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40 Cards in this Set
- Front
- Back
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What method for irrregular rhythms?
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6 second count
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What are non-invasive treatments of dysrhythmias?
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Vagal maneuvers - valsalva, coughing, immerce face in cold water (diving reflex), carotid massage (perform by MD)
Medications - antiarrhythmics electrical therapy - synchronized cardioversion, defibrillations |
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When do you use defibrillations regarding dysrhythmias?
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ventricular fibs
pulseless V-Tach |
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What do pulseless v-tach indicate?
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weak cardiac activity (minimal)
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What is echocardiogram?
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Provides information about blood flow, structure, and function of heart.
Can also get ejection fraction, valvular stenosis, or incomptence, regurgitation, velocity of blood flow, wall motion, etc. |
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When do you use synchronized cardioversion regarding dysrhythmias?
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"stable" supraventricular dysrhythmias, atrial tachycardia, atrial fibrillation, etc.
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What can doppler echocardiography do?
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determine VELOCITY and PRESSURE GRADIENT of flow by using doppler shift from red blood cells
estimation fo ejection fraction, JET VELOCITIES (eg stenosis, regurgitation, ASD, VSD, etc) |
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What are the colors in color flow doppler?
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Red is coming towarsd transducer and blue is going away from transducer.
Mosaic of color indicates turbulent flow |
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How to perform transesophgeal echo?
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sedate patient
transducer passed into esophagus |
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what is tranesophgeal echo useful for?
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patients with COPD, ribs close together, or obesity
same information as transthoracic echo |
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What are stress tests used for?
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Determine exercise tolerance, oxygen consumption, ECG
for diagnosis for pre-discharge assessment for follow-up assessment |
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What chemicals are administered in pharmacological stress test?
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adenosine, persantine - for vasodilation
dobutamine - accelerate HR and myocardial contractility do NOT provide information about the patient's functional ability |
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What is steal syndrome?
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in Persantine stress test, sclerotic coronary arteries don't vasodilate
so healthy CA vasodilate and steal blood from areas with plaque result in reduced blood flow to diseased area |
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For whom is persantine stress test used?
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used in older patients with known CAD for stress test
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What is advantage of stress echo?
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Yields more info than traditional stress test
can confirm results of stress test allow eval of wall motion, valvular function, and ventricular function more functional eval than traditioanl ECG |
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What does ambulatory monitoring devices do?
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Used to assess BP during functional activity 9small device)
can be used by patients on their own, keep diary |
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What is a holter/event monitor?
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Ugly shirt with electrodues, useful to evaluate etiology of dysrhythmias awayf rom the office or assess symptoms that do not have predictable patterns
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What is implanted cardioverter defibrillator?
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basically little implanted device that detects v-fib (and similar) and shocks the heart in response
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What is the gold standard for determining teh degree of coronary artery stenosis?
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Angiography (aka cardiac cath)
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What is PTCA (percutaneous translumenal coronary angioplasty)
aka PCI (precutaneous coronary intervention) |
catheter in baloon advanced to block and inflate baloon to push plaque away/apart/expand out
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What are pros of PTCA?
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no foreign body
nothing for new clots to form onto least invasive |
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What are downsides of PTCA/PCI ?
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reoccurence of original clot possible
possibly dislodge part of clot |
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What is a PTCA stent?
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same as regular PTCA but with a wire frame cage about the balloon. Once the balloon leaves the cage stays there and keeps the plaque open/apart.
coated with various drugs to prevent re-stenosis |
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Why perform CABG?
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PTCA did not work as expected
multiple/distal occlusion sites very symptomatic CAD (MYHA 3 or 4) +EKG changes with exercise or phamacological stress test |
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What are the CAB approaches?
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sternotomy - sternum split
minimally invasive -1 to 3 intercostal incisions median sternotomy |
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why do back hurt after CABG?
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opening chest/ribs cause compression pressure alone spine/rib joints
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what are sternal precautions for sternotomy?
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splinting the incision
log rolling for transfers elevate height on FWW to avoid UE weight bearing no driving, lifting, resistance for 6-8 weeks UE ROM should began after surgery |
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active or passive ROM for patients with sternotomy?
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ACTIVE
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What is SVG (saphenous vein graft)?
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grafting vein to CA
require donor site, vein has valves, patients will need TED hose, and beware of footdrop... (IL or CL???) |
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What is minimally invasive direct coronary artery bypass? (MIDCAB?)
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require smalll incisions and no heart/lung bypass
appropriate for LAD and RCA bypass |
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what are pros and cons of MIDCAB?
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shroter hospital course but more pain
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What is pro of LIMA and RIMA (left/right internal mammary artery graft)
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pro: artery acccustomed to pressure
one end already attached to aorta easy to get to best for LAD/RIMA artery longer graft survival vs SVG |
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What is a downside of mechanical valve implant?
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life-long commmitment to anti-coagulation therapy
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what approaches work for valve repair/replacement?
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sternotomy or minimally invasive technique
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What is ventilation perfusion performed for?
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detection of pulmonay emboli
assessment of regional lung function |
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make sure u know the flow volume loops...
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:)
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what is lung volume reduction for?
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performed to improve pulmonary function in patients with obstructive type disease
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how can you perform a lung volume reduction?
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lateral thoractomy
clam shell thoractomy thoracoscopic approach |
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surgical scars vs postural misalignment
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TO BE FILLED
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Swan-Ganz Cathether stuffs
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TO BE FILLED
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