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NCLEX Prep > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

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1
Q

normal PR interval

A

.10-.20

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2
Q

normal QRS complex

A

.05-.12

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3
Q

saw tooth waves are characteristic of…

A

atrial flutter

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4
Q

causes of atrial flutter

A

heart disease
MI
CHF
pericarditis

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5
Q

tx for atrial flutter

A

If hemodynamically stable → vigilant observation
If hemodynamically unstable → digitalis, beta blockers
Lastly - cardioversion

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6
Q

causes of atrial fibrillation

A

heart disease
pulmonary disease
stress
alcohol
caffeine

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7
Q

tx for a fib

A

If a common rhythm disturbance in a hemodynamically stable patient → might be no treatment
Digitalis, CCBs, BBs
Cardioversion if unstable
Sync cardioversion shocks on R wave

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8
Q

how to tx v tach

A

Patient is awake and alert with adequate vital signs → amiodarone
-150 mg IV bolus over 10 minutes
-Might add BB to prevent from coming back

If patient has inadequate vital signs and is not awake → treat with defib/cardioversion

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9
Q

what is v fib referred to as?

A

sudden cardiac death

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10
Q

tx for v fib

A

Defibrillate
CPR
Defibrillate
CPR, epinephrine 3-5 mins
Defibrillate
Continue with CPR, ACLS protocol
Second drug of choice = amiodarone high dose (300 mg IV)

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11
Q

do you have a pulse with v fib

A

rhythm does not generate a pulse

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12
Q

which receptors are in the heart

A

beta 1

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13
Q

when heart rate goes up, what is it called

A

chornotropy

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14
Q

when contractility increases, what is it called

A

inotrophy

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15
Q

what is CO

A

amount of blood heart pumps per minute
SV x HR

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16
Q

normal CO

A

4-8 l / minute

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17
Q

normal CVP

A

2-8 mmhg

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18
Q

MOA of ace inhibitors

A

blocks conversion of angiotensin to angiotensin II
results in decreased renin levels –> decreased aldosterone
results in vasodilation

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19
Q

3 nursing considerations for ACE inhibitors

A

can cause dry cough - need to manage so it doesn’t lead to angioedema
monitor BP
contraindicated during pregnancy

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20
Q

which drugs are the sartans?

A

ARBs

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21
Q

nursing considerations for CCBs

A

avoid grapefruit
monitor for orthostatic hypotension
gingival hyperplasia

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22
Q

what kind of drug is amlodipine

A

CCB (selective)

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23
Q

do patients on CCBs need to stop taking calcium supplements

A

no

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24
Q

what are 2 examples of arterial vasodilator

A

hydralazine
minoxidil

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25
when is hydralazine used
hypertensive crisis
26
what are 2 venous dilators
nitroglycerine isosorbide dinitrate
27
3 nursing considerations for beta blockers
do not discontinue abruptly can mask signs of hypoglycemia caution with asthma and COPD - can cause bronchospasm
28
what kind of med is amiodarone
k+ channel blocker
29
MOA of amiodarone
stops K+ from leaving cells and prolongs resting period
30
which clients should not receive atropine
clients with glaucoma because it'll cause blurred vision (it is an anticholinergic)
31
when should adenosine be used
SVT
32
how should adenosine be administred
rapid push
33
what does digoxin do
increased contractility (+ inotrope) decrease HR (- chronotrope)
34
what are therapeutic lab levels for digoxin
.5-2ng/ml
35
early signs of digoxin toxicity
n/v anorexia vision changes
36
late signs/symptoms of digoxin
bradycardia --> arrythmias
37
which electrolyte abnormalities increases digoxin toxicity
hypokalemia hypomagnesemia hypercalcemia
38
what does licorice extract act like
aldosterone --> Na/H2O retention, and K+ loss
39
when should you hold digoxin
HR < 60
40
what is the antidote for digoxin
digoxin immune fab
41
do you have a pedal pulse in peripheral vascular disease
YES because when you palpate pulses you are feeling for pulsation through an artery
42
what is peripheral vascular disease
inadequate venous return over a long period
43
s/s of peripheral vascular disease
brown discoloration uneven wound edges around ankle swelling
44
tx for peripheral vascular disease
elevate legs focus on proper wound care
45
superior vena cava syndrome: what is the patho
blood can't drain from upper body d/t tumor or solid body putting pressure on SVC
46
s/s of superior vena cava syndrome
headache blurry vision glossitis distension of veins above chest upper extremity edema dyspnea facial plethora
47
what is facial plethora
facial swelling and puffiness redness symptom of SVC
48
what are 4 causes of aneurysms
atherosclerosis HTN smoking family history
49
what is an aneurysm?
local dialation of a vessel wall most common = aorta
50
s/s of abdominal aortic aneurysm
abdominal/back pain gnawing/sharp pain
51
s/s of thoracic aortic aneurysm
SOB hoarseness/struggling to swallow upper back pain
52
which patients are at risk for embolism
pregnancy d/t hypercoagulable state a fib long bone fracture (fat embolism)
53
s/s of fat embolism
hypoxia dyspnea tachypnea confusion altered LOC petechial rash
54
what is peripheral arterial disease
atherosclerosis of arteries that perfuse limbs
55
4 signs of PAD
pallor pulselessness hairlessness intermittent claudication poor/absent pedal pulses eschar in wounds
56
what is intermittent claudication
pain that occurs in legs when walking pain that gets better with rest
57
tx for PAD
dangle legs antiplatelet therapy
58
tx for PVD
elevate legs proper wound care
59
instructions for nitroglycerine
do not swallow sublingual administered 1 pill q5 mins for 3 doses expect a headache! keep in a dark bottle in dry, cool place
60
is a myocardial infarction reversible or irreversible damage
irreversible
61
what does ST elevation inidcate
injury QRS does not come back to baseline inverted T wave
62
what would show ischemia on a EKG
ST depression and/or T wave inversion
63
what is door to balloon time? (PCI)
90 minutes
64
3 causes of pericarditis
infection tumor drugs
65
4 findings for pericarditis
sharp chest pain tachypnea fever & chills weakness
66
tx for pericarditis
NSAIDs
67
2 findings for pericardial effusion
chest pain muffled heart sounds d/t fluid
68
tx or pericardial effusion
pericardiocentesis to remove fluid
69
cardiac tamponande s/s
chest pain SOB decreased CO muffled heart sounds JVD narrowed pulse pressure (<40)
70
what is endocarditis
infection and inflammation of the endocardium
71
what is the number 1 cause of HF
HTN
72
LHF symtpoms (FORCED)
fatigue orthopnea rales/restlessness cyanosis/confusion extreme weakness dyspnea
73
8 signs of RHF
JVD dependent edema hepatomegaly splenomegaly ascites weight gain fatigue anorexia
74
how do you decrease workload of the heart
ACEs to decrease afterload ARBs to decrease afterload diuretics digoxin to increase contractility
75
what does hyperkalemia look like on an EKG
wide flat P prolonged PR widened QRS depressed ST tall peaked T waves
76
if you see prominent u-waves on an EKG, what electrolyte imbalance exists
hypokalemia
77
what electrolyte disturbance can cause long QT
hypo calcemia --> can lead to v tach
78
hypomagnesemia EKG
prolonged PR long QT can go into torsades!
79
hypermagnesemia EKG
wide flat P wave tall T wave (not peaked)
80
what receptors does norepi work on
alpha 1 causes peripheral vasoconstriction
81
when is dopamine used
low doses used in kidney failure to increase renal blood flow low doses increases contractility high doses cause vasoconstriction
82
when is milrinone used
cardiogenic shock decreased CO congenital/aquired heart defects
83
what kind of drug is milrinone
phosphodiesterase inhibitor phosphodiesterase breaks down cAMP allows heart o contract more
84
s/s of cardiac tamponade
tachycardia tachypnea pericardial rub JVD hypotension narrowed pulse pressure

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