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Flashcards in CVS Deck (53)
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What is starling's law?

the greater the stretch, the greater the contraction

1

Identify 4 unique functional properties of cardiac cells.

automaticity - independent electrical activity and initiation
excitability - ability to respond to external stimuli (chemical, mechanical, or electrical)
conductivity - conducting electrical activity from cell to cell
contractility - contraction in response to stimulus

2

What happens when Beta 1 sympathetic receptors are stimulated?

increased heart rate, increased force of contraction, increased speed of conduction via the AV Node, increased oxygen consumption

3

What happens when beta 2 adrenergic receptors are stimulated?

affects the heart, lungs, and skeletal muscle by dilation, and increased organ perfusion

4

What is the inherent rates of the SA node?

60-100 bpm

5

What is the intrinsic rate of the av junction?

40-60 bpm

6

What is the intrinsic pacemaker rate of the purkinje fibres?

20-40 bpm

7

What does PQRST mean?

P - Precipitating factors
Q - Quality and Quantitative
R - Radiating
S - Signs and Symptoms
T - Timing and Treatment

8

What are the characteristics of S3?

end diastolic sound, normal in pregnancy, children, and YA due to rapid ventricular feeling, abnormal after 40 years. Causes are acute MI, heart failure, valve disease, systematic or pulmonary hypertension

9

Why are hemoglobin, WBC and platelets so important when assessing your adult cardiac patient?

Hemoglobin oxygen carrying capacity not below 90
WBC inflammation, infection
Platelets - risk of coronary artery disease - increased clotting factors

10

How does magnesium affect the heart?

affects AV node conduction

11

How does creatine kinase show cardiovascular function?

-enzyme specific to brain, myocardium, skeletal muscle
-followed to determine timeline of the injury
-level rises 4 - 8 hours, peaks in 24 hours, decreases in 48-72 hours
-total CK
-CK - MB enzyme more specific to myocardium

12

How does troponin show cardiac function?

released into the circulation with cellular damage
specific to myocardial cells - most sensitive indicator of myocardial damage
rises in 4 to 6 hours; remains detectable for 7 - 15 days (is undetectable by 2 weeks)

13

How does BNP indicate cardiac function?

brain natriuretic peptide
hormone secreted from the ventricles of the heart
secreted in response to changes in pressure (stretch) occurring when heart failure develops and worsens

14

How does CRP indicate cardiac function?

indicates acute inflammation
trend more beneficial
increased CRP levels correlate with increased cardiac risk
-threeford increase in risk of acute MI

15

How does HbgA1c indicate cardiac function?

minor component of hemoglobin to which glucose is bound
higher the glucose concentration in blood, higher the level of HbA1c
not influenced by daily fluctuations in blood glucose; reflects average glucose levels over prior six to eight weeks

16

What is the formula for figuring out MAP?

SBP + 2 DBP divided by 3

17

What are the characteristics of central venous pressure?

reflects preload - end diastolic volume
normal 2 - 6mmHg
mean reading used
obtained through CVC

18

What is the normal ejection fraction?

55-70%

19

define afterload

the amount of resistance to flow the ventricles must overcome to eject blood from the heart
increased afterload means an increased workload of the heart

20

What are the steps to troubleshooting a pacemaker?

1. find pacemaker rate
2. should it have fired? if there is an intrinsic beat between pacer beats it shouldn't fire
3. is it sensing?

21

Define arterosclerosis

hardening of the arteries

22

Define atherosclerosis

chronic inflammatory disorder
formation of plaque with fibrous cap

23

define coronary artery disease

progressive atheroslerotic disoder, narrowing to complete occlusion of coronary arteries.

24

What are the three types of angina?

stable - predictable, specific triggers, responds to treatment
unstable - unpredictable, increased frequency, increased duration, no response to treatment
variant - prinzmetal angina, coronary artery spasm, occurs with or without atherosclerotic lesions

25

What are the immediate treatments for a suspected MI?

early triage
initiate O2
vital signs
data collection
ECG
initiate medications such as ASA and clopidigrel

26

What do beta blockers do?

decreases cardiac workload, myocardial O2 demand, decreases risk for tachyarrythmias

27

What do ACE inhibitors do?

blocks conversion of angiotensin I to angiotensin II
prevents Na and water reabsorption
reduces afterload

28

What are the considerations to unfractionated heparin?

response to medication unpredictable
narrow therapeutic window
closely monitor PTT
acts within minutes of administration

29

What are the considerations of low molecular weight heparin?

more predictable and sustained response
proven better efficacy
no need for lab monitoring
ease of administration