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81 Cards in this Set

  • Front
  • Back
Congestive Heart Failure
Inability of heart to pump sufficiently to meet metabolic needs of body
decreased tissue perfusion
SOB with physical activity or while lying flat; tiredness, weakness, and feeling dizzy of faint; irregular or rapid heartbeat; coughing and wheezing, especially at night; weight gain due to excess fluid in the body, which also may cause swelling of the abdomen, feet, and ankles; kidney problems, which can lead to retention of fluid; difficulty concentrating or decreased alertness; difficulty sleeping
Systolic Heart Failure.
inability of the heart to generate an adequate cardiac output
dyspnea, orthopnea, cough of frothy sputum, fatigue, decreased urine output, and edema
pulmonary edema (cyanosis, rales, pleural effusions), hypotension or hypertension, an S3gallop, and evidence of underlying CAD or hypertension
pulmonary edema
cyanosis, rales, pleural effusions
The acute onset of left (congestive) heart failure is most often the result of
acute myocardial ischemia
Meds to improve myocardial oxygenation
Oxygen, nitrate, and morphine
ACE inhibitors
reduce preload and afterload and have been shown to reduce mortality in left heart failure
Diastolic heart
pulmonary congestion despite a normal stroke volume and cardiac output
results from decreased compliance of the left ventricle
pulmonary edema
Side effects Diastolic Heart Failure
dyspnea on exertion; fatigue; evidence of pulmonary edema (rales on auscultation, pleural effusions)
poor ventricular filling with normal ejection fractions
Right Heart Failure
As pressure in the pulmonary circulation rises, the resistance to right ventricular emptying increases
pressure will rise in the systemic venous circulation, resulting in peripheral edema and hepatosplenomegaly
Right Heart Failure treatment
management of the left ventricular dysfunction
When right heart failure occurs in the absence of left heart failure, it is caused most commonly by
diffuse hypoxic pulmonary disease such as COPD, cystic fibrosis, and ARDS.
Coronary Artery Disease
any vascular disorder that narrows or occludes the coronary arteries
impairs the pumping ability of the heart by depriving the heart muscle of blood-borne oxygen and nutrients
the most common cause of coronary artery obstruction
Persistent ischemia or the complete occlusion of a coronary artery causes
infarction of the deprived myocardial tissue
strong link between CAD and
elevated plasma lipoprotein
Modifiable major risks of CAD
cigarette smoking
diabetes and insulin resistance
sedentary life-style
atherogenic diet
Signs CAD
sudden weakness, fatigue, dizziness, body aches, or mild discomfort in the back
chest pain and dyspnea
Encloses heart
Protects heart against infection and inflammation from lungs
Contains mechanoreceptors that make changes in BP and HR
thickest layer
AKA cardiac muscle
Damaged during MI
Inside myocardium
connective tissue & squamous cells
contraction of the myocardial layer
o Blood leaves the ventricles into the circulation
o Occurs when left ventricle contacts
 Diastole
relaxation of the myocardial layer
Blood fills the ventricles in early and late diastole
o Occurs when left ventricle relaxes and refills with blood
 Contractility
o Degree of myocardial fiber shortening
 Preload
The pressure generated in the left ventricle at the end of diastole
determined by end-diastolic volume
increased preload increases ..
o The resistance to ejection of blood from the left ventricle. It is the load the muscle must move after it starts to contract.
 Stroke volume
o Amount of blood ejected from the ventricle with each contraction
 Aneurysm
o Local dilation or outpouching of vessel wall or cardiac chamber
thickening and hardening of the vessel
manufactured by liver and primarily contain cholesterol and protein
 Atherosclerosis begins with injury to
the endothelial cells that line artery walls
Signs atherosclerosis
arterial bruits
decreased blood flow to tissues
evidence of
primary goal of atherosclerosis management
restore adequate flow to affected tissues
 Remove cause of vessel damage, prevent lesion progression
 The most relevant age associated changes in cardiovascular performance
myocardial and blood vessel stiffening, decreased beta-adrenoreceptor responsiveness, and impaired autonomic reflex control of heart rate.
 Individuals are diagnosed as having hypertension when
average of two or more blood pressure measurements made on two or more consecutive clinical visits documents a diastolic pressure of 90 mmHg or greater or a systolic pressure of 140 mmHg or greater.
most significant factor in causing target organ damage.
 Hypertension is caused by
increases in cardiac output, total peripheral resistance, or both
signs HTN
 Headache, dizziness, n/v, confusion, visual disturbances, renal insufficiency, aortic dissection, HTN crisis
 Things that drop the blood pressure
o Sodium depletion, dehydration
safest and most effective medications for lowering blood pressure
thiazide diuretics
Buerger’s Disease tends to occur in
men who are heavy cigarette smokers
Buerger’s Disease
inflammatory disease of the peripheral arteries
chief symptoms of Buerger’s Disease
pain and tenderness of the affected part
sluggish blood flow and rubor, and cyanosis,
Chronic ischemia causes the skin to thin and become shiny and the nails to become thickened and malformed
meds for Buerger's disease
Vasodilators are prescribed to alleviate vasospasm
Raynaud Phenomenon and Disease
attacks of vasospasm in the small arteries and arterioles of the fingers
vasospastic attacks of Raynaud's disease are triggered by
brief exposure to cold or by emotional stress.
signs Raynaud's
changes in skin color and sensation caused by ischemia
pallor, numbness, and the sensation of cold in the digits
cyanotic. Rubor
signs pulmonary embolism
profound shock, hypotension, tachypnea, tachycardia, severe pulmonary hypertension, and chest pain.
 Paroxysmal nocturnal dyspnea
Patient has left ventricular failure
Fluid in lungs, redistribution of body water
 Kussmaul respirations
o Increased ventilatory rate, large tidal volumes, little expiratory pause
 Cheyne Stokes
o Gradual increase in depth and rate, followed by decreased, leading to apnea
most common cause hypoxemia
abnormal ventilation-perfusion ratio
hypersecretion of mucus
obstructs airflow & causes mismatching of ventilation & perfusion
Loss of elastic lung fibers
Loss of alveolar tissue
signs chronic bronchitis
decreased exercise tolerance, wheezing, and shortness of breath
productive cough
best “treatment” for chronic bronchitis
meds chronic bronchitis
Bronchodilators and expectorants
abnormal permanent enlargement of gas-exchange airways accompanied by destruction of alveolar walls
Elastic components lose their recoil
signs emphysema
dyspnea on exertion
Little coughing and very little sputum
tachypnea with prolonged expiration
must use accessory muscles
chest has a hyperresonant sound with percussion
often leans forward with arms extended and braced on knees when sitting
meds emphysema
Inhaled bronchodilators
corticosteroids and antibiotics
signs atelectasis
dyspnea, cough, fever, and leukocytosis.
signs atelectasis
pain, breathe shallowly, are reluctant to change position, and produce viscous secretions that tend to pool in dependent portions of the lung after surgical procedures
Recurrent episodes of obstructive airway inflammation causing mucus secretion & mucosal edema or bronchial spasms due to hyperresponsiveness to stimuli
signs asthma
chest constriction, inspiratory and expiratory wheezing, dyspnea, nonproductive coughing, prolonged expiration, tachycardia, and tachypnea occur at the beginning of an attack. With severe attacks the accessory muscles of respiration are prominent
meds asthma
inhaled bronchodilators
oral corticosteroids
lungs cancers arise from
epithelium of the respiratory tract
signs lung cancer
coughing, chest pain, sputum production, hemoptysis, pneumonia, airway obstruction, and pleural effusions
Most common sign pneumothorax
tracheal deviation
signs TB
fatigue, weight loss, lethargy, anorexia, and a low-grade fever
Night sweats
general anxiety
Dyspnea, chest pain, and hemoptysis
infection of the lower respiratory tract caused by bacteria, viruses, fungi, protozoa, or parasites
Inflammation of alveoli, interstitial tissue and bronchioles
signs pneumonia
Severe shaking with chills, fever, SOB, cough, rapid breathing, chest pain, n/v, headache, fatigue
inspiratory crackles, increased tactile fremitus, egophony
whispered pectoriloquy
diagnosis of pneumonia is confirmed by
finding infiltrates on chest x-ray
first step in the management of pneumonia
establishing adequate ventilation and oxygenation
acute laryngotracheobronchitis
common among young children from 6 months to 5 years
due primarily to subglottic edema
signs croup
rhinorrhea, sore throat, and low-grade fever
seal-like barking cough
Dissociation curve shift to left
Decreased PaCO2
Decreased temp
Increased pH
Alkalosis, hypothermia
Increased oxygen affinity for hemoglobin
Dissociation curve shift to right
Increase PaCO2
Increased temp
Decreased pH
Acidosis, fever
Decreased oxygen affinity for hemoglobin (blood will release oxygen more readily)
pH ↓
CO 2 Normal
CO3 ↓
partially compensated
pH ↓
CO2 ↓
CO3 ↓
fully compensated
pH ↓ N
CO2 ↓
CO3 ↓
Pleural effusion
fluid in the pleural space
pain of chest caused by inflammation of pleural space
Will hear friction rub