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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
Q

magnesiums role on heart muscles

A

magnesium MELLOWS out the heart muscles

if low = overactive heart

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26
Q

p-wave depicts

A

atrial fibrillation

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27
Q

ORS Wave depicts

A

ventricular rhythm

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28
Q

“lack of QRS complexes”

A

patient is in asystole

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29
Q

“wide bizarre QRS complexes”

A

patient is in v-tach

30
Q

“chaotic or unorganized”

A

describes fibrillation

31
Q

“chaotic rhythm w no P waves”

A

atrial fibrillation

32
Q

“chaotic rhythm with no QRS complexes”

A

ventricular fibrillation

33
Q

antidote for epinephrine, norepinephrine, and dopamine

A

Phentolamine

34
Q

cardiac catheterization complications

A

affects kidneys
cardiac tamponade (fluid in heart)
hematoma
artery dissection
restenosis
retroperitoneal bleeding

35
Q

4 stages of coronary artery disease

A
  1. endothelial damage
  2. fatty streak
  3. fibrous plaque
  4. complicated lesion
36
Q

metabolic syndrome

A

increased - blood pressure, blood sugar, obesity, insulin resistence and abnormal cholesterol levels

37
Q

statins & adverse effects

A

*atorvastatin, simvastatin, lovastatin

adv effects = hepatotoxicity & myopathy

38
Q

cholesterol absorption inhibitors

A

**ezetimbe

risk of hepatotoxicity & myopathy when taken with statins

39
Q

Fibrates nursing instructions & adverse effects

A

*gemfibrozil

take 30 min BEFORE breakfast & dinner

adv = gallbladder disease, myopathy, hepatotoxicity, & bleeding

40
Q

4 stages of hypertension

A
  1. pre-hypertension = 120- 129
  2. Stage 1 = 130-139 / 80-89
  3. stage 2 = > 140/90
  4. hypertensive crisis > 180 / 120
41
Q

DASH meal plan

A

high in fruits vegetables, nuts, seeds, and beans

low in dairy, animal meat, saturated fats, and sweets.

41
Q

manifestations of hypertensive crisis

A

epistaxis
severe headache
dizziness
blurred vision

42
Q

vasodilators

A

NITROGLYCERIN & HYDRALAZINE

decreases preload, afterload, & O2 demand

used cautiously w antihypertensives
headache = common

43
Q

alpha adrenergic blockers

A

PRAZOSIN, DOXAZOSIN , TERAZOSIN

first dose = orthostatic hypotension

admin at night

44
Q

left sided heart failure can result in

A

right sided heart failure

45
Q

clinical manifestations for left-sided heart failure

A

*PULMONARY

EF normal = 55%-70%

decreased pulse ox
crackles / dyspnea
frothy sputum
nocturia
altered LOC

46
Q

clinical manifestations for right-sided heart failure

A

*SYSTEMIC CONGESTION

EF normal = 45%-60%

edema
jugular vein distention
anorexia/ vomiting
hepatomegaly
ascites (abdominal swelling)

47
Q

dietary restrictions for heart failure

A

limit fluid & sodium
*2-3 g sodium diet

48
Q

manifestations of acute pulmonary edema

A

respiratory distress
crackles
tachycardia / anxiety
frothy blood-tinged sputum

49
Q

nursing actions for acute pulmonary edema

A

NO FLUIDS

  1. high fowlers
  2. admin O2 / intubate
  3. IV loop diuretics
  4. IV morphine
  5. alternate rest & activity
50
Q

pericardial tamponade manifestations & diagnostic studies,

A
  1. hypotension, muffled heart souds, JVD, & paradoxical pulse
  2. chest x ray
    echocardiogram
51
Q

chronic stable angina

A

episodic 5-15 min

provoked by exertion but relieved by nitroglycerin

caused by MI – St depression or T inversion

*atypical in women

52
Q

acute coronary syndrome

A

caused by rupture of thickened plaque w angina > 30 min

nitroglycerin DOES NOT work

53
Q

Prinzmetal’s angina

A

occurs primarily at REST

triggered by increased smoking, histamine, & epinephrine

54
Q

Ranolazine

A

sodium current inhibitor that treats chronic angina

55
Q

contraindications for anginal meds

A

erectile dysfunction meds
severe anemia
head injury
closed-angle glaucoma
alcohol

56
Q

sublingual nitroglycerin

A

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
Q

nitroglycerin topical ointment

A
  1. check BP B4
  2. gloves
  3. clean & hairless area
  4. DO NOT MASSAGE OR RUB
58
Q

nontunneled percutaneous venous catheter is for

A

SHORT-TERM USE ONLY

subclavian and jugular vein

59
Q

tunneled percutaneous venous catheter is for

A

LONG term use

60
Q

normal Troponin levels

A

less than 0.03

61
Q

normal LDL levels

A

less than 130

62
Q

nursing interventions for echocardiogram

A

*measures ejection fraction & heart

client lays on LEFT side
Non-invasive
1 hour

63
Q

nursing interventions for a stress test

A
  1. instruct client to fast 2- 4 hrs before
  2. avoid alcohol, caffeine, etc
  3. apply 12-lead EKG
64
Q

4 medications for a medical stress test

A
  1. adenosine
  2. dobutamine
  3. dipyridamole
  4. regadenoson
65
Q

nursing considerations for cardiac cathetherization

A
  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
Q

hydrochlorothiazide nursing considerations

A

monitor for hyopkalemia (muscle weakness)

*in the morning

67
Q

atenolol and Bp is unchanged

A

notify the provider

68
Q

ACE & ARB’s act to

A

decrease

69
Q

tertiary prevention

A

walking program
teaching how to read food labels
adhering to medication regimen

70
Q

captopril nursing considerations

A

no salt substitutes
*ACE inhibitor = hypokalemia

Med Surg 1 (8 decks)

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