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exam 4 cont Flashcards

1
Q

60-100

A

sa node

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2
Q

40-60

A

av node

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3
Q

20-40

A

perkingje fibers

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4
Q

.12-.20 (>.20 = AV block)

A

pr

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5
Q

.04- .10

A

qrs

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6
Q

st depression

A

ischemia

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7
Q

st elevation

A

mi

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8
Q

if what is prolonged it can cause dysrhythmias

A

qt interval

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9
Q

analyzing strip what do you ask

A

o Rate- fast or slow?
o Rhythm- regular or irregular? (obtain fastest with counting QRS for 6 sec x 10)
o P waves- one before every QRS?
o QRS complex- do they look the same? Follow P wave?

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10
Q

sinus brady

A

atropine ; hr is <60

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11
Q

tachycardia

A

IV Adenosine or Lopressor (Metoprolol)

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12
Q

PSVT tx

A

vagal down first then IV adenocard, Cardizem, Digoxin, Amiodarone, Adenosine

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13
Q

a fib meds to slow the rate

A

Cardizem (Diltiazem), Metoprolol, Digoxin, Amiodarone, Synchronized Cardioversion,

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14
Q

a fib meds to anticoagulate

A

warfarin and heparin

pt: 11-14
ptt: 25-35
inr: 0.8-1.2

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15
Q

digoxin toxicity

A

n/v and halos

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16
Q

pulseless v tach

A

cpr and defibrillation ; unstable

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17
Q

pulse v tach

A

amiodarone ; stable

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18
Q

no cardiac out put

A

ventricular fib

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19
Q

tx for v fib

A

CPR, Defibrillation (d/t no pulse), ACLS Protocol, Amiodarone, Epi

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20
Q

important with heart failure

A

bnp

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21
Q

Represents the time to pass from the SA node through the atria & AV node to the ventricles.

A

pr interval

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22
Q

pr greater than .20 means

A

communication is no longer between SA node and AV node

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23
Q

5x5 on ekg is

A

.20 seconds

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24
Q

pr intervals should be how big on ekg

A

5 boxes. anymore than that=prolonged pr interval

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25
analyzing the strips what 4 questions do you want to ask yourself
rate: fast or slow; count T wave regular or irregular p wave before QRS do every QRS look the same and have a P wave before?
26
rate of 100 to 150
sinus tachy; normal rhythm just really fast
27
albuterol, dehydration, exercise, hypovolemic shock, fever, hyperthyroidism
sinus tachy
28
questions to ask every patient
dizzy/lightheadedness, LOC impaired, low bp, dyspnea, chest pain, hypotension
29
tx for sinus tachy
tx the cause. vasovagal response, iv adenosine or metoprolol but give a CCB instead
30
#1 intervention for sinus tach
find the cause and fix the cause
31
150-250 hr
PSVT
32
Paroxysmal
means it starts and stops spontaneously
33
premature atrial contractions so p waves are abnormal
PSVT
34
Causes: caffeine, stress, stimulants, dig toxicity, CAD
PSVT
35
tx for PSVT
vagal response, adenosine, cardizem, digoxin, amiodarone | SLOW HR
36
when giving adenosine to PSVT pt what do you need to do
give it in a proximal IV because the half life is only 10 seconds; 18 gauge is better because the med will go in faster. RAPID IV PUSH FOLLOWED BY FLUSH
37
what do you do for a premature atrial contraction- PAC
wear a holter monitor for healthy heart- no big deal pt w underlying issue- should go see doc tx:ccb
38
ventricular rate is 60-180
a fib
39
a fib- atrial is quivering
its not pushing all the blood through so blood sits and clots there then when the blood does move through it pushes the clot out to the rest of the body
40
why does a fib affect hr
ventricles are trying to keep up w the atria
41
tx for a fib
slow the rate and treat the clotting risks
42
anticoagulant for a fib
warfarin- takes 2-3 days to become therapeutic; pt goes home on this. INR heparin- starts quick. people dont go home on this- ptt
43
tx for a fib
cardizem, digoxin, metoprolol, amiodarone, synchronize cardioversion ; cardioversion can be done with meds or with pads
44
a flutter
a little more of a contraction than a fib; less risk for blood clots
45
normal slow rhythm
sinus brady
46
meds that cause sinus brady
betablockers and ccb
47
crackles and fluid volume overload
think HEART FAILURE
48
med for sinus brady
atropine and oxygen
49
prolonged pr interval
1st degree heart block
50
how to treat first degree
usually no treatment but monitor for new changes; usually a precursor for dysrhythmia
51
Complete AV Heart Block Atrial and ventricular rhythms regular, but independent of each other
third degree heart block
52
third degree heart blocks will progress to
asystole
53
tx for third degree
transcutaneous pacemaker until transvenous pacemaker can be inserted. Atropine, epinephrine, dopamine.
54
post op for permanent pace makers
Don’t lift arm above head Antibiotic therapy Monitoring of rhythm Pacemaker function checked frequently
55
premature ventricular contraction
like the pac but in the ventricles; QRS depression
56
not a problem in a healthy heart but if they happen more frequently or together then this is a problem
pvc
57
stable v tach
they have a pulse
58
unstable v tach
no pulse
59
v tach and no pulse
cpr and shock patient; epi /amiodarone
60
v tach and pulse
amiodarone and lidocaine
61
shockable rhythms
v tach no pulse and v fib
62
asystole
epi and cpr
63
will never have a pulse because there are no contractions
v fib ; shock/epi/cpr
64
drug of choice for ventricular dysrhythmias
amiodarone
65
how is amiodarone give
pulse- iv drip | no pulse- iv push
66
what to do for v fib
cpr, amiodarone, defibrillation, epi
67
pea
pulseless electrical activity
68
electrical shock
v tach and v fib
69
people who survive sudden cardiac death or dysrhythmias get
automatic implantable cardioverter defibrillator
70
Area that is causing dysrhythmias is burned
ablation
71
digoxin toxicity
potassium level
72
prolonged pr interval is what
an AV block
73
chronic heart failure weight gain
>3-5lb in a week, >3lb in 2 days, or >2lb in a day
74
intervention for endocarditis
get blood cultures quickly
75
triggers for dvt
venous stasis, endothelial damage, hypercoaguability
76
immobility, obesity, long surgery, prolonged bed rest, varicose veins, heart failure, stroke
venous stasis
77
abdominal and pelvic surgery, trauma, indwelling catheter, iv meds, iv drug abuse, prior dvt, fractures of hip, leg, or pelvis
endothelial damage
78
pregnancy, estrogen therapy, oral contraceptives, cancer, inherited coagulopathies, antithrombin, polycythemia, dehydration
hypercoagulability
79
complications of dvt
pe; bleeding from thrombolytic therapy
80
what causes rheumatic fever
strep infections
81
intermittent claudication- pain triggered by exercise and relieved with rest, & thin shiny skin
PAD
82
5 p's in pad
Pain, Pallor, Pulselessness, Paresthesia, Paralysis
83
intervention for aortic dissection
blood pressure control to prevent tear from getting worse

adult health (10 decks)

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