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Flashcards in Cardiac notes Deck (49):
1

Inotropic

increase or decrease contractility

digoxin: positive inotropic (stronger)

most meds : negative inotropic (depress contractility

watch for CHF because not pumping blood out

2

Dromotropic

conduction system (impulses)

positive : increased conduction

most meds : interfere with conduction

treat tachy arrythmias

drugs have potential for blocks

3

chronotropic

rate @ SA node

stimulate SA node 

4

women

have weird angina

5

diagnostic evaluation procedure

ECG

troponin 

cardiac enzymes

isoenzymes

myoglobulin

WBC

Sed rate

6

CK 

creatinine kinase

goes up fast then decreases

best for determining early MI

7

Isoenzymes

CKMB (MB means heart)

 

8

WBC

increases because of inflammatory response to attack on heart 

9

sed rate

stays increased for awhile 

10

ECG changes

 Q - does not go back to normal

ST elecated

T wave inversion

11

emergency management of MI

O2

2 IV's

ECG

nitro/asprin/morphine

bloodwork/x-rays (enlarged heart)

assess antiplatelet/anticoagulation?thrombolytics

beta blockers/ antidysrhythmics

12

thrombolytics

TPA

4-6 hours after start of chest pain (asap pre-damage)

TPA goes to where its needed

side effects: hemorrhage/anemia

hypotension/fever

bronchospasm/anaphyaxis

periorbital swelling/itching/uticaria/headache

dysrhythmias

can cause another clot when a large clot is broken up

13

Heart failure

right side -fluid backup

left side - pulmonary

 

14

systolic ventricular dysfunction

not enough blood ejection

foward failure

decrease cardiac output -fluid backs up

15

diastolic ventricular dysfunction

left ventricule cant relax enough to accumulate blood to pump out 

16

right vs. left side heart failure 

arteries Left

veins right

rt. failure can be caused by left failure

rt ventricular MI

 

17

high output failure

cardiac ouput can be ok

increase metabolic demands on heart

hyperthyroid

septecemia

18

what diagnoses Heart Failure

BNP

from fluid in ventricles

chest xray

echocardiogram 

19

diltiazem (cardizem)

calcium channel blocker

20

metoprolol (lopressor)

beta blcoker

21

atenolol (tenormin)

beta blocker

22

Nifedipine (procardia)

calcium channel blocker

23

timolol (betimol)

beta blocker 

24

amlodipine (norvasc)

calcium channel blocker

25

the condition of having a reduced clood supply to myocardial cells is call

myocardial ischemia

26

by causing venodilation, nitrates reduce the amount of blood returning to the heart thus decreaseing

cardiac output

27

which of the following is true regarding the effect of atenolol (tenormin) on the heart

it selectively blocks beta receptors 

28

the primary mechanism of calcium channel blockers

reducing cardiac workload

29

what agent has the ability to inhibit the transport of calcium ions into myocardial cells and relaxes both coronary and peripheral blood vessels

diltiazem (cardizem)

30

what are the goals for pharmacotherapy of acute MI

restore blood supply to the damaged myocardium as quickly as possible

prevent associated dysrhythmias with antidysrhythmics

reduce post- MI mortality with aspirin and ACE inhibitors

31

in treating MI the function of thrombolytic therapy is to 

restore blood supply to the damaged myocardium

32

the primary risk during thrombolytic therapy is 

excessive bleeding

33

following an acute MI , metoprolol (lopressor) is infused slowly until

a target heart rate of 60-90 beats perminute is reached 

34

opiods such as morphine sulfate are sometimes administered to patients with MI to 

reduce acute pain associated with MI

35

the nurse should administer aspirin as soon as possible following an suspected MI in order to 

reduce post MI mortality

36

patients at high risk for stroke are often treated with 

antihypertensives

37

a drug that blocks impulses from the parasympathetic nervous system is known as 

cholinergic blocker 

38

which cardiac enzyme would the nurse expect to elevate first ina client diagnosed with an MI

Troponin

39

along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect that the client is experiencing an MI

diaphoresis and cool clammy skin

40

The client diagnosed with rule out myocardial infarction is experiencing chest pain while walking to the bathroom.  Which action should the nurse implement first

have the client sit down immediately.

41

The nurse caring for a patient diagnosed with MI who is experiencing chest pain.  what interventions should the nurse implement

administer aspirin

apply O2

42

The patient who had an MI is admitted to the telemetry unit from ICU.  which referel is most appropriate for the patient

cardiac rehab 

43

patient is day one post-op coronary artery bypass sugery.  the client complains of chest pain.  which intervention should the nurse implement first 

assess the clients chest dressings and vital signs

44

patient diagnosed with MI is 6 hours post right femoral percutaneous transluminal coronary angioplasty,  which assessment data would require immediate attention by the nurse 

complains of numbness in right foot 

45

the ICU nurse is assessing the client who is 12 hours post MI.  The nurse assesses an S3 heart sound.  Which intervention should the nurse implement

notify the health care provider immediately

46

The nurse is administering a calcium channel blocker to the client diagnosed with a MI.  Which assessment data would cause the nurse to question administering this medication 

the clients bood pressure is 90/62

47

The client diagnosed with MI is on bedrest.  The CNA is encouraging the client to move the legs.  Which action should the nurse implement 

praise the CNA for encouraging the client to move his legs 

48

The client diagnosed with a MI asks the nurse "why do I have to rest and take it easy?  My chest doesn't hurt anymore"  Which statement would be the nurse's best response

your heart is damaged and needs abou four to six weeks to heal

49

The client has just returned from a cardiac catheterization.  Which assessment data would warrant immediate intervention from the nurse 

the client refuses to keep the leg straight.