CARDIO Flashcards
(91 cards)
1
Q
A hollow muscular organ that resembles like a closed fist?
A
Heart
2
Q
Where is the heart located?
A
Middle of the mediastinum
3
Q
The heart weighs approximately ______.
A
300-400 grams
4
Q
It is the largest chamber of the heart.
A
Left Ventricle
5
Q
- Located between right ventricle and pulmonary artery.
- semilunar valve
A
Pulmonic valve
6
Q
- located between the left atrium and left ventricle
- atrioventricular valve
A
Bicuspid/Mitral valve
7
Q
- located between right atrium and right ventricle
- atrioventricular valve
A
Tricuspid valve
8
Q
- located between left ventricle and aorta
- semilunar valve
A
Aortic valve
9
Q
middle/muscular layer of the heart
A
Myocardium
10
Q
innermost layer of the heart
A
Endocardium
11
Q
outermost layer of the heart
A
Epicardium
12
Q
Sac the surrounds and protect the heart
A
Pericardium
13
Q
Which inner pericardial layer also forms a part of the wall?
A
Visceral pericardium
14
Q
The outer layer of the pericardium
A
Parietal pericardium
15
Q
A buildup of excess fluid in the sac that surrounds the heart:
A
Pericardial sac
16
Q
To prevent friction the amount of fluid in the pericardial sac is ______.
A
5-20 ml
17
Q
Modifiable Risk Factors
A
- Stress
- Diet
- Exercise
- Smoking & Alcohol
- HPN
- Obesity
- Lifestyle/Behavior
18
Q
Non – Modifiable Risk Factors
A
- Age
- Sex
- Race
- Family history
19
Q
Physical examination of the heart: IPPA
A
- Inspection
- Palpation
- Percussion
- Auscultation
20
Q
Electrical conductivity of the heart:
A
Conduction system
21
Q
Upon inspection the skin color of the patient is?
A
Pallor, Cyanotic
22
Q
Upon inspection the respirations of the patient is?
A
Dyspnea
23
Q
Upon inspection what do you expect to assess in the peripheral edema of the patient?
A
Venous insufficiency
24
Q
Upon inspection what do you expect to assess in the neck vein of the patient?
A
Venous congestion
25
Normal cardiac percussion:
Dullness **(thudlike sound)**
26
Normal heart sounds are ____, and ____.
S1 ("lubb") and S2 ("dubb")
27
Auscultated upon closure of **AV valve (TV & BV)**
S1 ("lubb")
28
Auscultated upon closure of **semilunar valve (PV & AV)**
S2 ("dubb")
29
This heart sound is considered normal in **children, young adult,** and **pregnant women**
S3 (ventricular gallop)
30
Hearing this heart sound in **older adult** indicate an *early indication* for **CHF**?
S3 (ventricular gallop)
31
Heart sound that is abnormal in **all ages** and present in **CHF**
S4 (atrial gallop)
32
Dyspnea on Exertion
DOB r/t activity
33
DOB in lying position
Orthopnea
34
DOB upon sleep onset
Paroxysmal nocturnal dyspnea
35
Elevated RBCs suggest _______.
Hypoxia
36
Elevated WBCs may indicate ______.
Infections, heart disease, or MI
37
3 Cardiac Enzymes:
- Aspartate Aminotransferase (AST)
- Dehydrogenase (LDH)
- Creatinine Phosphokinase (CK-MB)
38
Cardiac enzyme produce by **liver**
Aspartate Aminotransferase (AST)
39
Cardiac enzyme produce by **skeletal muscle**
Lactic Dehydrogenase (LDH)
40
Most **cardiac specific enzyme**
Creatinine Phosphokinase (CK-MB)
41
- most important, most indicative
- **protein** found in myocardial cells; **reliable critical markers** of myocardial injury
Troponin I
42
Normal value of Troponin I:
0-0.04 mg/ml
43
Troponin I remains elevated for as long as _______.
2 weeks
44
- *protein* found in *cardiac & skeletal muscle*
- *Not very specific* (negative result can **rule out MI**)
Myoglobin
45
Records **electrical activity** of the heart
Electrocardiogram (ECG)
46
Atrial depolarization
P wave
47
Ventricular Depolarization
QRS Complex
48
Ventricular Repolarization
T wave
49
- Transient **chest pain** caused by *insufficient blood flow* to the *myocardium* resulting in myocardial ischemia
- **fancy name** for chest pain
Angina Pectoris
50
What causes Angina Pectoris?
- Atherosclerosis **plaques** *obstruction*
- HPN
- DM (viscous blood) *insufficient blood flow*
51
Pain manifestation of Angina Pectoris **SAVERS**
**S**ubsternal (below the sternum)
**A**nterior chest (pericordial)
**V**ague: radiates➡️jaw, neck,back,L shoulders both arms
**E**xertion: related
**R**elieved by Rest & NTG
**S**hort-duration (>30mins)
52
Precipitating Events of Angina Pectoris **4 E’s**
**E**xertion: NO vigorous exercise
**E**motions: excitement; sexual activity
**E**ating heavy meal
**E**nvironment: cold exposure
53
**Direct Vasodilators (Nitrates)**
- directly relax smooth muscles of blood vessels = **vasodilation**
- Nitroglycerine
- ISMN (Isosorbide Mononitrate)
- ISDN (Isosorbide Dinitrate)
54
**Beta-Blockers**
- blocks SNS that **slows HR** and **lower BP**
- "-olol" **"Bolol"**
- Nitroglycerine
- ISMN (Isosorbide Mononitrate)
- ISDN (Isosorbide Dinitrate)
55
**Calcium - Channel blockers**
- indirect vasodilators
- "dipine" **"Cdipine"**
- Nifedipine (Procardia)
- Amlodipine (Norvasc) **tablet**
- Nicardipine (Cardene) **IV**
56
drug of choice for pain relief
Nitroglycerine Therapy
57
Direction in taking Nitroglycerine Therapy:
Take maximum of **3 doses** at **5 mins** interval; if not relieved **call physician**
58
Nitroglycerine Therapy indication of potency: ____________________ under the tongue when **taken sublingually**
**burning/stinging**
59
Nitroglycerine Therapy dry of mouth inhibit absorption. As nurse what will you offer?
Offers sips of water prior admission
60
You are educating pt. under nitroglycerine therapy he/she should **avoid**?
- Alcohol **prevent Hypotension**
61
You are educating pt. under nitroglycerine therapy how will he/she would rise from bed?
Gradual change of position
**R:** prevent Orthostatic hypotension
62
Pt. under nitroglycerine therapy should Always carry _____ in pocket
3 tabs
**Instruction:** take 1 tablet before exercise
63
Nitroglycerine tablet are *destroyed by heat, light or moisture.*How to **store** nitroglycerine tablet?
- cool, dry place
- used dark/amber colored air tight container
- do not store in refrigerator
64
How often will the pt. change his/her nitroglycerine tablet stock?
Change stock every **3 mons**
65
What are the side effects of nitroglycerine therapy?
headache, flushed face, dizziness, faintness, tachycardia
- common: during 1st few doses
- instruct to: do not discontinue medication
66
Beta-Blocker Therapy
⬇️HR and ⬇️BP
67
Prior the admission of Beta-Blockers, what will you assess first?
Assess HR and BP
**R:** If mababa **WITH HOLD**
68
To prevent GI upset while taking Beta-Blockers it should be taken with?
A. Without meals
B. With meals
B. With meals
69
Beta- Blockers were contraindicated with _______.
Propanolol (Inderal)
70
Why beta-blockers contraindicated in **asthma**?
cause **bronchoconstriction**
71
Why beta-blockers contraindicated in **DM** patients?
cause **hypoglycemia**
72
Antidote for BB poisoning:
Glucagon
73
Calcium Channel Blocker
Prior admission assess **HR** and **BP**
74
Calcium channel blockers causes **food delay absorption:
**Empty stomach**
- early morning upon waking
- 1hr prior meal
- 2hrs after meal
75
Antidote for CCB poisoning:
Calcium gluconate
76
Formation of localized necrotic areas within the myocardium
Myocardial Infarction (Heart Attack)
77
Most common site of MI:
Left ventricle
78
What causes MI?
- Coronary occlusion
- Cessation of blood supply
79
3 Types of Coronary occlusion?
- **Atherosclerosis:** fat accumulation
- **Thrombosis:** clot formation
- **Embolisms:** dislodged/foreigner
80
A classification of MI **necrosis "endocardium"
Subendocardial
81
A classification of MI **patchy areas myocardium"
Intramural
82
A classification of MI **from endo to epicardium "
Transmural
83
Pain manifestion of MI?
- crushing, severe pain
- radiating arms, neck and back
- not relieved by rest and nitroglycerine
- lasting **>30 mins**
84
MI's **universal sign of distress** in pain:
Levine's Sign
85
MI ECG:
- STEMI – ST segment elevation **MI** (**Deadliest!**)
- NSTEMI – Non ST segment elevation
86
MI Laboratories:
- increased Cardiac Enzymes: **AST, LDH, CK-MB**
- elevated Troponin levels: **most definitive** finding for MI
87
MI's Management: **MONA**
**M**orphine: Opioid Analgesic - DOC for pain relief in MI
**O**xygen Therapy by *cannula*: Increase myocardial O2 supply
**N**itroglycerine: for vasodilation
**A**spirin (ASA): Antiplatelet
88
Oxygen therapy by *cannula*, Why in cannula?
Stop feeling of suffocation **"6 lpm"**
89
_______ commode; ________ bed pan
**use** commode; **avoid** bed pan
Ratio: *Valsalva Maneuver*
90
Reiterate the use of stool softener to **avoid straining.**
what would be the **diet** of MI patients:
- **LSLF:** low salt, low fat
- **SFF:** small frequent feeding
91
What are the complications of MI?
- **Dysarthria:** most common **PVC**
- **Cardiac arrest:** "premature ventricular contraction"
