Section 2 Flashcards
(288 cards)
1
Q
In 3rd degree block -CHB, the atrial rate will be ___ from the ventricular rate. Also, the P and the QRS will be ___
A
- separate;
- dissociated
2
Q
Preload is
A
volume
3
Q
AV node is represented by the ___ on the ECG
A
PR interval
4
Q
Percutaneous transluminal coronary angioplasty (PTCA) route
A
- Go up through femoral artery to aorta
- Inflate and deflate the balloon over and over until wall of the vessel stretches out so it is more patent
- Stent may be placed to keep the vessel open permanently
5
Q
3rd Letter in Universal Pacemaker Code means
A
Type of response
6
Q
What can precipitate angina pain?
A
- Physical exertion
- Exposure to cold
- Eating a heavy meal
- Stress and emotional factors
- Stimulants
7
Q
Afterload is
A
the resistance the left ventricle must overcome to circulate blood
8
Q
Patients with hyperthyroidism will have a ____ heart rate
A
much higher
9
Q
3 types of pacemaker implantation
A
- External or Transcutaneous
- Internal or Transvenous
- Epicardial
10
Q
For a patient with ventricular fibrillation, treat with what 3 things?
A
- CPR
- atropine
- epi
11
Q
Who’s at risk for Venous PVD?
A
- Family history
- Patients own history
- > 40 years of age
- Surgery of > 30 mins. duration
- Varicose veins
- Estrogen treatment - BCP or as a cancer treatment
12
Q
Percutaneous transluminal coronary angioplasty (PTCA) increases myocardial perfusion by
A
cracking the plaque
13
Q
If a patient has ventricular tachycardia and has a pulse, what do you do?
A
Cardiovert
14
Q
Takotsubo
A
- “broken heart syndrome”
- release of catecholamines causing a cardio myopathy
15
Q
Signs of dropped cardiac output
A
Restlessness, changes in LOC, cool/pale skin
16
Q
Unstable Angina is ___ pain w/ little or no activity
A
unpredictable
17
Q
Pulmonary Embolism
A
An embolism ( a blood clot) that becomes lodged in the pulmonary artery, obstructing the blood supply to the lungs
18
Q
Implantable Cardioverter Defibrillators - ICD are used to treat
A
Life threatening arrhythmias
19
Q
Low calcium has little effect on the heart but can lead to ____
A
tetany (intermittent muscle spasms)
20
Q
Cardioversion is usually an ____ procedure
A
elective
21
Q
MI may cause FVE b/c
A
heart is not adequately pumping, fluid accumulating in lungs (pulmonary edema)
22
Q
Coronary arteries come off above the
A
aortic arch and aortic valve
23
Q
“Capture” in pacemaker terms means
A
Effective depolarization of the heart by an artificial pacer
24
Q
If Atheroma ruptures, it can cause a ____
A
blood clot
25
With Pulmonary Embolism, there is ventilation, but no ____ to that area
perfusion
26
Which of the following interventions should be your first priority when treating a patient experiencing chest pain while ambulating in the halls?
1. Obtain a stat
2. EKG Administer sublingual nitroglycerine
3. Have the patient sit down right where he is
4. Get the patient back to bed
3. Have the patient sit down right where he is
27
Phlebitis
inflammation of the walls of a vein
28
During a nursing assessment, the patient says, "I don't really know why I'm here. I feel fine and haven't had any symptoms." The nurse would recognize the importance of explaining to the patient that symptoms of hypertension:
1. Are often not present.
2. Signify a high risk of stroke.
3. Occur only with malignant hypertension.
4. Appear after irreversible kidney damage has occurred.
1. Are often not present.
29
Coronary arteries fill during
diastole
30
Pathophysiology of arterial PVD
1. Arteriosclerosis/ Atherosclerosis
2. Obstruction by thrombus or emboli
3. Severe vasoconstriction as in Raynaud’s
4. Arterial inflammation
31
High calcium can lead to \_\_\_\_
arrhythmias
32
Post-procedure nursing interventions for cardioversion (4)
1. ECG
2. VS
3. O2 Sat
4. LOC
33
From the beginning of systole to the end, about \_\_\_% of the blood is pumped out
55-70
34
Healing from MI takes about ___ weeks
6-8
35
With Sinus tach, the heart rate will be
100-160
36
The ___ is the natural pacemaker of the heart
SA node
37
Your patient with congestive heart failure is anxious and fearful. As the nurse, you want to calm and reassure her as anxiety and fear can:
1. Increase the cardiac workload
2. Decrease respirations.
3. Produces an elevation in temperature.
4. Increase the amount of oxygen available to the tissues.
1. Increase the cardiac workload
38
When is the echocardiogram done in a stress test?
Immediately before AND after
39
Major adverse drug effect of Thrombolytics is
bleeding
40
What does Atrial Flutter look like on ECG?
* No ventricular rate
* SAW TOOTH
* PRI not measurable
41
Hematemesis
Vomiting blood
42
Treat a first-degree heart block if
they become systematic or bradycardic
43
Calcium channel blockers slow down the ____ and help relax the blood vessels
rate of conduction
44
Decreased PaO2 and increased PaCO2 are ABG signs of
acute pulmonary edema
45
For patient on digoxin, listen to the heart for ___ min
a full
46
In a Ventilation Perfusion Scan, the "ventilation" part is
patient breathes through a mask for 5 minutes
47
2 sources of cholesterol:
diet and liver
48
In an Echocardiogram, high frequency sound waves are bounced off the heart which means we can see
* the moving heart as its pumping
* also can see bowel sounds
49
Primary cause of conductive irritability is \_\_\_\_
hypoxia
50
Returning to your unit after his coronary angiogram was performed through his right femoral artery, which intervention is now part of this patient’s post-procedural care?
1. Maintain his NPO status.
2. Avoid range of motion of the right leg.
3. Use high Fowler's position to prevent dyspnea.
4. OOB as soon as possible to prevent deep vein thrombosis.
2. Avoid range of motion of the right leg.
51
Pre-procedure nursing interventions for cardioversion (4)
1. NPO
2. Consent
3. IV
4. Sedation
52
as a response to rheumatoid arthritis, C reative protein would be
high
53
Left main coronary artery bifurcates into the ___ and \_\_\_
descending coronary artery (left anterior) AND circumflex
54
Stroke Volume is
the amount of blood ejected from the heart with each contraction
55
TELL PATIENT: LDL are your LOUSY ones - you want those to be \_\_\_. Your HDL - you want that to be ____ because they’re healthy
* low (LDL)
* high (HDL)
56
Preload is dependent on
the amount of volume that returns back to the heart
57
Atherosclerosis is
An abnormal accumulation of lipid and fibrous tissue in the vessel wall
58
Modifiable (can be changed) risk factors for CAD:
* High cholesterol level
* Cigarette smoking
* Hypertension
* DM
* Lack of physical activity
* Obesity
* Stress
59
Patient should be NPO for ___ hours before stress test
4
60
After menopause, the male and female CAD rate is pretty equal. But men are ____ times more likely than women before menopause
3
61
BP \>210/120 is
HTN crisis
62
Surgical Management of Arterial PVD
* Endarterectomy
* Vascular grafting
* Amputation
* Embolectomy
63
A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel.
Hematoma
64
From the onset of chest pain, you have ___ hours to try to reverse the damage
6
65
2 ways that we can directly go into the right atrium through invasive procedure to measure output
1. Swan Ganz/R Heart Catheter
2. Cardiac Catheterization
66
Calf pain and tenderness, edema, and increased warmth to leg are all signs of
Peripheral vascular disease
67
In a pharmacological stress test, the patient is injected with what?
vasodilating agent
68
Prinzmetals or Variant Angina is characterized by
2nd CA vasospasm, not provoked by exercise
69
Usual pathway of heart conduction
SA node --\> AV node --\> bundles of his --\> purkinje fibers
70
Sinus node is the ___ of the heart
pacemaker
71
Etiology of reduced blood flow
Atheroma, vasospasm
72
What are the 2 vasodilators given to patients in cardiogenic shock?
1. Amrinone (Inocor)
2. Nitroglycerin (Tridil)
73
2nd degree block-Type I Wenckeback, the P waves will be ___ and the PRI will be \_\_\_\_
* Some P w/o QRS
* Progressivly longer
74
high levels of Homocysteine correlate with risk of
CAD, stroke, PVD
75
If patients have high afterload, give
nitrogylcerin (vasodilator)
76
How do you treat 3rd degree heart block?
with a pacemaker
77
Types of patients that should not be administered Thrombolytics (3):
1. Major trauma or surgery w/in the past 6 weeks
2. Active bleeding
3. Pregnancy
78
Atrial flutter can be treated with
* beta blockers
* calcium channel blockers (amiodarone)
* cardiovert the patient
79
Class II CHF
Slight limitations
80
Etiology of compete arterial occlusion
Thrombi, emboli
81
Goal of stress test
try to reach patient’s heart rate up to 80-90% of target heart rate
82
Where should you listen to the aortic valve?
2ICS right side
83
for patient on metformin or glucophage, the provider would ___ them on the day they are giving the CAT scan
HOLD
84
Acute pulmonary edema is caused by
anything that decreases the ability of the left ventricle to pump:
* - MI
* - HTN
* - Valvular disease
* - Rapid arrhythmias
85
Stress test is deemed "positive" when
patient is symptomatic
86
2nd Letter in Universal Pacemaker Code means
Chamber being sensed
87
Cause of congestive heart failure is
anything that decrease the ability of the L Vent to pump efficiently, CHRONIC
* CAD
* HTN
* Valve disease, esp Aortic
* Arrhythmias
* Fever
* Hypoxia, Anemia, FVE
88
Women and Minorities have a ____ in-hospital mortality risk than men
higher
89
Vagus nerve affects the ___ and ___ nodes
SA and AV
90
Patients with MI will have ___ levels of CK-MB and Troponin
increased
91
If patient has a high preload, we can decrease by what 2 medications?
1. nitroglycerin (vasodilators)
2. diuretics
92
Afterload =
Arterial Resistance that's opposing the left ventricle
93
If a patient has ventricular tachycardia with loss of LOC + no pulse, what do you do?
call a CODE and defibrillate
94
Treatments for sinus tachycardia include
* beta blockers
* carotid sinus massage (increases pressure on baroreceptors, stimulates vagus nerve which stimulates PSNS)
* valsalva maneuver (stimulates vagus)
95
After cardiac catheterization, vitals should be monitored every ___ minutes for the first hour
15
96
Coronary veins empty back into the
right atrium of the heart
97
In 1st degree block, the PRI will be constantly \_\_\_
\>.20
98
don’t give beta blockers during an
acute situation
99
Which 2 medications of choice for HTN crisis are those that act immediately?
1. Sodium Nitroprusside
2. Nitroglycerin
100
What 3 things should you assess in a patient with sinus tachycardia
1. LOC
2. restlessness
3. skin color/temp
101
CK-MB and Troponin will be ___ after MI
elevated
102
PET uses injected radioactive isotopes to look for
cancer - shows areas of metastasis, areas of decreased circulation
103
Stage 1 hypertension
140-159/90-99
104
On the morning your patient is to be discharged to home, she develops an acute myocardial infarction (MI). One of the STAT orders for is Aspirin 325 mg PO. This is administered to her because of its:
1. Thrombolytic action
2. Anti-inflammatory action
3. Antiplatelet action
4. Analgesic action
3. Antiplatelet action.
105
With Sinus brady, the heart rate will be
\< 60
106
What happens in an Electrophysiological Study?
Put specialized catheter up into the heart for an intracardiac ECG Looks for places of irritability
107
Your patient is experiencing angina pain with increasing frequency. He states that now when he walks up the flight of steps in his home to go to his bedroom at night he has angina. Which intervention would most likely help him with this problem?
1. Sell his 2-story home and buy a ranch house.
2. Rest for at least an hour before climbing the stairs.
3. Take a nitroglycerin tablet before climbing the stairs.
4. Lie down once he reaches the bedroom.
3. Take a nitroglycerin tablet before climbing the stairs.
108
When a vessel is completely occluded, it leads to ___ and ___ in the myocardium supplied by that vessel
hypoxia and ischemia
109
1st Letter in Universal Pacemaker Code means
Chamber being paced
110
Monitoring uses universal lead \_\_\_, looking at \_\_\_\_
* 2
* negative to positive
111
Triglycerides are stored in \_\_\_, and are released as a rapid source of energy for the body to use as a \_\_\_\_
* adipose tissue
* stress response
112
Patients with atrial fibrillation can develop \_\_\_, so they should be treated with \_\_\_
* clots
* Coumadin/warfarin to prevent ischemic stroke and MI
113
for low BP, baroreceptors stimulate the SNS, which has what effect?
HR and contractility increase
114
For patient on digoxin, you're monitoring for what ADE?
bradycardia
115
Cardioversion treats \_\_\_
tachyarrhythmias
116
What drug should you give a patient with Wenkebach?
atropine
117
A patient acutely develops bradycardia and is symptomatic. The drug the nurse should anticipate to be ordered is
1. Atropine
2. Digoxin
3. Lidocaine
4. Inderal
1. Atropine
118
What are the 2 main vasopressors?
1. Norepinephrine (Levophed)
2. Dopamine
119
Medical Management of Arterial PVD
* PTA - percutaneous transluminal angioplasty usually w/ stent
* Medications: ASA, Ticlid, Heparin, or Coumadin
120
Hematuria
Blood in the urine
121
Coronary veins empty back into the
right atrium of the heart
122
patient on metformin or glucophage are covered with ___ in the 2 days following a cat scan
insulin
123
Venous ulcers often occur on
medial or lateral malleolus
124
With what should you treat a patient with 2nd degree heart block Mobitz?
pacemaker
125
If Troponin is 2.3 or higher, that's positive for \_\_\_
MI
126
For a patient with an EKG showing Ischemia and ST depression, this may be
angina
127
If chest pain lasts for more than 10 minutes and is not relieved by 2 Nitros, 5 minutes apart, this may be an
impending myocardial infarction
128
Ventricular depolarization is represented by the ___ on the ECG
QRS
129
During CABG, Patient is cooled to ___ degrees to decrease the metabolic rate
82-89
130
Where should you listen to the pulmonic valve?
2ICS left side —\> S2
131
Atheroma, or "plaque," is blockage that narrows the vessel wall and \_\_\_\_
decreases blood flow to the myocardium
132
Premature ventricular contraction is \_\_\_, and the QRS complex will be ___ on the ECG?
* Premature ectopic
* Wide and bizarre (greater than .12)
133
To increase the preload (3 days)
1. dopamine, epinephrine (vasoconstriction)
2. blood if patient has been bleeding
3. give fluids if FVD
134
Goal for patient after CABG
pt out of bed in chair w/in 12 hours, home in 4 days
135
Which of the following are generally considered to be modifiable risk factors for the development of atherosclerosis?
1. Family history of early MI and hypertension
2. Gender and race
3. Post-menopausal female and age
4. Weight and a sedentary lifestyle.
4. Weight and a sedentary lifestyle.
136
If a patient presents with “fullness” or pressure in the chest, SOB, decreased systolic pressure, and muffled heart sounds, this is most likely
pericardial effusion
137
In Ventricular tachycardia, heart rate will be ___ and the QRS will look \_\_\_\_
* 150 - 250
* wide and bizarre
138
Coronary arteries run between the __ and the \_\_\_
myocardium and epicardium
139
Remember: do not ___ or ____ for patients with pulmonary embolism
* Assess Homan's sign
* Cross legs
140
Venous Thrombosis
blood clot in a vein
141
An MI appears with a ___ on the EKG
ST segment elevation
142
Signs and Symptoms of heart attack in Women
* Fatigue
* Back pain
* Dyspnea
* Nausea
* Weakness
143
C reative protein is produced in the
liver
144
high levels of Homocysteine are treated with
B6 and B12
145
Stage 2 HTN
160-179/100-109
146
Where do you place paddles for defibrillating?
upper right chest and lower left
147
Intrinsic Rate for ventricles
20-40 bpm
148
If a patient develops an obstruction in the left main coronary artery, they call it
the “Widow maker” - cutting off all circulation to the side of the heart
149
PT/INR time therapeutic level is ___ seconds
18 second
150
Digoxin, Dopamine, and Primacore are all
positive inotropics
151
Cardioversion delivers a \_\_\_\_
"timed" electrical current
152
What passes electrical excitation from atria to ventricles with a small delay?
AV node
153
Lipid levels blood test must be measured after a ___ hour fast to be accurate
8-12
154
Efficiency of the CV system depends on what 4 things?
1. Hearts ability to pump
2. Patency of the blood vessels
3. Quality of the blood
4. Quantity of the blood
155
Preload is increased in what 3 conditions?
1. hypervolemia
2. regurgitation of cardiac valves
3. heart failure
156
KVO =
keep vein open
157
Sinus tachycardia leads to \_\_\_
hypoxia
158
2 ways to Tx CAD
Carotid stent or Carotid Endarterectomy
159
Hold beta blockers when systole is less than ___ and HR is less than \_\_\_
* systole less than 90
* HR less than 60
160
4 scenarios that decrease the ability of the left ventricle to pump
1. MI
2. HTN
3. Valvular disease
4. Rapid arrhythmias
161
to increase HDL:
stop smoking, get blood sugar under control, lose 10% of body weight
162
Irritable cells that speed up can override the \_\_\_\_
pacemaker cells
163
Non-modifiable (can't be changed) risk factors for CAD
* Family History
* Gender
* Increasing Age
* Race
164
Intrinsic Rate for AV node
40-60 bpm
165
Medications for client with Congestive Heart Failure (CHF)
1. ACE Inhibitors: Capoten, Vasotec
2. ARB: Losartan
3. Diuretics
4. Beta Blockers: Carvedilol (Coreg) and Metoprolol (Toprol XL)
5. Digitalis
* Others:
Dobutamine, Milrinone (Primacor)
Anticoagulants
Antihypertensives
Antianginal
166
HGB: HCT is always about a ____ ratio
1:3
167
Ventricular repolarization is represented by the ___ on the ECG
T wave
168
Avoid ___ for patients with aterial PVD
vasoconstrictors
169
adrenergics and anticholinergics can both cause sinus \_\_\_
tachycardia
170
Top nursing diagnosis relating to MI is
Alteration in CO: decrease in cardiac output r/t L ventricular MI
171
Stage 3 HTN
\>180/\>110
172
6 “Ps” for assessment with Arterial PVD
1. Pain - intermittent claudication with exercise
2. Pulseless
3. Poikilothermic
4. Pallor
5. Paresthesias
6. Paralysis
173
premature atrial contraction is considered normal after \_\_\_
open heart surgery
174
If cardiogenic shock is due to FVE, give what 2 types of meds?
diuretics, vasodilators
175
Sinus bradycardia is treated with \_\_\_
atropine
176
How to calculate the heart rate from the ECG
* Count the number of R waves in a 6 second strip x 10
* Look at R to R interval for rhythm
177
Class I CHF
No limitations
178
dig, beta blockers, cholinergics, severe visceral pain, well conditioned atheletes can all cause
sinus bradycardia
179
1 CAT scan = ___ chest x-rays
150-250
180
Intervene after cardiac catheterization if:
* bleeding from site
* loss of pulses
* clotting
181
Melena
black "tarry" feces that are associated with upper gastrointestinal bleeding
182
Do not use ___ to assess PVD
Homan's sign
183
Single Chamber pacemakers
* VVI
* AAI
184
Ecchymosis
A small hemorrhagic spot, larger than a petechia, in the skin or mucous membrane forming a nonelevated, rounded or irregular, blue or purplish patch.
185
PR interval is from beginning of P to beginning of Q, and should last \_\_\_\_
0.12-0.20
186
Stress test is deemed "negative" when
patient is asymptomatic
187
Where should you listen to the tricuspid valve?
4ICS left side
188
During a stress test, the normal artery can dilate up to \_\_\_
4x
189
Post-op nursing care for a Carotid Endarterectomy includes what 4 things?
1. label B/P
2. Airway
3. Check that the trachea is midline
4. Neuro checks q 1 hr for the 1st 24 hrs
190
Dual chamber pacemakers
* DDD
* Most physiologic
191
When Chemoreceptors are stimulated, this will increase what 3 things?
* Respiratory rate
* stroke volume
* cardiac output
192
Patient should not have tobacco or caffeine within ___ hours of stress test
12
193
The "Perfusion" portion of the Ventilation Perfusion Scan is
IV isotope injected & images are taken of the lungs at various angles showing blood flow (perfusion) to the lungs
194
\_\_\_ % of total blood volume is solid particles
45
195
Virchow’s triad
1. \*Venous Endothelial Damage
2. \*Hypercoaguability
3. \*Venous Stasis
196
Catecholamines are ____ drugs produced within the body itself
adrenergic
197
V/Q scan takes ___ minutes
45
198
Base of the heart is across from the
angle of Louis
199
Radionucleotide Imagery can assess ___ function?
left ventricular
200
Electrophysiological Studies are used for 4 for reasons?
1. Evaluate and treat arrhythmias
2. Mapping
3. Ablation
4. Evaluate effectiveness of medications and devices
201
If Thrombophlebitis is present
rest, moist heat, anticoagulants
202
patients are advised not to move legs for ___ hours after a cardiac catheterization
2-8
203
Albumin exerts a ____ osmotic pressure
strong
204
If cardiogenic shock is due to FVD, give what?
* IV fluids (NS, RL),
* and plasma expanders like Albumin
205
Venous Ulcers are typically
large, superficial, and highly exudative
206
Your patient has a history of angina and begins having crushing substernal chest pain that radiates to his jaw and left arm. As his nurse, you know this angina pain is due to:
1. Left ventricular failure.
2. Cardiogenic shock
3. Electrolyte imbalance.
4. Insufficient oxygen reaching the heart muscle.
4. Insufficient oxygen reaching the heart muscle.
207
Epistaxis
Bleeding of the nose
208
What reduces cardiac blood flow
Hemorrhage, shock
209
Where should you listen to the S1?
5ICS left side mid-clavicular
210
Sinus bradycardia means the HR is less than \_\_\_
40
211
HTN has the same risk factors as
CAD
212
PAC-Premature Atrial Contraction is
Single premature ectopic
213
\_\_\_ % of total blood volume is plasma
55
214
for high BP, baroreceptors stimulate the \_\_\_, causing what?
* PSNS
* causing: vasodilatation, decrease in HR, BP goes down
215
Patients with MI will often be
Diaphoretic (sweating heavily)
216
Two most common locations of aortic aneurysms
1. Thoracic
2. Abdominal aortic aneurysm – “Triple A” or “AAA”
217
Cardiac Output =
Stroke volume x HR
218
PR gradually gets longer until it drops a QRS (going, going, gone)
Wenkebach
219
Intrinsic Rate for SA node
60-100 bpm
220
Normal WBC/Leukocytes count
5,000 – 10,000
221
If patient is in trauma or is FVD, preload will
drop
222
Always remember to ___ after defibrillating
evaluate/inspect skin
223
Average cardiac output is about
5.6 L/min
224
anytime you do something through an artery, you can risk losing circulation ___ to that area
distal
225
Afterload is increased in what 2 situations?
1. Hypertension
2. Vasoconstriction
226
Pathophysiology of CHF
* CAD
* Systemic or pulmonary hypertension
* Valvular heart disease
* Increased workload of the heart
227
240 or higher cholesterol is considered
high risk
228
CPR is done ____ defibrillating
in between
229
Atrial Fibrillation will have a ___ ventricular rate and the P waves will look like \_\_\_
* grossly irregular
* chaotic fibrillation
230
6 nursing interventions to prevent venous stasis
1. TED stocking or sequential compression devices
2. Early ambulation
3. Raise the foot of the bed occasional - NOT if the pt has arterial insufficiency
4. Passive and active ROM
5. Monitor IV sites and D/C ASAP!
6. Anticoagulants
231
First 3 Nursing Interventions: Angina in order of priority
1. rest
2. oxygen (3L O2 nasal cannula, Keep O2 sat higher than 95%)
3. nitroglycerin
232
Couplet can lead to \_\_\_
ventricular tachycardia
233
Hold nitroglycerin if systolic pressure is less than
90
234
2 types of pacemakers
1. temporary
2. permanent
235
In 2nd degree block- type II classic, the heart rate will be ___ and the PRI will be \_\_\_\_
* HR: \< 60
* constantly greater than .20
236
Patients with HTN are initially given
* diuretics and Beta Blockers
* THEN ACE inhibitors, ARBs, &/or Calcium Channel Blockers
237
Defibrillation treats ___ and \_\_\_\_
VF/VT AND pulseless VT
238
Chronic Venous Stasis Nursing Interventions:
* Elevate the legs
* Pressure stockings
* Encourage walking
* Protect from trauma
* Inspect daily, keep clean and dry
239
Ventricular Fibrillation looks like \_\_\_, and the there will be ___ P waves, PRI, or QRS
* Chaotic fibrillation
* no
240
Goals for patient with MI:
* Minimize myocardial damage and prevent complications
* Restore circulation
* Reduce myocardial oxygen demand
241
A characteristic saw-tooth pattern, a “F” wave, on an ECG strip is:
1. Sinus tachycardia
2. Premature Atrial contraction
3. Atrial Flutter
4. First degree heart block
3. Atrial Flutter
242
QRS should be \_\_\_\_
0.12 or less
243
Most reliable sign of cardiac arrest is
absence of a pulse
244
Increased afterload means increased
cardiac workload
245
for 3rd Letter in Universal Pacemaker Code, what does TIDO stand for
* T – Triggered
* I – Inhibited
* D – Atria Triggered, Ventricle inhibited
* O - None
246
2 main nursing goals for patient with pulmonary edema
1. Improve the pumping of the left ventricle
2. Improve respiratory exchange
247
Cardioversion works by synchronizing and discharging on the \_\_\_\_
"QRS"
248
Hemoptysis
Coughing up blood, or blood in the sputum
249
Post-procedure for PTCA, patients can be given what medications?
Nitroglycerine Anticoagulants: (Heparin, Aggrastat)
250
Cardioversion/Defibrillation works by
Delivering electrical current that stops the heart and allows the SA node to resume control
251
A priority nursing assessment related to thrombolytic therapy administration is to:
1. Monitor for hematuria.
2. Monitor for dysrhythmias.
3. Monitor a 12-lead ECG every 4 hours.
4. Monitor for signs of crackles.
1. Monitor for hematuria.
252
Bruce’s protocol for stress test
comprised of multiple exercise stages of three minutes each. At each stage, the gradient and speed of the treadmill are elevated to increase work output, called METS. Stage 1 of the Bruce protocol is performed at 1.7 miles per hour and a 10% gradient. Stage 2 is 2.5 mph and 12%, while Stage 3 goes to 3.4 mph and 14%.
253
Nursing Assessment for patient with pulmonary embolism
* Cyanosis
* SOB
* Tachypnea
* Hemoptysis
* ↓O2 Sat, ↓PaO2
* Chest pain
254
Atrial depolarization is represented by the ___ on the ECG
P wave
255
For patients with CHF, what's a main lab tesT?
BNP
256
The higher the C reactive, the higher the correlation with
developing CAD
257
Primary nursing diagnosis for pulmonary embolism
Ineffective gas exchange
258
Class III CHF
Limitations to ADL
259
for patient on metformin or glucophage, if BUN and Creatinine stay WNL for 2 days after CAT scan, then they can \_\_\_\_
go back on the drugs
260
When assessing a patient for the presence of deep vein thrombosis, the nurse anticipates which of the following clinical manifestations?
1. Absence of a peripheral pulse in the affected extremity.
2. Swelling of the affected extremity.
3. Pale, cool, hairless skin.
4. Absence of Homan's sign in the extremity.
2. Swelling of the affected extremity.
261
V/Q scan allows ___ in the lungs to be identified
blood clots
262
Increased HR and RR, restlessness, and increased capillary refill time are all signs of
cardiogenic shock
263
Class IV CHF
Symptoms at rest
264
Arriving at the emergency department with chest pain and a history of angina pectoris, the patient has an electrocardiogram done. As his nurse, which part of the EKG complex do you examine to determine acute myocardial ischemia?
* P wave
* QRS complex
* ST segment
* U wave
ST segment.
265
myoglobin
blood protein that helps transport oxygen - found in the heart and in skeletal muscle
266
Preload is
the volume of blood in the ventricles at the end of diastole
267
When assessing your new patient you find her restless, SOB, and cyanotic. She has bilateral crackles and pink frothy sputum. As the nurse, you suspect she is experiencing:
1. Cardiomyopathy.
2. Ventricular tachycardia.
3. Mitral stenosis
4. Pulmonary edema.
4. Pulmonary edema.
268
If something happens to knock out the SA node, then the ____ site would take over
next fastest ex. AV node or a abnormal group of cells that is conducting faster
269
Classic or Stable Angina is pain or pressure lasting ___ minutes. It is predictable, and can be relieved with \_\_\_\_.
* \< 10 minutes
* rest and/or nitroglycerine
270
First sign of an aortic aneurysm is
Sudden and persistent pain
271
Where does angina pain usually radiate?
to the neck or left arm
272
Potential complications for PTCA
* Dissection, perforation, or vasospasm of the CA
* MI
* Dysrhythmias
* Cardiac arrest
* Hemorrhage
* Thrombus
273
If a patient has transient blindness, weakness, tingling, and slurred speech, this may indicateeech may slur
Carotid artery disease
274
TEE is
trans-esophageal echocardiogram
275
for 1st and 2nd Letter in Universal Pacemaker Code, what does AVDO stand for
A- Atria V- Ventricle D- Dual (atria and vent) O- none
276
Hemoglobin helps to
transport the oxygen
277
Your patient had an acute MI. As part of her nursing care, you teach her to move her legs while resting in bed. This type of exercise is recommended primarily to:
1. Prepare her for ambulation.
2. Promotes urinary and intestinal elimination
3. Prevent deep vein thrombosis
4. Prevent atelectasis.
3. Prevent deep vein thrombosis
278
Use ____ lbs of pressure (for handheld) when defibrillating
20-25 lbs
279
If patient has been bleeding, give ___ to increase the preload
blood
280
ASA, Ticlid, Heparin and Coumadin are prophlactics given to prevent
Arterial PVD
281
With gangrene, you must
amputate
282
Embolectomy
a procedure to remove a clot that formed
283
Arterial PVD causes ulcers that are normally
small, circular, deep
284
With arterial PVD, patients are at risk for further injury because they
lose sensation (ex. they would be able to feel the hot water in a bath with their feet so they could get serious burns)
285
Ankle-brachial index
Leg systolic/arm systolic
286
Important levels for ankle-brachial index
* Normal = 1
* \< 1 abnormal
* .36 is severe
287
How should you position a patient with arterial PVD?
Feet down, elevate the head
288
Endarectomy is
the removal of plaques (artherosclerosis)
