Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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?
|
Hypertrophy
|
|
|
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
|
|
|
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?
|
Vasodilation
|
|
|
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?
|
Hypertension
|
|
|
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?
|
systemically
|
|
|
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?
|
*Edema
*Fatigue *Hepatomegaly *Weight gain |
|
|
List some of the major signs/symptoms of left-sided heart failure:
|
*Tachycardia
*Pulmonary edema *Crackles |
|
|
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?
|
Inotrope
|
|
|
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
*anorexia *seeing halos around lights *confusion *nausea *vomiting *diarrhea *heart block *A-tach *dizziness *headache *weakness |
|
|
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?
|
Narcan
|
|
|
What does a BNP level of over 100 indicate?
|
heart failure
|
|
|
What does Natracore mimic within the body?
|
BNP
|
|
|
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?
|
Dysrhythmias
|
|
|
Among others, Natracore is incompatible with what major drug?
|
Heparin
|
|
|
Besides dysrhythmia, list some other side effects of Natracore:
|
*Headache
*Back pain *Anxiety |
|
|
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 *shock *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?
|
Atropine
|
|
|
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?
|
*Angina
*Dyspnea *Syncope |
|
|
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?
|
7.35-7.45
|
|
|
What is a normal PaCo2 level?
|
35-45
|
|
|
What is a normal HcO3
|
22-26
|
|
|
Which system compensates very quickly for a metabolic problem?
|
Respiratory system
|
|
|
Hyperventilation causes what condition initially?
|
respiratory alkalosis
|
|
|
Which patients commonly have respiratory acidosis?
|
*COPD
|
|
|
What are breath sounds like in a hemothorax?
|
Diminished
|
|
|
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?
|
Morphine
Oxygen Nitroglycerin Aspirin |
|
|
What does atropine do?
|
speeds the heart rate
|
|
|
Can atropine be given to an MI patient?
|
NO!!!
|
|
|
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?
|
80-100%
|
|
|
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?
|
ABG's
Vital capacity |
|
|
What are the signs/symptoms of a spontaneous pneumothorax?
|
*chest pain
*shortness of breath *cough |
|
|
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?
|
O2
|
|
|
What opens PDA?
|
prostaglandins
|
|
|
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?
|
-lol
|
|
|
What is the hallmark sign of mitral valve regurgitation?
|
chronic volume overload
|
