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111 Cards in this Set

  • Front
  • Back
What is heart failure?
Inadequate cardiac output; inability of the heart to pump blood throughout the body
What is the first and quickest compensatory mechanism when the heart begins to fail?
Sympathetic nervous response
What happens when the sympathetic nervous system responds to compensate for heart failure?
Catecholemines are released (epinephrine & norepinephrine)
What effect do the catecholemines epinephrine and norepinephrine have on the cardiac system?
*Increase heart rate
*Increase blood pressure
What is the formula for cardiac output?
Heart rate x stroke volume = cardiac output
What is one of the last compensatory mechanisms of the heart, which is indicative of an extremely oxygen-deprived heart?
Describe hypertrophy of the heart:
The heart walls become very thick and muscular, compressing the chambers of the heart
Describe dilation of the heart:
A compensitory mechanism in which the heart becomes very large in mass (not muscular)
What do the kidneys release when they sense a "low-flow" state?
Rennin is converted to angiotensin 1, which is then converted to what?
Angiotensin 2
What effect does angiotensin 2 have on the body?
It is a potent vasoconstrictor
What kind of medication counteracts the rennin-angiotensin-aldosterone system?
ACE inhibitors
How do ACE inhibitors work?
They counteract the rennin-angiotensin system by preventing angiotensin 1 from converting to angiotensin 2
ACE inhibitors work by inhibiting the conversion of angiotensin 1 to angiotensin 2; what specific effect does this have on the body?
What is "preload?"
Volume returning to the heart, or volume at end diastole
What is "afterload?"
The resistance the heart pumps against
What is the most common reason for a preload problem?
What is stroke volume?
The amount of blood pumped out with each contraction
What is cardiac output?
The amount of blood ejected per minute
What is ejection fraction?
The percentage of blood pumped out of the ventricles with each beat
What determines stroke volume?
Stretch (amount of elasticity)
The effects of right-sided heart failure are seen where?
The effects of left-sided heart failure are usually seen where?
The lungs/pulmonary system
List some major signs/symptoms of right-sided heart failure?
*Weight gain
List some of the major signs/symptoms of left-sided heart failure:
*Pulmonary edema
Why is morphine a good drug to treat pulmonary edema?
It helps to keep the majority of the circulation in the peripheral blood vessels (away from the heart and lungs)
In which drug class is digoxin?
What effect does digoxin have on the heart?
It increases contractility
What is a toxic blood level for digoxin?
Greater than 2
List some signs/symptoms of digoxin toxicity:
*bluured vision
*seeing halos around lights
*heart block
What pre-disposes an elderly person to digoxin toxicity?
Low potassium
What should the nurse do routinely if a patient is on digoxin
*check potassium levels
*check dig levels
*check apical pulse
*educate patient not to take antacids
What should the nurse watch for when a patient is taking an ACE inhibitor?
*Orthostatic blood pressure
*Watch carefully for signs/symptoms of decreased blood pressure
What do beta blockers do?
Block the adrenaline affect on the heart
What is the therapeutic effect of beta-blockers?
Slow the heart rate
Why do people usually NOT want to take a beta-blocker?
It makes them feel tired/weak/dizzy
What is nitroglycerin?
a vaso-dilator
What is important to know about Lasix?
*Take with potassium
*Always check potassium level before administering
*Can be extremely ototoxic
What should a nurse check to evaluate the effectiveness of lasix?
lung sounds
What is Nipride?
A potent vasodilator
What is Nipride often used for?
Hypertensive crisis
What is significantly important about Nipride?
It is very quick-acting
What is a major concern about Nipride?
It can turn to cyanide in the body
What lab value should be closely monitored to avoid nipride toxicity?
thyocyanate level
What should a nurse monitor closely in a patient who is on morphine?
Respiratory status
What is the antidote for morphine?
What does a BNP level of over 100 indicate?
heart failure
What does Natracore mimic within the body?
What effect does Natracore have on the heart?
*decreases preload
*decreases afterload
*mimics the endogenous process of BNP (vasodilation)
What is the biggest side effect of Natracore?
Among others, Natracore is incompatible with what major drug?
Besides dysrhythmia, list some other side effects of Natracore:
*Back pain
What is a cardiomyopathy?
Heart disease that is caused by a change in either the structure or function of the heart
Describe a heart that has a dilated cardiomyopathy
Big and weak
What is the treatment for dilated cardiomyopathy?
heart transplant
What is the major problem with a dilated cardiomyopathy?
Systolic function problem
Which cardiomyopathy is commonly found among athletes?
Hypertrophied cardiomyopathy
What is the major problem in a hypertrophied cardiomyopathy?
Diastolic function problem
What EKG changes will be seen in a patient who has had a heart transplant?
*2 p-waves
What should a nurse monitor for a heart transplant patient postoperatively?
*Bleeding (cardiac tamponade)
What are the signs/symptoms of cardiac tamponade?
*Muffled heart sounds
*decreased blood pressure
*decreased cardiac output
What is significant about a transplanted heart?
it is a de-nervated heart (no response to vagal stimulation)
Because the transplanted heart is de-nervated, what drug will not affect it?
What is the hallmark sign of Mitral Valve Prolapse?
mid-systolic click
What is the hallmark sign of aortic stenosis?
Fixed cardiac output
What are the three cardinal signs/symptoms of a fixed cardiac output?
Which kind of replacement valves always require anti-coagulant therapy?
Mechanical valves
Which valve replacement MUST be mechanical?
Aortic valve
What is very important for a patient who has had a valve replacement?
Always use antibiotic prophylaxis before procedures
What is a normal blood pH?
What is a normal PaCo2 level?
What is a normal HcO3
Which system compensates very quickly for a metabolic problem?
Respiratory system
Hyperventilation causes what condition initially?
respiratory alkalosis
Which patients commonly have respiratory acidosis?
What are breath sounds like in a hemothorax?
What is the hallmark sign of tension pneumothorax?
*trachial deviation
What is the immediate treatment for a tension pneumothorax?
Decompress the chest
What are the classic signs of ARDS?
*refractory hypoxemia
*ground-glass appearance on chest x-ray
What does a Q-wave represent on an EKG?
MI has occured; part of the heart has necrosed
What is a major priority for MI patients?
*decrease pain
*decrease anxiety
*these help to restore perfusion
What is used to decrease pain and anxiety in an MI?
morphine (this also vasodilates)
A blockage in which main coronary artery is referred to as "the widowmaker?"
The left main coronary artery
What is MONA?
What does atropine do?
speeds the heart rate
Can atropine be given to an MI patient?
Which congenital heart defects require SBE prophylaxis?
*Ventricular Septal Defect
*Pulmonic Stenosis
*Transposition of the great arteries
What 4 defects make up Tetralogy of Fallot?
*Pulmonic Stenosis
*Right Ventricular Hypertrophy
*Ventricular septal defect
*Over-riding aorta
What is the oxygen-hemoglobin curve?
The reverse process where oxygen is released from hemoglobin, thus oxygenating the body tissues
What is a normal oxygenation level?
In "flail chest," what type of treatment is more effective than surgery?
Mechanical ventilation
What should be monitored closely in a patient with flail chest?

Vital capacity
What are the signs/symptoms of a spontaneous pneumothorax?
*chest pain
*shortness of breath
What is the name for the epithelial cells that form a barrier around the alveoli?
Type 1 cells
What is the name of the cells that make surfactant?
Type 2 cells
Without surfactant, what would happen?
*The alveoli do not inflate
*gas exchange cannot take place
What happens to the lungs in ARDS?
*injury to the alveolar-capillary membrane
*fluid leaks into alveoli
*reduced surfactant
*lungs become stiff (loss of compliance)
What is the hallmark sign of ARDS?
refractory hypoxemia
How does PEEP work?
*It keeps the alveoli open
*The positive pressure keeps the alveoli from collapsing
Why are diuretics used in the management of ARDS?
To help decrease pulmonary edema
Why are antibiotics used in ARDS management?
To prevent pulmonary infection
Why are colloids used in the management of ARDS?
to increase intravascular volume expansion
What is the purpose of a pulmonary artery catheter with a thermistor?
It is used for hemodynamic and cardiac output monitoring
What is the main problem in people with cystic fibrosis?
failure to thrive
Which congenital heart defect can be discovered by doing 4-limb blood pressures?
coarctation of the aorta
What closes patent ductus arteriosus?
What opens PDA?
What should be done when a child is having a "tet" spell?
knees to chest
What is the pathology of CF?
*difficulty maintaining / gaining weight
*delayed bone age
*short stature
*delayed onset of puberty
With what suffix do the beta-blockers end?
What is the hallmark sign of mitral valve regurgitation?
chronic volume overload