Cardiac

Question 1

increased preload = increased ______

Answer 1

workload

Question 2

_____ released with stretch caused by _______

Answer 2

ANP, preload

Question 3

afterload = _______

Answer 3

resistance

Question 4

stroke volume = ______

Answer 4

amount of blood with each contraction

Question 5

________ depends on CO

Answer 5

perfusion

Question 6

______ influences CO
MORE _______ = ________ CO
LESS ________ = _______ CO

Answer 6

volume
volume = increased
volume = decreased

Question 7

preload meds ________ to _______ preload
diuretics ________
nitrates _______

Answer 7

vasodilate, reduce
furosemide
NTG

Question 8

afterload meds \_\_\_\_\_\_ to \_\_\_\_\_\_\_ afterload
ACE \_\_\_\_\_\_
ARB \_\_\_\_\_\_
hydralazine
nitrates \_\_\_\_\_

Answer 8

vasodilate, reduce
-pril
-sartan
hydralazine
NTG

Question 9

these drugs improve contractility

1. ______ 2. ______ 3. ______

Answer 9

inotropes

1. dopamine 2. dobutamine 3. milrinone

Question 10

these drugs control rate
beta blockers ______
CCB ______
Digoxin

Answer 10

-olol

diltaizem, verapamil, amlodipine

Question 11

this drug controls rhythm

antiarrhythmic, used for _______

Answer 11

amiodarone

v-tach

Question 12

Patho of Decreased CO
\_\_\_\_\_\_ ventricle
\_\_\_\_\_\_ volume, \_\_\_\_\_\_ pressure, \_\_\_\_\_\_ CO, \_\_\_\_\_\_ perfusion
LOC \_\_\_\_\_\_\_
\_\_\_\_\_\_ pain
lungs \_\_\_\_\_\_
SOB? \_\_\_\_\_
skin is \_\_\_\_\_\_ & \_\_\_\_\_\_\_\_
urine output \_\_\_\_\_\_\_
pulses are \_\_\_\_\_\_
\_\_\_\_\_\_\_ are no big deal until they affect \_\_\_\_\_

Answer 12

left
less, less, decreased, poor

decreases
chest
wet
YES!
cool, clammy
decreases
weak
arrhythmias, CO

Question 13

These arrhythmias are always a big deal

Answer 13

V-tach
V-fib
Asystole

Question 14

CAD includes:

Answer 14

1. Chronic Stable Angina

2. Acute Coronary Syndrome

Question 15

Chronic Stable Angina
Patho:
\_\_\_\_\_\_\_ leads to temporary \_\_\_\_\_\_\_
low \_\_\_\_\_\_ due to \_\_\_\_\_\_ 
relieved by \_\_\_\_\_\_ and \_\_\_\_\_\_\_

Answer 15

ischemia, chest pain
oxygen, ischemia
rest, NTG

Question 16

CSA Meds–Nitro:
NTG which causes _______ = ________ preload & afterload = _______ workload & ______ O2 demand
______ arteries are also dilated, which ______ O2 to the heart
do not _______ NTG, take _____ pill every ______ minutes for a max of ____ pills
do not store in _________
different brands may cause ______ or _______
client WILL get a _________ d/t _________
new pills after _____ months or new spray after ____ years
expect BP to _______ d/t ________
prophylactically, ______ then take ______

Answer 16

vasodilation, decreased, decreased, decreased

coronary, increases

swallow, 1, 5, 3

pockets
burn, fizz
HEADACHE, vasodilation
3-5, 2

decrease, vasodilation
rest, NTG

Question 17

CSA Meds--Beta Blockers:
for \_\_\_\_\_\_\_\_\_ of angina
BP, HR, contractility all \_\_\_\_\_\_\_\_\_\_
workload of the heart \_\_\_\_\_\_\_\_\_ = \_\_\_\_\_\_\_ CO
check \_\_\_\_\_\_\_ before giving

Answer 17

prevention
decreased
decreased, decreased
BP

Question 18

CSA Meds–Calcium Channel Blockers:
for ________ of angina
BP _______
cause _______ of arterial system, ______ afterload
since they decrease ________, they increase _________ to the heart muscle by dilating ________ arteries

Answer 18

prevention
decreases
vasodilation, decrease
afterload, oxygen, coronary

Question 19

CSA Teaching/Education
_______ frequently: _______ activity with rest
avoid ______: ______ fat, _______ fiber
avoid _________
wait ____ hours after eating to exercise, dress ______ in cold weather because _____ decreases workload
take _______ prophylactically
QUIT ________
lose ______ and ______ calories
avoid _______ exercises and reduce ________

DO __________ YOU CAN TO ________ THE WORKLOAD ON THE HEART

Answer 19

rest, balance
overeating: decrease, increase
caffeine
2, warm, warmth

NTG
SMOKING
weight, decrease
isometric, stress

EVERYTHING, DECREASE

Question 20

Cardiac Cath
asses for allergies to: _____ & ______
using contrast dye, so check _______ function
_______ pre-procedure with kidney problems
client will feel ________ during contrast dye
__________ are normal
Monitor ________ post-procedure
assess for ________ at the puncture site
assess extremity ______ to the puncture site with the 5 P’s plus skin _______ and ________
client is on __________, keep extremity
major complication: ________
report any ________ ASAP
hold _________ for _______ hours post procedure because we’re worried about the _______

Answer 20

iodine, shellfish
kidney
Mucomyst
flushing/hot shot
palpitations
VS
bleeding
distal, Pulse, Pallor, Paresthesia, Paralysis, Pain, temp, cap refill
BEDREST, straight
HEMORRHAGE
PAIN
metformin, 48, kidneys

Question 21

unstable chronic angina = IMPENDING ______

Answer 21

MI

Question 22

Acute Coronary Syndromes: MI and Unstable Angina

________ blood flow to myocardium = _____ AND _______; ______ and ______ do NOT relieve this pain
S/S include pain, described as ________, women usually have _______ symptoms, elderly often have ________; ______ drops because cardiac output is __________; ECG ______, vomiting due to _______ nerve stimulation (via decreased HR, ____ and BP)

WORRY ABOUT THE ________ CLIENT

CPK-MB will be _______ with damage to cells
______ is the most sensitive to MI–remains _____ for up to _____ weeks
Myoglobin results we want to be _______

Answer 22

decreased, ischemia, necrosis, rest, NTG

crushing, GI, SOB

BP, decreasing
changes, vagus, CO

STEMI

increased
TROPONIN, elevated, 3

negative

Question 23

Treating MI
SPECIFIC ORDER: _____, ______, ______, _______
elevate ______ because it decreases ______ on the heart and increases __________

Answer 23

oxygen, aspirin, nitroglycerin, morphine

HOB, workload, CO

Question 24

Complications of ACS
three untreated arrhythmias will lead to DEATH

v-fib PRIORITY treatment is _______
after defibrillating, if client is still in v-fib, give ______
if epi doesn’t work, give ______

lidocaine toxicity results in _______ changes

significant side effect of amio = ________

Answer 24

v-fib, v-tach, asystole

defibrillation
epi
amiodarone

neuro

hypotension

Question 25

goal of thrombolytics is to ________ the clot which is blocking ________ and will _______ the size of infarction these drugs end in _______; examples include alteplase, tenecteplase, reteplase and streptokinase Which one has allergic reaction potential? _____ _________ PRECAUTIONS because _______ is the MAJOR COMPLICATION any bleeding will be a ____________ NO _______, decrease number of needle ______ given in ______ lines, NOT ______ lines--easier to hold _____ if they bleed

Answer 25

dissolve, blood flow, decrease -plase or -ase streptokinase BLEEDING, HEMORRHAGE contraindication ABGs, sticks peripheral, central, pressure

Question 26

Interventions: PCI & CABG percutaneous coronary interventions all open _______ arteries, including ______ and ________ major complication is ______, the site could _____ or re-________ IF CLIENT HAS CHEST PAIN POST-PROCEDURE: ________ because it's ________ thrombolytics and antiplatelets are given to keep ________ open CABG is used for ______ main coronary artery occlusion, it supplies the _______ left ventricle

Answer 26

coronary stents, angioplasty MI, bleed, re-occlude CALL THE PROVIDER IMMEDIATELY, re-occluding arteries LEFT, ENTIRE

Question 27

Cardiac Rehab Teaching: QUIT _________ increase activity _________ diet changes include _____ fried foods, _____ fat, ______ salt, _____ cholesterol no _______ exercises, ______ is ideal no straining, so give _______ sex can be resumed when they can _______, safest time of day for sex is ________ S/S of HF to teach include weight ______ d/t fluid, ankle _______ (Shoes fit too _____), short of _______, mental changes like _________

Answer 27

SMOKING gradually NO, low, low, low isometric, walking docusate walk up stairs with no pain, morning gain, edema, tight, breath, confusion

Question 28

Heart Failure is caused by cardiomyopathy, _______ disease, _______ MI, _______, endocarditis Blood does not move ______ so it backs up into the ______ or ______ system Left sided = Lung symptoms Right sided = Venous symptoms diagnosed with ______; chest x-ray shows ______ enlargement and _____ infiltrates; echocardiogram classes 1-4, ______ is most serious

Answer 28

heart valve, acute, hypertension forward, lungs, venous dyspnea, S3, crackles, tachycardia, restlessness edema, ascites/weight gain, distended neck veins BNP, heart, pulmonary 4

Question 29

HF Treatment--Meds ACEs #1: _________, ARBs #2 both block aldosterone = losing ______ & ______, which retains ________ these drugs _____ workload on heart, _____ CO, keeping blood moving _______ ACE = arterial ______, increased ______ ARB = decreased arterial ______, decreased _____ ACE has ______, _____ cough Need to monitor for ____________ with BOTH Digoxin enhances _________, decreases _______, cardiac output ______, kidney perfusion will ______ earliest signs of toxicity: GI 3 late signs of toxicity: ______ and _____ changes measure ________ pulse before admin ANY __________ IMBALANCE CAN PROMOTE ________ TOXICITY, BUT ______ IS WORST _______ + digoxin = ________ TOXIC OVER _____ ng/mL Diuretics always ______ the HF client because they can't handle the ______ decrease ________, the ______ returning to heart give in the _________

Answer 29

drug of choice sodium, water, potassium decrease, increases, forward dilation, SV resistance, BP dry, nagging HYPERkalemia contractility, HR, increases, increase anorexia, nausea, vomiting arrhythmias, vision apical ELECTROLYTE, DIGOXIN, POTASSIUM HYPOkalemia, toxicity 2 diurese, fluid preload, volume morning

Question 30

HF Misc. Low ______ diet _____ fluid retention, which decreases _______; salt substitutes contain excessive ______ whereas canned/processed foods contain a lot of _____ Elevate _______ because this helps with ______ Daily _____, report a gain of _______/day FLUID RETENTION? THINK _______ PROBLEMS FIRST

Answer 30

sodium, decrease, preload potassium sodium HOB, breathing weights, 2-3 HEART

Question 31

Pacemakers heart rate below ______ = _______ CO ______ HR with ________ bradycardia ALWAYS WORRY IF HR _____ BELOW _______ most common post-op complication is electrode ______ _______ the arm post-op, PROM to prevent ______ shoulder no movement of arm ________ shoulder height if no _____ follows stimulus = loss of _______ failure to ______ = inappropriate _______ teach client to check ______ daily as it must be ______ the set rate wear ______ bracelet or carry a card avoid _______ and electromag fields might set off alarms at _______ avoid contact ______

Answer 31

``` 60, decreased increase, symptomatic DROPS, SET RATE displacement immobilize, frozen ``` above contraction, capture sense, firing pulse, above ID MRIs airport sports

Question 32

Pulmonary Edema at risk clients include those getting IV fluids really ______, the very ______ and very ____, anyone with _____ or _____ disease fluid backs up into _____, heart can't move it ________ usually occurs at _____ S/S = _____ onset, restless/_____ d/t severe ______, pink, ______ sputum, breathless treat with ____, titrate to keep SpO2 above _____% Treat with: Diuretics to reduce ______, push lasix _____ to avoid ________/____toxicity; _____ for rapid fluid _______; NTG for ______ to decrease _______ so that blood can be moved _________; Morphine for ________ which will ______ preload & afterload; Nesiritide vasodilates ______ & _____ and has a _______ effect Position client ______ which _____ CO and promotes _______ of blood in lower extremities Prevent pulmonary edema by checking _____ sounds and avoiding fluid volume _______

Answer 32

fast, old, young, heart, renal lungs, forward night sudden, anxious, hypoxia, frothy oxygen, 90 ``` preload, slowly hypotension, oto; Bumex removal; vasodilation, afterload forward; vasodilation decrease arteries, veins, diuretic ``` upright, decreases pooling lung excess

Question 33

Cardiac Tamponade blood, ______, exudate ______ into pericardial sac, resulting in ______ of the heart causes include MVC, ______, pericarditis, _____ post CABG S/S = _______ CO, ______ CVP, BP will ________ HALLMARK SIGNS: _____ CVP, ______ BP muffled/______ heart sounds, ______ neck veins, shock, ______ pulse pressure Treat with pericardiocentesis to remove ______ or do _______

Answer 33

fluid, leaking compression MI, hemorrhage decreased, increased, decreased INCREASING, DECREASING distant, distended NARROWED fluid surgery

Question 34

Arterial Disorders if you have atherosclerosis, you have it ______ acute arterial ________ is a medical _______ numbness and ______, ______ extremity, ____ PALPABLE PULSE, ______ extremities are more symptomatic HALLMARK SIGN: _________ CLAUDICATION-- always a sign of ______ disorder PRIORITY ASSESSMENT: ________ pulses pain at ______ = _______ obstruction DON'T ANSWER _______ FOR _______ QUESTION ELEVATE _______, DANGLE _______ usually treated with ______ or endarterectomy

Answer 34

everywhere occulsion, emergency pain, cool, NO lower ``` INTERMITTENT arterial peripheral rest, severe OXYGEN, VEIN/VENOUS VEINS, ARTERIES angioplasty ```