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Exam 1 (C&P) Flashcards

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1
Q

Small square on EKG

A

0.04 seconds

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2
Q

Large box on EKG

A

0.20 seconds

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3
Q

5 Large boxes on EKG

A

1 second

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4
Q

QRS Complex Duration

A

0.04 - 0.12 seconds (1 - 3 small boxes)

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5
Q

PR Interval on EKG

A

0.12 - 0.20 seconds (3 - 5 small boxes)

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6
Q

If ST segment is elevated on EKG

A

Possible code STEMI –> rule out heart attack

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7
Q

Sinus Arrhythmia

A

Check pt for symptoms

-normal in children

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8
Q

Causes: Sinus Bradycardia

A

Beta Blockers

Calcium Channel Blockers (Digoxin)

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9
Q

Treatment: Sinus Bradycardia

A

Atropine

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10
Q

Causes: Sinus Tachycardia

A

Fever
Stress
Pain
Anxiety

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11
Q

Treatment: Sinus Tachycardia

A

Vagal maneuver
Beta Blockers
Calcium Channel Blockers
Carotid massage

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12
Q

Causes: A-Fib

A

Cardiac Surgery
Pulmonary Hypertension
Hyperthyroidism

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13
Q

Symptoms: A-Fib and A-Flutter

A 
Chest pain
Hypoxia
Hypotension
Lethargy
SOB
Anxiety
palpitations
dizziness
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14
Q

Treatment: A-Fib and A-Flutter

A 
anticoagulants (they are at HIGH RISK)
Beta Blocker
Cardiac Ablation
Digoxin
ElectroCardioeversion
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15
Q

Causes: A-Flutter

A 
COPD
Pulmonary hypertension
valve disease
excess thyroid hormone
CABG or CHD repair
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16
Q

Impending Acute Heart Failure

A

Underlying heart disease + sudden onset of arrhythmia

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17
Q

In Supraventricular Arrhythmias, the QRS complex is _____, due to _____ excitation of the ventricles.

A

1) narrow

2) rapid

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18
Q

In Ventricular Arrhythmias the QRS complex is ______, due to _____ excitation of the ventricles.

A

1) wide

2) slower

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19
Q

Supraventricular Tachycardia

A

Rate: 150-250 bpm
Rhythm: regular
P-waves are buried in previous T waves
QRS: narrow

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20
Q

Causes: Supraventricular Tachycardia

A

stimulants (caffeine)
sepsis
stress
alcohol

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21
Q

Treatment: Supraventricular Tachycardia

A

Vaso Vagal maneuver
adenosine (w/ MD, rapid push + rapid flush)
Ablation
Cardioversion

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22
Q

Ventricular Tachycardia

A

Rate: > 250 bpm
rhythm: regular
No P wave
QRS: wide and even

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23
Q

Causes: Ventricular tachycardia

A 
stimulants (caffeine, meth, cocaine)
Med toxicity (digoxin)
Low Mg2+
Low K+
cardiac injury
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24
Q

Treatment: Ventricular tachycardia

A

w/ pulse: amiodarone, cardioeversion

w/out pulse: CODE –> CPR and defibrillation

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25
Ventricular Fibrillation
``` Rate: not measurable Rhythm: irregular No p wave QRS: no contraction, only quivering monomorphic or polymorphic ```
26
Causes: V-Fib
``` cardiac Injury Med toxicity (digoxin) Electrical disturbance (electrolytes, acid/base, electrical shock) ```
27
symptoms: V-Fib
loss of consciousness
28
Treatment V-Fib
defibrillation | Epinephrine
29
ST Elevated Myocardial Infarction (STEMI)
ST segment elevated because something is causing it to remain contracted
30
Causes: STEMI
Low O2 from CAD | High Potassium
31
Treatment: STEMI
reperfusion cath lab - angioplasty Possible CABG
32
1st degree AV Block
longer PR interval
33
2nd degree AV block type 1
progressively longer PR intervals until it drops a QRS complex
34
2nd Degree AV block type 2
No warning sign or PR change, but some QRS complexes are dropped
35
3rd Degree AV block
random loss of QRS and P waves
36
Treatment: Asystole
1) CPR + ET tube 2) Deliver ACL drugs 3) Epi every 3- 5 minutes 4) Vasopressin
37
Atrial PAcing
pacing spikes precede the P wave
38
Ventricular pasing
Pacer spikes precede the QRS complex
39
Dual Chamber Pacemakes
Pacer spikes precede both P and QRS
40
Pacemaker: Post Op
Immobilize arm Infection precautions Inspect HR and BP
41
Pacemaker: AVOID
``` 2 C's: contact sports constrictive clothing 4 M's: MRI Microwaves Metal detectors MP3 earphones ```
42
The 6 H's
``` Hypoxia Hypovolemia Hypothermia H+ ions (acidosis) Hypo/Hyperkalemia ```
43
The 6 T's
``` Tablets (overdose) Tamponade (cardiac) Tension pneumothorax Thrombosis (coronary) Thrombosis (pulmonary) ```
44
Pulseless Electrical Activity (PEA)
Electrical activity appears but there is no pulse
45
Treatment for PEA when pt is unresponsive
``` CPR O2 Start IV (if not already there) Push EPI Treat H's and T's ```
46
Artifact
distortion of ECG tracing by electrical activity that is non-cardiac in origin
47
troubleshooting artifact
Assess client first identify problem check electrodes ensure electrical equipment is grounded properly
48
Causes: Hypoxemic Respiratory Failure
``` V/Q mismatch - COPD, asthma Shunt Diffusion Limitation Alveolar Hypoventilation Neuromuscular disease ```
49
Causes: Hypercapnic Respiratory Failure
Airways and alveoli abnormalities CNS abnormalities Chest wall abnormalities Neuromuscular conditions
50
Early signs of Acute Respiratory Failure
``` Mental Status change tachycardia tachypnea mild hypertension anxiety ```
51
Complications of ARDS
``` Infection Barotrauma Volutrauma Stress Ulcers Renal Failure DIC Multi-Organ dysfunction syndrome ```
52
Causes: Low-Pressure Ventilator Alarm
Extubation Disconnection of tubes Deflated cuff
53
Causes: High Pressure Ventilator Alarm
``` Pulmonary Edema Biting the tube Kink in tube Secretions Coughing ```
54
The primary cause of Respiratory Acidosis is _____.
Hypoventilation
55
The primary cause of Respiratory Alkalosis is _____.
Hyperventilation
56
Casuse: Metabolic Alkalosis
Vomiting | NG suction
57
Cause: Metabolic Acidosis
Diarrhea Renal Failure DKA
58
Causes: ARDS
``` #1: Sepsis vaping near drowning pancreatitis severe burns ```
59
The three early signs of HYPOXEMIA are _____, _____, and _____.
restlessness anxiety confusion
60
Symptoms of ARDS:
``` #1: refractory hypoxemia substernal and intercostal retractions SOB cyanosis hemodynamic instability (hypotension, tachycardia, arrhythmia) ```
61
Primary Survey is done for trauma and emergencies. What is included in the survey?
``` Airway Breathing Circulation Deficit Exposure ```
62
A secondary survey once the patient is admitted includes...
``` History Head-to-toe exam Chest X-Ray CBC ECG and Cardiac Enzymes ```
63
Primary intervention for rib fractures...
Pain control to prevent hypoventilation | -NSAIDs and opioids
64
Supplies to have at bedside for ventilated patients
``` Intubation kit ambu bag oxygen crash cart suction ```
65
Treatment for Torsades De Pointes
- Magnesium Sulfate | - Electrical Pacing
66
Drugs used for 2nd and 3rd degree AV Block
``` Beta Blockers Calcium Channel Blockers Digoxin ... Atropine Dopamine Epinephrine ```
67
Main treatment for 3rd degree AV block
Pacemaker
68
Shockable waveforms are _____ and _____.
``` Pulseless Ventricular Tachycardia (V-tach) Ventricular Fibrillation (V-fib) ```
69
Cardiac Output
Blood pumped by the heart in 1 minute - SV x HR - 4 8 L/min
70
Systemic Vascular Resistance (SVR)
Measure of afterload resistance -(MAP-CVP) / CO 700 - 1500
71
1st line treatment for hyper/hypotension
Fluid management
72
Alpha receptors effect ____ ____ & _____.
Smooth muscle vasoconstriction & relaxation
73
Beta receptors affect _____ & _____.
Inotropy (strengthening and weakening of the heart) & chronotropy (heart rate)
74
Endocarditis
infection of inner layer of the heart | -forms vegetations on the valves specifically mitral and aortic
75
Risk factors: Endocardtis
- prosthetic valves - hemodialysis - IV drug abuse
76
Endocarditis diagnostics
``` Hx Labs: cultures, CBC, ESR, C-reactive Echocardiography Chest X-ray ECG ```
77
Pericarditis
inflammation of the outer lining of the heart w/ possible fluid accumulation (pericardial effusion)
78
Complications: pericarditis
Pericardial effusion Cardiac Tamponade Hiccups Hoarseness
79
Diagnostics: Pericarditis
``` 12-lead ECG Echocardiogram CT MRI Chest x-Ray Labs: CBC, CRP, ESR, troponins Cultures ```
80
Treatment: Cardiomyopathies
``` treat underlying cause Control Heart Failure Medications VAD PAcing ICD transplant ```
81
Nursing care for heart transplant patient:
- monitor chest tube drainage - monitor cardiac rate and rhythm - monitor cardiac output, pulmonary artery pressures, and CVP

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