Cardiac Flashcards
(143 cards)
1
Q
normal blood flow through the heart
A
RA RV PA lungs PV LA LV Aorta Body
2
Q
the amount of blood returning to the right side of the heart and the muscle stretches that the volume causes
A
preload
3
Q
_____ is released when the heart stretches
A
ANP
4
Q
is the pressure in the aorta and peripheral arteries that the LV has to pump against to get the blood out
A
afterload
5
Q
after load is referred to as ____
A
resistance
6
Q
the amount of blood pumped out of the ventricles with each beat
A
stroke volume
7
Q
___ ____ is dependent on adequate cardiac output
A
tissue perfusion
8
Q
factors that affect CO
A
heart rate
blood volume
decreased contractility
9
Q
meds to decrease preload
A
furosemide
nitro
10
Q
meds to decrease afterload
A
ACE inhibitors
ARBS
hydralazine
nitrates
11
Q
meds to improve contractility
A
inotropes (dopamine, dobutamine, milrinone)
12
Q
meds for rate control
A
BB
CCBs
Digoxin
13
Q
meds for rhythm control
A
anti-arrhythmics (amiodarone)
14
Q
3 arrhythmias that are always a big deal
A
pulselessl v. tach
v. fib
asystole
15
Q
the most common type of cardiovascular disease
A
coronary artery disease
16
Q
coronary artery disease is a broad term that includes which 2 things?
A
chronic stable angina
acute coronary syndrome
17
Q
chronic stable angina has pain that is brought on by?
A
low O2 on exertion
18
Q
what relieves pain with chronic stable angina
A
rest and/or nitro
19
Q
nitro causes venous and arterial _____
A
vasodilation
20
Q
can you swallow nitro?
A
NO
21
Q
where do you keep nitro?
A
in a dark glass bottle
22
Q
most common sx of nitro
A
HA
23
Q
renew nitro how often?
A
every 3-5 months
24
Q
what to BB do to BP, HR, and myocardial contractility?
A
drops!
25
CCBs dilate the _____ arteries
coronary
26
2 benefits of CCBs are that they ?
decrease after load and increase Oxygen to the heart muscle
27
avoid what type of exercises for chronic stable angina?
isometric
28
pre-procedure for cardiac cath need to ask?
iodine/shellfish allergy
29
check ____ function before heart cath?
kidney
30
_____ is a med most HCP order prior to heart cath to protect the kidneys
acetylcysteine
31
main priority concern post op heart cath
bleeding
32
assess for the 5Ps post op heart cath
```
pulselessness
pallor
pain
paresthesia
paralysis
```
33
unstable chronic angina = impending _____
MI
34
acute coronary syndrome is also known as ____ and ___ ____
MI
| unstable angina
35
does acute coronary syndrome have ischemia, necrosis or both?
both
36
does the client with acute coronary syndrome have to be doing anything to bring this pain on?
NO
37
will rest or nitro fix the pain with acute coronary syndrome?
NO
38
sx of acute coronary syndrome
```
pain
cold/clammy/BP drops
decreased CO
ECG changes
vomiting
```
39
with acute coronary syndrome they may describe pain as ____
crushing
40
#1 sign of an MI in elderly?
SOB
41
this indicates that the client is having a heart attack
STEMI
42
the goal with STEMI is to get them to the cath lab for PCI in less than ____ minutes
90
43
cardiac specific isoenzyme
increases with damage to cardiac cells
CPK-MB
44
CPK-MB elevates within __-__ hours and peaks in __-__ hours
3-6
12-24
45
cardiac biomarker with high specificity to myocardial damage
troponin
46
troponin elevates within ___-___ hrs and remains elevated for up to ____ weeks
3-4 hrs
| 3 weeks
47
troponin T level
<0.10
48
troponin I level
<0.03
49
increases within 1 hour and peaks in 12 hours
myoglobin
50
with myoglobin ____ results are a good thing
negative
51
which cardiac biomarker is the most sensitive indicator for an MI?
troponin
52
which enzyme or biomarker are most helpful when the client delays seeking care?
troponin
53
treatment for V. fib
shock
| defib the v.fib
54
if the first shock for v. fib doesn't work....give?
epi
55
an anti-arrhythmic used when v. fib and pulseless VT are resistant to treatment, and also for fast arrhythmias
amiodarone
56
how to monitor for lidocaine toxicity
neuro changes
57
the first antiarrythmic of choice
amiodarone
58
important side effect for amiodarone?
hypotension
59
what meds are used for chest pain when they get to the ED?
O2
aspirin
nitro
morphine
60
goal for thrombolytic therapy
dissolve the clot that is blocking blood flow to the heart muscle
61
example of thrombolytics
streptokinase
alteplase
tenecteplase
reteplase
62
thrombolytics should be administered within __-__ hours of an MI
6-8
63
with a stroke...time is _____
brain
64
major complication with thrombolytic therapy
bleeding
65
absolute contraindications for thrombolytics
intracranial neoplasm
intracranial bleed
suspected aortic dissection
internal bleeding
66
antidote for thrombolytics
idacrucizumab
67
Percutaneous Coronary Intervention (PCI) includes all interventions such as ____ and ____
angioplasty and stents
68
major complication of an angioplasty is a ____
MI
69
if there is chest pain after PCI
call Dr
70
what could it mean if they have pain post op PCI?
reoccluding
71
used with multiple vessel disease or left main coronary artery occlusion
CABG
72
the ____ _____ coronary artery supplies the entire left ventricle
left main
73
when there is left main coronary artery occlusion think what????
SUDDEN DEATH
| it's the widow maker
74
diet changes for cardiac rehabilitation
decreased fat, salt, and cholesterol
75
why can't cardiac patients do isometric exercises?
they increase workload of the heart
76
when can sex be resumed after a heart issue?
when they can walk around the block or up a flight of stairs with no discomfort
77
what is the safest time of day for sex?
morning
78
best exercise for MI client?
walking
79
teach sx of HF
weight gain
ankle edema
SOB
confusion
80
HF is a complication that can result from problems such as ?
```
cardiomyopathy
valvular heart disease
endocarditis
acute MI
HTN
```
81
in LHF the blood is not moving forward into the aorta and out to the body....if it does not move forward, then it will go backward into the ______
lungs
82
sx of LHF
```
pulmonary congestion
dyspnea
cough
blood tinged frothy sputum
restlessness
tachycardia
S3
orthopnea
nocturnal dyspnea
```
83
RHF is when the blood is not moving forward into the lungs....if it does not move forward then it goes backward into the ____ system
venous
84
sx of RHF
```
distended neck veins
edema
enlarged organs
weight gain
ascites
```
85
term that means the heart can't contract and eject
systolic heart failure
86
ventricles can't relax and fill
diastolic heart failure
87
secreted by ventricular tissues in the heart when ventricular volumes and pressures in the heart are increased
BNP
88
BNP can be positive for HF when the ____ doesn't indicate a problem
CXR
89
if the client if the client is on nesteritide, turn if off ____ hrs before drawing a BNP
2 hours
90
the CXR shows what with HF
```
enlarged heart
pulmonary infiltrates (edema)
```
91
looks at the pumping action or ejection fraction of the heart.
Echocardiogram
92
an ECG can also give you information about ____ and ___ ____
back flow and valve disease
93
is a balloon flotation catheter that can be floated into the R side of the heart and pulmonary artery.
swap-ganz catheter
94
standard medication therapy for HF is ___ and ____
ACE inhibitors and ARBs
95
ACE inhibitors and ARBs both block ______.
aldosterone
96
when we block aldosterone we do what?
lose Na and water and retain K+
97
med used when the client is in sinus rhythm or a. fib and has accompanying chronic HF
digoxin
98
what does digoxin do to contraction of the heart and the heart rate
stronger contraction
| slows down the HR
99
normal dig level
0.5-2.0
100
how do yo know the dig is working?
the CO goes up
101
early sx of dig toxicity
anorexia
nausea
vomiting
102
lare sx of dig
arrhythmias
| vision changes
103
before you admin dig check?
apical pulse 1 min
104
digoxin + _____ = toxicity
hypokalemia
105
diuretics decrease ____
preload
106
when do you give diuretics?
morning
107
low Na diet decreases fluid retention and helps decrease _____
preload
108
salt substitutes can contain excessive ___-_
K+
109
your natural pacemaker is the ___ ___
SA Node
110
if you heart rate drops to 60 or below cardiac output can ______
decrease
111
pacemakers are used to increase the heart rate with _______ bradycardia
symptomatic
112
_______ is when the ventricles are resting and are filling up with blood
repolarization
113
a _____ pacemaker kicks in only when the client needs it to
demand
114
most common complication post-op with permanent pacemakers?
electrode displacement
115
you need to make sure to do passive ROM to prevent what after permanent pacemakers?
frozen shoulder
116
can't raise your arm higher than ___ ____ after pacemaker placement
shoulder height
117
what is it called when no contraction follows the stimulus
loss of capture
118
what is it called when the pacemaker fires at inappropriate times
failure to sense
119
what can cause loss of capture, failure to sense or any malfunction?
not programmed correctly
electrodes can dislodge
battery may be depleted
120
will they set of alarms at airports with pacemakers?
YES
121
may be used to pace the heart, or it might be used to defibrillate people in v-fib
ICD
122
who's at r/f pulmonary edema
receive IV fluids very fast
very young and very old
hx of heart or kidney disease
123
pulmonary edema usually occurs at ____, when the client goes to bed
night
124
sx of pulmonary edema
```
sudden onset
breathless
restless/anxious
severe hypoxia
pink frothy sputum
```
125
the priority nursing action is to administer ____ to the patient with pulmonary edema
high flow oxygen
126
meds for pulmonary edema
diuretics
nitro
morphine
nesiritide
127
an IV infusion used for short term therapy with pulmonary edema
vasodilates veins and arteries and has a diuretic effect
nesiritide
128
remember to turn off the nesiritide infusion ____ hrs before drawing a BNP
2
129
never give nesiritide for longer than ____ hrs
48
130
positioning for pulmonary edema
upright position
| legs down
131
________ is when blood, fluid, or exudates have leaked into the pericardial sac resulting in compression of the heart
cardiac tamponade
132
cardiac tamponade can happen if the client had
a motor vehicle collision, right ventricular biopsy, an MI, pericarditis, or hemorrhage post CABG
133
sx of cardiac tamponade
```
narrowed pulse pressure
decreased CO
CVP increased
BP drops
distended neck veins
```
134
hallmark signs for cardiac tamponade
increased CVP
| decreased BP
135
treatment for cardiac tamponade
pericardiocentesis
| surgery
136
narrowed pulse pressure: think ???
cardiac tamponade
137
widened pulse pressure: think???
increased intracranial pressure
138
it is a medical emergency if you have an acute arterial _____
ooclusion
139
with an arterial disorder the patient will report?
numbness/pain
cold extremity
no pulse
140
hallmark sign of arterial disorders
intermittent claudication
141
with arterial disorders....pain at rest means _____ obstruction
severe
142
treatment of arterial disorder
dangle the legs
143
_____ the veins
elevate
