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Fundamentals II > Cardiovascular and Perfusion > Flashcards

Cardiovascular and Perfusion Flashcards

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1
Q

Define afterload.

A

The resistance to the ejection of the blood from the left ventricle.

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2
Q

Define cardiac output.

A

The amount of blood ejected from the left ventricle each minute.

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3
Q

When are instances that cardiac output would increase and decrease?

A

Increase: exercise, pregnancy, fever.
Decrease: sleep.

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4
Q

Define ejection fraction.

A

Percentage of blood leaving the heart each time it squeezes.

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5
Q

What is an infarction?

A

Necrosis of a portion of the heart muscle caused by obstruction in a coronary artery.

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6
Q

Define preload.

A

Volume of blood in the ventricles at the end of diastole, immediately before ventricular contraction.

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7
Q

What is pulse pressure?

A

Difference between the systolic and diastolic pressures.

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8
Q

Define pulsus alternans.

A

An arterial pulse with alternating strong and weak beats.

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9
Q

When can pulsus alternans be found?

A

In the setting of severe ventricular dysfunction.

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10
Q

What is stroke volume?

A

Amount of blood ejected by the ventricles with each contraction.

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11
Q

What is a venous thrombo-embolism?

A

Blood clots in the veins. It is an obstruction of a blood vessel by a blood clot that has become dislodged from somewhere else.

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12
Q

Systole vs. diastole.

A

Systole: Maximum pressure when ejection occurs.
Diastole: Relaxation, this is the minimal pressure exerted against the arterial walls at all times.

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13
Q

What are some examples of things that would increase cardiac output?

A

HR increase, greater heart muscle contractility, increased blood volume.

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14
Q

Peripheral resistance is directly correlated with what?

A

Blood pressure.

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15
Q

What is the normal circulating blood volume?

A

5000 mL.

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16
Q

What determines blood viscosity?

A

Hematocrit (% RBC).

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17
Q

As hematocrit increases how does blood pressure change and why?

A

Arterial BP increases because blood viscosity is increased and slows movement.

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18
Q

What happens to the elasticity of arteries in the case of arteriosclerosis? What does that cause?

A

Elasticity decreases, which causes increased resistance to blood flow, which causes systolic pressure to rise.

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19
Q

What are 8 factors that influence blood pressure.

A

Age, stress, ethnicity/genetics, gender, medications, daily variation, activity/weight, smoking.

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20
Q

What is normal blood pressure?

A

<120 AND <80 mmHg

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21
Q

What is considered elevated BP?

A

120-129 AND <80

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22
Q

What is considered hypertension stage I?

A

130-139 OR 80-89

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23
Q

What is considered hypertension stage II?

A

140+ OR 90+

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24
Q

What is considered a hypertensive crisis?

A

180+ AND/OR 120+

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25
What is considered hypotensive?
When systolic BP is less than 90.
26
What are some reasons that hypotension may occur?
Dilation of the arteries, loss of a substantial amount of blood, or failure of the heart to pump enough blood.
27
What is considered orthostatic hypotension?
Drop in systolic by 20, drop in diastolic by 10.
28
What does a complete blood count show?
Number of RBC and WBC per cubic mm of blood.
29
What does a high creatine kinase count indicate?
Highly indicative of an MI.
30
What do cardiac troponins blood studies show?
Troponin I and T levels which can indicate MI's time line.
31
Why would a brain natriuretic peptide blood test be done?
To determine severity of heart failure (with increased levels).
32
What is scintigraphy used for?
Used to evaluate cardiac structure, myocardial perfusion, and contractility.
33
What does a cardiac catherization do? What is measured?
Helps visualize the cardiac chambers, valves, great vessels, and coronary arteries. Pressures and volumes are measured.
34
What is the overall purpose of an automated external defibrillator?
To strengthen the chain of survival.
35
What area of the heart is the SA node found in?
The right atrium.
36
What begins the electrical conduction of the heart?
The depolarization of the SA node in the right atrium.
37
What node in the heart stimulates ventricular contraction>
The AV node.
38
Define perfusion.
Passage of fluid through the circulatory system or lymphatic system to an organ or tissue,
39
What is cardiac output? What is the equation?
Volume of blood pumped by the heart in one minute. CO = SV x HR.
40
What is considered a normal EF?
> 50%
41
If an EF is less than 40% what does that mean?
Potentially heart failure, means that the left ventricle is not pumping blood out effectively.
42
In what instances may you see a high pulse pressure?
Atherosclerosis, exercise, or older adults.
43
In what instances may you see a low pulse pressure?
Severe heart failure, hypovolemia.
44
What are the [new] steps to take in a cardiac emergency?
CAB Compressions, Airway, Breathing.
45
In CPR how deep should you compress the chest?
At least 2 inches.
46
During CPR how many compressions should be done per minute?
120.
47
Now it is recommended that only who gets mouth to mouth CPR?
Young children and infants.
48
Why is high blood pressure a problem?
Eventually changes your arterial walls and damages then which causes increased peripheral vascular resistance. The heart has to compensate for the resistance by pumping more and pumping harder, which may lead to heart failure.
49
How does someone get diagnosed with hypertension?
Having an average of two or more high blood pressure readings at at least two subsequent health care visits.
50
Under what circumstances would someone seek emergency care for high blood pressure?
Blood pressure over 180/120. Severe headache, dyspnea, chest pain, numbness/weakness, loss of vision, difficulty speaking, nosebleed, unresponsiveness.
51
What is the principle behind the DASH diet?
To limit sodium to reduce blood pressure.
52
What is the main concern with hypotension?
Organs are not getting perfused correctly, can lead to permanent damage.
53
What are 3 potential causes of hypotension?
Dilation of arteries, loss of blood volume, failure of the heart to pump enough.
54
What are some symptoms associated with hypotension?
Clammy, pallor skin. Decreased perfusion to the brain which can cause lightheadedness, syncope, and/or confusion. Blurred vision. Chest pain. Rapid/weak heart rate. Decreased urine output. Nausea/vomiting.
55
How do you treat hypotension?
Treat the cause of the hypotension. (loss of blood volume, vasodilation, failure of the heart to pump)
56
Do you recommend more or less salt for a hypotensive patient?
More.
57
Why would a patient that has hypotension need to wear TED hose?
Increase venous return to heart.
58
Who is at risk of developing orthostatic hypotension?
Those with low blood volume, elderly, immobilized patients, and those that are pregnant.
59
How are you supposed to assess someone for orthostatic hypotension?
Measure BP and HR in laying down position after 5 minutes. Remeasure BP/HR within 3 minutes of postural change.
60
What is hyperlipidemia?
Too much lipids in the blood. Includes cholesterol and triglycerides.
61
When is it recommended to start cholesterol testing? And how often?
At age 20. Every 4-6 years.
62
How long to fast for lipid panels?
9-12 hours.
63
What is a good cholesterol level?
< 200 mg/dL
64
What is borderline high cholesterol?
200-239 mg/dL.
65
What is considered a high cholesterol level?
240+ mg/dL
66
What is considered good HDL cholesterol for women and men?
Women: >45 Men: >55.
67
What is considered good LDL levels for women and men?
<100 mg/dL for both.
68
What is the healthy range for triglycerides?
40-150.
69
What are some dietary modifications that would help lower cholesterol?
Reduce saturated and trans fats. Increase complex carbs and fiber (whole grain, fruit, veggies), limit major sources of cholesterol (egg yolks, whole milk, red meat). Eat fatty fish weekly (salmon, tuna, mussels).
70
What would someone who has high triglycerides limit?
Alcohol and simple sugars.
71
What are 3 types of patients that are at risk for developing a venous thrombus-embolism?
1. Those with venous stasis. 2. Those with hypercoagulability. 3. Those that have endothelium damage.
72
What are signs and symptoms of a venous thrombus-embolism?
Localized pain, tenderness, and swelling over vein sites. Warmth, tenderness, firmness of calf muscle. Complaints of calf pain while ambulating. Unilateral differences.
73
What is the only reliable way to diagnose a venous thrombus embolus?
Ultrasound.
74
What is the normal range of hemoglobin for women and men?
Women: 12-16 Men: 14-18
75
What is the percentage range of hematocrit for women and men?
Women: 37-47% Men: 42-52%
76
What two purposes does a chest x-ray serve?
Assess for fluid accumulation in the lungs and assess heart size.
77
What does telemetry do?
Monitors the patients heart rhythm continuously.
78
Does an EKG or telemetry have more detail?
EKG.
79
What is the placement tricks for telemetry?
White on right Snow over grass Smoke over fire Chocolate next to my heart
80
Prior to CPR where do you check for a pulse?
Carotid artery
81
How long do you check for a pulse before starting CPR?
More than 5 seconds, less than 10 seconds.
82
If a patient has no pulse and no respirations, what do you do?
Begin CPR
83
Where do you give chest compressions for a patient that needs CPR?
Heel of hand on breastbone. Under nipple line.
84
How many chest compressions do you perform per minute during CPR?
120.
85
How deep should chest compressions be for an adult?
At least 2 inches.
86
How often do you give rescue breaths?
1 every 5-6 seconds, or after 30 compressions (giving 2 breaths)
87
What are the key two things to do BEFORE beginning CPR?
Assess scene for safety and call for help.
88
How often to reassess blood pressure if normal?
Yearly
89
When someone has an elevated blood pressure what interventions begin happening?
Increase frequency of blood pressure checking, opening up the conversation for lifestyle changes
90
How often would a patient with hypertension stage 1 be coming in to check their blood pressure with the HCP?
3-6 months
91
What should happen when a patient is diagnosed with hypertension stage 2?
Therapies should be initiated within the month, follow up should be fast (one week-ish)
92
What are dietary modifications for people that have hypertension?
Need diets high in fiber, whole grains, fresh fruit, vegetables, nuts, lean meats, fish, chicken, and omega-3 fatty acids. Diets low in saturated and total fat.
93
Hypotension has systolic blood pressure less than:
90
94
How will a patient present if they are symptomatic for hypotension?
Potentially dizzy, light-headed (indicates low perfusion to the brain), complaining of chest pain (lower perfusion to heart), complains of upset stomach (lower perfusion to gut), and complaints of SOA (lower perfusion to the lungs)
95
In regards to hyperlipidemia, at age 40 what does the HCP conduct?
10-year risk assessments for CVD or strokes
96
What HDL level is has protective qualities?
> 60
97
What intercostal space are the white and black telemetry nodes located/placed?
At the 2nd intercostal space
98
Where is the brown telemetry node located/placed?
Left sternal border, at the 4th or 5th intercostal space

Fundamentals II (4 decks)

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