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Critical Care FP-C 2.0 > Cardiology > Flashcards

Cardiology Flashcards

(72 cards)

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1
Q

First thing the heart perfuses?

A

Itself via coronary arteries

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2
Q

Preload

A

Amount of blood returning to the heart

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3
Q

After load

A

Resistance against which the left ventricle has to pump against to get blood out of the heart

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4
Q

Leads affected by LCx/diagnonal LAD

A

Lateral leads
1-avL-V5-V6

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5
Q

Leads affected by LCx and/or RCA

A

Inferior leads
2-3-AVF

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6
Q

Leads affected by LAD

A

V1-V2-V3-V4

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7
Q

Starlings Law

A

Increased preload causes more myocardial stretch

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8
Q

X-ray finding with heart failure

A

Kerley B-lines

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9
Q

Treatment for Wolff-Parkinson’s-white

A

Procainamide

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10
Q

Dissection Findings

A

Tearing or ripping pain
Often tachy and hypertensive

X-ray findings:
Widened mediastinum

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11
Q

Dissection treatment

A

Anti pulse therapy is priority
-HR goal: 60-70 bpm
SBP goal: <120 mmHg
Aggressive analgesia

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12
Q
A

Overdampening

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13
Q
A

Underdampening

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14
Q

Normal RA CVP

A

2-6 mmHg

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15
Q

Normal RV pressures

A

Systolic: 15-25 mmHg
Diastolic: 0-5mmHg

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16
Q

Normal PA pressures

A

Systolic: 15-25
Diastolic: 8-15

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17
Q

Mixed Venous oxyhemoglobin saturation (SvO2)

A

Normal: 65-70%
Measures oxygen content of blood returning to right side of heart

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18
Q

Increased SvO2

A

Increased O2 delivery, decreased demand
(Right shift)

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19
Q

Decreased SvO2

A

Elevated O2 consumption/demand

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20
Q

Cardiac Index

A

2.5-5 L/min/m2
Reflects cardiac function in relation to the patients size

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21
Q

Systemic Vascular Resistance

A

800-1200 dyne

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22
Q

High SVR

A

Vasoconstriction

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23
Q

Low SVR

A

Vasodilation

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24
Q

Counterpulsation (IABP)

A

Ballon inflates in diastole: perfuses coronary arteries
Ballon deflates during systole: reduces afterload

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25
IABP triggers
EKG Arterial Waveform (pressure)
26
Normal IABP timing/waveform
27
Early inflation
28
Early/Late deflation
29
ECMO
Extra-corporeal membrane oxygenation -pulls blood out and into ECMO machine -Can be used up to 30 days
30
Venous-Arterial ECMO (V-A)
Provides hemodynamic support Provides flow Offloads work of the heart
31
Venous-Venous ECMO (V-V)
Indication: Refractory respiratory failure Does not support hemodynamic flow
32
Transducer
Phlebostatic axis: 4th ICS anterior mid-axillary line Zero when transitioning between monitors and with significant altitude change
33
Overdamping
Will yield low systolic BP May be due to clot, air bubbles or kinks in line
34
Underdampening
Overestimation of systolic BP Underestimation of diastolic BP Due to catheter whip, low pressure on fluid bag, tachydysrhythmias
35
RA Waveforms
Measures central venous pressure (CVP) Normal CVP: 2-6mmHg
36
Drugs for AAA
Nipride and beta-blockers
37
BNP
Brain natriuretic peptide Heart failure marker Below 100 = normal Above 500-700= heart failure
38
Normal blood volume
70 mL/kg adult 80 mL/kg Peds
39
Normal ped SBP
SBP: 90 + (2x age) DBP: 2/3 the SBP Drops after 25% blood loss
40
When to assess CVP/PA pressure?
When mechanically ventilated assess pressures at the end of exhalation
41
Cardiogenic shock
CVP: high CO: low CI: low PAS/PAD: High SVR: High Heart rate initially fast, then slows down
42
CHF considerations
Preload: many are hypovolemic. Careful with diuretics and medications that can decrease preload Lab test: BNP > 500 Medications; Natracor (neseritide) = synthetic version of BNP
43
Treat HTN when BP?
Over 220 systolic MAP over 130
44
PAWP/PCWP
Looks at the left side of the heart, if high can indicate pulmonary congestion, CHF, and cardiogenic shock
45
Neurogenic shock
CVP: down CO: down CI: down PCWP: down SVR: down (distributive shock)
46
Arterial line sites
Radial, femoral -maintain pressure bag at 300 mmHg
47
Most common reperfusion
AIVR
48
Most common hypothermia dysrhythmia
VF, Osborn wave
49
MAP formula
2 x diastolic + systolic/3
50
IABP signs/symptoms of balloon leak
Blood specs in tubing, alarm
51
IABP clot prevention
Cycle manually every 30 minutes
52
IABP increases CO by
10-20%
53
IABP balloon rupture
Rusty flakes in line or turn machine off
54
IABP migration/dislodged
Assess left radial and urine output
55
Lethal IABP timing cycles
Late deflation and early inflation
56
Phlebostatic axis
Where pressure measurements are made with invasive line Fourth intercostal space, level of atria
57
Hypertension
Mild: 140-159/90-99 Moderate: 160-179/100-109 Severe: over 180/110
58
Volume for RBC administration
RBC: 10 mL/kg
59
Volume for WBC
20mL/kg
60
“PA Catheter” Named? Proximal port for? S/S of bad placement? Procedure for bad placement? Measures? Which port used? Pressure bag set to?
Swan-Ganz CVP, medications VT, Ventricular ectopy Float forward to PA or pull back to RA Right heart directly, left heart indirectly Distal port 300 mmHg
61
Normal cardiac index
2.5 - 4.3
62
Thrombolytics must be administered within
3 hours of onset of chest pain
63
Hypovolemic shock
CVP: down CO: down CI: down PAWP: down SVR: high Heart rate: fast
64
Tetralogy of Fallot (TOF)
PROV P-pulmonary stenosis R-right ventricular hypertrophy O-Overriding aorta V- ventricular septal defect
65
Atrial waveforms
“Filling pressures” Right atrial pressure (CVP) Left atrial pressure (PAWP/PCWP)
66
RVMI
SVR: High C.I.: Low CVP: High PAWP: Low
67
Cardiogenic shock
SVR: High C.I. : Low CVP: High PAWP: High
68
Hypovolemic
SVR: High CI: Low CVP: Low PAWP: Low
69
Anaphylactic
SVR: Low CI: Low CVP: Low
70
Neurogenic
SVR: Low CI: Low
71
Septic
SVR: Low CI: High
72
RICH ANSwer
RVMI CARDIOGENIC HYPOVOLEMIC ANAPHYLACTIC NEUROGENIC SEPTIC

Critical Care FP-C 2.0 (15 decks)

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