week 5: cardiac (pump) Flashcards by Grace Dziewit

what are the two main requirements for adequate perfusion

strong heart (pump) and patent arteries (pipes)

How well did you know this?

Not at all

Perfectly

what are the main factors that affect to perfusion specifically related to problems in the heart

congenital heart defects
muscle: cardiomyopathies and pericarditis
valve disorders like endocarditis
electrical conduction

How well did you know this?

Not at all

Perfectly

what are the main cues of right sided heart failure

systemic congestion: edema, JVD, nausea, anorexia, polyuria at night

How well did you know this?

Not at all

Perfectly

what are the two main symptoms of Left sided heart failure

decreased CO: fatigue, weak, dizzy, angina, tachycardia, etc.
pulmonary congestion: crackles, S3/S4 gallop

How well did you know this?

Not at all

Perfectly

what is an S3/S4 gallop

a triple rhythm in diastole

How well did you know this?

Not at all

Perfectly

what does elevated BNP mean

means the heart is being stretched, which means fluid overload and heart failure

How well did you know this?

Not at all

Perfectly

what does an echo test for

ejection fraction

How well did you know this?

Not at all

Perfectly

what is the worst case scenario for pump problems

decompensated heart failure (left ventricular failure)

How well did you know this?

Not at all

Perfectly

if someone had decompensated heart failure, what would they look like

sitting up, eyes wide, struggling to breathe

How well did you know this?

Not at all

Perfectly

a person with L sided heart failure is sitting up, eyes wide, struggling to breathe. what are the 4 main interventions in order

1) raise head of bed and reassure
2) administer O2 if sats are below 92%
3) assess vitals
4) administer meds as ordered

How well did you know this?

Not at all

Perfectly

should you leave the patient if they have decompensated heart fialure

How well did you know this?

Not at all

Perfectly

what are the 4 meds that improve ejection fraction (fantastic 4)

ACE inhibitors /ARNI
Beta blockers
MRA
SLGT-2

How well did you know this?

Not at all

Perfectly

what do MRAs do

minteralcorticoid receptor antagonist: blocks aldosterone and preserves K

How well did you know this?

Not at all

Perfectly

why do SGLT-2 inhibitors help with cardiac stuff

How well did you know this?

Not at all

Perfectly

whats the limit of salt per day in a cardiac patient

2-3 g of salt/day

How well did you know this?

Not at all

Perfectly

whats the limit of water per day for a cardiac patient

1.5-2L

How well did you know this?

Not at all

Perfectly

how many milligrams of sodium are in a tsp of salt

2300 mg

How well did you know this?

Not at all

Perfectly

whats the difference between stenosis and regurgitation

stenosis: when valve is narrowed, blood is restricted from moving forward
regurgitation: valve is sluggish with closing and may cause back flow

How well did you know this?

Not at all

Perfectly

which side of the heart does valvular heart disease usually develop

Left side most often (aortic and mitral)

How well did you know this?

Not at all

Perfectly

what are the main causes of valvular heart dz

rheumatic heart disease, endocarditis, MI, CT disease, bicuspid aortic valve, arteriosclerosis of aortic valve

How well did you know this?

Not at all

Perfectly

how does valvular heart diseases usually progress

it starts from left and moves to the right

How well did you know this?

Not at all

Perfectly

what are symptoms of valvular heart disease in the mitral valve

fib, hemoptysis (because atria will be overfilled)

How well did you know this?

Not at all

Perfectly

what are sx of valvular heart disease in the aortic valves

angina, syncope, nocturnal dyspnea (less overall cardiac output)

How well did you know this?

Not at all

Perfectly

which illnesses will cause rheumatic fever

strep throat, scarlet fever

How well did you know this?

Not at all

Perfectly

what is the difference between rheumatic fever and rheumatic heart disease

fever: inflammatory disease that can develop from strep throat and scarlet fever rheumatic heart disease: chronic disease resulting from rheumatic fever, scarring and deformity in the heart valves

what is a trans esophegeal echo

looks at valves

what is infective endocarditis

microbial infection of the heart valves or the endocardial surface of the heart

what are some conditions that can cause infective endocarditis

rheumatic heart dx, IVDU (IV drug user), recent valve or dental surgery

what are the main cues of infective endocarditis

regurgitation -youll see HF, arterial embolization, fever, cardiac murmur, anorexia and weight loss

what kind of symptoms would you see if a clot was carried to the kidneys

- decreased urine output - increased urea and creatinine (it'll be an infrarenal AKI)

which side of the heart would a clot most likely originate from

left side b/c the left side pumps blood into systemic curculation

what is aortic stenosis

aorta narrowed, won't fully open

which med decreases afterload

ACE inhibitors

what meds decrease preloads,

beta blockers, diuretics, digoxin, nitrates

when should you NEVER give nitro

pt has aortic valve stenosis OR hypertrophic cardiomyopathy

which dysrhythmia should we monitor for a patient with MV disease

afib

what is a TAVI

transcatheter aortic valve implantation: thread cath into heart, inflate ballon into valve

what is a TAVR

transcatheter aortic valve replacement

when should we use anticoagulants with endocarditis

if patient has a prosthetic valve

between valve repair and valve replacement: which is the better option

valve repair because the body is less likely to reject it

what are the two types of valve replacement

mechanical valves (synthetic material) biologic valve: animal valve

what are important points about mechanical valves

can last up to 20 years lifelong anticoagulants (increased risk of thromboembolism)

what are the main points about biologic valve

don't need anticoagulants failure rate increases after 7-10 years (not as long as mechanical) less durable- can calcify

why do patients need a dental exam before open heart surgery

risk of infective endocarditis if wounds in the mouth

how long prior to open heart surgery does one stop anticoagulants

72 hours prior to surgery

what is a cardiac tamponade

bleeding in the heart sack which increases pressure and decreases pumping

what is the main information to give for a patient with endocarditis post valve surgery

-avoid ppl with infection - good oral hygiene - inform HCP about condition - prophylactic antibiotics before procedures - fatigue is normal after surgery - importance of taking anticoagulants

what is SCD

sudden cardiac death

what are cardiomyopathies

chronic disease of the heart muscle

what are the two types of cardiomyopathy

dilated: too loose hypertrophic: too tight/thick

what are the main symptoms of dilated cardiomyopathy

-heart failure - dysrhythmias - emboli - SCD

what are the main issues with hypertrophic cardiomyopathy

-heart failure - dysrhythmias - emboli - SCD AND andina and syncope (only diff from dilated)

what does an angiography do

injects dye into coronary arteries and looks for blockages

what is the worst case scenario for cardiomyopathy's

- acute decompensated heart failure and SCD

what do you do with acute decompensated heart failure

LMNOP lasix morphine nitro (don't give with hypertrophic) oxygen positioning

what is the only way to help with SCD

defibrilator or AED

which CMO should you never give with digoxin and why

hypertrophic because if you squeeze it anymore it may obstruct the coronary arteries

what is an ICD (internal cardiac defibrillator)

it monitors rhythm and sends shocks through heart if it detects weird rhythm

what is pericarditis

inflammation of sac that surrounds the heart

what are the main cues of pericarditis

sharp chest pain (radiates to L neck/shoulder/back) gets worse with respiration (taking deep breath and lying flat)

what is a hallmark sign of pericarditis

pericardial friction rub

what would you see in an EKG for a person with pericarditis

ST elevation on all leads

why would you want to monitor urea and creating for pericarditis

could be ureic pericarditis due to ESRD

what are two main complications with pericarditis

pericardial effusion cardiac tamponade

what is a pericardial effusion

increased fluid accumulating in the pericardial sac

what is a cardiac tamponade and what are the main assessment findings

pressure from fluid surrounding the heart interferes with ability to pump findings: JVP tachycardia and hypotansion muffled heart sounds pulses paradoxus

what is pulsus paradoxus

drop in systolic BP with inspiration

what are the two main causes of pericarditis

infection kidney issues

how should you position someone with pericarditis

sit upright and lean foreward slightly

what is the main treatment for cardiac tamponade

pericardiocentesis

what is the MOA of amiodarone

potassium channel blocker, prolongs the effective refractory period to decrease atrial and ventricular arrhythmias

what is a synchronised cardio version

shock patients with arrhythmia (synchronise shock with R waves)

what is a pre ventricular contraction

a beat that's suddenly different from the others

what could PVC turn into

ventricular tachycardia and ventricular fibrillation (both a medical emergency

what are the first two things you do if a patient has Vfib

1) determine if they have a pulse 2) defibrillate (code blue) PRIORITY (also try and find care to see if its reversible)

whats the most effective way to terminate Vfib or pulses VT

defibrillate

what is Asystole

- complete absence of any ventricular rhythm

how do you treat ASystole

CPR + epinephrine NO DEFIBRILATION

week 5: cardiac (pump) Flashcards

(78 cards)