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IM 7 Test 1 > Care of the Cardiac Patient > Flashcards

Care of the Cardiac Patient Flashcards

(77 cards)

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1
Q

problems to right side of the heart lead to X2

A

generalized edema

decreased perfusion to the body

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2
Q

problems to left side of heart leads to

A

pulmonary congestion

decreased CO

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3
Q

preload

A

volume in ventricles at the end of diastole

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4
Q

afterload

A

resistance left ventricle must overcome to circulate blood

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5
Q

antidote to heparin

A

protamine sulfate

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6
Q

coumadin antidote

A

vitamin K

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7
Q

Acute Coronary Syndrome

A

condition characterized by decreased or blocked blood flow in the heart

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8
Q

3 categories of ACS

A

unstable angine
NSTEMI
STEMI

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9
Q

unstable angina

A

chest pain that will go away with treatment and does not cause necrosis

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10
Q

NSTEMI

A

causes necrosis

lab value changes

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11
Q

STEMI

A

causes necrosis

lab value changes

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12
Q

is NSTEMI or STEMI worse

A

STEMI

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13
Q

main objective with ACS

A

decrease O2 demand and increase O2 supply

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14
Q

first intervention with any cardiac problem

A

Apply Non-rebreather no matter what

decrease physical activity (wheelchair)

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15
Q

Ca Channel blockers in cardiac

A

reduces conduction and decreases HR

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16
Q

betablockers in cardiac

A

affect epi and adrenaline and decreases HR and contractility

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17
Q

Nitrates in cardaic

A

leaves less blood in ventricles and sends more out to the body

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18
Q

opioids in cardiac

A

causes coronary artery dilation to decrease workload

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19
Q

opioid of choice in cardiac patients

A

morphine

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20
Q

what is an MI

A

death or necrosis of myocardial cells caused by blockage

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21
Q

STEMI

A

100% blocked - emergent

cath lab immediately

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22
Q

what happens if STEMI is not promptly treated

A

total necrosis in 4-6 hours

generalized edema

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23
Q

akinesis

A

no pumping

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24
Q

NSTEMI

A

partial occlusion/narrowing

still need cath but have more time for imaging

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25
when does hypoxia begin after O2 deprivation
10 seconds
26
goal for STEMI treatment time
cath lab within 90 minutes
27
Typical S/S of MI
CHEST PAIN/DISCOMFORT Hyperglycemia diaphoresis tachycardia/pnea S3/S4 heart sounds Peripheral Vasoconstriction SOB AMS
28
how are MI Dx X6
elevated cardiac enzymes elevated CK and CKMB levels EKG Stress test ECHO Angiogram
29
what shows early signs of ischemia
EKG
30
what shows late signs of ischemia
cardiac enzymes
31
how long does it take troponin to increase
5-7 hours
32
how soon does troponin return to baseline
10-14 days
33
baseline CK level
30-170
34
when does CK return to normal
24-36 hours following injury
35
why are there false positives for CK
non-specific - working out could falsely elevate it
36
when does CK begin to elevate
6 hours after injury - peaks at 18 hours
37
what does CK MB show
myocardial injury - not necessarily MI
38
when does CKMB elevate
within 2 hours - peaks at 3-15 hours
39
baseline CKMB
<90
40
when does CKMB return to normal
12-24 hours post-injury
41
Chest pain interventions X5
``` O2 BR Nitro X3 Labs Morphine ```
42
when should you hold nitro X2
if systolic <90 and if taken viagra that dayq
43
mediations for MI X5
``` nitrates beta blockers antiplatelet anticoagulants thrombolytic therapy ```
44
clopidogrel class
antiplatelet agent
45
HIT
body forms antibodies against heparin
46
when does HIT usually occur
5-10 days into treatment or <24 hours
47
when should you suspect HIT
Plt <150K or drop of 50% from baseline + heparin drip
48
normal Plt value
150-300K
49
PCI
percutaneous coronary intervention
50
what is a PCI
catheter is inserted into femoral artery and into heart, clot is sucked out and artery is opened up
51
allergy CI with PCI
shellfish
52
post-op risk with PCI
bleeding
53
how long are you on bedrest after PCI
24 horus
54
what happens if PCI fails
CABG
55
cardiogenic shock
inadequate tissue perfusion d/t cardiac dysfunction
56
cardiogenic shock tx
give them something to make heart pump
57
what tx should be avoided in cardiogenic shock
fluid infusion - avoid as much as possible
58
cardiogenic shock classic s/s X2
increased HR and decreased BP
59
amiodarone class
antidysrhythmics
60
how to treat hypotension in cardiogenic shock
norepi and dopamine avoid beta blockers
61
how to treat fluid overload in cardiogenic shock
diuretics | vasodilators
62
new medications following MI X4
aspirin nitro clopidogrel Lipitor
63
how long are you on bedrest post CABG
6 hours
64
what will you always have after a CABG
chest type
65
max chest tube drainage/hr
100 mL/hr
66
what happens if chest tube disconnects from setup
put one inch of tube in sterile water until new setup
67
aneurysm
artery wall weakens causing it to widen abnormally or balloon out
68
nonruptured AAA s/s X3
abdominal, back or flank pain pulsating abdomen pain or discoloratoin in feet
69
rupture AAA s/s X3
severe, untreatable pain hypotension pulsatile abdominal mass
70
what happens if an AAA is ruptured
straight to OR
71
2 surgeries for AAA
open repair endovascular aneurysm repair (EVAR)
72
what happens in an EVAR
diseased part of aorta is replaced
73
AAA interventions
2 large bore IV's peripheral pulses No X-RAY - only CT/contrast or MRI
74
biggest risk for AAA
hemorrhage and death
75
cardiac tamponade
pericardial effusion extends the sac beyond its limits
76
beck's triad
hypotension JVD muffled heart sounds
77
cardiac tamponade tx
pericardiocentesis

IM 7 Test 1 (5 decks)

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