Scc Cardiac Review 4Th Semester

Front 1

Right Sided HF symptoms are seen where

Back 1

Peripherially

Front 2

What is Cardiac Output?

Back 2

volume of blood the heart expels per minute

Front 3

Dialated Cardiomyopathy

Back 3

*Impaired pumping action of the heart
*Most cases
*Causes include ETOH abuse and chemo
Pts. look like HF pts

Front 4

S/S OF CARDIAC TAMPONADE

Back 4

BECKS TRIAD

1. Hypotension
2. JVD w/ clear lungs
3. Paradoxical Pulses

Front 5

Extra complications of Pericarditis

Back 5

Pericardial Effusion & Cardiac tamponade

Front 6

NURSING CARE FOR PERICARDITIS

Back 6

Assess pain - MI or Pericarditis?
Auscultate for friction rub
Position
NSAIDS
Assess for pulsus paradox & other S/S of cardiac tamponade

Front 7

Central Venous Pressure (CVP)

Back 7

CVP measures preload and is used for the RIGHT side of the heart.
NORMAL VALUE: 2-8 mmHg

ELOW 2: dehydration, blood loss
ABOVE 8: Fluid Overload

Front 8

clients with angina should seek medical attention if chest pain lasts longer than

Back 8

20 min

Front 9

do not give NTG to patient who presents with angina whose SBP is <

Back 9

90

Front 10

meds for angina

Back 10

-Heparin
-aspirin
-beta blockers
-ca+ channel blockers
-nitrates (NTG)

Front 11

during anginal pain episode, EKG shows

Back 11

-ST depression

-inverted T

Front 12

1 risk for patients with aortic aneurysm

Back 12

hypovemia --> shock

-monitor VS
-I&Os
-Lab results
-S/S of shock

Front 13

drug therapy for abdominal aortic aneurysm

Back 13

- Oxycodone
-B-blockers (metoprolol, propanolol)
-anti-hypertensives (minipress, Nitropress, NTG)

Front 14

/S of abdominal aortic aneurysm

Back 14

-abdominal mass to the left of midline
-abdominal pulsations
-bruits over the site of aneurysm
-diminished femoral pulses
-Lower back/abd pain
-SBP in legs lower than SBP in arms

Front 15

dissecting aneurysm

Back 15

aneurysm vessel wall ruptures and a blood clot is retained in an outpouching of tissue

Front 16

Pulse Deficit

Back 16

Radial pulse rate falls behind apical rate

Front 17

What dx are usually associated with S4 sounds?

Back 17

HTN, CAD, aortic stenosis, cardiomyopathy

Front 18

Prinzmetal’s (variant) Angina

Back 18

a variant form that is characterized by chest pain during rest and by an elevated ST segment during pain and that is typically caused by an obstructive lesion in the coronary artery

Front 19

Unstable Angina

Back 19

pain characterized by sudden changes (as an increase in the severity or length of anginal attacks or a decrease in the exertion required to precipitate an attack) especially when symptoms were previously stable

Front 20

What are the actions of Adenosine and therapeutic uses?

Back 20

Decreases automaticity, conduction velocity at the AV node.
Increases the refractory period at the AV node
Used in treatment of paroxysmal supraventricular tachycardia
Given as rapid IV bolus ONLY, followed by saline flush
Continuous telemetry monitoring

Front 21

What are the adverse effects of lidocaine (Xylocaine)?

Back 21

(Xylocaine)? Most common:
CV system (dysrhythmias and hypotension)
CNS (dizziness/lightheadedness, fatigue, and drowsiness)
Excessive levels can produce confusion and seizures. Monitor ECG continuously and switch to another dysrhythmic as soon as stable.

Front 22

Atropine SO4
anticholinergic & Antiarrythmic

Back 22

decreases HR, BP, systemic vascular resistance.

Front 23

Vasopressin

Back 23

smooth muscle contraction of all areas of the vascular bed. can increase BP in hypotensive pt

Front 24

Lidocaine HCl

Back 24

decreases ventricular excitability

Antiarrhythmic

Front 25

Dobutamine HCL

Back 25

ardiac stimulant, increases co, by improving stoke volume c min increase in hr, bp

Front 26

Dopamine HCL

Back 26

Vasopressure,cardiac stimulant corrects hemodynamic imbalances-bradycardia

Front 27

condition in which fluid in the pericardial cavity creates enough pressure to cause cardiac compression

Back 27

tamponade

Front 28

What are the symptoms of dilated cardiomyopathy?

Back 28

fatigue
weakness
palpitations

Front 29

What can cause CHF?

Back 29

coronary artery disease
past history of MI
untreated hypertension
valvular disease
cardiomyopathy
infection
heart defect

Front 30

What are the symptoms of mitral valve prolapse?

Back 30

many cases are asymptomatic

can cause:
palpitations
tachycardia
light-headedness
fatigue
dyspnea

Front 31

inflammation of the endocardium, especially the cardiac valves, caused by bacteria, viruses, fungi, parasites, etc. that get into the bloodstream

Back 31

nfective endocarditis

Front 32

What are the signs and symptoms of shock?

Back 32

tachycardia
very low BP
cold and mild skin
decreased capillary refill
low urine output
metabolic acidosis

Front 33

What are the CM for cardiogenic shock?

Back 33

impaired mentation
systemic and pulmonary edema
low cardiac output
dusky skin color
low BP
oliguria
ileus (intestinal obstruction)
dyspnea

Front 34

What is the cause of hypovolemic shock?

Back 34

loss of blood, plasma, or interstitial fluid in large amounts

Front 35

What are the seven serum markers of myocardial damage?

Back 35

Troponin (T and I)
- Creatine kinase (CK)-MB
- Myoglobin
- Serum lipids (Cholesterol, Triglycerides, HDLs, LDLs, HDL /LDL ratio)
- Homocysteine
- C-reactive protein (hsCRP)
- Blood coagulation tests (PT,PTT,INR)

Front 36

Troponin (T and I)
- Creatine kinase (CK)-MB
- Myoglobin
- Serum lipids (Cholesterol, Triglycerides, HDLs, LDLs, HDL /LDL ratio)
- Homocysteine
- C-reactive protein (hsCRP)
- Blood coagulation tests (PT,PTT,INR)

Back 36

serum markers of an mi

Front 37

EKG changes:
What does ST depression indicate?

Back 37

Ischemia

Front 38

EKG changes:
What does ST segment elevation indicate?

Back 38

Injury

Front 39

lidocaine

Back 39

antiarrhtyhmic
Conversion of PSVT to sinus rhythm
Contraindications

Second- or third-degree AV block, or sick-sinus syndrome. Atrial flutter. Atrial fibrillation. Ventricular tachycardia. Hypersensitivity to adenosine

Adverse Reactions

Facial flushing Lightheadedness Paresthesia Headache Diaphoresis Palpitations Chest pain Hypotension Nausea Metallic taste Shortness of brea

Front 40

amiodarone

Back 40

antiarrhymic

Front 41

atropine

Back 41

antarrhymic
Contraindications

Tachycardia Hypersensitivity Unstable cardiovascular status in acute hemorrhage and myocardial ischemia Narrow-angle glaucoma

Adverse Reactions

Tachycardia Paradoxical bradycardia when pushed slowly or when used at doses less than 0.5 mg Palpitations Dysrhythmias Headache Dizziness Anticholinergic effects (dry mouth or nose, photophobia, blurred vision, urine retention) Nausea and vomiting

Flushed, hot, dry skin Allergic reactions



Hemodynamically significant bradycardia Asystole give 4 this

Front 42

procanimide

Back 42

Indications

Suppressing PVCs refractory to lidocaine

Suppressing ventricular tachycardia (with a pulse) refractory to lidocaine

Suppressing ventricular fibrillation refractory to lidocaine when bretylium tosylate is not readily available

PSVTs with wide-complex tachycardia of unknown origin (drug of choice when associated with WPW)

Contraindications

Second- and third-degree AV block

Digitalis toxicity Torsades de pointes

Adverse Reactions Hypotension Bradycardia

Reflex tachycardia AV block

Widened QRS Prolonged PR or QT interval

PVCs Ventricular tachycardia, ventricular fibrillation, asystole

CNS depression Confusion Seizure

Front 43

digoxin (Lanoxin)

Back 43

cardiotonic - inotropic
Increases force of contraction, used in CHF

Front 44

adenosine (Adenocard)

Back 44

antiarrhythmic

Front 45

atropine

Back 45

antiarrhythmics - anticholinergics

Front 46

Vasopressin considerations

Back 46

Only given one time. May cause cardiac ischemia and angina. May replace first or second dose of Epi. Not recommended for responsive patients with coronary artery disease.

Front 47

agnesium sulfate (electrolyte)

Indicated for?

Back 47

Cardiac arrest if torsades or Hypomagnesemia

Front 48

Lidocaine (antiarrhythmic)

Back 48

V-Fib/Pulseless V-Tach, Stable V-Tach
1-1.5 mg/kg

Front 49

Dopamine (catecholamine

Back 49

Symptomatic Bradycardia, Hypotension

Front 50

Atropine (parasympathetic blocker)

Indicated for?

Back 50

radycardia
0.5 mg q 3-5 min as needed

PEA, Asystole

Front 51

What is acute coronary syndrome?

Back 51

Ischemic coronary events that may result in a blood supply and demand mismatch.
Stable and unstable angina pectoris.
Myocardial infarction.

Front 52

Characteristics of stable angina?

Back 52

INTERMITTENT chest pain (usually with exercise or exertion)
Episodes CONSISTENT in duration and intensity (usually only last a few minutes).
CONTROLLABE with medications (ie nitroglycerine).
Can develop into unstable angina.

Front 53

Diagnostic studies for an MI:
Cardiac enzymes?

Back 53

CK-MB elevated (>5ng/mL)

Troponin I (>0.1 ng/mL)

Myoglobin

Myoglobin levels peak earlier, but Troponin is most frequently used to diagnose

Front 54

EKG changes:
What does ST depression indicate?

Back 54

Ischemia

Front 55

EKG changes:
What does ST segment elevation indicate?

Back 55

Injury

Front 56

EKG changes:
STEMI v NSTEMI:
STEMI characteristics?

Back 56

ST elevation MI

Tends to be more extensive

COMPLETE coronary artery occlusion

Front 57

Medical management of MI:
How do you--
reduce afterload?

Back 57

nitroprusside for short term

ACE inhibitors and ARBs for longer term

Front 58

Medical management of MI:
How do you--
decrease preload

Back 58

nitrates, morphine, diuretics

Front 59

Heart Valves:

Name the two atrioventricular.

Back 59

mi tri

Front 60

Mitral valve regurgitation:
Clinical Manifestations:
Chronic:
List 5 possible manifestations.

Back 60

Asymptomatic/no Sx

2. Weakness, general malaise

3. Dyspnea (orthopnea/pnd)

4. PERIPHERAL edema (advance Sx)

5. S3 and murmur at apex

Front 61

Mitral Valve Stenosis:
Clinical manifestations:
Name 4

Back 61

1. Dyspnea (hemoptysis)

2. Palpitations (A fib)

3. Diastolic murmur (apex)

4. Predisposed to EMBOLI

Front 62

CVP (Central Venous Pressure)
What does it measure?

Back 62

The pressure of blood within the right atrium.
Used to approximate the right ventricular end diastolic pressure (RVEDP

Front 63

CVP:
Normal values?
High indicates?
Low indicates?

Back 63

Normal 2-6 mmHg
High=overhydration, increased venous return or right sided cardiac failure.
Low=hypovolemia or decreased venous return

Front 64

Mean Arterial Pressure(MAP):
What is it?
Normal range?

Back 64

Reflects changes in the relationship between cardiac output (CO) and systemic vascular resistance (SVR) and reflects the arterial pressure in the vessels perfusing the organs.
70-100 mmHg

Front 65

Platelets

Back 65

140,000-340,000/mm3

Front 66

PT

Back 66

10-12

Front 67

INR

Back 67

2-3 for patients on coumadin therapy

Front 68

no P waves on the ECG

Back 68

svt

Front 69

cardiac tamponade

Back 69

medical emergency condition where liquid accumulates in the pericardium in a relatively short time. The elevated pericardial pressure prevents proper filling of heart cavities. Instead of reducing the filling of both ventricles equally, the septum of the heart will bend into either the left or right ventricle. The end result is low stroke volume, shock and often death

Front 70

True/False a pacemaker is senstivie to magnetic fields

Back 70

True, should not be exposed to these fields for more than a few seconds, avoid welding or chain saws, no gasoline powered tools, carry medical alert especially in airports inorder to be hand searched.

Front 71

Arteriosclerosis

Back 71

hardening that affects the small arterioles

Front 72

Teaching on Beta blockers

Back 72

symptoms may worsen and may take a few weeks before improvement in cardiac status, meds are titrated slowly

Front 73

signs of hypokalemia

Back 73

weak pulse, faint heart sounds, hypotension, muscle flabbiness, diminished deep tendon reflexes and generalized weakness

Front 74

signs and symptoms of hyponatremia

Back 74

pprehension, weakness fatigue, malaise, muscle cramps and twitching and a rapid thready pulse

Front 75

dobutamine (Dobutrex) action

Back 75

ncrease cardiac contractility.

Front 76

A vasopressor is

Back 76

a drug used to constrict the arteries and increase blood pressure. These agents include dobutamine, dopamine, epinephrine, isoproterenol, norepinephrine, phenylephrine and ephedrine. They are most commonly used in intensive-care and post-operative hospital settings for patients with critical hypotension (low blood pressure)

Front 77

Right sided heart failure

Back 77

pedal edema
ascites
hepatic congestio

Front 78

Drug classes of
verapamil (Calan)

Back 78

Calcium channel-blocker
- Antianginal agent
- Antiarrhythmic
- Antihypertensive
Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells

Front 79

Desired actions of
verapamil (Calan)

Back 79

1. decreased cardiac workload
2. decrease oxygen demand
3. decreased cardiac energy consumption
4. increased delivery of oxygen to myocardial cells
SVT
too!