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Med Surg 1 > week 3 <3 > Flashcards

week 3 <3 Flashcards

1
Q

amiodorone

A

administered when heart is in a-fib to help prevent clots

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2
Q

formula & amount of normal cardiac output

A

CO= HR x SV

*4-8 L per minute

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3
Q

formula of cardiac index

A

CI= cardiac output / body surface area

*normal = 2.8 to 4.2

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4
Q

formula for mean arterial pressure

A

MAP = SBP + 2DBP / 3

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5
Q

in patients with heart failure, their pulse pressure

A

decreases

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6
Q

in relation to the heart…chemicals associated with the sympathetic nervous system are

A

epinephrine & norepinephrine

  • INCREASE contractility, HR, & vasoCONSTRICTION
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7
Q

In relation to the heart… (a) chemical associated with the parasympathetic nervous system are

A

acetylcholine

*DECREASES– contractility, HR, & vasoDILATION

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8
Q

baroreceptors

A

found in carotid sinus & aortic arch & function to MAINTAIN NORMAL BLOOD PRESSURE

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9
Q

chemoreceptors

A

MAINTAIN ABG’S - cardiorespiratory hemostasis

2 locations =
(1) BRAIN - stimulated by pH and PCO2 (arterial co2)

(2) peripheral in carotid & aortic bodies - stimulated by pH & PO2

** hyperventilation stimulates them

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10
Q

testing for orthostatic hypotension includes

A
  1. BP while lying down
  2. sit-up & wait 5 min then take BP
  3. stand and take BP
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11
Q

8 sites for palpating arteries

A
  1. carotid
  2. brachial
  3. radial
  4. ulnar
  5. femoral
  6. popliteal
  7. posterior tibial
  8. dorsalis pedis
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12
Q

3 types of drugs for a slow heart

***these drugs help speed it up

A
  1. Beta Blockers = -lol
  2. Calcium channel blockers = -zem
  3. digoxin = -digitalis
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13
Q

atropine

A

anticholinergic drug used to elevate heart rate bradycardia

used only when symptoms are present

atroPINE = PINE on top of the tree = ELEVATE

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14
Q

3 cardiac biomarkers

A

Troponin ( 7 days)
Creatinine kinase (up to 3 days)
Myoglobin (within 24 hrs)

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15
Q

normal cholesterol levels

A

< 200 mg/dL

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16
Q

c-reactive protein range

A

< 0.3 mg/dL

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17
Q

EKG 5 step interpretations

A
  1. # of R peaks x 10 = bpm
  2. rhythm = space between R peaks
  3. presence of P wave next to QRS
  4. PR interval less than 5 mini boxes
  5. QRS wave (present, upright, & tight)
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18
Q

V-fib on an EKG looks like & is treated by:

A

*flopping squiggly line

  1. use DEFIB
  2. admin drugs LAP
    (L) lidocaine
    (A) amiodorone
    (P) praocainamide

**caused by v-tach. post MI, & electorlyte imbalances

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19
Q

V-tach on an EKG looks like

A

*TOMBSTONES

*no pulse = d-fib
pulse = cardioversion

*caused by LOW K+ & MG, & MI

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20
Q

a-fib on an EKG

A

no p wave (starting hill) fibrillation flopping

  1. TTE to rule out clots
  2. cardioversion
  3. digoxin
  4. anticoagulants

*caused by COPD, HTN

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21
Q

before administering digoxin check for

A

A.T.P.
**digoxin DIGS for deeper contraction
A = apical pulse is 60 +
T = toxicity (<2,0, n/v, green halos)
P = potassium less than 3.5

NO ANTACIDS

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22
Q

atrial flutter

A

*saw TOOTH w/ 2 T’s
treated same as a-fib

  1. TTE to rule out clots
  2. cardioversion
  3. digoxin
  4. anticoagulants
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23
Q

treatment for supraventricular tachycardia

A

** super fast — hr

synchronized cardioversion = priority if HR & RR is elevated & Bp is low

  1. pt to bear down or ice cold stimulation
  2. rapid push of adenosine
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24
Q

torsades de pointes on EKG

A

*wavy tornado

caused by low MG, MI, & hypoxia

treated w magnesium sulfate

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25
magnesiums role on heart muscles
magnesium MELLOWS out the heart muscles if low = overactive heart
26
p-wave depicts
atrial fibrillation
27
ORS Wave depicts
ventricular rhythm
28
"lack of QRS complexes"
patient is in asystole
29
"wide bizarre QRS complexes"
patient is in v-tach
30
"chaotic or unorganized"
describes fibrillation
31
"chaotic rhythm w no P waves"
atrial fibrillation
32
"chaotic rhythm with no QRS complexes"
ventricular fibrillation
33
antidote for epinephrine, norepinephrine, and dopamine
Phentolamine
34
cardiac catheterization complications
affects kidneys cardiac tamponade (fluid in heart) hematoma artery dissection restenosis retroperitoneal bleeding
35
4 stages of coronary artery disease
1. endothelial damage 2. fatty streak 3. fibrous plaque 4. complicated lesion
36
metabolic syndrome
increased - blood pressure, blood sugar, obesity, insulin resistence and abnormal cholesterol levels
37
statins & adverse effects
*atorvastatin, simvastatin, lovastatin adv effects = hepatotoxicity & myopathy
38
cholesterol absorption inhibitors
**ezetimbe risk of hepatotoxicity & myopathy when taken with statins
39
Fibrates nursing instructions & adverse effects
*gemfibrozil take 30 min BEFORE breakfast & dinner adv = gallbladder disease, myopathy, hepatotoxicity, & bleeding
40
4 stages of hypertension
1. pre-hypertension = 120- 129 2. Stage 1 = 130-139 / 80-89 3. stage 2 = > 140/90 4. hypertensive crisis > 180 / 120
41
DASH meal plan
high in fruits vegetables, nuts, seeds, and beans low in dairy, animal meat, saturated fats, and sweets.
41
manifestations of hypertensive crisis
epistaxis severe headache dizziness blurred vision
42
vasodilators
NITROGLYCERIN & HYDRALAZINE decreases preload, afterload, & O2 demand *used cautiously w antihypertensives* headache = common
43
alpha adrenergic blockers
PRAZOSIN, DOXAZOSIN , TERAZOSIN first dose = orthostatic hypotension admin at night
44
left sided heart failure can result in
right sided heart failure
45
clinical manifestations for left-sided heart failure
*PULMONARY EF normal = 55%-70% decreased pulse ox crackles / dyspnea frothy sputum nocturia altered LOC
46
clinical manifestations for right-sided heart failure
*SYSTEMIC CONGESTION EF normal = 45%-60% edema jugular vein distention anorexia/ vomiting hepatomegaly ascites (abdominal swelling)
47
dietary restrictions for heart failure
limit fluid & sodium *2-3 g sodium diet
48
manifestations of acute pulmonary edema
respiratory distress crackles tachycardia / anxiety frothy blood-tinged sputum
49
nursing actions for acute pulmonary edema
NO FLUIDS 1. high fowlers 2. admin O2 / intubate 3. IV loop diuretics 4. IV morphine 5. alternate rest & activity
50
pericardial tamponade manifestations & diagnostic studies,
1. hypotension, muffled heart souds, JVD, & paradoxical pulse 2. chest x ray echocardiogram
51
chronic stable angina
episodic 5-15 min provoked by exertion but relieved by nitroglycerin caused by MI -- St depression or T inversion *atypical in women
52
acute coronary syndrome
caused by rupture of thickened plaque w angina > 30 min nitroglycerin DOES NOT work
53
Prinzmetal's angina
occurs primarily at REST triggered by increased smoking, histamine, & epinephrine
54
Ranolazine
sodium current inhibitor that treats chronic angina
55
contraindications for anginal meds
erectile dysfunction meds severe anemia head injury closed-angle glaucoma alcohol
56
sublingual nitroglycerin
decreases demand for O2 MOST RAPID = up to 3 tabs 5 min apart call 911 if pain is not relieved by FIRST tab, wait 5 min then take 2nd.. up to 3 dark container away from light/heat replace every 6 mo take acetaminophen for headache orthostatic hypotension
57
nitroglycerin topical ointment
1. check BP B4 2. gloves 3. clean & hairless area 4. DO NOT MASSAGE OR RUB
58
nontunneled percutaneous venous catheter is for
SHORT-TERM USE ONLY subclavian and jugular vein
59
tunneled percutaneous venous catheter is for
LONG term use
60
normal Troponin levels
less than 0.03
61
normal LDL levels
less than 130
62
nursing interventions for echocardiogram
*measures ejection fraction & heart client lays on LEFT side Non-invasive 1 hour
63
nursing interventions for a stress test
1. instruct client to fast 2- 4 hrs before 2. avoid alcohol, caffeine, etc 3. apply 12-lead EKG
64
4 medications for a medical stress test
1. adenosine 2. dobutamine 3. dipyridamole 4. regadenoson
65
nursing considerations for cardiac cathetherization
1. NPO 8 hours 2. allergy to IODINE / SHELLFISH 3. ask if pt. is taking METFORMIN (if they are then resume 48hrs after) **warmth & flushing is normal **pressure on site **extremity kept STRAIGHT
66
hydrochlorothiazide nursing considerations
monitor for hyopkalemia (muscle weakness) *in the morning
67
atenolol and Bp is unchanged
notify the provider
68
ACE & ARB's act to
decrease
69
tertiary prevention
walking program teaching how to read food labels adhering to medication regimen
70
captopril nursing considerations
no salt substitutes *ACE inhibitor = hypokalemia

Med Surg 1 (8 decks)

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