Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURS 3512 acute & chronic > Week 3 Perfusion Lecture > Flashcards

Week 3 Perfusion Lecture Flashcards

1
Q

What is the most common health problem seen in primary care?

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What BP indicates hypertensive crisis?

A

> 200 systolic or >150 diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If someone is in hypertensive crisis, we check Neuro, Respiratory and Kidney symptoms. Why are each of these indicated?

A

Neuro - spasms in cerebral vessels
Lungs- increased pressure = pulmonary edema
Renal- high BP can damage kidneys. Bringing down BP too fast can damage kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What IV meds do we give for hypertensive crisis?

A
  1. Nitroprusside- powerful vasodilator
  2. Labetolol - BB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which two acute illnesses do we only lower BP quickly?

A

Acute MI
ischemic stroke (tPA- related)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 7 main symptoms of hyptertensive crisis?

A
  1. Dizzy
  2. Severe headache
  3. Blurred vision
  4. Epitaxis
  5. SOB
  6. Decrease urine out put
  7. severe anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How long does chronic stable Angina last?

A

3-5 min - goes away with rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 7 main symptoms of Acute coronary syndrome?

A

1 Chest pain
2 Nausea and vomiting
3 Diaphoresis
4 Dyspnea
5 Anxiety
6 Fatigue
7 Palpitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When someone complains of chest pain, how many min after do we need a 12 lead EKG in place?

A

10 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If someone is experiencing acute coronary syndrome, what is our O2 % sat min. goal?

A

> 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What’s the prefered way to manage ACS?

A

coronary angioplasty first
fibrinolytic therapy second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 4 non-surgical interventions for ACS?

A
  1. manage pain
  2. Restore perfusion
  3. Manage dysrhythmias
  4. monitor and manage HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do we manage ACS pain?

A

Assess pain
Vital signs
IV access
Medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do we restore perfusion with ACS?

A

meds:
ASA
Beta-blockers
ACE inhibitors
Statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do we manage dysrhythmias with ACS?

A

Cardiac monitoring
Evaluate hemodynamics (CO=SV X HR), (BP= CO x SVR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a common complication of ACS?

A

Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do we monitor and manage HF with ACS?

A

Common complication after MI
Assess for signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What two interventions are for STEMI only?

A

-coronary angioplasty (open up & place stent)
- Fibrinolytic therapy (tPA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the most important interventions during and after tPA?

A

BLEEDING
1. neuro status to get baseline and after
2. IV sites for bleeding and patency (not blocked)
3. check clotting labs - INR aPTT, PTT
4. Internal bleeding - BP, hemat. hemoglobin
5. Stool, urine, emesis - for blood
6. monitor heparin continuous infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is PCI?

A

coronary angioplasty with stent - first choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Is tPA indicated in STEMI or NSTEMI?

A

STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how many minutes do we want to have done a PCI after STEMI Dx?

A

within 90 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What medication is given during a PCI?

A

high dose IV heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What two med therapies are often used with PCI?

A

Anti-platelet
1. ASA
2. Platelet inhibitor

BB, ACE or ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What 5 things do we monitor for with PCI?
Acute closure of vessel - d/t clot Bleeding from insertion site Reaction to contrast medium Vital signs (BP, dysrhythmias) Low potassium Risk of stroke
26
What does CABG stand for?
Coronary Artery Bypass Graft
27
What does a CABG do?
surgical procedure to graft a healthy artery around a blocked coronary artery
28
What do we watch for and tell the patient when they have a TR band?
1. compartment syndrome 2. Bleeding 3. Hematoma formation (when band is decreasing air) 4. tell patient to treat it like it's broken - to avoid hematoma 5. Assess kidney for AKI - d/t dye 6. BP- hypotension 7. Dysrhythmias - antidysrhymic meds d/t irritation to artery 8. K+ levels - we want balance
29
What do we monitor for patients after CABG in ICU?
Initially: intubated, large chest tubes, pacemaker wires, invasive hemodynamic monitoring dysrhythmias, fluid and electrolyte imbalance, hypo/hypertension, hypothermia, bleeding, decreased LOC, anginal pain
30
What do we monitor in patients after CABG on the ward?
DB+C Supervised ambulation Monitor for: decreased CO, pain, dysrhythmias, decreased O2 sats, S+S of infection, monitor donor site/neurovascular status
31
What is the most common cardiac dysrhythmia seen in practice?
AFIB
32
Is AFIB regular or irregular?
irregular
33
What is the arterial rate in AFIB?
>350 bpm or fib waves
34
Is the ventricular rate greater or lesser than arterial rate in AFIB?
lesser
35
how long is the QRS complex in AFIB?
36
What is AV conduction like in AFIB?
variable
37
What are 4 causes of AFIB?
1. heart disease 2. electrolyte imbalance 3. Stress 4. Caffeine
38
What are 2 priority problems for patients with AFIB?
1. potential for embolus formation (blood pooling) 2. potential for HF d/t altered conduction pattern
39
What are the 2 treatments to prevent embolus formation in a patient with AFIB?
1. correct and control rate of rhythm - Amiodarone or Metoprolol 2. Anticoagulation - warfarin or apixaban
40
What are the 2 treatments for potential HF d/t altered conduction patterns for patients with AFIB?
1. drug therapy 2. non-surgical - electrical cardioversion - ablation - pacing
41
What is Cardioversion?
1. a sync'd countershock on the R wave of QRS to restore normal conduction 2. sedation before procedure 3. vitals monitored throughout 4. patient shocked
42
What is ablation ?
Radiofrequency energy burns/ ablates area of conduction system that is a problem. Definitive treatment of tachydysrhythmias
43
What is the most effective way to terminate V FIB and Pulseless VT?
defibrillation
44
Is someone responsive in VFIB?
no. no BP, pulse, breathing, heart sounds, and unresponsive
45
What is the priority in VFIB?
defibrillate the patient (CPR first till defib available) Call code blue - ACLS guidelines
46
What are reversable causes of VFIB?
Hypovolemia Hypoxemia Hydrogen ion (acidosis) Hypo/hyperkalemia Hypothermia Tension pneumothorax Tamponade, cardiac Toxins Thrombosis, pulmonary Thrombosis, coronary
47
Do we defibrillate someone in ASYSTOLE?
no - flat line
48
in Asystole, where is there no rhythm, ventricular or atrial?
ventricular
49
What is another word for Asystole?
flat line - dead
50
What are the 2 interventions for asystole?
1. CPR 2. epinephrine
51
What does acute HF usually manifest as?
Pulmonary edema
52
What is one symptom that Lt sided and Rt sided HF have in common?
Peeing issues at night Lt- nocturia Rt - polyuria
53
What identifies Pulmonary Edema from other cough productive respiratory issues like PN?
pink, frothy sputum
54
How do we treat pulmonary edema?
1. Nitro SL 2. IV line 3. Lasix IV QUESTION IV FLUID INTAKE
55
How often do we monitor VS for pulmonary edema?
q 30-60 min
56
What pain med can we give for pulmonary edmea?
IV morphine if BP is goochie
57
What are 6 things to teach a patient with HF?
1. Weigh daily a.m. b/f breakkie 2. Fluid restrict 1500-2000 mL/day (6-8 glasses) 3. Meds - take regularily as per doctor 4. Food - decrease or no salt 5. Activity/rest balance
58
what weight change is a warning in HF?
>4 lbs in 2 days (2kg) > 5lbs in 1 week (2.5kg)
59
what are cardiomyopathies often caused by?
1. etoh abuse 2. chemo 3. infection 4. inflammation 5. poor nutrition 6. unknown
60
What are 3 types of cardiomyopathies?
1. Dilated 2. Hypertrophic 3. Restrictive
61
What is Dilated cardiomyopathy?
HF Dysrhythmias Emboli SCD
62
What is hypertrophic cardiomyopathy?
HF Dysrhythmias Emboli Angina Syncope SCD
63
When a patient has dilated cardiomyopathy, the drugs that are used help with which part of heart function? preload, afterload, contractility, HR, filling of certain chambers, etc.
decrease preload and afterload
64
When a patient has hypertrophic cardiomyopathy, the drugs that are used help with which part of heart function? preload, afterload, contractility, HR, filling of certain chambers, etc.
ventricular filling
65
What is ICD?
cardioverter defibrillator
66
When is Afib conversion indicated?
High ventricular HR Low BP
67
What is PVC?
pre ventricular contraction (early stage) - Ventricles fire off abnormally - if it happens too many times in a row then you have CO and perfusion issues
68
What is V TACH?
Ventricular tachycardia repetitive firing >100 bpm Looks like mountains - QRS very wide
69
What lytes are low in PVC?
K+- low Mag - low
70
When does V Tach become life threatening?
>15 seconds
71
what are the 5 most common causes of V tach?
heart disease, valve disease, post MI, electrolyte issues, cocaine use
72
What are 2 ways we get patients out of V tach- if they have a pulse?
1. Amiodarone - antiarrhythmics 2. Synchronized cardioversion
73
What do we do if someone is V-tach without a pulse?
1. call a code 2. CPR till defibrillator comes
74
What is V-fib?
Ventricular fibrillation - fluttering firing from all over the ventricles No MI contraction, no pulse, hemodynamic collapse
75
What rhythm is most fatal?
V-fib
76
How do we treat v-fib?
defibrillation - gets the heart back in rhythm
77
When is cardioversion used and when is defibrillation used?
Cardioversion- A fib, V-tach (with a pulse) Defibrillation - V fib, V-tach (pulseless),
78
If someone is in V-Fib what are the reversible causes?
Hs and Ts Hypovolemia Hypoxemia Hydrogen ion (acidosis) Hypo/hyperkalemia Hypothermia Tension pneumothorax Tamponade, cardiac Toxins Thrombosis, pulmonary Thrombosis, coronary
79
What is asystole?
Complete absence of any ventricular rhythm. No electrical impulses in the ventricles and therefore NO ventricular depolarization, no QRS, no contraction, no CO, and no perfusion to rest of body
80
Does electrical shock help in asystole?
no b/c no electrical impulses in ventricles so there's nothing to shock back into rhythm. Give CPR & epinephrine
81
how many litres is normal CO / day?
4-6 L

NURS 3512 acute & chronic (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions