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88 Cards in this Set
- Front
- Back
- 3rd side (hint)
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The 5 common cardiovascular related complaints.
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Chest pain
dyspnea fainting palpitations fatigue |
Dys Chest is so Fat, if you Palpate it I'll Faint.
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List considerations of
SCENE SIZE UP |
BSI
Help Assess scene clues |
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List considerations of
PRIMARY ASSESSMENT |
General Impression (appearance of patient)
Baseline level of consciousness (AVPU) ABCs Transport decision |
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The point of the primary assessment is:
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to look for life threats
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When should you consider giving a cardiac patient oxygen?
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During Primary Assessment when doing "breathing"
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Where do you check the pulse for a conscious patient?
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radial pulse
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Where do yo u check pulse for an unconscious patient?
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carotid pulse
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What should you check during the Circulation portion of your ABCs?
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Pulse: rate, rhythm, regularity, overall quality over time
Skin color & condition |
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When do you make your transport decision?
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After assessing your ABCs during the primary assessment
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In general, urgent transport of cardiac patients by paramedics IS or IS NOT required?
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urgent transport by paramedics is generally not required
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The focus of the SECONDARY ASSESSMENT should be:
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focus on the Cardiac issues
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LOC is an indicator of _________, where 'Alert and Oriented' generally indicates ________, and 'Stupor or confusion' generally indicates ________
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indicator of Cerebral perfusion.
A&O: good perfusion stupor: bad perfusion |
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List the parts of the SECONDARY ASSESSMENT.
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SAMPLE history (includes OPQRST)
1st set of vital signs physical exam Treatment |
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What comes after the secondary assessment and is the final step in the patient assessment process?
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Reassessment
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The presenting symptom of AMI is:
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Chest Pain
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List the OPQRST questions related to the Symptom of "Chest Pain"
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O - 'how did it start' Sudden vs. gradual
P: provocation/palliation Q: have patient describe R: Does it move? Where to? S: 1-10, 10 is worst T: when did it start? |
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OPQRST
O,OPT ++ for Dyspnea |
O: sudden/gradual?
O: during activity/rest? P: prov/pall Q: continuous/intermitten? T: when did it start? Have they had it before? Cough or other associated symptoms? |
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Dyspnea can be an early indicator of _______ sided heart failure.
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LEFT-sided heart failure
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To determine if Fainting occurred because of cardiac causes, you should ask these 5 questions:
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O: under what circumstances did it happen?
O: were there any warnings? O: what position were you in? Has this happened before? Associated symptoms? |
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Cardiac related syncope can occur due to the decline of _________.
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decline of cardiac output.
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Define Palpitations
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sensation of abnormally fast or irregular heartbeat
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Palpitations are often caused by ______________.
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dysrhythmias
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When your patient presents with palpitations, you should ask these 4 questions during your assessment.
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ONSET: how and when did it start
FREQUENCY: happened before? if so, how often DURATION: how long does it last each time Previous episodes: what actions were taken, what outcomes? |
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During your medical history taking, be sure to ask about these 3 things:
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Family History
Medical History Caridac Risk factors (smoking, stress, etc) |
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3 considerations when asking about allergies:
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Medications
Food Environmental elements |
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When asking a patient about their medications, you should remember to ask if the medications are _____, and the patient is _______ with them.
Additionally, you should not only ______ the medication, but should _______ with you. |
current, compliant
Document, bring them to the hospital |
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Digital preparations are for treating _________ and certain_________.
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Digitalis treats chronic CHF or certain dysrhythmias
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The effect of digitalis on the heart is _____ inotropy and ________ chronotropy.
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positive/increased inotropy
negative/decreased chronotropy |
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Toxic digitalis effects develop in ____% of patients. And they will be sensitive to _________ preparations and have a decline in __________ levels.
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30%
sensitive: calcium preps decline: serum potassium levels |
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Nitrates are _________ agents, which work by overall _______, which happens because of the medication _______
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anti-anginal agents
decreasing work of the heart causing significant vasodilation |
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The anti-anginal agents Nitrates take _________ minutes to work.
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3-5
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Beta blockers are ________ agents, which work by ________, which causes these effects on the heart:
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anti-anginal
blocking beta receptors Decrease rate/strength of cardiac contractions |
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Beta blocker medications may lead to resistance of __________.
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Beta-stimulating agents
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A medication that ends in "-olol" or "-alol" is what type of drug?
What affects on the heart do they have? |
Beta Blocker
negative inotropy/negative chronotropy |
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Calcium channel blockers are ___________ agents, that work by _________ which has the therapeutic effect of ___________, though _______ may be a side effect.
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Anti-anginal
Block influx of calcium ions into cardiac muscle relieving angina Hypotension |
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Dihydropyridines are ______________ drugs and their names end in "________"
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calcium channel blockers
end in "-ipine" |
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Nifedipine is what type and category of drug?
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calcium channel blocker
dihydropyridine |
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nondihydropyridines are ___________ and the 2 most commonly prescribed are:
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calcium channel blockers
Diltiazem, Verapamil |
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Name 4 commonly prescribed antidysrhythmic meds
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1) amiodarone
2) DIGOXIN 3) Lidocaine 4) Procainamide |
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These type of drug are used for chronic fluid overload and hypertension because they help secrete sodium and water, and inadvertently potassium.
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diuretics
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Name the 5 categories of commonly prescribed diuretics:
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1) loop diuretics
2) potassium-sparing diuretic 3)Thiazide diuretics 4) vasodilator/nitrate 5) combination drugs |
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Furosemide is a _____________
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loop diuretic
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Name 2 potassium-sparing diuretics.
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spironolactone
triamterene |
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-Thiazides and metolazone are _______ drugs
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thiazide diuretics
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Hydralazine is a _________
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vasodilator/nitrate diuretic
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nonselective beta blockers can be bother _____ agents or ______ agents
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anti-anginal
antihypertensive |
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a complication with antihypertensive medications is that _____, so it may cause ________. to avoid this you should ________
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its difficult to regulate dosage,
hypotension check BP in recumbent and sitting positions |
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blood thinners are ______ drugs
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anticoagulant
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Antiplatelet drugs are used in managing _____ and work by
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myocardial infarctions
keeps platelets from sticking together |
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clopidogrel (plavix) is a ___ drug
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antiplatelet
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drugs ending with "-sartan" are _____.
ex. losartan |
angiotensin II receptor blockers (ARBs)
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"-statin" drugs are _______.
ex. lovastatin |
cholesterol lowering drugs
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Important to ask about these 4 things when inquiring about patient's medications:
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herbal supplements
recreational drugs Sildenafil (viagra) in last 24-48 non-prescribed medications |
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For past medical Hx, specifically ask about
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current physician care
Heart attacks angina heart failure HTN abnormal heart rhythm Heart-related medical procedures (CABG, stents) stroke, diabetes, lung, liver, kidney disease risk factors of heart disease recent hospitalizations/surgery family history |
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Vitals for your cadiac patient should inclue
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Pulse ox (earlier and repeated at appropriate stage in assessment)
RR, effort & quality Pulse rate, force, quality BP, BGL, ECG 3&12 |
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The vitals you should get sooner than their typical time are:
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pulse ox
3 & 12 lead ecg |
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Systolic >_____mmHg = Hypertension, may be indicative of these 4 things:
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150 mmHg
Aortic dissection heart failure HTN crises Stroke |
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4 things that would contribute to your doing a 12 lead ECG on a patient are:
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1) age
2) chief complaint 3) cardiac history 4) associated symptoms (dyspnea, fainting) |
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physical exam should begin with
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inspection, auscultation, and palpation
Neck: JVD (in semi-fowler), tracheal position |
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During the physical exam of the chest (after neck), you should look for
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surgical scars
Nitro patch pacemaker/ACID bulge Chest enlargement Creptius be sure to use stethoscope |
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If you auscultate on the Right side, mid chest between clavicle-nipple (like V1) you can hear the ______ valve
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aortic valve
(Right side, mid chest between clavicle-nipple) |
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If you auscultate the Left side, mid chest between clavicle-nipple (like V2) you can hear the _____ valve.
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pulmonary valve
(Left side, mid chest between clavicle-nipple) |
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Auscultating the V2 position, just below nipple line, you hear the _________
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tricuspid valve
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Auscultating just to the patient's left the V2 position, just below nipple line, you hear the _________
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mitral valve
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the S1 sound is the:
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closure of the mitral and tricuspid valves.
start of systole |
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S2 sound is:
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closure of aortic and pulmonic valves.
end of systole |
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the heart sound that corresponds to a carotid pulse:
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S1
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decreased heart sounds can be due to these 4 things:
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Mitral valve fibrosed or calcified
obesity emphysema cardiac tamponade |
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a Louder S2 sound may indicate:
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chronic high BP or pulmonary hypertension
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decreased S2 sounds may indicate:
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hypotension
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if the S2 sound is split, it may indicate:
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a right bundle branch block
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S3 is caused by _____, occurs after ______, is usually found in ______ and sounds like ______
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ventricular wall vibrations
120 -170 ms after S2 young adults/children kentucky |
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S4 is caused by _______, heard when? Sounds like _____
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turbulent filling of the stiff ventricle in hypertrophy, possible MI
just before S1 Tennessee |
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and 'opening snap' sound indicates"
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noncompliant valve
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an 'ejection click' sound indicates
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dilated pulmonary artery or septal defect
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a pericardial friction rub sound indicates:
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pericarditis
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a 'murmur' sound is due to
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turbulent blood flow
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a 'thrill' sound is
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a frequently occurring and constant vibration (like a cat purring)
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a 'pericardial knock' sound is indicative of
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thickened pericardium
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a pulse deficit is when
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radial pulse is less than the apical pulse rate. happens because contractions too weak to propel blood through peripheral arteries.
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to diagnose pulsus paradoxus
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listen for systolic sounds just during expiration then continue until you hear them all the time
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pulsus alternans = _______ damage
characterized by ________, due to _____ |
severe left ventricular systolic damage
beat-to-beat difference in strength, decrease in number of myocardial cells contracting during alternate beats which reduces contractility. |
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pulsus alternans may be related to ____________
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bigeminy PVCs
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pulse pressure is ___ and is a product of _____ and _____.
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difference between systolic and diastolic BP.
SV and arterial elasticity. |
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normal pulse pressure range is _____.
it will _____ in later stages of shock, and _______ during tachycardia/cardiac tamponade. |
30-40 mm Hg
widen during shock. narrow during tachycardia and cardiac tamponade |
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pre-hyptertension sys/dia ranges are:
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sys 120-129
dia 80-89 |
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increased pulse pressure may be indicative of:
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arteriosclerosis
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during your reassessment, you should:
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transmit ECG to ER if STEMI
repeat primary assessment repeat vitals 5-15 mins repeat physical assess intervention effectiveness begin documentation if possible |
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