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Nurs 212 > Test 1 > Flashcards

Test 1 Flashcards

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0
Q

Stroke volume

A

volume of blood in ventricles just before contraction

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1
Q

Stroke Volume average

A

70 ml/beat in adults

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2
Q

Ejection Fraction

A

fraction or percent of blood ejected with each contraction

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3
Q

Ejection Fraction Average

A

50-70%

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4
Q

Average Cardiac Output

A

4-8 L/min

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5
Q

Preload is

A

volume of blood in cardiac muscle

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6
Q

Afterload is

A

Pressure the blood overcomes to eject blood

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7
Q

Cardiac Index normal range

A

2.5-4.2 L/min/m2

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8
Q

Hear a Bruit feel a Thrill

A

bruit-swishy noise from turbulent blood

thrill- feeling over a shunt

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9
Q

Order of listening to valves

A 
APTM
aorta-upper right of sternum
Pulmonic-upper left
Tricuspid-lower right
Mitral-lower left
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10
Q

aortic and mitral valves have the most

A

murmurs

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11
Q

S1 sound

A

lub
closure of AV valves
beginning of systole
heard loudest at apex

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12
Q

S2 sound

A

dub
closure of semi lunar valves
end of systole beginning of diastole

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13
Q

Echocardiogram

A

test for wall motion and valve movement that also gives us ejection fraction

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14
Q

Transesophageal Echo

A

more invasive echo used with afib for blood clots

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15
Q

Troponin cardiac enzyme

A

measures protein released after MI, most specific and most widely used, usually under 0.3, rises in 3-6 hours and stays elevated up to 2 weeks

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16
Q

Healthy lipid

A

HDL

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17
Q

Lethal lipid

A

LDL

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18
Q

Most common electrolyte imbalance for heart pts

A

K- performs major function in cardiac depolarization and repolarization

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19
Q

Na in heart

A

vital part in depolarization of myocardium

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20
Q

Ca in heart

A

important function in depolarization and myocardial contraction

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21
Q

Absolute Refractory Period

A

cardiac cell unable to respond to new electrical stimulus

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22
Q

Relative Refractory Period

A

repolarization is almost complete, cardiac cell can be stimulated to contract prematurely if stimulus is stronger then normal

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23
Q

How long does artia need to rest

A

0.15 sec

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24
how long does ventricles need to rest
0.25 to 0.30 sec
25
hearts period of rest is also called
repolarization
26
P wave is
atrial depolarization
27
PR interval should be
0.12-0.20 sec
28
QRS is
ventricular depolarization
29
T wave is
ventricular repolarization
30
U wave is a sign of
hypokalemia and dig tox
31
St segment elevation and depression
elevation- infarction | depression- ischemia
32
Hypocalemia causes
prolonged st and qt intervals
33
Hypokalemia does what to T wave
shallow flat or inverted
34
Hyperkalemia does what to EKG
tall peaked t waves flat p waves widened qrs complex prolonged pr interval
35
Rate for SA, AV, and ventricles
SA- 60-100 AV- 40-60 Ventricles- 20-40
36
Sinus rhythm
regular p waves present between 60-100
37
Sinus arrhythmia
irregular rhythm
38
Treatments for Sinus Brady
if giving atopine warn telly tech and watch for rebound, treat the cause check med lists
39
Treatments for Sinus Tachy
treat the cause- if no cause and is not tolerated by pt treat with betablockers the lol's
40
PAC
random premature beat, stop stimulants and alcohol | can use beta blockers to reduce frequency if problematic
41
PSVT
paroxysmal supraventricular tachycardia | pretty much every tach that isnt sinus, afib, and aflutter usually caused by reentry from AV node
42
PSVT treatment
cardioversion for instability (dropping BP) | IV beta blocker and treat the cause
43
Adenosine is also used as a
chemical cardioversion
44
dosing for adenosine
6, 12, 12
45
AFib
irregularly irregular | narrow qrs, no definite p wave
46
Afib treatments
cardioversion (if new onset) anticoagulation (with PTT/heparin and PTINR/warfarin for therapeutic range) rate control (calcium channel blockers, amiodarone, and beta blockers for additional rate control) abation
47
A Flutter
same as AFib in causes and treatments except rhythm is regular with characteristic sawtooth pattern
48
INR average
International Normalized Ratio Normal people should be around 1 people on anticoags should be between 2.0-3.0
49
Expect what with 2nd/3rd degree heart block
to send to cath lab for pacemaker and look at meds
50
PVCs
wide bizarre QRS complex optimize cardiac and pumonary disease management unifocal or mulltifocal R-on-T phenomenon that usually leads to runs of Vtach Bigeminy, trigeminy, quad....
51
Vtach is considered after run of how many PVCs
3 or more
52
VTach treatment
exclude heart disease with echo and stress may need anti-arrhythmia treatment cpr/defibrillation if unstable
53
Unstable VTach or VFib treatment
``` cpr immediate defibrillation (V/E followed by A/L) vasopressin/epi then amiodarone/lidocaine magnesium for Torsades/renal failure pt ```
54
Asystole
``` NEVER SHOCK!!!!!! CPR Epi critical to reverse identified cause if able may use pacing until rhythm established ```
55
PEA
monitor shoes rhythm but pts heart is not beating treat as asystole
56
CPR procedure
30 compressions | 2 breaths
57
Symptoms of CAD
``` none angina pectoris acute coronary syndrome mi dysrhythmias heart failure sudden death ```
58
Coronary Arteries
RCA L Main circumflex-lateral wall of left ventricle L anterior descending-anterior inter-ventricular septum and apex
59
Collateral Circulation
develop between small arteries for alternate route
60
Coronary arteries blocked by...
coronary artery spasm, arteriosclerosis, or atherosclerosis
61
Atherosclerosis
initiated by abnormal lipid metabolism and or inflammation of the vessel lining
62
Modifiable Risk Factors
``` hypertension high blood lipid levels smoking physicial inactivity obesity diet diabetes stress and anger ```
63
Estrogen is
cardio protective
64
Inflammatory markers
homocysteine, crp, lipoprotein A
65
Management of Risk Factors
``` smoking cessation wt loss/exercise control of HTN and glucose levels diet modifications decreased saturated far and cholesterol increased Omega 3, Fiber, and B vitamins ```
66
Statins (Lipitor, Crestor, Pravachol)
may cause myopathies | monitor liver function
67
Cholesterol absorption inhibitors (Zetia)
contraindicated in liver dysfunction
68
Nicotinic Acid
Niaspam is a B vitamin | facial flushing
69
Types of Angina
stable Prinzmetal's (variant) unstable- progressing to acute coronary syndrome silent ischemia
70
Stable Angina
``` realizes certain activities cause less than 20 min with activity and exertion goes away with rest and or nitro normal EKG normal Troponin ```
71
Unstable Angina
``` severe, unprovoked, substernal pain radiating into jaw, back, and arm resting doesnt relieve over 20 min EKG changes Troponin increases ```
72
Nitrates can be taken
q5 min x 15 then go to ER
73
SE of Nitro
headache | decreased BP
74
No's of Nitrates
``` no switching bottles/no light no cold no condensation no sharing (diff doses) no taking with other vasodilators no keeping (have expiration date) ```
75
Why take beta blockers for CAD?
decreases heart workload by decreasing heart rate, contractility, and BP to decrease myocardial oxygen consumption
76
Calcium Channel Blockers are used most for....
Prinzmetal's angina | reduce contractility, may slow HR, and vasodilation
77
Primary cause of ACS/acute coronary syndrome
rupture or eroded plaque | typically have stenosis of one or more of the major coronary arteries
78
Management of ACS
drugs to reduce myocardial ischemia to reduce the risk for blood clotting thrombolytics may be used
79
Pre care of the Cath pt
informed consent comprehensive CV baseline assessment NPO for 6 hrs (waived in emergency) HOLD oral hypoglycemics, insulin, diuretics give all usual cardiac meds unless instructed otherwise IV access (2 20 or greater) administer ASA
80
Post care of Cath pt
frequent VS, cath access site checks, and assessment of peripheral pulses telemetry monitoring, EKG with chest pain bedrest as ordered with head elevated less than 30 degrees keep affected extremity straight monitor for vasovagal response monitor for dye reaction

Nurs 212 (1 decks)

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