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MedSurg4 Exam 1 > Mod 1 cardiac > Flashcards

Mod 1 cardiac Flashcards

(84 cards)

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1
Q

Arterial catheters

A

provide pressure readings
BP
saline flush bags pressured to 300 mmHg

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2
Q

central venous pressure

A

placed in internal jugular or subclavian or femoral vein
indicates right atria pressure and estimate of R ventricular filing pressure (preload)

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3
Q

normal CVP

A

8- 12 mm hg

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4
Q

Swanz-Ganz catheter or PA catheter

A

placed in internal jugular or subclavian or measures pulmonary artery
normal systolic is 15-30
diastolic 4-12

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5
Q

normal PR interval

A

0.10-0.20 or < 5 small boxes

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6
Q

QRS interval

A

0.06 to 0.10 seconds

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7
Q

1 small box equals

A

0.04 secs

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8
Q

1 large box equals

A

0.20 secs

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9
Q

5 large box

A

1 second

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10
Q

depolarization

A

contraction

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11
Q

repolarization

A

relaxation

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12
Q

P-wave

A

atrial depolarization
SA node sending out impulse

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13
Q

QRS

A

ventricular depolarization

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14
Q

T-wave

A

ventricular repolarization

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15
Q

Sinus bradycardia Tx

A

atropine 0.5mg IVP
pacemaker

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16
Q

Sinus tachycardia causes “TACHY HEARTS”

A

Temperature
Aerobics
Cardiac disease
Hyperthyroidism
Yelp (pain)

Hemorrhage or hypovolemic shock
Emotional stress/fear
Anemia
Respiratoy conditions
Therapeutics (atropine, albuterol, dopamine, epinephrine)
Simulants

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17
Q

Sinus tachycardia tx

A

BB
CCB
pain meds
antipyretic

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18
Q

Premature atrial contractions (PACs)

A

pacemaker cell close to SA node fired too early has pause at end

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19
Q

PVC tx

A

dependant on cause
eliminate cause

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20
Q

atrial flutter

A

no P-waves has F-waves
QRS complex < 0.12 secs

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21
Q

Dobutamine nursing considerations

A

continous cardiac montioring
weight for dosage calculatino
baseline v/s
monitor i&O
monior potassium
monitor drug range (40-190)

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22
Q

Dobutamine s/e

A

tachycardia
pain at injection site

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23
Q

Dobutamine indications

A

heart failure
cardiogenic shock

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24
Q

Nitroglycerin nursing considerations

A

take off at night and then reapply in morning
contraindicated in taking erectile dysfunction meds
take tylenol for headache
keep in amber glass
do no chew crush or swallow SL tabs

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25
Nitroglycerin S/E
FLUSHED Flushing Lightheadedness Upset stomach Syncope Hypotension/Headache Effectiveness/tolerance decreases dizziness
26
Amiodarone teaching
take in divided doses if upset stomach avoid grapefruit juice use sunscreen no tanning beds stays in body for a long time so side effects may remain even after if stopped
27
Amiodarone s/e
AMIODARONE Abnormal thyroid function Muscle weakness Interstitial lung disease Optic neuropathy Discoloration of skin (blue skin) Ataxia Reduction of HR Occular corneal microdeposits Nausea/vomiting/constipation Enzyme fluctuations of the liver
28
Beta blocker teaching
Hold if SBP <90 HR <60 take medication with food monitor for bradycardia & hypotension can mask hypoglycemia (anxiety, shakiness, palpitations except for sweating & hunger) dont stop quickly, reduce over 2 weeks
29
Beta blocker S/E
BAD FISH Bradycardia/bronchospasm AV block/arrhythmias contrindications dizziness/depression fatigue impotence s/s of hypoglycemia masked hypotension
30
ACE inhibitor side effects
TOP CARD teratogenic orthostatic hypotension potassium increase cough angiodema renal impairment dizziness
31
Premature ventricular contractions
impulse starts in ventricles no p=wave QRS wide > or equal to 0.12 or 3 smal boxes
32
PVC tx
based on s/sx correct cause
33
ventricular tachycardia with pulse
pt maintaining BP and pulse with or without s/sx
34
Vtach tx
antiarrhythmic meds elctrolyte replacement cardioversion
35
Pulseless Vtach tx
CPR and defib
36
Ventricular fibrillation
chaotic impulses w/i ventricles prevents blood flow stopping cardiac output causing death
37
Vfib tx
CPR and defib
38
1st degree heart block
PR interval > 0.20 secs
39
2nd degree AV block type 1
not all atrial impulses form AV node get to ventricles more p-waves than QRS complexes PR interval gets longer until QRS drops
40
3rd degree AV block
complete heart block R-R regular P-P regular
41
MI management
Oxygen, nitroglycerin, aspirin, pain meds
42
labs for MI
troponin CK CKMB ECG *gold standard* echo stress test
43
Cardiogenic shock
heart muscles can't adequately contract, causing decrease CO
44
Cardiogenic shock s/sx
CP thready reapid pulse diaphoresis narrow pulse pressure n/v JVD tachycardia hypotension dyspnea
45
Cardiogenic shock management
meds to increase BP &CO intra-aortic ballon pump LVAD or RVAD ECMO
46
Cardiogenic shock nursing care
v/s neuro assessment labs o2 therapy adminster meds fluid replacement
47
Cardiac tamponade
sudden accumulation of fluid in pericardial sac
48
Cardiac tamponade causes
knife/gun wounds ventricle rupture anticoagulants viral infections pericarditis TB
49
Cardiac tamponade s/sx
dyspnea tachycardia tachypnea pallor cold extremities
50
Cardiac tamponade management
pericardiocentesis thoracotomy inotropic meds
51
Cardiac tamponade nursing care
ABCs fluid resuscitation O2 therapy administer meds assess drainage site
52
DIC
overactivation of clotting mechanisms leading to enhanced bleeding
53
DIC s/sx
hematuria epistaxis petechiae ecchymoses
54
DIC labs
d-dimer platelets PTT INR
55
DIC management
PRBC, FFP Heparin Pulm artery catheter (PAC)
56
DIC nursing care
monitor for bleeding no razor or electric razor give meds 02 therapy
57
Norepinephrine
vasoconstrictor increase HR, BP and contractility
58
Norepinephrine s/e
tissue necrosis at IV site; infuse through central line myocardial ischemia reflex bradycaria
59
Dopamine
vasoconstriction to increase BP and H R
60
Positive inotropes
dopamine dobutamine digoxin
61
Negative inotropes
Beta blockers CCB
62
Negative chronotropes
digoxin BB CCB
63
Positive chronotropic
atropine dopamine epinephrine dobutamine
64
Adenosine
slow conduction in AV node
65
Adenosine indications contraindications s/e
indications: SVT contraindications; 2/3 AV block s/e : flushing hypo BP and HR tingling numbness
66
Clonindine
antihypertensive
67
clonidine contraindications
active liver disease active use of MAOI pregnancy
68
clonidine s/e HTN DRUG
HTN DRUG Headache Tired Not able to poop Dizziness/dry mouth Rash Unable to sleep GI upset
69
clonidine teaching
avoid abrupt d/c to avoid rebound htn avoid driving when drowsy avoid alcohol if using patch apply to hairless area
70
clopidogrel (plavix)
antiplatelet
71
clopidogrel (plavix) contraindications
intracranial hemorrhage peptic ulcer pregnancy hepatic impairment
72
statins
inhibit cholesterol synthesis
73
statin s/e CHAMG
CHAMG Cpk increase Hepatotoxicity/headache Avoid in pregnancy Myalgia/myopathy GI upset
74
statin teaching
monitor LFT avoid grapefuit take in evening/bedtime
75
Nitroglycerin teaching
take ER tabs with water on empty stomach dose meds to have 10-12 hr nitrate free period to decrease tolerance avoid alcohol use take 7 hrs apart for IR isosorbibe formulation max dose 3 q15 mins rise slowly dont take if SBP is <90
76
Inotropes
dopamine dobutamine epinephrine vasopressin isoproterenol norepinephrine
77
Antiarrhythmics
potassium chanel blockers BB CCB sodium channel blockers digoxin
78
vasodilators
nitrates nitroprusside sodium (Nipride) ACEs
79
Vasoconstrictors
Dopamine Epinephrine Norepinephrine Phenylephrine Vasopressin
80
what do vasoconstrictors do?
increase HR, BP increase contractility
81
what do vasodilators do?
increase HR, and decrease BP no effect on contractility
82
what do inotropes do?
increase HR and contractility decrease BP
83
afib tx
rate control w/ digoxin BB, CCB anti-arrhythmic meds cardiac ablation cardioversion
84
Sinus brady causes SLOW RATES
Sick sinus syndrome Low thyroid hormone Older adults Weak and damage heart muscle Raised ICP Athlete Toxicity of BB CCB, digoxin Electrolyte imbalances Stimulation of vagal response

MedSurg4 Exam 1 (4 decks)

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