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Module 7 > Care of The Cardiac Patient > Flashcards

Care of The Cardiac Patient Flashcards

(66 cards)

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1
Q

depolarizing=

A

contracting

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2
Q

repolarizing=

A

resting

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3
Q

pacemaker cells that helps the heart function on its own regardless of what the brain does

A

SA Node

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4
Q

when SA node fires then the HR is

A

60-100bpm

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5
Q

what node is next in line if the SA node stops working

A

AV node

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6
Q

when the AV node fires then the HR is

A

40-60 bpm

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7
Q

if something is wrong with the AV node what fires next

A

purkinje fibers

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8
Q

when the purkinje fibers fire then the HR is

A

20-40 bpm

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9
Q

what are the 2 parts of autonomic nervous system

A

sympathetic and parasympathetic

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10
Q

in sympathetic the heart is beating

A

fast

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11
Q

in parasympathetic the heart is beating

A

slow

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12
Q

which nerve responds in parasympathetic

A

vagus nerve located at the carotid (cranial nerve 10)

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13
Q

starling’s law of the heart

A

stroke volume is dependent on venous return

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14
Q

if venous return is _______ then stroke volume is _______ and cardiac output is ______

A

increased; increased; increased

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15
Q

what does the right coronary artery feed

A

the SA node, right atrium, AV node, and part of the posterior wall

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16
Q

if there is an inferior wall MI what could be blocked

A

right coronary artery

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17
Q

what does the left main coronary artery bifurcate into

A

left anterior descending branch and the left circumflex branch

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18
Q

if there is an occlusion at the top of the left main coronary artery what is it called

A

“widow maker”

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19
Q

what feeds the left atrium

A

left circumflex branch

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20
Q

what feeds the septum wall

A

left anterior descending branch

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21
Q

on an EKG how many “big squares” are 1 second

A

5

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22
Q

on an EKG how many seconds is 1 tiny square

A

0.04sec

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23
Q

what are the different hardwire monitoring of ECG/EKG

A

three lead system
five lead system
12 lead system

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24
Q

what are the different telemetry monitoring of ECG/EKG

A

three lead system

5 lead system

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25
why should you change a 5 lead EKG daily AND date them
pt sweats and the gel is conductive gel, so when pt sweats it has salt in it so the EKG can be obscured
26
what is the placement for 5 lead EKG
``` RA (white) LA (black) MCL (Brown) RL (green) LL (red) ```
27
for a 5 lead (limb lead) what is lead one
RA (-) to LA (+)
28
for a 5 lead (limb lead) what is lead 2
RA (-) to LL (+)
29
for a 5 lead (limb lead) what is lead 3
LA (-) to LL (+) | *Legs are ALWAYS positive and V1 (MC) is always negative, so aVr, aVl, and aVf are all +
30
flat lines that tell us what is elevated and what is depressed
isoelectric lines
31
for it to be sinus rhythm what needs to be present
p wave needs to be upright and accompany QRS
32
P wave should be no longer than ____ boxes
3
33
PR interval should be no longer than ___ boxes
5 | *if longer this should tell you there is a block
34
QRS interval should be _____ boxes because if wider there is a block
2.5
35
QT interval should be __-__ large boxes
1-2
36
atrial depolarization causes
P wave
37
what are the 2 phases of the P wave
completes right side them moves over to left atrium
38
ventricular depolarization causes
QRS wave * initial Q can be present or absent * a significant Q wave is when it is 1/3 the height of the R wave (major problem) myocardial damage
39
ventricular repolarization causes
T wave * slower because we are heading into the resting phase * ALWAYS an R wave before the T wave
40
sometimes you see this wave, sometimes you don't. if you see them its usually associated with repolarization of purkinje fibers
U wave * if you see it ask if they are diabetic, cardiac hx, taking digoxin, hypokalemic, hypothermic * mostly seen in slower heart rates <65
41
what is important about the pause occurring at the AV node (PR segment)
allows time for blood to empty from the atrium into the ventricle
42
what is important about the ST segment
line is flat and after that it will show us if the T wave is inverted, depressed, or elevated
43
T wave inversion=
ischemia
44
ST depression=
injury
45
ST elevation=
infarction
46
ST segment below the isoelecto line
ST depression= injury *if it looks like a label it is digitalis effect give oxygen and ask about meds
47
ST segment above the isoelectro line
ST elevation= infarction * tx is MONA * even if pt states they are not having chest pain you still get 12 lead EKG and call physician
48
what is MONA
morphine, oxygen, nitroglycerine, aspirin, | then cardiac cath or surgery
49
what should you do if the T wave is inverted
indicates ischemia so give oxygen and let physician know
50
originates in the right or left VENTRICLE, does not follow normal conduction path, each ventricle fires separately, these are wide and bizarre shaped
premature ventricular contraction (PVC)
51
every other beat is a PVC=
bigeminy | *give oxygen
52
every third beat is a PVC=
trigeminy
53
a pair of PVC, one is up one is down
multifocal couplet
54
if pt is having multiple PVCs (>6/min) what should be given
lidocaine
55
what van V tach turn into
ventricular fibrillation
56
what is the purpose of a pacemaker
control heart rate when conduction is compromised
57
paces either the atria or ventricle
single chamber
58
paces both atrium and ventricle
dual chamber
59
what is the 3 letter system for pacemaker
first letter= chamber is being paces second letter= chamber is being sensed third letter= response to heartbeat
60
what is important to teach the pt who gets a pacemaker
do not raise affected extremity above shoulder, bend at the knee, or push up for 2 weeks (cause dislodged electrode)
61
what interval will be wide if pt has a pacemaker
QRS
62
pt has a pacemaker that shows a spike with no response is
failure to capture
63
pt has a pacemaker what fires after pt's own beat is
failure to sense
64
failure to sense is the most ______ because if fires ______ the pt's own ______ and if we have electrical impulse after pt own beat it might hit on the ___ wave and could cause an __ on __ phenomenon
concerning; after; beat; T; R on T
65
what is an indication that pacer wire is dislodged or perforated the myocardium
hiccupping, rhythmic chest wall or diaphragmatic twitching | *must notify physician and monitor pt
66
what are the 6 steps of rhythm strip analysis
1. regularity of R wave 2. calculate HR 3. identify P wave (upright, present before QRS) 4. measure PR interval 5. measure QRS complex 6. ST depression or elevation 7. is there any other unusual occurrence

Module 7 (8 decks)

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