CCRN- Cardiac Flashcards

Question

What do SBP and DBP indirectly measure?

Answer 1

SBP - measure of CO and SV > if a drop occurs, hypovolemia and drop in CO DBP - measure of SVR >if a drop occurs, vasodilation cause drop in SVR, seen with sepsis and septic shock

Answer 2

diagnostic cath w/in 24hrs w/ high risk score or continued CP, signs of instability Start GPIIb/IIIa inhibitors (Integrilin, Reopro)

Answer 3

- abnormal conduction pathway allows reentrant tachycardia pathway to bypass the normal AV conduction pathway --> SVT - will see delta wave: slow upstroke of QRS -S/s of SVT: palpitations, dizzy, CP, SOB, syncope >>If patient unstable, cardiovert or give adensosine; patient needs ablation **If wide QRS, may be pre-excited Afib>> treated differently! Give BB, amiodarone or procanimide IV (giving CCB, adenosine or Digoxin for pre-excited Afib will enhance conduction and lead to VF)

Answer 4

- give BB to prevent effects of Norepi (prevent vasoconstriction) - give ACE-I (prevent Angiotensin I from convert to Angiotensin II which cause more vasoconstriction) or ARB (prevent Angiotensin II - K sparing diuretics to prevent aldosterone release (which holds on to sodium and water) >>Vasoconstriction and Na/H2O retention cause ventricular remodeling (hypertrophy, dilation, apoptosis)

Answer 5

Stage A- high risk, no dysfxn Stage B- Heart disorder or structural defect, NO symptoms Stage C- Heart disorder or structural defect WITH symptoms Stage D- End-stage cardiac disease, w/ symptoms despite maximal therapy (inotropic or mechanical support)

Answer 6

Class I- ordinary activity, no symptoms; Extraordinary activity results in HF symptoms Class II- Comfortable at rest, ordinary activity results in HF symptoms Class III- Comfortable at rest, minimal activity results in HF symptoms Class IV- Symptoms of HF at rest, severe limitation with physical activity

Answer 7

Mechanical lasts longer, but requires life long anticoagulation Biological wears down with high pressure, only short term anticoagulation but requires lifelong ASA

Answer 8

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a narrowed aortic valve that fails to open properly (aortic valve stenosis). If too high risk for open heart Requires DAPT: ASA for life and Clopidigrel 75mg/d for 3-6mo

Answer 9

Abdominal: 75% >pulsation in ABD or low back pain, N/V, shock Thoracic: 25% >SUDDEN TEARING, RIPPING CHEST PAIN that radiates to neck, shoulder, back >cough, hoarseness, dyspnea, dysphagia **If < 5cm just monitor regularly w/ US or CT **If > 6m need surgical repair; aggressively treat HTN and HR control with Labetalol drip DISSECTION IS EMERGENCY SURGERY

Answer 10

-gives systolic and diastolic -systolic is RV squeeze blood in Pulm artery >>>elevated with any lung problem *Pulmonary HTN *Hypoxia *COPD, ARDS, PE ``` -diastolic pulmonic valve closed, thus reflects LVEDP >>>elevated with heart problems *cardiac tamponade *LV failure *MV disease ``` Normal PAP is 25/10 ("quarter/dime") or (PAS 20-30/ PAD 6-12) PAWP is 1-4mmHg lower than PAP (never higher!!!) So PAWP norm is 8-12 mmHg >>>PAOP is an indirect measure of LAP which is reflective of LV preload and therefore LVEDP **LV failure or fluid overload leads to an increase in PAOP a wave = atrial contraction (after QRS) Dicrotic notch = closure of pulmonic valve c wave = MV closing v wave = atrial filling (after T wave)

Answer 11

a long R-R followed by short R-R Most commonly seen with Afib

Answer 12

NO. Not with RBBB. Not w/ MV stenosis. Not w/ MV insuffi/regurg (Large V waves on PAOP) Not w/ Pulm HTN Not w/ decreased LV compliance Not w/ aortic insufficiency or pulmonic insufficiency

Answer 13

**MOST OFTEN FROM MI!!! Compensatory: Initially decr in CO, SNS compensates and adrenaline released which incr HR, BP, releases ADH to retain water an vasocontriction. Tachycardic, cool, pale, decr UOP Progesses to acidosis from vasocontriction, causing vasodilation which decr CO and BP causing hypotension (decr CVP, PCWP, CO and incr SVR). The patient is obtunded and stuporous from hypovolemic shock. REPLACE VOLUME: CRYSTALOIDS, FFP, BLOOD, COLLOIDS

Answer 14

If JVD is 10cm above the sternal angle, just at 5cm to get CVP. So 15cm H2O. Normal CVP 3-8

Answer 15

Acute aortic dissection

Answer 16

AV block may develop due to edema, inflammation, hemorrhage, or suturing near the node >>monitor for: 2nd degree type II

Answer 17

SaO2- arterial O2 saturation >>most accurate for amount of O2 in blood = DO2 (oxygen delivery) PaO2- represents only 3% that is dissolved in plasma SvO2- venous O2 saturation >>represents O2 reserve, it's what's left over after the tissues have extracted what they need

Answer 18

``` PR segment (not PR interval, that is atrial repolarization to ventricle depolarization) ```

Answer 19

Right ventricle, it's the most anterior and behind sternum

CCRN- Cardiac Flashcards

(43 cards)