv infusion

1-2 mg IV push

60
Q

remember to turn the nesiritide infusion OFF ….. when?

A

2 hrs before drawing a BNP level

61
Q

cardiac tamponade

A
  • blood ,fluid, or exudate have leaked into the pericardial sac resulting in compression of the heart
  • this can happen if the client has had a motor vehicle collision, right ventricular biopsy, and MI, pericarditis, or hemorrhage post CABG/s of c
62
Q

s/s of cardiac tamponade

A 
decreased CO
cvp will go UP
BP will drop
 (hallmark is increase cvp, decrease bp)
heart sounds will be muffled or distant
neck veins distended
pressure in all 4 chambers are the same
shock
narrowed pulse pressure (bp 120/80...pule pressure is 40)
63
Q

narrowed pulse pressure think:

widened pulse pressure think:

A

cardiac tamponade

increased intracanial pressure

64
Q

tx for cardiac tamponade

A

pericardiocentesis to remove blood from around the heart

-surgery

65
Q

intermittent claudication is hallmark sign for __.

A

arterial disorders

66
Q

postion:
we ELEVATE ___
we DANGLE ___

A

veins

arteries

67
Q

s/s of dissecting aorta

A

severe burning back pain, unlike anything

may feel pulsation

68
Q

if vein problems, dont answer with an ____.

A

oxygen!

NCLEX (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions