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Pccn > Cmc > Flashcards

Cmc Flashcards

1
Q

Signs and symptoms of aortic regurg or insufficiency ?

A

S2 murmur

Poor coronary artery perfusion
Syncope 
Angina
Wide pulse pressure
Left ventricular hypertrophy
Increased left ventricular diastolic volume
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2
Q

What murmur do you have with aortic regurg? Where do you hear it?

A

Blowing Diastolic murmur

Right sternal border and radiates to the apex

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3
Q

What is happening when you have an S 1 murmur?

A

Mitral and tricuspid regurg
Aortic and pulmonic stenosis
Also with ventricular septal defects

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4
Q

When do you hear an S2 murmur?

A

Aortic and pulmonic regurg

Mitral and tricuspid stenosis

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5
Q

When do you hear S4

A

Left ventricular diastolic heart failure

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6
Q

When would you get a wide pulse pressure

A 
Aortic regurg or insufficiency 
Aortic stiffening
Iron deficiency anemia
Hyperthyroidism
CAD
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7
Q

Why would you hear a systolic click?

A

Mitral prolapse

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8
Q

Signs and symptoms of mitral regurg

A 
SOB
Fatigue 
A fib
Pulmonary hypertension
Left ventricular insufficiency-pulmonary congestion
leads to rr sided 💜 failure
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9
Q

What is the normal cardiac index

A

2.5-4.0 mmhg

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10
Q

What is the normal cardiac output

A

4.0-8.0

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11
Q

What is a normal CVP

A

2-6 mmhg

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12
Q

What is another term for CVP?

A

Right atrial pressure

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13
Q

What is a normal PAOP (wedge)?

A

8-12 mmhg

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14
Q

What is the normal pulmonary arterial pressure?

Systolic and diastolic

A

15-25 mmhg/ 8-15 mmhg

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15
Q

What are the weaning criteria for a vented pt?

A

FiO2 less than 0.5 or 50%
TV greater than 6 ml/kg
RR less than 25
Nif greater than 25 cm

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16
Q

What is lovanox used for

A

NSTEMI,
Unstable angina
DVT

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17
Q

What is streptokinase used for?

A

Acute arterial thrombus/emboli

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18
Q

What is alteplase (activase) used for?

A

Acute ischemic stroke or PE

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19
Q

What is reteplase (retavase) used for?

A

AMI when thrombolisis indicates

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20
Q

WhT drugs can increase digoxin levels?

A 
Alprazolam
Amiodarone
Anti acids 
Verapamil
Spiralactone
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21
Q

What drug class is digoxin?

A

Cardiac glycoside

22
Q

What is a cardiac glycoside?

A

Inhibits the activity of ATpase that controls the movement of Ca, K+, Na in the heart muscle.
Holds Ca in the heart muscle to increase strength of contractions.

23
Q

What does giving digoxin do ?

A

Holds Ca in the heart muscle for stronger contractions
Chronotropic
Positive inotrope
Slows electrical
Activity between the atria and the ventricule

24
Q

When do they use digoxin?

A

CHF and afib

25
Q

What is the concern about potassium levels while taking digoxin?

A

Low potassium in the body can give you digitalis toxicity

26
Q

What is the normal range for dog levels?

A

0.5-2.0
For arrhythmia
0.5-0.9 for heart failure

27
Q

Where is the blockage if you have elevations in leads II, III, AVF?
What vessel?

A

Inferior, RCA

28
Q

Where is the infarct for EKG changes in v1-v6? Vessels?

A

Anterior septal

LAD or LCerc

29
Q

Changes in lead 1, AVL, V5 V6?

Vessels?

A

Lateral wall

LAD or circ

30
Q

What are the signs and symptoms of pulmonary valve stenosis?

A

Right heart failure

Peripheral edema, JDV, dyspnea on exertion light headedness

31
Q

How does dobutamine work?

A

Increases contractility but causes vasodilation to decrease systemic vascular resistance.

32
Q

What does dopamine do?

A

Increases contractility and increases SVR

33
Q

What is the cause of restricted cardiomyopathy?

A

S-scar tissue build up
C-Chemotheropthy
A-amyloidosis
R-Radiation exposure of the chest

Idiopathic

34
Q

Signs and symptoms of restricted cardiomyopathy

A

Shortness of breath (at first with exercise; but over time it occurs at rest)
Fatigue (feeling overly tired)
Inability to exercise
Swelling of the legs and feet
Weight gain
Nausea, bloating, and poor appetite (related to fluid retention)
Palpitations (fluttering in the chest due to abnormal heart rhythms)

35
Q

What are hallmark values in restricted cardiomyopathy?

A

Elevated right atrial pressure
Left ventricular diastolic disfunction occurs…. which is associated with very high end diastolic pressures and moderate to marked atrial enlargement
Normal systolic function

36
Q

What patients are at risk for developing contrast-induced nephropathy when admitted for a carotid arteriogram?

A

Hypovolemic
Anemic
Take metformin
Anti rejection meds (cyclosporine)

37
Q

What sound do you hear with a VSD?

A

Pansystolic mid-high pitch at the left sternal boarder

38
Q

What does Holotsystolic murmur mean?

A

A holosystolic murmur begins at the first heart sound (S1) and continue to the second heart sound (S2), as illustrated in the phonocardiogram. Typically high-pitched, these murmurs are usually caused by ventricular septal defect, mitral regurgitation or tricuspid regurgitation, as discussed below.

39
Q

Where can you hear Holotsystolic murmurs?

A

Holosystolic murmurs can be auscultated over the left 3rd and 4th intercostal spaces and along the sternal border.

40
Q

What heart soundnis made with a tricuspid regurg?

A

There is a loud, , pansystolic (holosystolic) murmur.

, rumbling,
diamond-shaped diastolic murmur.

41
Q

Where can you hear a Tricuspid regurg?

A

Harsh systolic murmur,
the maximum intensity is heard at the left lower sternal border. In addition, the murmur intensity increases with inspiration.

42
Q

What does PAOP measure?

A

Pulmonary capillary wedge pressure (PCWP) provides an indirect estimate of left atrial pressure (LAP).

43
Q

Why measure PAOP?

A

severity of left ventricular failure and to quantify the degree of mitral valve stenosis.

44
Q

What elevates left atrial pressure therefore elevating PAOP?

A

Left ventricular failure
Mitral stenosis
Mitral regurg
Aortic stenosis aortic regurg

45
Q

How high does left atrial

Pressure have to be to start pulmonary edema?

A

above 20 mmHg,

46
Q

What is Milrinone?

A

Inotrope and vasodilator

47
Q

When do you use milrinone?

A

heart failure.
stroke volume and cardiac output are increased
a slight fall in mean systemic arterial pressure. Decr. SVR
coronary vasodilator

48
Q

What murmur is heard with mitral valve stenosis?

A

Rumbling diastolic murmur loaders at the apex

49
Q

What is heard with an aortic stenosis?

A

Musical systolic murmur loudest right sternal boarder

50
Q

What is Wolff-Parkinson’s-white syndrome?

A

An extra electrical pathway between the atria and the ventricle

51
Q

Signs and symptoms of pericarditis?

A

Sharp chest pain can radiate to left shoulder or neck

Feels better when lean forward.

52
Q

What ekg changes do you see with pericarditis?

A

Diffuse ST elevation With an upward concavity

Pccn (2 decks)

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